Exploring predictors of interaction among low-birth-weight infants and their caregivers: a machine learning–based random forest approach

Abstract

Background Quality caregiver-infant interaction is crucial for infant growth, health, and development. Traditional methods for evaluating the quality of caregiver-infant interaction have predominantly relied on rating scales or observational techniques. However, rating scales are prone to inaccuracies, while observational techniques are resource-intensive. The utilization of easily collected medical records in conjunction with machine learning techniques offers a promising and viable strategy for accurate and efficient assessment of caregiver-infant interaction quality. Methods This study was conducted at a follow-up outpatient clinic at two tertiary maternal and infant health centers located in Shanghai, China. 68 caregivers and their 3-15-month-old infants were videotaped for 3–5 min during playing interactions in non-threatening environment. Two trained experts utilized the Infant CARE-Index (ICI) procedure to assess whether the caregivers were sensitive or not in a dyadic context. This served as the gold standard. Predictors were collected through Health Information Systems (HIS) and questionnaires, which included accessible features such as demographic information, parental coping ability, infant neuropsychological development, maternal depression, parent-infant interaction, and infant temperament. Four classification models with fivefold cross-validation and grid search hyperparameter tuning techniques were employed to yield prediction metrics. Interpretable analyses were conducted to explain the results. Results The score of sensitive caregiver-infant interaction was 6.34 ± 2.62. The Random Forest model gave the best accuracy (83.85%±6.93%). Convergent findings identified infant age, care skills of infants, mother age, infant temperament-regulatory capacity, birth weight, positive coping, health-care-knowledge-of-infants, type of caregiver, MABIS-bonding issues, ASQ-Fine Motor as the strongest predictors of interaction sensitivity between infants and their caregiver. Conclusions The proposed method presents a promising and efficient approach that synergistically combines rating scales and artificial technology to detect important features of caregiver-infant interactions. This novel approach holds several implications for the development of automatic computational assessment tools in the field of nursing studies. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-024-05080-8.