Chaney

• Outline the background of Chaney's funhaler study (4)

  1.Outline operant conditioning- Positive reinforcement (Skinner’s rats)2.Outline the evidence of poor adherence to medical regimes using inhalers-reference compliance rates.3.Chaney’s suggestion to improve adherence to medical regimes with the use of positive reinforcement.Operant conditioning involves learning through the consequences of behavioural responses. Positive reinforcement is the process in which behaviour is learnt through the use of rewards; behaviour is rewarded and so associated with positive responses therefore repeated again and again. Skinner (1948) showed how rats could learn to press a lever if they were rewarded with food.One major issue health practitioners have had to deal with is the poor adherence to medical regimes such as the use of inhalers, research suggests that as little as 50% of children use their inhaler correctly.Chaney et al. therefore suggested that one way to improve adherence to medical regimes in asthmatic children is to introduce a positive reinforcement within the inhalers. They suggested that if the inhaler was more interactive, this could improve medication adherence in young asthmatics.
• What was the aim for Chaney's research?

  To test whether a'Funhaler'could providepositive reinforcement to improve adherencein child asthmaticscompared to normal inhalers.
• Research method for Chaney's research

  field experiment
• What was the experimental design in Chaney's study?

  Repeated measures design
• How was the data collected in Chaney's study?

  conducted in the participants' home settings in Australia, self reports were used to gather the data.
• What was the IV in Chaney's study?

  type of device used: A standard volume spacer device or a Funhaler
• DV in Chaney's study


  the amount of adherence to the prescribed medical regime.
• Sample in Chaney's study (3)

  •32 Children (22 male and 10 female) from Perth Australia.

  •All Asthmatic

  •They had all had asthma for on average 2 years.
• What was the part of the Funhaler that encouraged children to use it in Chaney's study?

  -The child had to take the right amount of breaths and breath in deeply, this is the behaviour that was being encouraged/reinforced

  -The whistle made a noise and the spinner span when the child inhaled properly, this acted as the positive reinforcement/reward for the children
• Procedure in Chaney's study

  Parents contacted by phone and then visited at home to explain purpose of study, informed consent gained from parents. Interviewed using a questionnaire (yes/no responses) About their child's current usage of inhalers, characteristics of child, compliance of child and parents. Not shown from Helen yet in case influence their decision. Then given from Taylor to use for two weeks with child, only under adult supervision. Usage measured by phoning parents randomly and asking if they had used it the previous day. Same parent visited at the end and given a second questionnaire, attitudes and compliance measured again.
• Results in Chaney's study (4)

  •The use of the Funhaler was associated with improved parental and child compliance

  •When surveyed at random, 81% more parents were found to have medicated their children the previous day when using the Funhaler, compared to their existing inhaler (59%)

  •30% more children took the recommended four or more deep breaths per aerosol delivery when using the Funhaler compared with the standard inhaler

  •22% increase compliance with Funhaler
• Conclusions in Chaney's study (2)

  •Operant conditioning through the use of the Funhaler isuseful for managing the medical regimes of young asthmatics.The Funhaler encourages young children and parents to adhere to the treatment through the use of the incentive toy (whistle and spinner). If a child breathes deeply they are rewarded with the whistle being blown and a toy being spun which encourages them to repeat the breathing process.

  •The use of the self-reinforcement strategies can improve the overall health of children.
• Research method: Strengths in Chaney's study (2)

  High ecological validity: natural setting of the child's own home (field experiment) so likely to see natural usage of Funhaler

  
  

  Repeated measures design: controls for individual differences between children
• Research method: Weaknesses in Chaney's study (2)

  Low internal validity: lack of controls, such as parents losing Funhaler, not using it correctly, repeated measures design could lead to order effects

  
  

  Low internal validity: self-report method used to gather data (interviews, questionnaires) could lead to bias/misinterpretation (e.g. parents may lie about child's usage!)
• Sample: Weakness in Chaney's study

  Unrepresentative: Small sample (32) from only one area- can't generalise to children with asthma from other countries therefore lacking population validity
• Type of data: Strength in Chaney's study

  Quantitative data gathered through self-reports (Yes/No or fixed choice responses), easy to analyse and interpret this data to check for consistency in response from all 32 children
• Type of data: Weaknesses in Chaney's study (2)

  No real insight into WHY the children used the Funhaler more- was it the whistle and spinner or because the parents made them use it more? Lacking internal validity- verbal comments would give us more understanding

  
  

  Forced choice questions means finer detail was lost- lowering validity
• Validity: Strengths in Chaney's study (3)

  High ecological- natural setting

  
  

  High internal- objective data to analyse (not open to misinterpretation)

  
  

  High internal- Use of controls e.g. same Funhaler used to control for reward influencing response
• Validity: Weaknesses in Chaney's study (2)

  Low internal- lack of controls, SDB, demand characteristics

  
  

  Low internal- self-report methods open to misinterpretation
• Reliability: Strengths in Chaney's study (2)

  High external: Quantitative data gathered so can check for consistency in 32 children's usage of Funhaler compared to old inhaler

  
  

  High internal: Standardised procedure used- all use same Funhaler, for same time of 2 weeks, same questionnaire used with the same questions etc.
• Reliability: Weaknesses in Chaney's study (2)

  Low internal: Due to nature of field experiment difficult to entirely standardised- parents may use Funhaler in different ways

  
  

  Lack of consistency if parents did not understand the questions in self-report- would they answer in a consistent way?
• How Chaney's study useful?

  Chaney's study is useful as practical applications can be developed to improve adherence to medical regimes, overall improving the lives of people in society (e.g. through the use of rewards)
• How does Chaney's study have limited usefulness?

  The research is limited in generalisability as the sample is very unrepresentative (one country, small etc.)
• How is Chaney's study ethical?

  Chaney gained fully informed consent from parents (who will have discussed it with their children)

  Confidentiality is maintained
• How is Chaney's study unethical?

  Protection of participants: children may feel embarrassed about using a space device and embarrassed to have their personal feelings recorded
• How does Chaney's study illustrate the free will debate?

  Some parents/children could choose not to use it/ use it properly (only an increase of 22%)
• How does Chaney's study illustrate the deterministic debate?


  The adherence is being determined by the positive reinforcement (reward- whistle and spinner)
• How is Chaney's study socially sensitive?

  Stigma-attach stigma to parents that aren't able to medicated their children