Chaney

• Background

  • Operant Conditioning is behaviour learnt from experiences and consequences of behaviour (positive or negative).
  • It is a form of associative learning (a connection forms between a stimulus and a response/ behaviour).
• Background

  • Positive reinforcement: receiving a reward or positive consequence will form and subsequently strengthen the SR connection, causing the behaviour to be repeated next time the stimulus is presented.
• Background

  • Negative Reinforcement: can also be used whereby an unpleasant consequence is removed, which strengthens the SR connection and makes the behaviour more likely to be repeated.
• Background

  • Punishment: where receiving a punishing/ negative consequence will weaken the SR connection, eventually resulting in the behaviour being less likely to be repeated.
• Background

  • Behaviour therapy and behaviour modification have been major approaches used by clinical psychologists and health practitioners to improve adherence to prescribed medical regimes, for example complying with/ following the plan of medical treatment.
• Background

  • Although reasons for poor adherence are varied, Watt et al proposed that introducing some positive reinforcement (fun) into the act of using an inhaler would improve medication adherence in young asthmatics.
• Aim

  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 asthma inhaler with no additional features.
• Sample

  • 32 children (22 male, 10 female)
  • The mean age was 3.2 years
• Sample

  • The sampling method was random sampling
  • The children were recruited from clinics across a large geographical area- Perth, Australia
  • They were randomly selected from asthmatic children who had been prescribed drugs delivered by a standard inhaler and spacer.
• Research Method

  • The research method was a field experiment
• Research Method

  • It used a repeated measures design
• Research Method

  The IV was the type of device used to administer the asthma drugs:

  1. The standard inhaler
  2. A novel device known as the 'Funhaler'
• Research Method

  The DV was the amount of adherence to the prescribed medical regime.
• Procedure

  • Firstly, a comparison was made between the aerosol output of the standard inhaler and the Funhaler.
  • This pilot study makes the study more ethical by protecting participants from harm with changes in medication.
  • No significant differences were observed (the Funhaler did not compromise delivery).
• Procedure

  The study was undertaken in the participants' home settings
• Procedure

  • The children's parents gave informed consent to take part and completed a structured, closed question questionnaire with an interviewer about their child's current asthma device (the standard inhaler).
  • This included questions such as how easy the device is to use, the parent's and child's attitudes towards the medication and their compliance levels.
• Procedure

  • Participants were then asked to use a Funhaler instead of their normal standard inhaler for 2 weeks, with adult supervision.
• Procedure

  • The funhaler incorporated the standard inhaler and spacer, along with an additional attachment which included incentive toys designed to distract children from the drug delivery itself, and to provide a means of self-reinforcing the use of the effective technique.
• Procedure

  • The toy module could be replaced with other toys in the future, to prevent boredom.
• Procedure

  • The toys worked best with deep breathing patterns, so they rewarded the deep breathing pattern required for effective delivery of medication.
• Procedure

  • After 2 weeks of using the funhaler, parents completed a matched questionnaire on the use of the funhaler.
  • This allowed direct comparison between this and the standard inhaler
• Procedure

  • During the course of the study, each parent was telephoned at random to find out if they had attempted to medicate their child the day before.
• Results

  Parents reported their child was medicated the previous day:

  Standard= 59 %

  Funhaler= 81 %
• Results

  Recommended 4+ breath cycles regularly achieved:

  Standard= 50 %

  Funhaler= 80%
• Results

  Parents reported always being successful in medicating their child:

  Standard= 10%

  Funhaler= 73%
• Results

  Children reported pleasure when using:

  Standard= 10 %

  Funhaler= 68 %
• Results

  • A number of problems such as screaming when device was brought close to the child's face and unwillingness to breathe through the device were significantly decreased when using the Funhaler.
• Results

  • Of the parents who were unsuccessful with the standard inhaler, 17 became successful with time and practice whilst 11 never succeeded.
  • 7 of these were immediately successful with the Funhaler.
  • 1 became successful over time with the Funhaler.
  • 3 continued to have problems.
• Result- Compliance to the regular inhaler was 59 %, compared to 81 % with the Funhaler.


  Conclusion- Improved adherence suggests that the Funhaler may be useful for management of young asthmatics.
• Result- 30 % more children took the recommended 4 or more cycles per aerosol delivery when using the Funhaler, compared to when using the standard inhaler.


  Conclusion- The use of functional incentive devices such as the Funhaler may improve the health of children.