The Development, Reliability, and Validity of the Responsive Care Indicator Tool

• In Event: Factors Influencing Parenting Quality

Abstract

The Nurturing Care Framework (NCF) provides a roadmap to strengthen public policies and promote good health, adequate nutrition, safety and security, opportunities for early learning, and responsive caregiving for all children under the age of 5. Despite global action to promote the NCF, no tools exist that measure responsive caregiving as a distinct concept that are suitable for low- and middle-income settings and are open access. The present study provides reliability and validity evidence for an indicator tool developed to quantify responsive care in a rural, low-income setting in Sindh, Pakistan. Two hundred households were randomly sampled and data was collected on responsive caregiving, early learning, socio-demographic characteristics, maternal depression, and child development outcomes. Exploratory factor analysis and structural equation models were used to test the reliability and validity of the tool in this setting. The results indicate that the tool reliably loads onto two distinct factors, responsive caregiving and caregiver-initiated interactions, accounting for 96.01% of the underlying variation. Internal consistency reliability was high within each factor, with Cronbach’s alphas of 0.93 and 0.83, respectively. Factor loadings of individual items were all above 0.7 within factors. Concurrent validity was found as the responsive care factor was strongly and positively correlated with measures of the home environment quantified by the Home Observation Measurement of the Environment-Infant Toddler version (HOME-IT). Predictive validity was found as the responsive care factor was strongly and positively associated with child development outcomes measured by the Bayley Scales of Infant and Toddler Development, Fourth Edition (BSID-4). The caregiver-initiated interactions domain was significantly and negatively associated with both the home environment and child development outcomes. Overall, the results indicated that the responsive care indicator tool is a reliable and valid measure of responsive caregiving and can easily be administered in less than 5-minutes in a low-income and low-resource setting.

Authors

• Elizabeth Hentschel, Harvard University
  Presenting Author

• Saima Siyal, Aga Khan University

• Frances E Aboud, Centre universitaire de santé McGill

• Dana Charles McCoy, Harvard University

• Henning Tiemeier

• Aisha Khizar Yousafzai, Harvard TH School of Public Health