Recent research has shown that the quality of marital relationships is inextricably linked to physical and mental health of the individuals in the relationship. Included in the wide-ranging negative health outcomes associated with marital distress, individuals in distressed marriages are at greater risk for mortality relative to spouses in non-distressed marriages (Robles &Kiecolt-Glaser, 2003). The impacts of marital distress do not end with the spouses in the marriage;children of distressed couples who are exposed to characteristically high levels of conflict suffer negative mental and physical health consequences, such as externalizing and internalizing problems, depression, anxiety, and physical problems (El-Sheikh, Hargar, &Whitson, 2001). Recent government initiatives take into account the importance of the marital relationship on children;the Healthy Marriage Initiative (2005) defined a healthy marriage as """"""""a mutually satisfying relationship that is beneficial to the husband, wife, and children."""""""" The proposed prevention study seeks to intervene with couples during the transition to parenthood, a major life transition when marital satisfaction typically declines (Gottman &Notarius, 2002). A number of programs have been developed to prevent relationship and individual distress, but thus far no studies have examined effects of such programs in low-income couples. Given that low-income couples are at greater risk for a host of intra- and interpersonal problems, and often have unique circumstances and stressors that are not addressed in existing prevention programs (Karney &Bradbury, 2005), this proposal is timely. This study will examine the immediate and longitudinal effectiveness of a brief, cost-effective, preventive intervention designed for low-income couples during the transition to parenthood. Comparing Integrative Behavioral Couple Therapy (Jacobson &Christensen, 1998), an empirically supported treatment for couples, to treatment as usual in obstetrics clinics at a county hospital, this research will examine effects of the intervention on birth and infant health outcomes, as well as individual and relationship distress of the parents in a small sample of couples (N = 40 couples total). This study has important implications for public health. Given policy-makers'aims to support low-income couples in maintaining healthy marriages, it is imperative that interventions be implemented and researched in low-income communities. This study has the potential to inform future interventions and policies that affect low-income couples in particular, thereby improving the health and well-being of both partners and their families.
My research, coursework, and clinical experiences in psychology have helped me to determine my long-term goal of teaching and conducting clinical research in academia. My training goals for this fellowship are outlined below: 1) My first goal is to gain additional knowledge about cultural factors and mental health in low-income Latino families. I will audit a course in the School of Medicine, """"""""Hispanic Mental Health Issues and Treatment"""""""" (Psychiatry M231, Prof. Morales), that will increase my knowledge of factors that are particularly important in clinical work with Spanish-speaking couples. Another course I will audit to gain knowledge about mental health disparities is """"""""Health and Mental Health Disparities from a Psychosocial and Cultural Perspective"""""""" (Psychiatry 264, Prof. Williams). These two courses will give me a better understanding of the population I will work with at Harbor-UCLA and specific contextual factors to focus on in the intervention groups. Furthermore, weekly meetings with Dr. Reina-Patton will help me to apply the knowledge to the population in the intervention at Harbor.
