Remembering My Hat

28th September 2009

For the love of three Bookstart books

My almost-toddler had a routine Health Visitor checkup today. I was trying to work out why I took him along. I have no worries about him and felt no need to have my lack of worry validated by a Heath Professional. Taking him along risked getting sucked into surveillance practices that I know from previous experience can be very unhelpful. It was quite inconvenient to attend – I had to take time off work and he missed a nap.

I have, like most parents, considerable investment in being seen to be A Good Parent, and attending routine check-ups is one of the ways modern parents can do this. But I have sufficient theoretical traction on that to give me the resources to refuse it head-on. And sufficient articulateness and socio-cultural privilege to deal with the Health Visitor had they bothered me about it. I know my Health Visitor has targets to meet about getting parents to bring children to check-ups, but I don’t care enough about her to attend just to help her statistics.

In the end, I concluded that I went because I wanted the Bookstart books you get given at this check-up, and the handy sturdy canvas bag they come in.

That set me thinking about the role of trivial incentives in health and social care settings and in recruiting research participants.

Children often get given stickers by dentists and practice nurses these days. It doesn’t seem to encourage or reward my children significantly, but I guess it must do some children, or it wouldn’t have become such a common practice. Or is it, perhaps, not an evidence-based intervention?! Is is perhaps performed just to make practitioners feel they are doing being good with children?

Pregnant women in my area get given a pseudo-book ‘Emma’s Diary’ at an early antenatal appointment. I found it too irritating and patronising to read. I wonder whether it does improve pregnancy outcomes. Then there is the whole Bounty Bag Full of Nothing phenomenon. If you have a home birth you often end up not getting the post-birth bag – serves you right for bucking the system?

It is becoming increasingly common practice when doing academic research to reward participants with something like a £10 M&S voucher. I’ve always had rather mixed feelings about this. On the one hand, yes, it’s nice to symbolically give something in return for participants’ time, energies, insights and experiences. But on the other hand, £10 seems a woefully inadequate response given how crucial people’s participation is to academic research. And as vouchers-for-participants becomes more of a norm, it becomes more difficult to undertake unfunded research. And there’s an argument from the service-user movement that participants in research ought to be properly paid for their time if their contribution is so important.

I’ve often wondered whether the £10 is significant to research participants, or just to researchers, so that they can do being a good (ethical) researcher. But perhaps my own willingness to inconvenience myself suggests that trivial incentives can work.

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