Chaney et al

Compliance= The extent to which a person follows the instructions of another (Also known as adherence)

Operant conditioning= The idea that we learn behaviours through the consequences of actions

Positive reinforcement= Occurs when a behaviour is followed by a favourable stimulus that increases the frequency of that behaviour

Behaviour modification= Positive reinforcement that strengthens a behaviour so that it's more likely to be repeated

• In terms of health, compliance is the extent to which a patient follows the prescribed medical regime
• Low rates of adherence can lead to increased health risks and more emerency hospital admissions- Asthmatics are prone to this problem
• Smith et al- Showed rates of compliance in young children varies from 30-70%
• Celano et al- Showed that children find it difficult to master the deep breathing technique needed to take their medication through an inhaler
• Chapman et al- Identified reasons for non-compliance such as fear, boredom, ignorance, forgetfulness and apathy
• Chaney's study is based on operant conditioning and that children's sensitivity to positive reinforcement could be used to design a new inhaler device

To test whether the use of positive reinforcement via the funhaler could improve medical compliance in young asthmatics compared to the use of the conventional inhaler

• Field experiment
• Repeated measures design

Independant variable

• The device used to administer the asthma drugs

Dependant variable

• How well the participants complied with their prescribed medical regime- a Measured by parental responses to a self report questionnaire

Participants

• 32 children- 22 males and 10 females
• Age range from 1.5-6 years
• Mean age of 3.2 years
• Average duration of asthma of 2.2 years
• Sampling technique- Opportunity sample from health clinics across Australia

• Carried out in participant's hones over a 2 week period
• The parents gave informed consent but they weren't shown the funhaler to try and avoid demand characteristics
• Parents completed a self report questionnaire and interview- Consisted of closed questions about the parent and child's attitudes towards the medication and their compliance levels
• A random sample of parents were phoned to assess the use of the funhaler- reliability check

The funhaler is:

• a Brightly coloured
• Has spinning discs and it whistles which works best with the deep breathing technique needed for medication to be effective- This is a form of operant conditioning known as self-reinforcement (rewards children fit using the deep breathing technique)

• The use of the funhaler showed improved parental and child compliance
• The funhaler has increased daily use- 81% for funhaler and 59% standard inhaler
• Pleasure of use- 68% funhaler and 10% standard inhaler
• Effective use of inhaler- 80% funhaler and 50% standard inhaler
• Many problems with the standard inhaler were reduced eg: less fear and unwillingness to breathe deeply
• Parents happiness with the device- 61% funhaler and 10% standard inhaler

• The use of the funhaler could possibly improve clinical outcomes eg: lowering rates of admissions to hospital for asthma attacks
• Devices that use self-reinforcement strategies can improve the overall health of children

The research method

• Field experiment- High in ecolical validity as it was done in participants homes
• It's scientific because the cause and effect has been established
• Can't control all extraneous variables
• Self report- Open to bias eg: social desirability

Ethical considerations

• Parents gave informed consent
• They were briefed about the aims of the study
• All data responses were anonymised to ensure confidentiality
• The children were protected from harm by ensuring that the funhaler was administered safely
• Unaware of the long term effects of the funhaler- It was only trialled for 2 weeks

Validity

• High in ecological validity- The children weren't disturbed from their everyday lives
• Order effects- The children already had experience of using the standard inhaler
• Short term trial (2 weeks)- Results don't tell us about the long term success of the funhaler
• Limited attempt to assess the funhaler- Parents only asked once and the questions were simple

Reliability

• The procedure was standardised (All asked same questions)- Easy to replicate
• Parents attitudes measured using a questionnaire- The questions might have been ambiguous

Sampling bias

• Fairly representative- Used families from many different socio-economic backgrounds
• Might also be considered unrepresentative- Might have been more middle class families compared to working class families

Ethnocentrism

• Participants were all Australian- Ungeneralisable to other parts of the world due to cultural differences

Practical applications

• Correct compliance to a medical regime is important
• Chaney showed that the use of a device can self-reinforce the correct technique and dosage of medication in children
• The funhaler device and other self-reinforcement devices can be used to improve medical compliance in other age groups