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Health of the Nation Outcome Scales for Infants field trial: concurrent validity
Peter Brann1, Gordana Culjak2, Nick Kowalenko3
1Eastern Health Child Youth Mental Health Service and Adjunct Lecturer Monash University, Australia.
Insights
The Health of the Nation Outcome Scales for Infants (HoNOSI) demonstrates strong concurrent validity and internal consistency, meeting standards for infant mental health assessment. This clinician-reported tool is crucial for routine outcome measurement in young children.
Area of Science:
- Child and Adolescent Mental Health
- Psychometric Instrument Development
- Infant Mental Health
Background:
- Identified gap in routine outcome measures for social, emotional, and behavioral domains in infants and pre-schoolers.
- Developed the Health of the Nation Outcome Scales for Infants (HoNOSI), a clinician-reported measure for infants aged 0-47 months.
- Prior face validity testing indicated HoNOSI's utility in assessing mental health outcomes.
Purpose of the Study:
- To examine the concurrent validity of the HoNOSI.
- To assess the reliability and acceptability of HoNOSI using established criteria.
Main Methods:
- Clinicians rated the mental health status of 108 infants using HoNOSI, Parent-Infant Relationship Global Assessment Scale (PIR-GAS), and symptom/distress measures.
- Minimum of 26 clinicians participated in rating each infant's mental health status.
- Evaluated instrument acceptability using COsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria.
Main Results:
- HoNOSI showed statistically significant correlations with PIR-GAS (rs = -0.73), Clinical Worry (rs = 0.77), and Severity Judgement (rs = 0.85) (P < 0.001).
- Good internal consistency was observed for the HoNOSI.
- HoNOSI met COSMIN criteria for concurrent validity and internal consistency.
Conclusions:
- Confirmed a clear need for a routine outcome measure for infants.
- Provided positive evidence for HoNOSI's validity and internal consistency.
- Supported controlled release of HoNOSI with ongoing research and development.
Background:
A review of Australian mental health services identified a gap in routine outcome measures addressing social, emotional and behavioural domains for pre-schoolers and infants. A Child and Adolescent Mental Health Information Development Expert Advisory Panel working group developed the Health of the Nation Outcome Scales for Infants (HoNOSI), a clinician-reported routine outcome measure for infants 0-47 months. Prior face validity testing showed that the HoNOSI was considered useful in measuring mental health outcomes.
Aims:
To examine the concurrent validity of the HoNOSI.
Method:
Mental health clinicians providing assessment and treatment to infants in routine clinical practice participated in the study. The mental health status of 108 infants were rated by a minimum of 26 clinicians with the HoNOSI, the Parent-Infant Relationship Global Assessment Scale (PIR-GAS) and measures of symptom severity and distress.
Results:
The HoNOSI was statistically significantly correlated with the PIR-;GAS, rs = -0.73; Clinical Worry, rs = 0.77; and Severity Judgement ratings, rs = 0.85; P < 0.001. A good level of internal consistency was found. Using the COsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria for judging instrument acceptability, the HoNOSI meets the standard for both concurrent validity and internal consistency.
Conclusions:
There has been a clear need for a routine outcome measure for use with infants. This study provides positive evidence of aspects of validity. These findings, along with those from the prior face validity study, support a controlled release of the HoNOSI accompanied by further research and development.
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