Humor for health: a randomized controlled trial of clown visits in Palestinian hospitals

Hospitalization can be a highly stressful experience for children, potentially affecting their well-being and recovery. This study evaluates the impact of hospital clown visits on pediatric patients in Palestine. The health system of the country is severely challenged by the ongoing conflict and sociopolitical tensions which have major implications for the physical and mental health of children and obstruct patients’ access to healthcare services. We conducted a randomized controlled trial (RCT) to estimate the effects of clown visits on caregiver-rated health outcomes: children’s well-being during hospitalization, subjective recovery, and perceptions of hospital quality. We find that clown visits had a statistically significant positive effect on children’s well-being with levels of well-being in the treatment group being 0.25 standard deviations higher than in the control group. The effect was stronger among children from higher socio-economic backgrounds and those with a favorable predisposition towards clowns. We found no significant effects on caregiver-rated subjective recovery or perceptions of hospital quality. Our findings suggest that low-cost, non-medical interventions can play a meaningful role in improving the hospital experience for children, particularly in fragile and conflict-affected settings.