Key study :Yokley And Glenwick Flashcards
Aim
To evaluate the effectiveness of four different conditions for motivating parents of preschool children to get their children immunized
What were the conditions?
a) a mailed general prompt
b) a mailed specific prompt
c) a mailed specific prompt and extended clinic hours to increase access and convenience
d) a mailed specific prompt and a monetary incentive in the form of a cash lottery.
Sample
-1,133 preschoolers aged 5 and under who were immunization-defecient , they needed at least one immunisation.
-There was an even number of boys and girls.
-at a public health clinic at an american city
-64% were caucasian, the mean number of immunizations needed were 5.2.
Describe the procedure
-Families were sent cards that contained prompts to remind them to have their children caught up with immunization.
-Different families were sent different prompts depending on the condition they were in. There were 4 conditions
How many people received each prompt?
General prompt: 195, Specific prompt: 190, Increased access group: 185, Monetary incentive: 183
Describe the General prompt
Families in the general prompt position were mailed a card containing a prompt with general information that lacked the name of the child , specific immunization and the name of the hospital.
Describe the specific prompt group
families in the specific prompt group received a prompt that named the target child as well as the particular immunizations that the child needed and the clinics location and hours.
Increased access’ group
Families in the increased access group received a specific prompt as well as a second page that announced two special clinic off hours were being held at the clinic. The clinic name and the address were provided.
-It also contained an announcement about additional clinic hours with free child care facilities that included snacks, movies and games
Monetary incentive group
families in the ‘monetary incentive’ group received the specific prompt, as well as a second page that read “Attention! in an effort to get parents to have their children immunized against childhood diseases, the Akron health health department , with support from BF Goodrich is giving away $175 in cash prizes to parents who turn in the ticket attached to this page.
To be eligible the parent has to physically tear off the ticket and drop it at the lottery box at the clinic.
Three different prizes could be drawn $100 , $50 and $25”.
Control group
There were 2 control groups
the contact control group received a telephone contact (but no mailing), requesting basic information about immunisations and demographics but not giving any prompts
the no-contact control group, who were not contacted at all during the study.
-Both
what were the dependent measures/variables
there were 3 measures ;
1)The number of children receiving one or more immunizations at the clinic
2)The number of target children attending the clinic (for any reason)
3)The total number of immunizations received by the target children
How was the effect of the conditions measured?
The immediate effect of the conditions was measured after two weeks.
The first follow up measure was taken 2 months after the first day of intervention
A second follow up measure was taken after 3 months.
What checks were put in place to measure the accuracy of the specific prompts
-These checks were put in place to measure the accuracy of the names and addresses and if the correct immunization were given at the clinic.
-A random sample of 10% of specific prompts were checked against the original medical records and 93% were found to be completely accurate
-For the sample of the name and mailing addresses there was 100% accuracy
Results
Order of impact of the conditions in descending order:
the monetary incentive group had the biggest impact followed by the ;
increased access group
specific prompt group
general prompt group
control groups
These findings remained significant at both the two-month and three-month follow-ups.
The specific prompt and monetary incentive method produced a 29% increase in the number of immunisations given.
-The specific prompt was the most cost effective intervention
What was the conclusion
Evaluation
Generalisability :
-Carried out a large-scale study on a big target population of immune-deficient children,providing large amounts of data which were representee of the entire target population = high population validity
Reliability :
The researchers’ checks on prompt accuracy, mailing addresses, and correct immunisations are crucial controls which increased the accuracy and consistency of the findings.
Application :
The study provides valuable insights for departments of health and other healthcare providers. An understanding that general prompts are not very effective, but that specific prompts, with or without monetary incentives, are significantly more effective could make a huge difference in immunisation uptake, as well as a range of other important health-related campaigns.
Validity:
The study was longitudinal, meaning it included immediate measurements over two weeks and follow-up measures at two and three months later. This enhances validity by revealing long-term effects of each intervention, not just immediate benefits.
issues and debates -reductionism and holism
Reductionism = understanding complex behaviours and thoughts by breaking them into simpler parts or underlying factors, often looking at biological or physical aspects.
When thinking about adherence, it’s crucial not to oversimplify things or ignore the broader context.
e.g It is overly simplistic to view non-adherence to a treatment plan as purely rational. It’s influenced by a blend of past experiences, such as positive or negative ones, early trauma, and individual biological side effects.
Useful application to everyday life
The evidence strongly suggests that patients are more likely to adhere to medical request if there is some form of incentive such as monetary reward. Clinics can use this information to give monetary incentives to patients to motivate them to come for immunization and other important stuff
