Couplelinks online intervention for young couples facing breast cancer: A randomised controlled trial

Abstract

Objective Young women with breast cancer and their partners are more distressed than couples who are affected later in life. While dyadic interventions in the context of cancer are promising, there are access barriers, particularly for younger couples. This study evaluated Couplelinks, a professionally facilitated, web‐based program designed to help couples improve their conjoint coping. Method This randomised controlled trial employed a waitlist control evaluation of the program. Outcomes included dyadic coping, relationship adjustment, depression, and anxiety. Results Seventy‐five couples consented to participate and were randomised. The final analysis included 31 couples in the treatment group and 36 couples in the waitlist group. Modest improvements were found in positive dyadic coping but effects were not maintained at 3‐month follow‐up. No effect was seen on overall relationship adjustment. Conclusions Our findings inform the rapidly expanding field of online programming for couples in general, and those affected by BC in particular. Intervention timing, ‘dose’, low overall relational distress, and the mainly enrichment rather than problem‐focus of Couplelinks may help explain the lack of change on relationship adjustment.

Treatment Satisfaction With Couplelinks Online Intervention to Promote Dyadic Coping in Young Couples Affected by Breast Cancer

“…It is interesting to consider overall favorable treatment satisfaction findings relative to the RCT outcomes which demonstrated short term improvement in positive dyadic coping but no between group differences in marital adjustment or relationship satisfaction—and given that participants in the current sample represented 30 of the 31 couples randomized to the treatment arm of the RCT ( Fergus et al, 2021 ). Specifically, experiential gains of improved communication, greater closeness, and increased insight into the relationship, should, in theory, be reflected in improvements on standardized instruments such as the Revised Dyadic Adjustment Scale (RDAS).…”

“…Moreover, the Dyadic Coping Inventory, a measure that was evidently more sensitive to the changes provoked by Couplelinks, showed these changes were not maintained at follow-up ( Fergus et al, 2021 ). In this regard, it is important to bear in mind that the TSQ was completed soon after completing the program when any treatment gains would have been most salient for participants.…”

“…The current study is based on an analysis of feedback collected from 53 participants representing 30 couples who completed the Couplelinks program as part of an RCT ( Fergus et al, 2021 ; 23 dyads and seven individual partners). Couples were eligible for participation in the RCT provided that (1) they were in a committed (i.e., married, cohabitating, engaged, or dating for at least 6 months) heterosexual relationship, (2) the female partner was 50 years or younger and had a diagnosis of invasive, non-metastatic breast carcinoma within the previous 36 months, (3) both partners were fluent in English, and (4) they had access to a reliable Internet connection.…”

“…Adding to the literature on the benefits of remotely delivered couple-based interventions in general, and in relation to cancer specifically, are findings from a randomized controlled trial of the Couplelinks intervention to support younger couples affected by BC ( Fergus et al, 2021 ). The greater burden posed by BC to younger couples, combined with the known benefits of online modalities including greater flexibility, accessibility and convenience ( Korp, 2006 ; Paul et al, 2013 ; Badr et al, 2015 ; Kruse et al, 2017 ) inspired the development of “Couplelinks.” Couplelinks is an asynchronously delivered, professionally facilitated web-based program entailing a series of dyadic exercises and with opportunities for relationship reflection that partners undertake together with the aim of improving their mutual understanding, support, and ability to communicate constructively around the impacts of BC on each partner and the relationship (described further below).…”

“…In the RCT, couples from across Canada were randomized to treatment or waitlist control conditions. The analysis, based on 31 couples in the treatment group and 36 couples in the waitlist group, showed modest improvements in positive dyadic coping (Cohen’s d = 0.24) and perceived ability to cope as a couple with BC ( d = 0.23), but effects were not maintained at 3-month follow-up and no effect was seen on overall relationship adjustment or satisfaction ( Fergus et al, 2021 ).…”