Heterogeneity in the Effects of Interventions to Prevent Depression in Couples Facing Job Loss: Studying Baseline Target Moderation of Impact

Prev Sci. 2023 Feb;24(2):271-285. doi: 10.1007/s11121-022-01410-3. Epub 2022 Jul 29.

Abstract

Couples' communication styles are associated with depression following job loss for both job seekers and their partners. The Couples Employment Program (CEP), an eight-session program for couples facing job loss, was developed to integrate job search strategies sessions from the JOBS program with couple communication sessions, targeting job search behavior, motivation, mastery, and couple communication. We hypothesized that CEP would have compensatory effects, such that those who began the program with lower job search behavior, lower motivation, less mastery, and more negative or less positive couple communication would make more gains on these targets, and this would mediate impact on reducing risk for depression. We conducted a randomized field trial of CEP with 1477 heterosexual couples facing recent unemployment. Baseline levels of job search behavior and motivation, but not mastery or depression, moderated the impact of intervention on job seeker depression slopes over 12 months; job seekers reporting less job search behavior and motivation at baseline benefited more. Male partners with higher baseline depression also benefited. Opposite to our hypothesis, baseline levels of couple's communication moderated the impact of intervention such that partners in couples with more negative and less positive communication showed iatrogenic effects. There was no evidence that baseline target levels moderated the impact of the intervention on any of these targets. We speculate that more intensive communication training may be necessary for positive impact.

Keywords: Baseline target moderation; Couples; Depression; Randomized controlled trial; Unemployment.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Depression* / prevention & control
  • Employment
  • Family Characteristics
  • Humans
  • Male
  • Motivation*
  • Research