| Background: The aspects of marriage and relationship and their effect on couples’ satisfaction are essential and
critical aspects to be explored in this globalized and contemporary world. Since there are no reported meta-analysis
and systematic reviews conducted in the last two decades in this area, we aimed to investigate the effect of
marriage and relationship programs (MRP) on couples’ relationship satisfaction (CRS) and couples’ relationship
communication (CRC) and also to determine the gender differences if any.
Method: In this systematic review and meta-analysis, the randomized clinical trials (RCTs) published between 2000
and July 26, 2019, were retrieved from several online electronic databases such as Medline, Embase, ProQuest, and
Cochrane Library. Inclusion and exclusion criteria were developed using the PICO (Population, Intervention,
Comparison, Outcome) framework of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
The mean differences (MDs) and 95% confidence intervals (CIs) were calculated. The reported summary statistics
were calculated as random effects models based on the heterogeneity between the studies model. Funnel plots
and the Egger regression test was used to confirm the presence of any publication bias.
Results: Of the total 12 intervention studies included, five (5) are education/communication skills programs, three
(3) enrichment programs, and four (4) therapy programs. The impact of these programs was investigated on CRS
and CRC. Therapy programs had a larger effect than other programs (pooled MD: 0.53 (95% CI = 0.35 to 0.71, I2 =
71.5% p = 0.0001) and had a larger effect size on wives (pooled MD: 0.53 (95% CI 0.25 to 0.80, I2 = 74.1% p =
0.0001) than husbands RS (pooled MD: 0.26 (95% CI 0.25 to 0.76, I2 = 72.4% p = 0.0001). In RC (relationship
communication) area, the Enhancement programs showed the small to large effect on CRC (pooled MD: 1.31 (95%
CI = 0.13 to 2.50, I2 = 94.7% p = 0.0001)) and educational programs showed small to medium effect (pooled MD:
0.32 (95% CI = 0.13 to 0.50, I2 = 74.5% p = 0.0001) on women and no effect on men
Conclusion: Due to the high effect of the therapy programs on CRS and enhancement program on CRC in the
current meta-analysis, the priority of their utilizations in interventions, especially by psychologists and mental health
professionals, should be emphasized. Therefore, mental health planning in communities to develop MRP and care for
couples’ health should be given special attention to men’s health. Due to the high heterogeneity of the results and
with scanty literature in this specific domain, we are uncertain about their actual effect. However, well-designed RCTs
with a larger sample size would be beneficial in closely examining the effect of MRPs on CRS and CRC. |