Expanding Healthy Relationships Across Borders: Dr. Galena Rhoades’ MotherWise Initiative in Nicaragua
Dr. Galena Rhoades, a clinical psychologist and relationship education expert at Thriving Families, and her colleagues at University of Denver, Amanda Love and Dr. Maria-Ernestina Christl, are leading a culturally grounded expansion of the MotherWise program in Nicaragua—a country where the intersecting challenges of poverty, political instability, and intimate partner violence place pregnant and postpartum women at heightened risk. Her project, MotherWise in Nicaragua: The Impact of Culturally-Adapted Relationship Education for Women During Pregnancy and Postpartum, seeks to strengthen maternal well-being and family stability through accessible, evidence-based relationship education.
Originally developed and implemented in Denver, Colorado, MotherWise supports 600–800 women annually, many of whom are recent immigrants or monolingual Spanish speakers. The program combines a six-week group workshop curriculum (Within My Reach) with individualized coaching and case management to teach women skills in healthy communication, decision-making, conflict resolution, and recognizing signs of unhealthy relationships. Rigorous evaluation—including randomized controlled trials—has shown that MotherWise significantly improves outcomes such as birth weight, reduces preterm births by 55%, lowers maternal stress, and increases postpartum healthcare follow-through and contraception use. Importantly, it also helps prevent postpartum depression and reduces acceptance of relationship violence.
In 2021, Dr. Rhoades partnered with Thriving Families and the Health Outreach for Latin America Foundation (HOLA) to bring MotherWise to a small town in Nicaragua. Since then, eleven cohorts have participated, and the early data are promising: 90% of participants reported a stronger understanding of what a healthy relationship looks like, and 88% said they intended to use the skills in their daily lives.
Nicaragua, the second poorest country in the Western Hemisphere, faces systemic barriers to maternal and child health. Rates of maternal and infant mortality are significantly higher than in the U.S., and nearly 1 in 3 women report experiencing physical violence in their lifetime. These conditions underscore the urgent need for culturally responsive, community-based interventions like MotherWise.
Dr. Rhoades’ new phase of research will deepen the evaluation of MotherWise’s impact in Nicaragua through multiple data sources: pre- and post-program surveys, qualitative interviews with participants, and direct observation of program implementation. Her team will analyze changes in communication skills, relationship satisfaction, and attitudes toward violence, and explore how the curriculum might be further adapted to better reflect local cultural values and community needs.
The project also examines implementation fidelity and barriers, with the goal of generating practical recommendations for expanding MotherWise to other Spanish-speaking countries. By identifying which components are most effective and which adaptations enhance engagement, the study will offer a replicable model for delivering relationship education in other under-resourced settings.
Dr. Rhoades’ work aligns strongly with the mission of the Mental Research Institute to support innovative, interactional, and systemic approaches to improving human relationships. Her findings will be shared through peer-reviewed publications, conference presentations, and policy briefs, with the intention of influencing both clinical practice and public health systems. This project offers an inspiring example of how cross-cultural collaboration and community-engaged research can foster healthier families—and futures—worldwide.