Exploring the use of Infant CARE-Index to assess parent-infant interactions (0-15 months): Measurement properties and acceptability in practice

Background: The quality of parent-infant interactions is known to have a significant impact on the social and emotional development of infants. With the increasing mental health problems in children in the later years of life, there is a growing need of introducing an observational measure to assess parent-infant interactions during the first year of life as emphasised by NICE. Infant CARE-Index is a multi-dimensional observational play-based measure for assessing the quality of parent–infant interaction from birth up to 15 months. It can assess the risk to relationships, screen for developmental risk, as well as guide interventions and assess the outcomes of interventions. With these factors in mind, this research sought to answer the question: How can the parent-infant interactions (birth-15 months) be assessed with the help of Infant CARE-Index in association with its measurement properties and acceptability in practice?
Methods: A comprehensive search of the literature to date utilising Infant CARE-Index for the age range birth up to 15 months was performed encompassing key databases such as APA PsycINFO, MIDIRS, Embase, Ovid MEDLINE, CINAHL, Proquest etc. This was followed by a qualitative analysis (comprising of focus groups) on the acceptability of Infant CARE-Index from the perspective of health professionals within UK settings.
Results: Forty-one articles meeting the inclusion criteria were subjected to data extraction. COSMIN checklist was used for assessing reliability and validity evidence. Evidence on inter-rater reliability, hypothesis testing for construct validity and responsiveness was extracted and presented. While, the qualitative analysis revealed that there was a definite need of a measure for the age range (0-12 months), however, the training was rigorous and expensive, and a holistic approach was needed to improve the assessment procedures for assessing parent-infant interactions.
Conclusions: Exploring the use of Infant CARE-Index within large scale randomised controlled trials of parenting support programmes will reveal its applicability within community settings. Validation studies assessing its measurement properties will add the much-needed reliability and validity information still deficient in the literature. Adequate resources and support for training the health professionals by the commissioners is imperative in rolling out standardised assessments. Furthermore, perspectives from a wider range of users of Infant CARE-Index needs to be gathered to provide a broader overview on the acceptability of this measure.