The Effect of Pre-Marital Interventions on Relationship Satisfaction Among Married Couples: A Systematic Review and Meta-Analysis

Demet Akçayır; Kevser Sülüker; Selma Kahraman; Hasret Yalçinöz Baysal; Nihan Türkoğlu

doi:10.5281/zenodo.23012418

Authors

Demet Akçayır Harran Üniversitesi https://orcid.org/0000-0002-3802-6252
Kevser Sülüker Atatürk University https://orcid.org/0000-0001-5386-2489
Selma Kahraman Harran Üniversitesi https://orcid.org/0000-0002-4486-6629
Hasret Yalçinöz Baysal Ataturk University https://orcid.org/0000-0003-2177-3486
Nihan Türkoğlu Ataturk University https://orcid.org/0000-0002-5843-9097

DOI:

https://doi.org/10.5281/zenodo.23012418

Keywords:

Premarital intervention, Married couples, Relationship satisfaction, Meta-analysis

Abstract

Objective: This review aims to evaluate the impact of premarital interventions on relationship satisfaction among married couples by comparing them with usual care. The secondary objective is to identify the most effective premarital intervention for increasing relationship satisfaction, and to determine the key characteristics of such interventions in terms of their duration, format, delivery method, core components, and theoretical framework.

Material and Methods: For this meta-analysis, randomised controlled trials and experimental studies were identified using five search engines in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of nine studies involving 886 participants in the premarital process were identified. As three studies included multiple groups, 14 outcomes were pooled using a random-effects model in the CMA programme.

Results: Of the nine studies examining the effect on relationship satisfaction, none of the Q statistics were significant (p > 0.001, Q = 42.289, df = 13). I² was calculated as 69.25%, the average effect size was 0.020 (random), and the 95% confidence interval was 0.149–0.022 (p = 0.894).

Discussion and Conclusions: The overall effect of premarital interventions on postmarital relationship satisfaction was not found to be statistically significant. However, the heterogeneity observed across studies suggests that the effects of these interventions may depend on the characteristics of the programme and its participants. Methodologically robust, standardised studies with long-term follow-up are needed to determine the long-term effects and effectiveness of premarital interventions on relationship satisfaction.

References

1. Eurostat. Marriage and divorce statistics. Statistics Explained. 2025; https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Marriage_and_divorce_statistics

2. Huntington C, Stanley SM, Doss BD, & Rhoades GK. Happy, healthy, and wedded? How the transition to marriage affects mental and physical health. Journal of family psychology. 2022;36(4)-608. https://doi.org/10.1037/fam0000913

3. Markman HJ, Hawkins AJ, Stanley SM, Halford WK, Rhoades G. Helping couples achieve relationship success: A decade of progress in couple relationship education research and practice, 2010–2019. Journal of Marital and Family Therapy. 2022;48(1), 251-282. https://doi.org/10.1111/jmft.12565

4. Bühler JL, Krauss S, Orth U. Development of relationship satisfaction across the life span: A systematic review and meta-analysis. Psychological Bulletin. 2021;147(10)-1012. https://doi.org/10.1037/bul0000342

5. Fawcett EB, Hawkins AJ, Blanchard VL, Carroll JS. Do premarital education programs really work? A meta‐analytic study. Family Relations. 2010;59(3), 232-239. https://doi.org/10.1111/j.1741-3729.2010.00598.x

6. Higgins JP, Eldridge S, Li T. Including variants on randomized trials. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor (s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (updated February 2021). Cochrane, 2021. Available from www. training. cochrane. org/handbook.

7. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372-71. https://doi.org/10.1136/bmj.n71

8. Sterne JAC, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ. 2019; 366, 1-8. https://doi.org/10.1136/bmj.l4898

9. Guyatt GH, Oxman AD, Vist G, Kunz R, Brozek J, Alonso-Coello P, et al. GRADE guidelines: 4. Rating the quality of evidence—study limitations (risk of bias). Journal of clinical epidemiology. 2011;64(4), 407-415. https://doi.org/10.1016/j.jclinepi.2010.07.017

10. Nahcivan N, Seçginli, S. How are the methodological quality of quantitative studies included in systematic review. Turkiye Klinikleri J Public Health Nurs-Special Topics. 2017;3(1), 10-9.

11. Lipsey MW, Wilson DB. Practical meta-analysis. Thousand Oaks, CA: SAGE. 2001.

12. Light RJ, Pillemer DB. Summing up: The science of reviewing research. Harvard University Press. 1984. https://doi.org/10.3102/0013189x015008016

13. Duval S, Tweedie R. Trim and fill: A simple funnel-plot–based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2), 455–463. https://doi.org/10.1111/j.0006-341X. 2000.00455.x

14. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Comprehensive meta-analysis (Version 2)[Computer software]. Englewood, NJ: Biostat.2005; Retrieved July 14, 2011.

15. Kernová L, Halamová J, Deriglazov D. Effectiveness of digital interventions on relationship satisfaction among couples: a systematic review and meta-analysis. BMC psychology.2025;13(1), 1069. https://doi.org/10.1186/s40359-025-03444-y

16. Williamson HC, Rogge RD, Cobb RJ, Johnson MD, Lawrence E, Bradbury TN. Risk moderates the outcome of relationship education: A randomized controlled trial. Journal of Consulting and Clinical Psychology. 2015;83(3)-617. https://doi.org/10.1037/a0038621

17. Yılmaz T, Kalkan M. Evlilik öncesi ilişkileri geliştirme programının çiftlerin ilişki doyum düzeylerine etkisi. [Master's thesis, Ondokuz Mayıs University]. 2009; YOK Thesis Center. https://tez.yok.gov.tr/UlusalTezMerkezi/TezGoster?key=NtBAevXNhYaNqJFoAcdBdqVo76lvn8vwcZxR5EpWBUP8DdPMnCA3xF9tUvjjwrle

18. Yalçın İ. Evlilik Öncesi Çift Eğitimi Üzerine Bir Derleme. Kriz Dergisi. 2009;17(3), 9-22. https://doi.org/10.1501/kriz_0000000302

19. Ökten B. Premarital education programs and their practical impacts in Türkiye. OPUS– Journal of Society Research. 2025;22(5), 1104-1120. https://doi.org/10.26466/opusjsr.1771068

20. Barton AW, Futris TG, Bradley RC. Changes following premarital education for couples with differing degrees of future marital risk. Journal of Marital and Family Therapy. 2014;40(2), 165-177. https://doi.org/10.1111/jmft.12006

21. Williamson HC, Hammett JF, Ross JM, Karney BR, Bradbury TN. Premarital education and later relationship help-seeking. Journal of Family Psychology. 2018;32(2), 276. https://doi.org/10.1037/fam0000383

22. Busby DM, Ivey DC, Harris SM, Ates C. Self‐directed, therapist‐directed, and assessment‐based interventions for premarital couples. Family Relations. 2007;56(3), 279-290. https://doi.org/10.1111/j.1741-3729.2007.00459.x

23. Carlson RG, Daire AP, Munyon MD, Young ME. A comparison of cohabiting and noncohabiting couples who participated in premarital counseling using the PREPARE model. The Family Journal. 2012;20(2), 123-130. https://doi.org/10.1177/1066480712441588

24. Futris TG, Barton AW, Aholou TM, Seponski DM. The impact of PREPARE on engaged couples: Variations by delivery format. Journal of Couple & Relationship Therapy. 2011;10(1), 69-86. https://doi.org/10.1080/15332691.2011.539175

25. Larson JH, Vatter RS, Galbraith RC, Holman TB, Stahmann RF. The relationship evaluation (RELATE) with therapist‐assisted interpretation: Short‐term effects on premarital relationships. Journal of marital and family therapy. 2007;33(3), 364-374. https://doi.org/10.1111/j.1752-0606.2007.00036.x

26. Markman HJ, Renick MJ, Floyd FJ, Stanley SM, Clements M. Preventing marital distress through communication and conflict management training: A 4-and 5-year follow-up. Journal of consulting and clinical psychology. 1993;61(1), 70. https://doi.org/10.1037/0022-006x.61.1.70

27. Ridley, C. A., Jorgensen, S. R., Morgan, A. G., & Avery, A. W. (1982). Relationship enhancement with premarital couples: An assessment of effects on relationship quality. American Journal of Family Therapy, 10(3), 41-48. https://doi.org/10.1080/01926188208250087