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Intervention Summary

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Prevention and Relationship Enhancement Program (PREP)

The Prevention and Relationship Enhancement Program (PREP) is a marriage and relationship education intervention that teaches couples (premarital and marital) how to communicate effectively, work as a team to solve problems, manage conflicts without damaging closeness, and preserve and enhance commitment and friendship. Delivered in a group workshop format, PREP uses techniques of cognitive-behavioral therapy and addresses topics such as communication, affect management, conflict management, commitment, fun and friendship, sensuality and sexuality, problem-solving, forgiveness, and emotional supportiveness.

PREP workshops are generally provided as a series of 30- to 90-minute meetings during the week, followed by a weekend retreat. The total duration of the intervention is about 13-15 hours. Workshops are led by facilitators who have received training from PREP, Inc. Facilitators can be professionals in mental health, nursing, education, or other fields, clergy or lay leaders, or volunteers from the community. Educational strategies used in the workshops include video-recorded demonstrations of negative patterns and skills, didactic presentations, group exercises to foster learning and connection among couples, and couples practice time. Couples are encouraged to review materials, practice skills, and complete exercises between workshop sessions.

Five of the six studies reviewed for this summary evaluated PREP with U.S. couples, and one evaluated a German-language version of PREP with couples in Germany. In one study, the participants were U.S. Army couples (one or both spouses in the Army) who received a variation of PREP for military couples called PREP for Strong Bonds.

Descriptive Information

Areas of Interest Mental health promotion
Outcomes Review Date: January 2013
1: Divorce status
2: Communication skills
3: Confidence that marriage can survive
4: Positive bonding between couples
5: Satisfaction with sacrificing for marriage and partner

Review Date: September 2006
1: Relationship satisfaction and stability
2: Communication and conflict management
3: Problem intensity
Outcome Categories Family/relationships
Social functioning
Ages 18-25 (Young adult)
26-55 (Adult)
Genders Male
Female
Races/Ethnicities American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Race/ethnicity unspecified
Non-U.S. population
Settings School
Other community settings
Geographic Locations Urban
Rural and/or frontier
Implementation History PREP, Inc., has trained more than 19,000 leaders to implement PREP at community-based service centers, military bases, prisons, universities, and religious organizations throughout the United States. Evaluations have been conducted at 12 sites in the United States, Australia, and Germany with about 2,000 couples. An estimated 500,000 individuals have received or participated in PREP or adaptations of PREP.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: Yes
Evaluated in comparative effectiveness research studies: Yes
Adaptations

Adaptations of PREP include:

  • Christian PREP, for Christian couples
  • ProSAAM, for African American Christian couples
  • Within My Reach, singles version (available in English and Spanish)
  • On My Shoulders, for fathers
  • Got Your Back, for singles in the military
  • Workplace Challenge, for employees
  • Walking the Line, for incarcerated men
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal

Quality of Research
Review Date: January 2013

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Allen, E. S., Rhoades, G. K., Stanley, S. M., Loew, B., & Markman, H. J. (2012). The effects of marriage education for Army couples with a history of infidelity. Journal of Family Psychology, 26(1), 26-35.  Pub Med icon

Allen, E. S., Stanley, S. M., Rhoades, G. K., Markman, H. J., & Loew, B. A. (2011). Marriage education in the Army: Results of a randomized clinical trial. Journal of Couple and Relationship Therapy, 10(4), 309-326.  Pub Med icon

Stanley, S. M., Allen, E. S., Markman, H. J., Rhoades, G. K., & Prentice, D. L. (2010). Decreasing divorce in U.S. Army couples: Results from a randomized controlled trial using PREP for Strong Bonds. Journal of Couple and Relationship Therapy, 9(2), 149-160.  Pub Med icon

Supplementary Materials

Psychometric Information on Measures

Outcomes

Outcome 1: Divorce status
Description of Measures Divorce status was assessed at 1-year follow-up using a single question on a self-report survey: "Have you and/or your spouse filed for divorce or obtained a divorce?" If neither spouse answered "yes," the couple was coded as not divorced.
Key Findings Participants in the study were married U.S. Army couples (one or both spouses in the Army) who were randomly assigned to the intervention group, which received PREP for Strong Bonds delivered by Army chaplains, or a no-intervention control group.

At 1-year follow-up, couples who received PREP for Strong Bonds had one-third the divorce rate of those who received no intervention (6.20% vs. 2.03%; p = .03).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.8 (0.0-4.0 scale)
Outcome 2: Communication skills
Description of Measures Communication skills were assessed at pretest, posttest, and 1-year follow-up using 10 items from the Communication Skills Test. Example items include "When discussing issues, I allow my spouse to finish talking before I respond" and "When our discussions begin to get out of hand, we agree to stop them and talk later." Response options range from 1 ("almost never") to 7 ("almost always"). Total scores, obtained by summing scores for the 10 items, ranged from 10 to 70, with higher scores reflecting better communication skills.
Key Findings Participants in the study were married U.S. Army couples (one or both spouses in the Army) who were randomly assigned to the intervention group, which received PREP for Strong Bonds delivered by Army chaplains, or a no-intervention control group.

Couples who received PREP for Strong Bonds showed greater improvement in communication skills from pre- to posttest compared with couples who received no intervention (p < .01). This result was associated with a small effect size (Cohen's d = 0.20). No significant differences were reported between groups at 1-year follow-up.

Among couples with a history of infidelity, those who received PREP for Strong Bonds tended to have better communication skills at posttest and 1-year follow-up compared with those who received no intervention, after controlling for baseline differences in communication skills. However, the difference in communication skills between groups was only statistically significant at 1-year follow-up (p < .05).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.8 (0.0-4.0 scale)
Outcome 3: Confidence that marriage can survive
Description of Measures Participants' level of confidence in the long-term survival of their marriage was assessed at pre- and posttest using 5 items from the Confidence Scale. The Confidence Scale is a 10-item measure that measures an individual's level of confidence that he or she and his or her partner can handle their future and stay together. Example items include "I believe we can handle whatever conflicts will arise in the future" and "I am very confident when I think of our future together." Response options range from 1 ("strongly disagree") to 7 ("strongly agree"). Total scores, obtained by summing scores for the 5 items, ranged from 5 to 35, with higher scores indicating more confidence in the relationship.
Key Findings Participants in the study were married U.S. Army couples (one or both spouses in the Army) who were randomly assigned to the intervention group, which received PREP for Strong Bonds delivered by Army chaplains, or a no-intervention control group.

Couples who received PREP for Strong Bonds showed a pre- to posttest increase in confidence that their marriage could survive over the long term, whereas couples who received no intervention showed a decrease in confidence in their marriage's survival (p < .05). This result was associated with a very small effect size (Cohen's d = 0.11).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.8 (0.0-4.0 scale)
Outcome 4: Positive bonding between couples
Description of Measures This outcome was assessed at pre- and posttest using the Positive Bonding Scale, adapted from the Couple Activities Scale. The Positive Bonding Scale consists of 9 items assessing the couple's perceptions of their level of friendship, intimacy, fun, felt support, and sensual/sexual relationship. Examples of these questions include:

  • "We regularly have conversations where we just talk as good friends."
  • "We have a satisfying sensual or sexual relationship."
  • "I feel emotionally supported by my partner."
  • "We regularly make time for fun activities together as a couple."
Key Findings Participants in the study were married U.S. Army couples (one or both spouses in the Army) who were randomly assigned to the intervention group, which received PREP for Strong Bonds delivered by Army chaplains, or a no-intervention control group.

Couples who received PREP for Strong Bonds showed an increase in positive bonding from pre- to posttest, whereas couples who received no intervention showed a decrease in positive bonding (p < .05). This result was associated with a very small effect size (Cohen's d = 0.11).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.8 (0.0-4.0 scale)
Outcome 5: Satisfaction with sacrificing for marriage and partner
Description of Measures This outcome was assessed at pre- and posttest using 3 items from the self-report Satisfaction with Sacrifice Scale. This scale assesses the degree to which individuals view sacrifice for the relationship to be rewarding. An example item is "It makes me feel good to sacrifice for my spouse."
Key Findings Participants in the study were married U.S. Army couples (one or both spouses in the Army) who were randomly assigned to the intervention group, which received PREP for Strong Bonds delivered by Army chaplains, or a no-intervention control group.

Couples who received PREP for Strong Bonds showed no significant change from pre- to posttest in satisfaction with their sacrificing for marriage and partner, whereas couples who received no intervention showed a decrease in their satisfaction with sacrificing for marriage and partner (p < .05). This result was associated with a very small effect size (Cohen's d = 0.13).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.8 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 18-25 (Young adult)
26-55 (Adult)
50% Female
50% Male
70% White
12.5% Hispanic or Latino
9.5% Black or African American
5% Race/ethnicity unspecified
2% American Indian or Alaska Native
1% Native Hawaiian or other Pacific Islander

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Divorce status 4.0 4.0 3.0 4.0 3.5 4.0 3.8
2: Communication skills 4.0 4.0 3.0 4.0 3.5 4.0 3.8
3: Confidence that marriage can survive 4.0 4.0 3.0 4.0 3.5 4.0 3.8
4: Positive bonding between couples 4.0 4.0 3.0 4.0 3.5 4.0 3.8
5: Satisfaction with sacrificing for marriage and partner 4.0 4.0 3.0 4.0 3.5 4.0 3.8

Study Strengths

The measures used in the study had good psychometric properties, and data from independent investigators support their reliability and validity. The study used a randomized experimental design, which controlled for most of the confounding variables. Delivery of the intervention was manualized, the facilitators (Army chaplains) received training, and audiorecordings showed a high level of adherence to the lesson material. Attrition was low, and an intent-to-treat methodology was used. The statistical analyses used were appropriate for the outcomes of the study.

Study Weaknesses

A psychometrically tested instrument was not used to assess fidelity. Almost one quarter of the iterations of the intervention (i.e., repetitions of the program to accommodate multiple groups of couples) could not be coded for fidelity because some portion of the intervention was not audiorecorded.

Review Date: September 2006

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Markman, H. J., Floyd, F. J., Stanley, S. M., & Storaasli, R. D. (1988). Prevention of marital distress: A longitudinal investigation. Journal of Consulting and Clinical Psychology, 56(2), 210-217.

Markman, H. J., & Hahlweg, K. (1993). The prediction and prevention of marital distress: An international perspective. Clinical Psychology Review, 13, 29-43.

Markman, H. J., Renick, M. J., Floyd, F. J., Stanley, S. M., & Clements, M. (1993). Preventing marital distress through communication and conflict management training: A 4- and 5-year follow-up. Journal of Consulting and Clinical Psychology, 61(1), 70-77.  Pub Med icon

Renick, M. J., Blumberg, S. L., & Markman, H. J. (1992). The prevention and relationship program (PREP): An empirically based preventive intervention program for couples. Family Relations, 41, 141-147.

Study 2

Hahlweg, K., Markman, H. J., Thurmaier, F., Engl, J., & Eckert, V. (1998). Prevention of marital distress: Results of a German prospective longitudinal study. Journal of Family Psychology, 12(4), 543-556.

Study 3

Halford, W. K., Sanders, M. R., & Behrens, B. C. (2001). Can skills training prevent relationship problems in at-risk couples? Four-year effects of a behavioral relationship education program. Journal of Family Psychology, 15(4), 750-768.  Pub Med icon

Study 4

Stanley, S. M., Markman, H. J., Prado, L. M., Olmos-Gallo, A., Tonelli, L., St. Peters, M., et al. (2001). Community-based premarital prevention: Clergy and lay leaders on the front lines. Family Relations, 50(1), 67-76.

Study 5

Laurenceau, J. P., Stanley, S. M., Olmos-Gallo, A., Baucom, B., & Markman, H. J. (2004). Community-based prevention of marital dysfunction: Multilevel modeling of a randomized effectiveness study. Journal of Consulting and Clinical Psychology, 72(6), 933-943.

Supplementary Materials

Halford, W. K., Markman, H. J., Kline, G. H., & Stanley, S. M. (2003). Best practice in couple relationship education. Journal of Marital and Family Therapy, 29(3), 385-406.  Pub Med icon

Markman, H. J., Stanley, S., & Allen, E. S. (2006). The long-term effects of premarital intervention. Grant application submitted to the National Institute of Child Health and Human Development.

Markman, H. J., Whitton, S. W., Kline, S. M., Thompson, H., St. Peters, M., Leber, D. B., et al. (2004). Use of an empirically based marriage education program by religious organizations: Results of a dissemination trial. Family Relations, 53(5), 504-512.

Stanley, S. M., Allen, E. S., Markman, H. J., Saiz, C. C., Bloomstrom, G., Thomas, R., et al. (2005). Dissemination and evaluation of marriage education in the Army. Family Process, 44(2), 187-201.  Pub Med icon

Outcomes

Outcome 1: Relationship satisfaction and stability
Description of Measures Relationship satisfaction and stability were assessed by self-report measures of (1) marital functioning (Marital Adjustment Test); (2) frequency and quality of sensual or sexual activity (Sexual Dissatisfaction Scale); (3) steps taken toward separation (Relationship Status Inventory); (4) danger signs of interactions (Relationship Dynamic Scale); and (5) couples' confidence with one another (Confidence Scale).
Key Findings In a long-term study, PREP couples showed greater relationship satisfaction at 1 1/2 years and 3 years after the intervention than control couples who received pre- and postassessments only. Husbands participating in PREP reported greater relationship satisfaction than husbands in the control group at 4 and 5 years after the intervention.

In another study, at 3-year follow-up, couples participating in a PREP program modified for German couples (Ein Parschaftliches) had higher relationship satisfaction than control couples who participated in a conventional marital enrichment program (p < .013).

A third study compared a variant of PREP (Self-Regulatory Prevention and Relationship Enhancement Program, or Self-PREP) with a control condition (a relationship education program). The study found that high-risk couples (woman had divorced parents or man's father was violent toward mother) participating in Self-PREP exhibited higher relationship satisfaction at 4-year follow-up than control couples. In low-risk couples, where neither of the high-risk conditions was present, relationship satisfaction was higher in the control condition.
Studies Measuring Outcome Study 1, Study 2, Study 3, Study 4, Study 5
Study Designs Experimental, Quasi-experimental
Quality of Research Rating 2.6 (0.0-4.0 scale)
Outcome 2: Communication and conflict management
Description of Measures Communication and conflict management were assessed by: (1) self-report measures of how couples handle conflict (Conflict Tactics Scale); (2) couple's perception of their communication during interactions (Communication Box); (3) observer ratings of couple's proficiency in communicating with one another (Communication Skills Test); (4) observer's coding of couple's conflict management and intimacy (Interaction Dimensions Coding System); and (5) levels of commitment (Commitment Inventory).
Key Findings In a long-term study, PREP couples showed improved communication 1 1/2 years after the intervention and fewer negative-behavior communications at 3 years after the intervention compared with control couples, who received pre- and postassessments only. At 4 and 5 years after the intervention, husbands participating in PREP reported fewer negative communications than husbands in the control group.

Another study reported that couples participating in a PREP program modified for German families (Ein Parschaftliches) had consistently more positive and less negative communication behavior than control couples who participated in a conventional marital enrichment program.

In a third study using a variant of PREP (Self-PREP), results showed that high-risk couples (woman had divorced parents or man's father was violent toward mother) who participated in Self-PREP had better communication than control couples who participated in a relationship education program.

In a fourth study, couples who had taken PREP delivered by the clergy and lay leaders within a religious organization showed favorable patterns of communication over time when compared with the treatment-as-usual group.

In a multilevel modeling study in three group assignments, negative-behavior trends for wives receiving PREP from clergy showed significantly greater declines when compared with trends for wives receiving treatment as usual. Positive-behavior trends for those receiving treatment as usual or PREP from university clinician partners showed significant declines when compared with trends for wives receiving PREP delivered by clergy.
Studies Measuring Outcome Study 1, Study 2, Study 3, Study 4, Study 5
Study Designs Experimental, Quasi-experimental
Quality of Research Rating 2.6 (0.0-4.0 scale)
Outcome 3: Problem intensity
Description of Measures Problem intensity was assessed using: (1) the Relationship Problem Inventory, a self-report scale requiring each partner to rate the perceived intensity of couple's commonly experienced problem areas (e.g., communication, money, sex); and (2) the Marital Agendas Protocol, a scale that assesses intensity in problem areas (e.g., money, sex, children), as well as confidence in being able to solve problems (i.e., relationship efficacy).
Key Findings In a long-term study, PREP couples reported decreased levels of problem intensity from pre- to posttest and at 1 1/2 and 3 years after the intervention when compared with the control couples.
Studies Measuring Outcome Study 1, Study 4, Study 5
Study Designs Experimental
Quality of Research Rating 1.8 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 18-25 (Young adult)
26-55 (Adult)
50% Female
50% Male
Data not reported/available
Study 2 18-25 (Young adult)
26-55 (Adult)
50% Female
50% Male
100% Non-U.S. population
Study 3 26-55 (Adult) 50% Female
50% Male
100% Non-U.S. population
Study 4 18-25 (Young adult)
26-55 (Adult)
50% Female
50% Male
90.4% White
6.2% Hispanic or Latino
1.8% Race/ethnicity unspecified
0.3% American Indian or Alaska Native
0.3% Asian
0.3% Black or African American
Study 5 18-25 (Young adult)
26-55 (Adult)
50% Female
50% Male
85.2% White
12.2% Hispanic or Latino
1.8% Black or African American
0.9% American Indian or Alaska Native
0.7% Asian
0.7% Race/ethnicity unspecified

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Relationship satisfaction and stability 3.0 3.5 2.0 2.5 2.0 2.5 2.6
2: Communication and conflict management 3.0 3.5 2.0 2.5 2.0 2.5 2.6
3: Problem intensity 2.0 2.0 1.5 2.5 1.5 1.5 1.8

Study Strengths

PREP has been tested using diverse measures, including some measures with strong psychometric properties. There is a clear connection between the need, theory, and intervention. Similar outcomes have been achieved in research conducted by independent investigators.

Study Weaknesses

The studies did not discuss in detail how attrition was addressed. One study used a self-selection process that makes it difficult to attribute the findings wholly to the intervention. Inadequate information was provided to determine the influence of religion, which is important given that a number of the studies were conducted in faith-based communities. Intervention fidelity measures were weak, and some studies did not mention methods used to control for leaders' effects. Because participants with different ethnicities were grouped together, it is difficult to analyze if the information is appropriate for diverse ethnic groups. Little descriptive and psychometric information was provided for Communication Box, one of the measures used to rate couple's communication skills.

Readiness for Dissemination
Review Date: January 2013

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Billings, D. (2004). The primary colors personality test. Greenwood, CO: PREP for Individuals, Inc.

PREP Educational Products, Inc. (2005). Understanding commitment with Scott M. Stanley [CD-ROM]. Greenwood Village, CO: Author.

PREP Educational Products, Inc. (2007). PREP for Strong Bonds: PowerPoint (v.1.3B) [CD-ROM]. Greenwood Village, CO: Author.

PREP Educational Products, Inc. (2007). PREP for Strong Bonds: Video clips: Part 1 [DVD] Greenwood Village, CO: Author.

PREP Educational Products, Inc. (2007). PREP for Strong Bonds: Video clips: Part 2 [DVD] Greenwood Village, CO: Author.

PREP Educational Products, Inc. (2008). PREP on PowerPoint (v.7.0) [CD-ROM]. Greenwood Village, CO: Author.

PREP Educational Products, Inc. (2008). The PREP resource disk [CD-ROM]. Greenwood Village, CO: Author.

PREP Educational Products, Inc. (2009). PREP for Strong Bonds: Participant manual (v.1.3b). Greenwood Village, CO: Author.

PREP Educational Products, Inc. (2009). PREP for Strong Bonds: Resource disk (v.1.3B) [CD-ROM]. Greenwood Village, CO: Author.

PREP Educational Products, Inc. (2009). The PREP participant manual (v. 7.0). Greenwood Village, CO: Author.

PREP Educational Products, Inc. (2010). The calming skills CD [Compact Disc]. Greenwood Village, CO: Author.

PREP, Inc. (2007). General consent form for participants. Greenwood Village, CO: Author.

PREP, Inc. (2007). Instructions for follow up assessment. Greenwood Village, CO: Author.

PREP, Inc. (2007). Instructions for post assessment. Greenwood Village, CO: Author.

PREP, Inc. (2007). Instructions for pre assessment. Greenwood Village, CO: Author.

PREP, Inc. (2007). Relationship education workshop questionnaire: Follow up assessment. Greenwood Village, CO: Author.

PREP, Inc. (2007). Relationship education workshop questionnaire: Post assessment. Greenwood Village, CO: Author.

PREP, Inc. (2007). Relationship education workshop questionnaire: Post assessment: Annotated. Greenwood Village, CO: Author.

PREP, Inc. (2007). Relationship education workshop questionnaire: Pre assessment. Greenwood Village, CO: Author.

PREP, Inc. (2007). The marriage and relationship education evaluation package: Agreement for use. Greenwood Village, CO: Author.

PREP, Inc. (2007). The marriage and relationship education evaluation package: Overview. Greenwood Village, CO: Author.

PREP, Inc. (2007). The marriage and relationship education evaluation package: Scoring scales and background references. Greenwood Village, CO: Author.

PREP, Inc. (n.d.). Speaker listener technique [cards]. Greenwood Village, CO: Author.

Stanley, S., Markman, H., Jenkins, N., & Blumberg, S. (2009). PREP for Strong Bonds: Leader manual (v.1.3). Greenwood Village, CO: PREP Educational Products, Inc.

Stanley, S., Markman, H., Jenkins, N., & Blumberg, S. (2009). PREP leader manual (v. 7.0). Greenwood Village, CO: PREP Educational Products, Inc.

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.8 3.0 3.5 3.4

Dissemination Strengths

Implementation materials are attractive, comprehensive, and appropriate for implementers from various backgrounds and knowledge bases. The Leader Manual contains sufficient background information for new implementers, including the program's history, rationale, and research. The manual is heavily scripted and provides guidance on how to staff the program, select participants, and effectively run a group. Implementers use a variety of teaching strategies during groups, including didactic lectures, video clips, group discussion, and activities for couples to complete together and separately. The PREP Leader Training is required, which strengthens implementation fidelity. The program Web site lists upcoming off-site trainings and information on scheduling an on-site training. Fidelity checklists for each lesson are available for leader use. Pre-, post-, and follow-up measures are available to gather data on participants' perceptions of their relationship and of the PREP program.

Dissemination Weaknesses

The organization of the PowerPoint CD-ROM makes navigation of the large number of slides (more than 400) difficult. Important information about training cost, qualifications for master trainers, and available support resources for implementers is difficult to find or not available. Quality assurance is not an emphasized or integrated part of overall program delivery.

Review Date: September 2006

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Markman, H., Stanley, S., & Blumberg, S. (2001). Fighting for your marriage. San Francisco: John Wiley & Sons, Inc.

PREP Educational Products, Inc. (1996). The PREP approach [DVD].

PREP Educational Products, Inc. (n.d.). The PREP Instructors Kit.

PREP Educational Products, Inc. (2006). PREP Couples' Manual.

PREP Educational Products, Inc. (2006). PREP on PowerPoint [CD-ROM].

Stanley, S., Markman, H., & Blumberg, S. (2005). The PREP couples' notes: Outline for the 12-hour PREP program. Greenwood Village, CO: PREP Educational Products, Inc.

Stanley, S., Markman, H., Blumberg, S., & Jenkins, N. (2006). PREP Leader's Manual. Greenwood Village, CO: PREP Educational Products, Inc.

Stanley, S., Markman, H., Jenkins, N., & Blumberg, S. (2006). Fighting for your marriage: The PREP clips [DVD]. Greenwood Village, CO: PREP Educational Products, Inc.

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.5 2.5 2.8 2.9

Dissemination Strengths

Implementation materials are easy to understand, accommodate a wide range of learning styles, and could be adapted by a wide range of providers, including social workers, clergy, counselors, nurses, and lay leaders within religious organizations. Implementation materials are engaging, and their format and print size make them easy to read. Materials also offer various formats for implementing this program. Detailed leader and participant manuals are provided as well as a variety of visual teaching methods. The highly scripted nature of this program contributes to intervention fidelity. Many if not all lectures are directed by the included media. A variety of outcome measures with brief descriptions are provided.

Dissemination Weaknesses

The training information does not clearly specify what type of ongoing training, technical assistance, and supervision are available from developers. No specific outcome or process measure is suggested to support quality assurance.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Participant Manual
  • 1-49 copies: $11 each
  • 50-99 copies: $10 each
  • 100+ copies: $9 each
Yes
Resource Disk CD-ROM (packaged with Understanding Commitment CD-ROM) $75 each Yes
PowerPoint DVD $75 each Yes
Video Clips DVD $75 each Yes
Personality Tools (package of 10)
  • 1-49 packages: $11 each
  • 50-99 packages: $10 each
  • 100+ packages: $9 each
Yes
Fighting for Your Marriage book
  • 1-49 copies: $19.95 each
  • 50-99 copies: $16.95 each
  • 100+ copies: $14.95 each
No
Speaker/listener floor cards (package of 100) $10 per package No
Calming Skills audio CD
  • 1-49 copies: $5 each
  • 50+: $4 each
No
3-day, on- or off-site Facilitator Training (includes the Leader Manual and all trainee materials) About $450-$1,050 per person for up to 50 trainees, plus travel expenses for off-site training; cost varies depending on location and number of trainees Yes
Phone or email technical assistance $100-$150 per hour No
On-site technical assistance $1,000- $1,500 per day, plus travel expenses No
Audio and/or video review of workshop leaders $100-$150 per hour No
Facilitator review Webinar $100-$150 per hour No
Marriage and Relationship Education Evaluation Pack (includes participant evaluation measures) Free No

Additional Information

Complete pricing information for PREP, PREP for Strong Bonds, and other PREP programs is available on the PREP Inc., Web site.

Replications
Contact Information

To learn more about implementation, contact:
Natalie H. Jenkins
(800) 366-0166
info@prepinc.com

Scott M. Stanley, Ph.D.
(800) 366-0166
info@prepinc.com

To learn more about research, contact:
Howard J. Markman, Ph.D.
(303) 871-3370
hmarkman@du.edu

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

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