The answers to the final open-ended interview question for both the experimental and control groups were analyzed. We believed that the catheter calendar, used to record catheter problems, could have contributed to self-monitoring and in turn measurement reactivity in the control group. The unintended improvement in the control group compelled the researchers to try to determine its potential cause, specifically whether the calendar or other factors caused behavior changes in the participants. Importantly, similar improvements were not observed in a prospective observational study of 34 catheter users of the same population who were assessed bimonthly over a 6-month period ( Wilde et al., 2010), causing the researchers to wonder what contributed to both groups' improvements in the 12-month RCT. The improvements of decreasing symptomatic catheter-related urinary tract infection and catheter blockage over the 12-month study were clinically meaningful in both the control and intervention groups ( Wilde et al., 2015). The research team attributed this to an increase in self-monitoring (awareness and observations or recordings) caused by use of the catheter calendar, but this conclusion was not supported by data from the study.
#REACTIVITY DEFINITION SOCIOLOGY TRIAL#
In a 1-year randomized trial teaching self-management skills to 202 people with long-term indwelling urinary catheters, both groups appeared to have improved. This can create questions regarding whether or not the intervention was effective ( Gravetter & Forzano, 2009). Specifically, the measures themselves may inform the study participants of the intended behaviors being evaluated and in turn influence the achieved results. Measurement reactivity is a special case of the Hawthorne effect that specially focuses on the processes by which repeated measurement leads to changes in the participants being measured ( French & Sutton, 2010 Shadish, Cook, & Campbell, 2002). McCambridge, Witton, and Elbourne (2014) operationalized the Hawthorne effect by describing it as the testing effect that occurs when participants are assessed by being directly observed, made aware of being studied, or asked to report on their behavior by answering questions.
In randomized clinical trials (RCTs), the use of these measures can lead to internal validity concerns due to the testing effects (i.e., Hawthorne effect or measurement reactivity) that these measures may elicit. Self-reported measures, such as diaries, checklists, interviews, or surveys, are common in behavioral interventions.
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