Pathways-to-Outcomes: How Healthy Marriage and Relationship Education Program Activities May Lead to Intended Outcomes

Publication Date: July 8, 2020
This is the cover of Pathways-To-Outcomes: Research-Informed Connections Between Healthy Marriage and Relationship Education Program Features and Intended Outcomes

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Healthy Marriage and Relationship Education (HMRE) programs for low-income participants are funded by the Office of Family Assistance (OFA) within the Administration for Children and Families (ACF). Trained facilitators deliver curricula, typically in weekly interactive classes, using lectures and in-class practice with partners or small groups. According to the current literature, HMRE programs may improve participants’ romantic relationships by increasing communication, conflict management, and other relationship skills. In turn, these skills are theorized to lead to improvements in long-term outcomes such as relationship satisfaction or stability and, it is hoped, positive outcomes for the participants’ children. However, there is little research examining this sequencing of outcomes (from skill gains to relationship improvement to child outcomes) in HMRE programs.

ACF has funded multiple rigorous evaluations of HMRE programs. These evaluations offered important contributions to the body of knowledge on HMRE programs and their impacts but did not aim to identify which specific program activities contributed to participant changes. To help address this gap, ACF directed Mathematica to create a set of HMRE Pathways-to-Outcomes models to explore hypothesized links between program activities and intended outcomes for adult couples.


Mathematica created a set of HMRE Pathways-to-Outcomes models to explore how and why programs for couples may achieve different outcomes and to examine the potential links between program activities and outcomes. The report presents three Pathways-to-Outcomes models for HMRE programs serving adult couples. Each model reflects an aspect of program design and implementation: (1) curriculum and delivery, (2) maximizing participation, and (3) addressing couple and individual characteristics. Although we present the models separately, readers should consider the set of models together and complementarily. The models presented in this report do not provide causal evidence to link specific program activities to specific outcomes.  Rather, they are intended to advance the field of HMRE programming and research. These models further the field by depicting hypotheses that practitioners and program developers could use as they design and implement programs These models could also be used to design research to examine the connections between specific program activities and their impact on participants. Findings from this research could inform practitioners about the effects of specific HMRE program activities.

Key Findings and Highlights

Hypotheses for each HMRE Pathways-to-Outcomes model are as follows:

  1. Improvements on couple functioning outcomes may vary depending on programs’ selection and implementation of HMRE curriculum. Programs may improve outcomes related to couple functioning by selecting an HMRE curriculum that (1) is evidence-informed, (2) is intended for a clearly specified target population, and (3) adequate time to deliver the intended content in a group format. Additionally, the implementation of the curriculum by program facilitators may influence outcomes; specifically, a curriculum delivered by qualified, well-trained facilitators, who are supervised to ensure the curriculum is delivered with fidelity, may improve outcomes related to couple functioning.
  2. Increased participation in HMRE curriculum workshops may improve couple functioning outcomes. Programs may increase participation by selecting and implementing plans that include activities to reduce participation barriers and improve retention. These plans may include (1) case management services, (2) participation supports (such as incentives, child care, and transportation), and (3) flexible workshop scheduling. Building staff–participant relationships/rapport and relationships among participants may also increase participation. Increased participation is expected to lead to better couple functioning outcomes.
  3. HMRE programs that account for or address potential couple-level and individual factors such as relationship distress, commitment, race/ethnicity and/or economic disadvantage may be more likely to improve couple functioning outcomes. Programs that consider how couple and individual characteristics affect all aspects of their program activities—from recruitment to curriculum to partnerships—may be more likely to engage their target populations and provide services more relevant to their lives, which may lead to improved participation, more meaningful program content and delivery, and better couple functioning outcomes.


To inform the development of the Pathways-to-Outcomes models presented in this report, we selected three programs from the pool of sites participating in federal evaluations and reviewed the federal evaluation literature associated with each. The three HMRE programs each participated in two of three federal evaluations (Exhibit II.1). These evaluations included, large-scale impact studies and included in-depth implementation studies.

We drew upon three sources to develop the models: (1) information from the federal evaluations, (2) discussions with researchers and practitioners, and (3) a targeted literature search. From these sources, we identified activities that were likely to be associated with program effectiveness. Based on the information from our review of the federal evaluation literature —that is the programs’ key activities and their implementation— we generated evidence-informed hypotheses.


Friend, Daniel, Scott Baumgartner, Pamela Holcomb, Elizabeth Clary, Heather Zaveri, and Amy Overcash. (2020). Pathways-To-Outcomes: How Healthy Marriage and Relationship Education Program Activities May Lead to Intended Outcomes. OPRE Report # 2020-52. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

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