JMIR Publications

ABSTRACT

Background:

Despite the effects of poor relationship quality on individuals’, couples’ and families’ wellbeing, help-seeking often does not occur until problems arise. Digital interventions may lower barriers to engagement with preventative relationship care. The Paired app, launched October 2020, aims to strengthen and enhance couple relationships. It provides daily questions, quizzes, tips, and detailed content, and facilitates in-app sharing of question/quiz responses and tagged content between partners.

Objective:

To explore the potential of mhealth to benefit couple relationships, and how it may do this, we explored (a) Paired’s impact on relationship quality, and (b) its mechanisms of action.

Methods:

In this mixed-methods evaluation, Paired subscribers were invited to complete (1) brief longitudinal surveys over 3 months (n=440); (2) a 30-item online survey (n=745); and (3) in-depth interviews (n=20). For objective (a), survey results were triangulated to determine associations between duration/frequency of Paired usage and relationship quality measures, and qualitative data were integrated to provide explanatory depth. For (b), mechanisms of action were explored using a dominant qualitative approach.

Results:

Relationship quality improved with increasing duration and frequency of Paired use. Online survey data indicate that Multidimensional Quality of Relationship Scale score (MQoRS, which represents relationship quality on a 0-10 scale) was 35.5% higher (95%CI: 31.1-43.7%, P<.01), at 7.03, among people who had used Paired for >3 months, compared to 5.19 among new users (≤1 week’s use of Paired); similar positive trends were observed in the longitudinal data. Of those who had used Paired for >1 month, 64.3% agreed that their relationship felt stronger since using the app (95%CI: 60.2-68.4%), with no or minimal demographic differences observed. Regarding Paired’s mechanisms of action, interview accounts demonstrated how it prompted and habituated meaningful communication between partners, which occurred within and outside the app. Couples made regular times in their days to discuss the topics Paired brought up. Daily questions were sometimes light-hearted and sometimes concerned topics that couples might find challenging to discuss (e.g. money management). Interviewees valued the combination of fun and seriousness. It was easier to discuss challenging topics when they were raised by the ‘neutral’ app, rather than during stressful circumstances or when one partner broached the topic. Engagement appeared to be enhanced by users’ experience of benefits to their relationship, as well as by the app’s design.

Conclusions:

This study demonstrates proof-of-concept, showing that Paired may have potential to improve relationship quality over a relatively short timeframe. Positive relationship practices became embedded within couples’ daily routines, suggesting that relationship quality improvements might be sustained. Digital interventions can play an important role in the relationship care ecosystem. Mixed-methods design enabled triangulation and integration to strengthen our findings. However app users were self-selecting and methodological choices impact on our findings’ generalizability. Clinical Trial: not applicable