Defining and evaluating the Hawthorne effect in primary care, a systematic review and meta-analysis
Berkhout and colleagues searched January 2012 to March 2022, screened 180 records and included 74 for the definition of the Hawthorne effect in primary care and 15 for quantifying it. They define it as an aware or unconscious complex behaviour change in a study environment, linked to four biases (selection, commitment and congruence, conformity and social desirability, observation and measurement), with size varying by time, people, setting and outcome. The pooled effect was not significant in well-designed studies, and they conclude that refining study designs can substantially reduce it. Their motivation was a 2015 waiting-room trial of posters and pamphlets in which influenza vaccination rose in both arms although public health data showed a decline.
Berkhout and colleagues searched January 2012 to March 2022, screened 180 records and included 74 for the definition of the Hawthorne effect in primary care and 15 for quantifying it. They define it as an aware or unconscious complex behaviour change in a study environment, linked to four biases (selection, commitment and congruence, conformity and social desirability, observation and measurement), with size varying by time, people, setting and outcome. The pooled effect was not significant in well-designed studies, and they conclude that refining study designs can substantially reduce it. Their motivation was a 2015 waiting-room trial of posters and pamphlets in which influenza vaccination rose in both arms although public health data showed a decline.
Written from the abstract and full text page, Frontiers in Medicine, 2026-11-02.
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Berkhout, C., Berbra, O., Favre, J., Collins, C., Calafiore, M., Peremans, L., & Van Royen, P. (2022). Defining and evaluating the Hawthorne effect in primary care, a systematic review and meta-analysis. Frontiers in Medicine, 9, 1033486. doi:10.3389/fmed.2022.1033486 https://doi.org/10.3389/fmed.2022.1033486