That online technology can put out information in a flexible, “contagious” and cost effective way is beyond any doubt: the key question for prevention science is whether targeted advice has any consistent impact on outcomes.

A study published in the Journal of Family Psychology, this month, suggests that internet-based interventions are inching toward measurable success.  

It presents results from a second trial of ePREP, a computer-based prevention program developed at Florida State University for teenagers and young adults. The new findings suggest that it can relieve conflict in relationships and improve mental health. 

Students who took part showed lower levels of physical and psychological aggression in their relationships, as well as less anxiety in general. 

Young participants progress through modules that attempt to teach effective communication and problem-solving skills and to enhance positive aspects of romantic relationships. Tuition is delivered entirely online. 

Developers Scott Braithwaite and Frank Fincham tested the effect of ePREP on around 80 psychology students at Florida State who had been in relationships for four months or longer. 

Participants were asked about their relationships and mental health before the program, eight weeks later and then after ten months. 

The authors were not interested in whether the intervention stopped couples breaking up, which they considered to be a healthy aspect of the process of selecting a partner. Improved outcomes were not linked to whether relationships endured.
 
There were indications that program participants suffered less anxiety, to a degree similar to that achieved by evidence-based online interventions focusing on mental health issues. Levels of depression remained unchanged, however. 

A curious pattern emerged: the progress of ePREP participants tended to show a turn for the worse before their responses improved. Levels of anxiety, violence, aggression and communication all deteriorated immediately after the intervention, and then steadily recovered. 

The authors speculate that the new communication skills learned from ePREP tuition may have unearthed and successfully dealt with issues that hitherto had been swept under the carpet. 

Braithwaite and Fincham observe that as well as being flexible and cheap to administer and offering the possibility of successful engagement with the individual, online delivery also has the potential to reach some hard-to-reach sections of the population, such as teenage boys who are technology-savvy but cannot cope with face-to-face relationship education.

Although it reflected the demographics of the psychology department, the Florida student sample included over 70% young women which, developers acknowledge, may have skewed their results. The fact that the program was evaluated in-house using students on site will also be a cause of some concern [See: Why is independent scrutiny only "desirable"?]

Braithwaite and Fincham are optimistic: “Policy makers who are interested in cost and time effective ways to improve outcomes may be particularly interested in the flexibility and cross domain impact offered by ePREP,” they say. 

See: Braithwaite S R and Fincham FD (2009), “A Randomized Clinical Trial of a Computer Based Preventive Intervention: Replication and Extension of ePREP,” Journal of Family Psychology, 23, 1, pp. 32-38