Bring in the Clowns: A Randomized Controlled Trial of Clown Visits in Palestine

Medical treatments in hospitals can be highly stressful for children, potentially affecting their wellbeing and recovery. Clown interventions have been proposed as an effective non-medical approach to alleviate this stress and improve health outcomes. Here, we employ a randomized controlled trial (RCT) to evaluate the effects of hospital clown visits on pediatric patients in Palestine, an environment characterized by challenges in healthcare access, sociopolitical tensions and conflicts, and limited resources. As outcomes, we consider the children’s well- being during the hospital stay, the recovery process, and the caregiver’s perception of the quality of the hospitals. The results show that clown visits have a significant, positive effect on the well-being of children during their hospital stay: The children’s well-being in the treatment group was by 0.25 standard deviations higher compared to children who did not see a clown during their hospital stay. The positive wellbeing impacts are particularly strong among children with a higher socio-economic status and those with a positive attitude towards clowns. No effects of clown visits are found on the subjective recovery of patients as measured by caregivers and on the caregiver’s perception of the hospitals. The findings underscore the potential of non-medical interventions like clown visits to alleviate the psychological burden of hospitalization for children and to increase their well-being, particularly in vulnerable settings like Palestine.