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Healthcare Utilization Unchanged in the Control Arm of a Randomized Clinical Trial.
Pratik Gongloor1, Saad Nadeem2, Xiaoying Yu1
1University of Texas Medical Branch, Galveston, TX, US.
Journal of Primary Care & Community Health
|September 27, 2025
Summary
This study found no Hawthorne effect on healthcare utilization in a low-income control group. This suggests consistent health behaviors or a lack of resources to act on increased health awareness in these populations.
Area of Science:
- Public Health
- Clinical Trials
- Health Disparities
Background:
- The Hawthorne effect, where participants alter behavior due to observation, is poorly understood in low-income settings.
- Clinical trial participation may influence participant behavior, potentially affecting intervention outcomes.
Purpose of the Study:
- To explore healthcare utilization changes in control participants of a randomized clinical trial (RCT) in a low-income setting.
- To investigate the presence of the Hawthorne effect on healthcare-seeking behaviors.
Main Methods:
- Retrospective analysis of electronic medical records from 26 control participants in an RCT for type 2 diabetes.
- Comparison of healthcare utilization (provider visits, services) during the year before and during the 12-month study period.
- Inclusion of participants from a low-income Hispanic community clinic.
Main Results:
- Total healthcare utilization remained similar between the pre-study (11.9 exposures/year) and study periods (11.4 exposures/year).
- No statistically significant changes were observed in healthcare visit types or monthly visit frequency over time.
- P-values for all comparisons were non-significant (e.g., P = .93 for total utilization).
Conclusions:
- No evidence of a Hawthorne effect on healthcare utilization was found in this low-income control group.
- Consistent healthcare behaviors may be indicated, or participants may lack resources to act on increased health awareness.
- Larger studies are recommended to understand behavioral patterns in low-income populations and their implications for public health.
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