2 - (OP9) Development and Pilot Trial of a Self-guided Dyadic Positive Psychology Intervention: Reimagining Us in the Context of Bariatric Surgery (ReConnect)

Background: Bariatric surgery is the leading evidence-based treatment for severe obesity in terms of improvements in physical health and quality of life, yet psychosocial challenges – including declines in relationship satisfaction and coping – often emerge in the years following surgery. Existing interventions typically focus on the individual patient and their risk or pathology, leaving relational contexts and strengths-based approaches under-utilized in an already highly-stigmatized population. To fill this gap, my team developed ReConnect (Reimagining Us in the Context of Bariatric Surgery), a fully remote, self-administered, dyadic intervention grounded in positive psychology principles and designed for patients and romantic partners.

Methods: Guided by the ORBIT model for behavioral intervention development, we employed an iterative, patient-centered development process, utilizing both qualitative and quantitative methods. Phase I (Define/Refine) involved analysis of possible treatment targets in our large clinical-research database, followed by focus groups and module testing and optimization with 6 post-bariatric surgery couples to inform adaptation of positive psychology strategies for this context. Couples highlighted unmet needs for partner-inclusive support, desire for strengths-based approaches, and barriers to accessibility of existing interventions. Feedback resulted in an 8-module program targeting gratitude, values and meaning, intimacy, and adaptive coping. Phase II (Preliminary Testing) evaluated feasibility, acceptability, and proof-of-concept in an NIH/NCATS K12-funded randomized waitlist-control pilot trial (N=40 couples; ClinicalTrials.gov ID#NCT05958615). Couples included one partner who was 1-3 years post-bariatric surgery, diverse in age (26-64), relationship length (3-45 years), and demographics (42% racial/ethnic minority; 18% LGBTQ+).

Results: Pre-specified feasibility metrics were exceeded: retention>80% (97.5%), weekly surveys and intervention activity completion >70% (89.5%), outcome assessment completion >90% (97.5%). Satisfaction was high (patients: 3.3/4, partners: 3.3/4) with the module for channeling strengths and positive focus rated most beneficial. Qualitative feedback reinforced acceptability. Proof-of-concept analyses suggest plausible clinically relevant improvements in depressive symptoms, anxiety, healthy eating, and physical activity for both patients and partners.

Conclusions: These findings support progression to a fully powered efficacy trial and further exploration of mediators and moderators of treatment effects. ReConnect demonstrates the feasibility and promise of a dyadic, strengths-focused approach that is fully remote and accessible, aligning with WCCBT’s vision for equitable and sustainable interventions. This work illustrates the value of integrating positive psychology and couples-level intervention strategies within behavioral medicine.