A Randomized, Controlled Trial of the Impact of the Couple CARE for Parents of Newborns Program on the Prevention of Intimate Partner Violence and Relationship Problems

  • Richard E. HeymanEmail author
  • Amy M. Smith Slep
  • Michael F. Lorber
  • Danielle M. Mitnick
  • Shu Xu
  • Katherine J. W. Baucom
  • W. Kim Halford
  • Phyllis Holditch Niolon


Effective, accessible prevention programs are needed for adults at heightened risk for intimate partner violence (IPV). This parallel group randomized controlled trial examines whether such couples receiving the American version of Couple CARE for Parents of Newborns (CCP; Halford et al. 2009) following the birth of a child, compared with controls, report fewer first occurrences of clinically significant IPV, less frequent physical and psychological IPV, and improved relationship functioning. Further, we test whether intervention effects are moderated by level of risk for IPV. Couples at elevated risk for IPV (N = 368) recruited from maternity units were randomized to CCP (n = 188) or a 24-month waitlist (n = 180) and completed measures of IPV and relationship functioning at baseline, post-program (when child was 8 months old), and two follow-ups (at 15 and 24 months). Intervention effects were tested using intent to treat (ITT) as well as complier average causal effect (CACE; Jo and Muthén 2001) structural equation models. CCP did not significantly prevent clinically significant IPV nor were there significant main effects of CCP on clinically significant IPV, frequency of IPV, or most relationship outcomes in the CACE or ITT analyses. Risk moderated the effect of CCP on male-to-female physical IPV at post-program, with couples with a planned pregnancy declining, but those with unplanned pregnancies increasing. This study adds to previous findings that prevention programs for at-risk couples are not often effective and may even be iatrogenic for some couples.


Prevention Randomized controlled trial Partner aggression Intimate partner violence 



This work was supported by a grant from the Centers for Disease Control and Prevention (5U49CE00124602).

Compliance with Ethical Standards

Conflict of Interest

W. Kim Halford is the co-developer of Couple CARE and Couple CARE for Parents programs and receives royalties from the sale of these programs. He is also the Principal Investigator on grants which provide funding for intervention research on Couple CARE for Parents program. All the other authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained for all individual participants included in the study.


The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Supplementary material

11121_2018_961_MOESM1_ESM.pdf (717 kb)
ESM 1 (PDF 716 kb)


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Copyright information

© Society for Prevention Research 2018

Authors and Affiliations

  • Richard E. Heyman
    • 1
    Email author
  • Amy M. Smith Slep
    • 1
  • Michael F. Lorber
    • 1
  • Danielle M. Mitnick
    • 1
  • Shu Xu
    • 1
  • Katherine J. W. Baucom
    • 1
  • W. Kim Halford
    • 2
  • Phyllis Holditch Niolon
    • 3
  1. 1.New York UniversityNew YorkUSA
  2. 2.University of QueenslandBrisbaneAustralia
  3. 3.Centers for Disease Control and PreventionAtlantaUSA

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