Chaney et al

Chaney et al

1. Background

   • Environment a child is brought up in will have an affect on their behaviour - reinforcement
     • Chaney wanted to see if this was the same in context of reinforcement in a health setting

2. Aims

   • If rewards could be used to increase health behaviours rather than illness behaviours

3. Research Method

   • Field experiment
     • The questionnaires, phone interviews were conducted in the children's own home

4. Experimental Design

   • Repeated measures
     • In order to find out if compliance increased needed to use the same people

5. Sample

   • 32 children, aged 1.5 - 6 years, 22 boys 10 girls from Australia
     • Recruited at random from paediatrician or GP clinics
     • Clinics all located within 51km radius of Perth, Western Australia, spanned different socioeconomic areas

6. Procedure

   • IV: Inhaler used - funhaler or normal aerochamber used
   • DV: 1. Children's behaviour - specifically how frequently the children took their medication and any problems the children had with taking medication; 2.
   • Initial data - questionnaires given to parents to find out about current inhaler, not told about funhaler, all had to sign consent form
   • Data collection (2 weeks) - Parents given funhaler and instructed to see if it had been used the previous day
     • Use of funhaler - steady breath would activate spinning dish & whistle. Face mask used for young children
   • Final data - After 2 week, parents were given another questionnaire to access their behaviour and attitudes towards the funhaler

7. Results

   • Behaviour
     • Percentage of children who used inhaler day before: inhaler - 59; funhaler - 81
     • Percentage of children who achieved 4+ breath cycles per delivery: inhaler - 50; funahaler - 80
     • Percentage of parents who always successfully medicated their child: inhaler - 10; funhaler - 73
   • Attitudes
     • Attitude of children towards medication
       • Inhaler: pleasure - 10, acceptance - 58, suspicion - 0
       • Funhaler: pleasure - 68, acceptance - 19, suspicion - 10
     • Attitudes of parents towards medication
       • Inhaler: completely happy - 10, dislike - 16
       • Funhaler: completely happy - 61, dislike - 0

8. Conclusions

   • Behaviour: significantly more parents were able to successfully medicate using funhaler. Attitudes: 100% of parents completely happy with funhaler

9. Evaluation

   • Sample of 32 Australian children between 1.5 and 6 years (22 boys 10 girls)
     • Strengths: Age appropriate for the target population; funhaler used for younger children. Weaknesses: Narrow age restricts study's generalisability
   • Using self-report questionnaires to collect data about children's adherence to asthma
     • Strengths: Easy to administer to collect thoughts/opinions of parents. Weaknesses: Parent's may not be honest with their answers due to social desirability
   • 'Yes; or 'No' choices mainly ('forced choice' answer)
     • Strengths: Yes/No questions makes it easy to make comparisons etc. Weaknesses: Doesn't tell us why there are any differences in attitude
   • Use of field experiment
     • Strengths: natural home environment makes study high in ecological validity. Weaknesses: Not usual for parent to complete questionnaire every day, reducing ecological validity
   • Use of repeated measures design
     • Strengths: controls participants variables as both conditions are tested with each child. Weaknesses: parents could work out the aim of the study, demand characteristics could be an issue

10. Ethics

    • Protection from harm: all children benefited from the funhaler rather than suffering. Consent: All parents signed a consent on behalf of the children. Confidentiality: no trace's of children's identities. Ethics = high

11. Reliability

    • Internal - Many controls put in place such as timings, all Ps had same questionnaire
    • External - Only 32 children in unequal gender ratio - can't suggest consistency

12. Validity

    • Internal - self-report - parents can lie about giving funhaler (social desirability) so results may not be accurate
    • External - ecological: took place in children's homes (high). Population: children from Australia don't represent other children/adults

13. Ethnocentrism

    • Not: all children like noise; Is: Only consists of one area in the world, shows response to Western values

14. Summary

    • Developmental area - shows how parents can help acquire desired behaviour - positive reinforcement
    • External influences - Shows new way in which children learn

15. Debates

    • Individual/situational - 81% of children used funhaler, so being given the funhaler makes them want to use it. 19% refused to use it - personality has an affect
    • Usefulness - shows how children develop/acquire behaviour. Can be used to get children to use their inhaler more, improving their health. Useful for doctors to increase compliance by using funhaler
    • Reductionist/holism - simplified behaviour to just funhaler. Ignores factors such as parents and education levels (reductionist)