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Romantic relationships are a key health determinant underlying both morbidity and mortality. Dr. Janice Kiecolt-Glaser's prolific research revealed cardiovascular, metabolic, endocrine, and immune pathways connecting marriage to health and longevity. In addition to her empirical work, she developed conceptual models on marriage, the gut microbiome, stress reactivity, and spousal health concordance; these models guide and inspire mechanistic research, serve as essential readings for graduate students and mentees, and provide inspiration for researchers across career stages. This paper highlights Dr. Kiecolt-Glaser's influential work, includes personal reflections and professional growth as past mentees, and provides Dr. Kiecolt-Glaser-inspired evidence linking relationships to health among couples in breast cancer survivorship. Using baseline questionnaires and daily dairies, breast cancer survivors (stage I-IIIB) and their cohabiting partners (60 individuals, 30 couples) rated their relationship satisfaction, stress, and physical health symptoms every day for 7 days. Results suggest that breast cancer survivors and their partners who felt more satisfied with their relationships also felt less stressed, both typically and on a daily basis. Survivors' and partners' lower stress was also associated with fewer physical health problems on average and in daily life. These findings demonstrate the daily stress and health advantages of satisfying relationships for both breast cancer survivors and their partners. We discuss the study's implications and several avenues for Dr. Kiecolt-Glaser-inspired research addressing a relationship's long-term health impact among couples in survivorship.

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Although attachment insecurity has been linked to sexual dissatisfaction in cross-sectional research, little is known about the mechanisms by which attachment is associated with sexual satisfaction over time. This study examined the role of attachment insecurities in sexual satisfaction over time using the Interpersonal Exchange Model of Sexual Satisfaction (IEMSS) as a theoretical framework. Participants were 151 Canadian mixed-gender couples in a long-term relationship (M = 9.7 years) who completed questionnaires at two time points. The results demonstrate that sexual exchanges explained the associations between attachment insecurities (anxiety and avoidance) and sexual satisfaction in both men and women in long-term relationships, although the specific pathways differed by gender. These results are discussed in the context of the IEMSS and attachment theory.

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Banking of umbilical cord blood (UCB) is performed to collect and store umbilical cord stem cells. Both public and private cord blood banks have been established around the world. The study aimed to determine the level of awareness of UCB banking among pregnant couples and to assess the attitude of the couples toward UCB banking. We also tried to explore the factors influencing the UCB banking donation and the couple's expectations of UCB banking in the future. A prevalidated questionnaire on UCB banking was administered, and the interview was conducted among the same pregnant couples (both husband and wife) attending the obstetrics and gynecology (OBG) outpatient department (OPD). Only 28% (N = 121) of the participants had heard of UCB banking, and only 12% had correct knowledge of UCB banking. Only 4.9% of participants had heard of public or private UCB banks. Only one couple of 121 has stored UCB in their previous pregnancy, and about 36% of couples were willing to store their newborn's UCB in the present pregnancy. Poor understanding continues to be a significant barrier to reaping the benefits of UCB and preservation. Obstetricians and pediatricians should take a more active role in educating patients about the benefits and drawbacks of UCB banking.

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Systemic theories addressing posttraumatic stress disorder (PTSD) in couples postulate associations between primary trauma survivor functioning, secondary trauma survivor functioning, and couple functioning. However, there is a lack of examination of the association between secondary trauma survivor functioning and couple functioning, which has clinical implications. Objectives of this study include informing clinicians of the evidence base for these associations and providing a synthesized review of research on PTSD in couples to inform future research. A systematic research synthesis screening 150 articles from three databases resulted in the inclusion of 15 quantitative articles to examine the quality of the available research addressing the association between secondary trauma survivor functioning and couple functioning. Correlation matrices in all studies and other partial evidence supported the current theory positing the relevance of secondary traumatic stress in interpersonal functioning for couples. Discussion includes the need for increased quality and diversity of systemic trauma research and treatment for couples.

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This study investigates baseline differences in couples enrolled in the "It Takes Two" HIV prevention intervention for transgender women and their partners, comparing in-person participation pre-COVID-19 and digital participation during the pandemic. Among 52 couples (40% in-person, 60% digital), bivariate analyses revealed that in-person participants were more likely to be African American, have cisgender male partners, report higher unemployment, incarceration histories, greater relationship stigma, and lower relationship quality. The findings highlight the limitations of digital modalities in engaging transgender women of color and those with structural vulnerabilities. The study emphasizes that reliance on digital methods in HIV research jeopardizes the inclusion of those lacking technological access and literacy, especially communities disproportionately impacted by HIV. Researchers must incorporate hybrid or in-person options and engage communities to ensure equity and inclusion, thus overcoming barriers and ensuring comprehensive population reach in HIV prevention studies.

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Reciprocal in vitro fertilization (IVF) and intravaginal culture (IVC) are two technologies that allow same sex female couples to jointly contribute biologically to a pregnancy. This systematic review aimed to synthesize clinical outcomes of each method including live birth rate, clinical pregnancy rate, embryo quality, and perinatal complications. A dual reviewer protocol identified eight studies on reciprocal IVF and ten studies on IVC. In retrospective studies reporting on a total of 1405 reciprocal IVF cycles, reciprocal IVF has demonstrated similar cycle and pregnancy outcomes to autologous IVF. The one study that reported on pregnancy complications found a comparable rate of hypertensive disease of pregnancy between patients undergoing reciprocal IVF and intrauterine insemination. However, a lack of prospective studies on reciprocal IVF limit the generalizability of these results. Overall, small prospective and retrospective studies reporting on a total of 776 IVC cycles show that IVC offers good cycle and pregnancy outcomes, comparable to IVF. However, randomized prospective studies reported that the rate of quality embryo creation in IVC may be lower than in IVF. While both reciprocal IVF and IVC show promise for same sex female couples and the larger LGBTQIA+ (lesbian, gay, bisexual, transgender, intersex, asexual, and other sexual or gender minorities) community, this review has highlighted the need for larger, prospective, more diverse studies on methods of shared biological contribution for family building.

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Integrative Behavioral Couple Therapy (IBCT) posits that couple distress can, in part, be attributed to four factors labeled with the acronym DEEP: natural Uifferences between partners in their perspectives, beliefs, interests, and personalities, partner's Emotional sensitivities related to these differences, the External, contextual stressors that often exacerbate their differences and sensitivities, and the resultant Patterns of distressed interaction. Although an extensive assessment process captures these four components and thus tailors targets for intervention based on the unique characteristics of each couple, it does not explicitly consider the uniqueness of African American couples. Given the historical and contemporary realities that African American couples face (e.g., anti-Black racism), the purpose of this article is to help clinicians use IBCT with African American couples in a culturally responsive way. We begin this article by highlighting the unique needs of African American couples. We then provide a broad overview of the benefits of adopting a multicultural lens of awareness, knowledge, and skills in clinical work, present an atheoretical overview of IBCT, and offer specific recommendations to attend to the unique cultural experiences of African American couples. Finally, we present a case study to exemplify our suggestions and highlight implications of using IBCT with African American couples in a culturally responsible way.

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Despite an established link between personality traits and relationship outcomes, few studies have examined whether personality impacts outcomes of couple interventions. Given the growing popularity of online relationship services, we examined whether Five-Factor Model personality traits moderated change in relationship satisfaction, relationship confidence, and depressive symptoms of couples completing the web-based OurRelationship program. Three-hundred couples were randomly assigned to the program or to a waitlist control group and were repeatedly assessed using self-report measures of relationship satisfaction, relationship confidence, and depressive symptoms. Overall, results suggested that Five-Factor Model personality traits are mostly unrelated to changes in individual and interpersonal well-being. However, across conditions, higher levels of neuroticism predicted a smaller decrease in depressive symptoms (Aim 1). In addition, the effects of the intervention (versus control) on change in relationship satisfaction and depressive symptoms were moderated by neuroticism, such that high levels of neuroticism predicted stronger intervention effects on relationship satisfaction and depressive symptoms (Aim 2). Lastly, the effects of conscientiousness and neuroticism on changes in depressive symptoms were partially mediated by baseline levels of depressive symptoms. These findings suggest that the OurRelationship program may already contain elements that address behaviors associated with high or low personality trait levels and that higher levels of neuroticism may actually augment intervention effects on relationship satisfaction and depressive symptoms. Given the inconsistency of our findings across the various outcomes as well as personality, further research is needed to determine the role of personality in web-based couple interventions.

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OBJECTIVES: To contribute to a better understanding of the complexities of social support exchanged within couples coping with Parkinson's disease (PD), the present study aimed to identify costs and complications of support between persons with PD (PWPs) and their partners, as well as how to effectively manage such challenges. METHODS: In-depth interviews were conducted with 63 participants, including 31 PWPs and 32 partners. Interviews were transcribed and analyzed using constant comparative techniques. RESULTS: Participants reported the following complications and costs of social support: partners' differing approaches to coping can make support difficult, support can be perceived as identity-threatening and controlling, support can lead to dependency, and support can be draining. In addition, participants discussed effectively managing challenges of support by seeking/providing support subtly, taking the other's perspective, and relinquishing control. DISCUSSION: In health care and interventions, it is important for PWPs and partners to be educated about social support so that couples can anticipate these costs and complications of support and consider which management strategies are likely to be effective for them in various circumstances.

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In the pursuit of rapid atomic migration in lightweight Fe-Al diffusion couples, rationally designing short-circuit diffusion paths has become paramount. Herein, a strain-mediated defect engineering strategy was proposed for reducing the vacancy activation energy and enhancing diffusion behaviors along dislocations (DLs) and grain boundaries (GBs). Combining the modified Arrhenius-type relationship, an interfacial apparent activation energy of 139 kJ mol-1 was acquired utilizing defect engineering, which was decreased by about 49%. This was closely related to high-density vacancies, DLs, and GBs formed in strained Fe and Al materials, which provided more low activation energy paths for atomic migration. First-principles calculations indicated that the lattice diffusion barrier mediated by monovacancy was reduced with strain incorporation, attributed to the weakened atom-vacancy bond as a consequence of less electron transport. The synergistic effect of abnormal electron-charge distribution in the bulk and strong attraction force at the Al/Fe interface radically resulted in rapid atomic migration, collectively regulating the "breaking-forming bond" process.

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Despite the repeal of "Don't Ask, Don't Tell" (DADT) over a decade ago, military processes and policies continue to function as significant structural and institutional barriers to research aimed at optimizing resources for military couples and families with marginalized sexual identities. Such research is essential given the apparent mental health and related disparities among lesbian, gay, bisexual, and those with other marginalized sexual identities (LGB+) active-duty service members (SMs), as well as the absence of appropriately tailored resources to support these members of the military community. In this paper, we review the empirical literature on the experiences and psychological health of LGB+ military couples, revealing severe limitations in our understanding of these diverse military romantic partnerships. We illuminate process-related barriers to conducting this essential research through an illustrative case example. Our review concludes with specific recommendations for reform and advocacy distinguished by coordinated efforts inclusive of all five military branches, policymakers, military leaders, researchers, and LGB+ stakeholders.

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Parents who have experienced cumulative childhood interpersonal trauma (CCIT, i.e., an accumulation of different types of abuse) tend to experience higher parental stress following the birth of a child. As CCIT is associated with lower levels of partner support, which is linked to increased parental stress, partner support could explain the link between CCIT and parental stress. Yet, these variables have never been studied using a dyadic approach. This study examined the role of received and provided partner support in the association between CCIT and parental stress. A randomly selected sample of 1119 couples with infants completed online questionnaires assessing CCIT, partner support, and parental stress. An actor-partner interdependence model path analysis showed that both parents' CCIT were associated with increased paternal stress through fathers' lower received and provided support, and with increased maternal stress through mothers' received and provided support. Overall, the findings highlight the significance of examining the interdependence between both parents' experience and the role of partner support as a key factor explaining the link between CCIT and parental stress, thereby emphasizing its importance as an intervention target.

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We piloted the delivery of a prototype couples-focused intervention, 'Diabetes Together' with 14 people living with diabetes (PLWD) and their partners, in Cape Town, South Africa in 2022. We aimed to: assess feasibility of recruiting couples in this setting; explore acceptability of intervention materials and changes needed; and investigate whether our prespecified logic model captured how the intervention may work. We used questionnaires, interviews and focus groups after each workshop and after couples completed counselling. We conducted a process evaluation to identify intervention modifications and used inductive thematic analysis to explore whether the data supported our logic model. Twelve of the 14 couples completed the second workshop and 2 couples completed two counselling sessions post-workshop. Feedback showed participants appreciated the intervention and limited improvements were made. Thematic analysis identified four main themes: (1) involving partners matters; (2) group work supports solidarity with other couples; (3) improving communication between partners is crucial; and (4) taking part helped couples to take control of diabetes. Data suggested the logic model should explicitly acknowledge the importance of group education and of equalising partners' knowledge. This pilot suggests that 'Diabetes Together' increased knowledge and skills within couples and could facilitate improved, collaborative self-management of diabetes.

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BACKGROUND: Technology has become an integral part of our everyday life, and its use to manage and study health is no exception. Romantic partners play a critical role in managing chronic health conditions as they tend to be a primary source of support. OBJECTIVE: This study tests the feasibility of using commercial wearables to monitor couples' unique way of communicating and supporting each other and documents the physiological correlates of interpersonal dynamics (ie, heart rate linkage). METHODS: We analyzed 617 audio recordings of 5-minute duration (384 with concurrent heart rate data) and 527 brief self-reports collected from 11 couples in which 1 partner had type II diabetes during the course of their typical daily lives. Audio data were coded by trained raters for social support. The extent to which heart rate fluctuations were linked among couples was quantified using cross-correlations. Random-intercept multilevel models explored whether cross-correlations might differ by social contexts and exchanges. RESULTS: Sixty percent of audio recordings captured speech between partners and partners reported personal contact with each other in 75% of self-reports. Based on the coding, social support was found in 6% of recordings, whereas at least 1 partner self-reported social support about half the time (53%). Couples, on average, showed small to moderate interconnections in their heart rate fluctuations (r=0.04-0.22). Couples also varied in the extent to which there was lagged linkage, that is, meaning that changes in one partner's heart rate tended to precede changes in the other partner's heart rate. Exploratory analyses showed that heart rate linkage was stronger (1) in rater-coded partner conversations (vs moments of no rater-coded partner conversations: rdiff=0.13; P=.03), (2) when partners self-reported interpersonal contact (vs moments of no self-reported interpersonal contact: rdiff=0.20; P<.001), and (3) when partners self-reported social support exchanges (vs moments of no self-reported social support exchange: rdiff=0.15; P=.004). CONCLUSIONS: Our study provides initial evidence for the utility of using wearables to collect biopsychosocial data in couples managing a chronic health condition in daily life. Specifically, heart rate linkage might play a role in fostering chronic disease management as a couple. Insights from collecting such data could inform future technology interventions to promote healthy lifestyle engagement and adaptive chronic disease management. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/13685.

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OBJECTIVES: This study examines the extent to which healthy lifestyle behaviours co-occur in individuals. We also explore within-couples concordance in healthy lifestyle behaviours in Namibia. STUDY DESIGN: Cross-sectional study. METHODS: We used data from 910 couples (1820 individuals) who were interviewed in the Namibia Demographic and Health Survey conducted in 2013. We assessed five different healthy lifestyle behaviours (alcohol non-consumption, non-cigarette smoking, healthy diet, physical exercise, and normal body mass index). An individual healthy lifestyle index (HLI) was derived by summing values across the five behaviours, with a binary indicator categorising each individual's lifestyle behaviour as 'healthy' (HLI ≥ 3) or 'unhealthy' (HLI < 3). Multivariate logistic regression models were fitted to explore the association between binary indicators of men's and their female partner's healthy lifestyles. RESULTS: About 48% of men and 57% of women had at least three co-occurring healthy lifestyle behaviours. A third of couples were concordant in reporting a healthy lifestyle (HLI ≥ 3), while 27% were concordant in reporting an unhealthy lifestyle (HLI < 3). In multivariate analysis, Namibian men were almost twice (aOR, 1.90; 95%CI, 1.43-2.52) as likely to have a healthy lifestyle if their female partner also had a healthy lifestyle, compared with those who had a female partner who had an unhealthy lifestyle, after adjusting for relevant individual, partner and household characteristics. CONCLUSION: The observed co-occurrence of healthy lifestyle behaviours and spousal concordance suggests it may be beneficial to consider couples a target for intervention when aiming to promote healthy behaviours and reduce cardiovascular diseases in Namibia.

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This paper illustrates a rigorous approach to the initial phases of scale development when evaluating an existing construct, dyadic efficacy, in a new population. Cancer-related dyadic efficacy represents a couples' confidence in their conjoint abilities to manage the effects of cancer. Two samples of individuals diagnosed with cancer and their partners, along with a professional panel, contributed lay and content expertise, respectively. Thematic analysis was used to describe cancer-related dyadic efficacy and identify content domains. Cancer-related dyadic efficacy was conceptualized as multidimensional, consistent with relational functioning, and distinct from self-efficacy. A pool of 50 items was developed to assess eight content domains grouped into three main themes: dyadic efficacy for managing (a) illness intrusions, (b) emotional responses and (c) communication and care for children. This paper responds to calls for more rigorous reporting of the qualitative procedures required to establish a conceptual grounding for a new scale.

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Background: Antiretroviral therapy has helped human immunodeficiency virus (HIV)-infected people live an enhanced quality of life and attempt for a pregnancy, without placing their partner at risk. Although periconceptional pre-exposure prophylaxis for the uninfected partner and consistent antiretroviral therapy for the HIV-infected partner are important to prevent HIV transmission, semen washing could be a great option to further reduce the semen viral load. Aim: The aim of this study were as follows: to determine if semen washing with intrauterine insemination provides an added safety net to HIV-serodiscordant couples when the male partner is HIV-infected and virally suppressed and to determine if the U = U concept (undetectable = untransmittable) holds true in virally suppressed HIV-infected males. Settings and Design: This was an observational study conducted in seropositive HIV men under treatment with highly active antiretroviral therapy (HAART) in collaboration with Metropolis Laboratory, a CAP recognised private Healthcare Laboratory in Mumbai, India. Materials and Methods: Blood and semen samples were collected from a total of 110 adult HIV-1-infected males virally suppressed on HAART. These samples were processed to assess the viral load in plasma as well as raw and processed semen fractions. Statistical Analysis Used: Descriptive statistics were used to analyse the data. Results: Only men with plasma viral loads < 1000 copies were selected in our study. Out of the 110 HIV-infected individuals, 102 (92.73%) patients had undetectable (<20 copies/ml) plasma viral load while 8 (7.27%) patients had a detectable (>20 copies/ml) viral load, who were excluded from the study. In the virally suppressed 102 men, the raw semen samples of 100 men showed an undetectable viral load, while 2 samples showed detectable contamination, even though their plasma samples from the blood showed a viral load of <20 copies/ml. The semen was then separated into the sperm and the seminal plasma samples. The seminal plasma had <20 copies/ml in 95 samples (93.14%) but a detectable viral load in 7 (6.86%) samples. After subjecting all the 102 processed (post-wash) sperm samples to quantitative analysis, an undetectable viral load of <20 copies/ml was found in all the samples. Thus, the raw sample (prewashed),seminal plasma and processed (postwash) samples were evaluated. The post-wash sperm sample showing zero contamination was frozen for intrauterine insemination (IUI) in the uninfected female partner. Conclusions: Semen washing with IUI should be advocated as a safe, efficacious way to increase the safety net and to further reduce the minimal risk of HIV transmission in serodiscordant couples in addition to the U = U concept.

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BACKGROUND: Aphasia impacts communication and relationships. While counselling is increasingly recognised as a component of the speech-language therapy role, the success of conversation partner training is typically measured in terms of communication alone. This scoping review aimed to describe how successful conversation is currently measured with couples-with and without aphasia, to inform the development of an ecologically valid measure for couples with aphasia. METHODS AND PROCEDURES: The scoping review was reported in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extensions for Scoping Reviews (PRISMA-SCR). MEDLINE, EMBASE, CINAHL and PsycINFO databases were searched for conversation treatment studies for couples with and without aphasia. Patient-reported outcome measures (PROMs) were extracted from included studies and screened against the three-tier model of situated language to shortlist those that measure everyday communication. Items within shortlisted PROMs were further described using the refined International Classification of Functioning, Disability and Health linking rules. RESULTS: Following screening and full-text review, 46 studies were included, consisting of 24 studies conducted with couples with aphasia and 22 studies conducted with couples without aphasia. For couples with aphasia, 13 PROMs were identified that measured everyday communication. Of these, 23% were dyadic (i.e., measured from the perspectives of both members of the couple); however, they usually only appraised the communication behaviours of the person with aphasia. For couples without aphasia, eight PROMs were identified that measured everyday communication; all were dyadic and measured both attitudes and communication behaviours of both partners. CONCLUSION: Conversation relies on the interaction of two people, and success in conversation is best rated by those having the conversation. The use of PROMs is recommended as part of person and relationship-centred practice; however, there is currently no validated PROM for conversation in aphasia that considers the perspectives and behaviours of both the person with aphasia and their communication partner. The PROM items identified in this study will form the basis of future research to develop a PROM for couples' conversations in aphasia. WHAT THIS PAPER ADDS: What is already known on the subject Communication partner training (CPT) for couples, where one person has aphasia, can improve conversation skills and enhance relationships. Clinician-rated measures, such as conversation analysis, have been used to measure the outcomes of CPT. However, there is a lack of person-centred or self-rated outcome measurement instruments. that is, patient-reported outcome measures (PROMs) for couples' conversations in aphasia. What this paper adds to existing knowledge We have identified outcome measurement instruments used in conversation treatment studies for couples with and without aphasia. We found that most PROMs used in aphasia treatment studies were not dyadic, that is, they did not include the self-report of both communication partners. In contrast, the PROMs used with couples without aphasia were dyadic and contained items that measured a more complex range of both partners' emotions, behaviours and attitudes. What are the potential or actual clinical implications of this work? This study provides insights into the content and characteristics of PROMs for couples' conversation therapy and may assist clinicians in selecting outcome measurement instruments in their practice.

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BACKGROUND: Pregnancy loss affects 1 in 4 women and is linked with poorer overall health and relationship outcomes. Despite sexual well-being's importance to health, how sexual well-being changes across time after a pregnancy loss and what might predict such changes, like perinatal grief, have never been examined, leaving practitioners and couples without knowledge of what to expect. AIM: We aimed to examine (1) how sexual satisfaction, sexual desire, sexual distress, and perinatal grief change from 10 to 25 weeks postloss for both couple members; and (2) if perinatal grief levels at 10 weeks postloss predict sexual well-being trajectories. METHODS: Women and gender-diverse individuals who were pregnant when a pregnancy loss occurred (within the last 4 months) and men, women, and gender-diverse partners who were not pregnant (N = 132 couples) independently completed 4 monthly assessments of sexual well-being and perinatal grief. OUTCOMES: Outcomes included sexual satisfaction (Global Measure of Sexual Satisfaction), sexual desire (Sexual Desire Inventory), sexual distress (Sexual Distress Scale-Short Form), perinatal grief (Perinatal Grief Scale). RESULTS: Dyadic growth curve modeling indicated that, from 10 to 25 weeks postloss, both couple members' sexual satisfaction increased, and their sexual desire remained stable; sexual distress decreased for partners but remained stable for individuals who were pregnant; and both couple members' perinatal grief decreased. Perinatal grief levels at 10 weeks postloss did not predict sexual well-being trajectories over time. CLINICAL IMPLICATIONS: Given sexual well-being's dynamic nature, clinicians should regularly discuss sexuality with both couple members after pregnancy loss. During such discussions, clinicians could reassure couples about their sexual relationship's recovery by sharing that, on average, sexual satisfaction, sexual desire, and sexual distress tend to improve or stay the same (rather than worsen) from 10 to 25 weeks postloss. They can also share that perinatal grief tends to decrease during this time and is unrelated to trajectories of sexual satisfaction, sexual desire, and sexual distress. STRENGTHS AND LIMITATIONS: This is the first study, to our knowledge, to examine how sexual well-being changes across time after a pregnancy loss and perinatal grief's role in such changes. The results may not generalize broadly, as most couples were in mixed-gender/sex relationships, identified as White, and were relatively affluent. CONCLUSION: From 10 to 25 weeks postloss, both couple members tend to experience improvements in their overall sexual well-being and declines in their perinatal grief. Early perinatal grief levels and subsequent sexual well-being trajectories are seemingly unrelated.

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Background and Aims: Metabolic syndrome (MetS) is a major risk factor for non-communicable diseases, including type 2 diabetes mellitus, cardiovascular disease, and cancer. The risk of MetS can be transmitted via epigenetic processes from both the mother and the father. Therefore, it is essential that both members of a couple are targeted in pre-conception nutrition and physical activity-based lifestyle programs. However, lifestyle interventions targeting both members of a couple are scarce in the literature. This study, therefore, aimed to explore the barriers and facilitators of a couples-based lifestyle intervention. Methods: Nulliparous couples who had an interest in having children in the future were recruited to the study and each member interviewed separately to gain insight into to gain insight into designing future couples-based lifestyle interventions. Interviews were conducted between June and October 2021. Reflexive thematic analysis (RTA) was applied to conduct and analyse semi-structured, in-depth interviews with nulliparous couples who had an interest in having children in the future. Results: Four major themes were identified in nine couples aged 25-34 years (here referred to as "millennials"): Millennials are committed to preparation for their future offspring; millennials know features of a good program likely to have high adherence and long-term behavior change; millennials acknowledge the importance of couples-based programs; and millennials appreciate that future global emergencies may require lifestyle modifications. Conclusion: This study found that millennial couples showed a strong intention to create optimal emotional, financial, and health conditions for their children. They supported couples-based approach (CBA) lifestyle interventions to mitigate potential epigenetic risks. Couples believed that participating together in these programs would enhance adherence to healthy habits, promoting long-term well-being. The findings advocate for exploring and testing CBA interventions that target both partners, as joint participation not only aids in healthy conception and reduces metabolic syndrome risks but also establishes a foundation for family health. These insights highlight the potential of CBA interventions to positively impact future generations.