Exploring the Potential of a Digital Intervention to Enhance Couple Relationships (the Paired App): Mixed Methods Evaluation (Preprint)

• DOI: 10.2196/preprints.55433
• Publication Date: 2025-04-14T17:05:06Z
• Authors: Catherine Aicken; Jacqui Gabb; Salvatore Di Martino; Tom Witney; Mathijs Lucassen

BACKGROUND Despite the effects of poor relationship quality on individuals’, couples’, and families’ well-being, help seeking often does not occur until problems arise. Digital interventions may lower barriers to engagement with preventive relationship care. The <i>Paired</i> app, launched in October 2020, aims to strengthen and enhance couple relationships. It provides daily questions, quizzes, tips, and detailed content and facilitates in-app sharing of question and quiz responses and tagged content between partners.

OBJECTIVE To explore the potential of mobile health to benefit couple relationships and how it may do this, we examined (1) <i>Paired’s</i> impact on relationship quality and (2) its mechanisms of action.

METHODS This mixed methods evaluation invited <i>Paired</i> subscribers to complete (1) brief longitudinal surveys over 3 months (n=440), (2) a 30-item web-based survey (n=745), and (3) in-depth interviews (n=20). For objective 1, survey results were triangulated to determine associations between relationship quality measures and the duration and frequency of <i>Paired</i> use, and qualitative data were integrated to provide explanatory depth. For objective 2, mechanisms of action were explored using a dominant qualitative approach.

RESULTS Relationship quality improved with increasing duration and frequency of <i>Paired</i> use. Web-based survey data indicate that the Multidimensional Quality of Relationship Scale score (representing relationship quality on a 0-10 scale) was 35.5% higher (95% CI 31.1%-43.7%; <i>P</i>=.002), at 7.03, among people who had used <i>Paired</i> for &gt;3 months compared to 5.19 among new users (≤1 wk use of <i>Paired</i>), a trend supported by the longitudinal data. Of those who had used <i>Paired</i> for &gt;1 month, 64.3% (330/513) agreed that their relationship felt stronger since using the app (95% CI 60.2%-68.4%), with no or minimal demographic differences. Regarding the app’s mechanisms of action, interview accounts demonstrated how it prompted and habituated meaningful communication between partners, both within and outside the app. Couples made regular times in their day to discuss the topics <i>Paired</i> raised. Daily questions were sometimes lighthearted and sometimes concerned topics that couples might find challenging to discuss (eg, money management). Interviewees valued the combination of fun and seriousness. It was easier to discuss challenging topics when they were raised by the “neutral” app, rather than during stressful circumstances or when broached by 1 partner. Engagement seemed to be enhanced by users’ experience of relationship benefits and by the app’s design.

CONCLUSIONS This study demonstrates proof of concept, showing that <i>Paired</i> may have the potential to improve relationship quality over a relatively short time frame. Positive relationship practices became embedded within couples’ daily routines, suggesting that relationship quality improvements might be sustained. Digital interventions can play an important role in the relationship care ecosystem. The mixed methods design enabled triangulation and integration, strengthening our findings. However, app users were self-selecting, and methodological choices impact our findings’ generalizability.