FIG. 1.

Modified couple interdependence conceptual framework. Predisposing characteristics of couples include both intrinsic qualities (e.g., sociodemographic such as age, education, marital status) and variables that have the potential to be modified through intervention (e.g., perception of health threat and couple communication). Transformation of motivation helps couples move from a self-centered understanding of a health issue to a relationship-centered perspective.⁴⁴ This process occurs when health issues are interpreted as having significance for the relationship or family, rather than simply for oneself.⁶⁶ Communal coping is when couples make a joint assessment of a health threat and have a shared vision for managing that threat.⁶⁷ It is influenced by outcome efficacy, or the couple's belief that a solution can be found to the health challenge, and couple relationship efficacy. Communal coping includes enhanced communication, joint decision-making, and working together to try new behaviors.