Chaney

• Background: Outline operant conditioning - positive reinforcement

  Operant conditioning involves learning through consequences of behavioural responses. positive reinforcement is the process in which behaviour is learnt through the use of rewards; behaviour is rewarded and 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.
• Background: outline the evidence of poor adherence to medical regimes using inhalers-reference compliance rates

  One major issue health practitioners faced 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.
• Background: Chaney's suggestion to improve adherence to medical regimes with the use of positive reinforcements

  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.
• Aim

  to test whether a 'Funhaler' could provide positive reinforcement to improve adherence in child asthmatics compared to normal inhalers.
• Research Method

  field experiment conducted in the P's home settings in Australia, in which a RMD was used (they used both inhalers). self reports were used to gather the data
• IV

  -a standard volume spacer device (used prior to experiment)

  -a new device called Funhaler (used for a 2 week period)
• DV

  the amount of adherence to the prescribed medical regime, measured through self-report method
• Sample

  32 children (22 male, 10 female)

  aged 1.5 - 6 years

  from Perth Australia

  they had all had asthma for on average 2 years

  all asthmatic
• Evaluation of sample

  +all have asthma = representative

  +no gender bias = can generalise findings into medical adherence to males + females

  -not representative of children of all ages = cannot generalise

  -ethnocentric - all from one western culture (Perth, Australia) - free healthcare so may adhere less because they themselves aren't paying for it OR the west has well developed healthcare so trust in healthcare professionals + there4 adhere, other less developed places may use more traditional medicines or lack trust in modern healthcare = cannot generalise to other cultures
• Procedure

  
• Results

  • the use of Funhaler was associated with improved parental and child compliance
  • when surveyed at random, 81% of 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 4 or more deep breaths per aerosol delivery when using the Funhaler compared with the standard inhaler
• Conclusions + practical applications

  
• Exam Q: how is Chaney's study a field experiment (2)

  Chaney's study is a field experiment as it took place in a natural setting (the children's home in Perth Australia) and the independent variable was manipulated (children used the funhaler and their normal space inhaler to see adherence to both)
• Exam Q

  
• Procedure exam Q

  
• Exam Q: outline one quantitative finding (2) - make comparisons

  When surveyed at random, 81% of parents were found to have used the funhaler the previous day compared to their normal inhaler (59%)
• Evaluation Table

  
• Link to key theme Q pt1

  WHAT = Chaney wanted to test whether a 'Funhaler' could provide positive reinforcement to improve adherence in child asthmatics compared to normal inhalers

  WHO = 32 asthmatic children (22 male, 10 female) from Perth, Australia

  HOW = children were given a new Funhaler to use for 2 weeks, instead of their original device, which included positive reinforcement of a whistle + spinner when used correctly, parents were interviewed by self report before and after the 2 week period
• Link to key theme Q pt2

  FINDING = through phone calls with the children's parents in which he asked closed Qs about parents' attitude + compliance he found that 30% more children took the recommended 4 or more deep breaths per delivery when using the Funhaler compared to the standard inhaler

  LINK = this links to key theme as it shows the external influence of the Funhaler, which included positive reinforcement through the whistle and spinning top, influenced the children's medical adherence as they used the Funhaler more often and more correctly
• Link to approach Q

  
• What debates does Chaney link to

  • situational = the change in the environment (the inhaler) led to improved medical adherence/explains children's improved medical adherence using situational factors such as the positive reinforcement Ps experienced due to the whistle and spinner on the Funhaler
  • reductionism = reduces the children's improved medical adherence to the single factor of the positive reinforcement within the child's environment due to the whistle and spinner on the Funhaler
  • useful