All versions of the CSNAT, including CSNAT (Paediatric), are protected by copyright, therefore a licence is required for their use. Licences and the tool itself are made available, free of charge, to researchers from non-commercial organisations.

Details are given below on using CSNAT in research and key messages about CSNAT analysis, which apply to all versions of CSNAT.

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(1) As a standalone research tool to identify unmet support needs (R1 use)

As the CSNAT is an evidence-based, comprehensive tool comprising 15 domains (broad areas of support need), it can be used solely to collect research data on domains of unmet support need. However, it is important to note that the response categories for each domain are there to help carers express that there is a need for support, they are not a scale to measure the level of need.

(2) In investigations of carers’ support needs that INCLUDE PROVIDING SUPPORT TO CARERS based on CSNAT responses (R2 use)

If within your study, support will be delivered, either by your team or practitioners you are working with, based on using the CSNAT, you are using the CSNAT as part of a practice intervention (CSNAT-I) even though this is within a research study. Therefore, this type of research use requires CSNAT-I Training by your team or practitioners you are working with.

The CSNAT is a communication tool designed to be used as part of a person-centred intervention, the CSNAT intervention (CSNAT-I). Correspondingly, it is suitable for qualitative investigation and analysis of carers’ support needs. Conversely, as it is not a questionnaire or measurement tool, it is not suitable for the quantitative analyses often used with such tools.

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The CSNAT questions are not ‘items’ but broad domains for exploration. Therefore, the CSNAT does not directly ‘measure’ need. If the carer indicates they need more support within a domain (question), it requires further exploration to establish what individual needs they have within that domain, as carers will have very different needs within each domain.

Areas of support need are qualitatively distinct. CSNAT domains capture very different areas of need and cannot just be grouped together. They do not represent a single, underlying concept of need.

The purpose of CSNAT response categories is to facilitate communication, not indicate level of need. We have learnt that response gradations may have little meaning to carers (one carer’s “a little more” often equals another carer’s “quite a bit more”). The gradations are there to facilitate communication, as it is often easier for carers to admit they need just ‘a little more’ support than categorically stating they need more help. What matters is whether the carer feels he/she needs more support or not.

If you decide to use analyses for the CSNAT that are not recommended here and publish the results, we would ask that you note in the publication that the analysis undertaken was not recommended by the CSNAT-I team.