Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects

Abstract

ObjectivesThis study aims to (1) elucidate whether the Hawthorne effect exists, (2) explore under what conditions, and (3) estimate the size of any such effect.Study Design and SettingThis systematic review summarizes and evaluates the strength of available evidence on the Hawthorne effect. An inclusive definition of any form of research artifact on behavior using this label, and without cointerventions, was adopted.ResultsNineteen purposively designed studies were included, providing quantitative data on the size of the effect in eight randomized controlled trials, five quasiexperimental studies, and six observational evaluations of reporting on one's behavior by answering questions or being directly observed and being aware of being studied. Although all but one study was undertaken within health sciences, study methods, contexts, and findings were highly heterogeneous. Most studies reported some evidence of an effect, although significant biases are judged likely because of the complexity of the evaluation object.ConclusionConsequences of research participation for behaviors being investigated do exist, although little can be securely known about the conditions under which they operate, their mechanisms of effects, or their magnitudes. New concepts are needed to guide empirical studies.

Impact of observing hand hygiene in practice and research: a methodological reconsideration

“…The impact of observation on usual behaviour is more complex and less consistent than currently recognised in hand hygiene audit and research because individuals react to the knowledge that they are being watched in different, sometimes unpredictable ways 15,18 . Aware of the emphasis placed on hand hygiene by mangers and infection prevention teams, health workers may respond by cleansing hands more often but they may also adopt strategies to evade observation that are opportunistic and unsystematic.…”

“…There is a consensus that individuals change behaviour when they are studied but not in a consistent or predictable manner 15,17,18 . Identifying the Hawthorne effect and other tactics of avoidance or deferred activity is important when undertaking and interpreting the findings of hand hygiene audit given the current emphasis on hand hygiene globally and the importance of health workers' compliance.…”

If it works there, will it work here? The effect of a multi-component responsible beverage service (RBS) programme on violence in Oslo

“…It is also notable that the estimated effect of the initial STAD project was a 29% reduction, while the subsequent extensions elsewhere in Sweden were much more modest, only around 3% on average . It could perhaps be hypothesised that the initial STAD intervention was associated with a so-called 'Hawthorne effect', i.e., the effects may have been the result of the effects of the involved actors and institutions of being singled out and made to feel important, and not of the intervention per se (Adair, 1984;McCambridge et al, 2014). In later interventions, it may have been difficult to replicate this effect.…”

Renal Denervation: Unde Venis et Quo Vadis?

“…3. Better medication compliance: Without a control group, the observed blood pressure reduction can be partially attributed to better intake of medication as a result, for example, of regular study follow-up (Hawthorne effect) [53]. 4.…”