Chaney et al (Funhaler study) Flashcards
Carried out in?,, Chaney
2004
Operant conditioning?,, Chaney
comes from Thorndike’s “law of effect”
If as a result of a behaviour something nice occurs, then we are likely to repeat it. If the result of a behaviour is something nasty occurs, the opposite. ~ learning.
Positive reinforcement?
Negative reinforcement ?
,,Chaney
Positive reinforcement ~ A nice consequence of an action, it encourages the learning of a desired behaviour.
Negative reinforcement ~ A nasty consequence of an action, It discourages undesired or unsuitable behaviour.
Theories/ background?
Chaney
The most important advance made by the behaviorists were the development of classical and operant conditioning.
Humans learn from positive/negative rewards/outcomes. Learn from positive/ negative reinforcement.
Humans will continue to perform behaviors which have positive rewards or outcomes and cease to perform behaviors which are coupled with negative rewards or outcomes (Thorndike’s law of effect)
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Parents reinforce pain behaviour:
If a child is in pain, it’s a natural reaction or caregiver to give the child lots of cuddles/ attention/ treats.
Chaney wanted to find out if this kind of rewarding behavior mentioned above could be given to increase health behavior rather than illness behavior.
In this case it was to encourage children to use their inhalers correctly if they had asthma.
Aim?
Chaney
To was the use of a novel asthma spacer device, the “funhaler”, which incorporates incentive toys isolated from the main inspiratory circuit by a valve. This novel inhaler, whilst not comporisinsing drug delivery, can provide reinforcement; which then leads to improved adherence to regular use in young asthmatics.
People used in the study?
Chaney
32 australian, asthmatic children (22 boys and 10 girls)
Ages ranges 1.5-6 years old (mean age 3.2)
Average time since first diagnosed with asthma: 2.2 years.
Method and design?
Chaney
Field experiment
Repeated measures designs
Variables?
Chaney
IV: Weather the child was using a standard/small volume spacer device ( the ‘breath-a-tech’ inhaler)
IV: or whether the child was using the novel ‘funhaler’
DV: A measure of the children’s adherence to their medical regime.
Procedures?
Chaney
Prior to procedures commencing, a comparison was made between the aerosol output of the standard/small volume spacer device and the funhale.
NO significant difference were observed; so the same levels of medication would be delivered by both devices (important control of a potential confounding variable)
Confounding variables ~ an influence that interferes with an accurate measurement between the independent and dependent variable.
Examples:
Order effects
Participant variability
Social desirability effect (want other people to like you)
Hawthorne effect (When you know you’re being watched, you change your behavior)
Demand characteristics
Evaluation apprehension
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Next, each participant was visited in their home (before any mention of the funhaler) Here, the researcher interviewed the parent ( using a standardised questionnaire) on their child’s existing use of a standard inhaler.
The children, via parents, were told to use their normal inhaler for 2 weeks, and then the funhaler for 2 weeks.
The funhaler employed a number of entertaining features to distract the attention of children from drug delivery and to positively reinforce correct use of the device.
The parents’ of the participants, then completed matching questionnaires after each inhaler.
Also, during the course of the study each parent was asked at random, whether they attempted to medicate their child the day before.
Findings/ results?
Chaney
1-
81% more children took the correct medical dosage when using the funhaler compared to using their normal inhaler.
2-
A significant number of parents (73%) reported they preferred using the funhaler for their child, compared to using the normal inhaler.
3-
Overall using distracting, pleasure association; the funhaler increased adherence to the child’s medication routine.
Conclusions?
Chaney
1-
A child’s adherence to regular medication can be improved and this improvement maintained, if it includes a rewarding experience.
2-
The funhaler had the potential, to be a useful device in managing medication for young asthmatics (application)
3-
The use of behavioural techniques (both operant and classic) could be expanded for similar use in other medical areas (application)
Notes on behaviourism!
What is Operant conditioning?
What is Classical conditioning?
Operant conditioning:
A behaviorist theory by skinner and explains how behavior is learned as a result of consequences. The child learns the result of using the new funhaler is more fun that using the old inhaler.
(Learning through consequences of voluntary action (skinner and behaviourism))
Classical conditioning :
Child learns to associate 2 stimuli in a positive or negative way. Child could come to associate the old inhaler with a negative experience (boring and stop them playing) and the funhaler as a positive experience (conditions taking medication with fun)
(Learning through reinforcements (Pavlov and behaviorism))
Evaluations ?
Chaney
Demand characteristics and social desirability: the nature of this experiment and the involvement of the parent’s self-reporting suggests that just participating in this study may have led parents to increase their children’s adherence to their asthma medication and to self-report as such in order to not appear bad or neglectful parents.
Generalisability: the small and narrow sample of Australian Asthmatice children, plus the application to just 1 specific treatment, makes the results of this study difficult to generalise to a larger population.
Usefulness: Despite restricted generalisability, the study is useful because it suggests that behaviourist techniques can be used to enhance adherence to medical regimes; however, small sample size, narrow geographic location and just one type of medication. Suggests more research is needed.
Internal validity: The study has clearly defined manipulated and measured variables. Also steps to control confounding variables (e.g. equal dosage)
Ecological validity: The task which the children had to complete was simple and was close to real life (it was conducted in their homes)
Some final evaluative points?
Chaney
This study would have benefitted from a control group (placebo), to investigate the extent to which just educating parents with the old inhalers may have imported the child’s adherence.
More research or a follow-up say 6 months later) would have been useful to investigate the efficacy of the procedure for long-term improvement in adherence. Becomes the “normal” and the excitement and thrill may die down of the reward.
