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The PedsQLTM 4.0 as a School Population Health Measure: Feasibility, Reliability, and Validity

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Abstract

Background: The application of health-related quality of life (HRQOL) as a school population health measure may facilitate risk assessment and resource allocation, the tracking of student health at the school and district level, the identification of health disparities among schoolchildren, and the determination of health outcomes from interventions and policy decisions at the school, district, and county level. Objective:To determine the feasibility, reliability, and validity of the 23-item PedsQLTM 4.0 (Pediatric Quality of Life InventoryTM) Generic Core Scales as a school population health measure for children and adolescents. Design: Survey conducted in 304 classes at 18 elementary schools, 4 middle schools, and 3 high schools within a large metropolitan school district. Methods:The PedsQLTM 4.0 Generic Core Scales (Physical, Emotional, Social, School Functioning) were completed by 2437 children ages 8–18 and 4227 parents of children ages 5–18. Results:The PedsQLTM 4.0 evidenced minimal missing responses, achieved excellent reliability for the Total Scale Score (α = 0.89 child, 0.92, parent report), and distinguished between healthy children and children with chronic health conditions. The PedsQLTM 4.0 was related to indicators of socioeconomic status (SES) at the school and district level. The PedsQLTM School Functioning Scale was significantly correlated with standardized achievement scores based on the Stanford 9. Conclusion: The results demonstrate the feasibility, reliability and validity of the PedsQLTM 4.0 Generic Core Scales as a school population health measure. The implications of measuring HRQOL in schoolchildren at the school, district, and county level for identifying and ameliorating health disparities are discussed.

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References

  1. LS Matza AR Swensen EM Flood K Secnik NK Leidy (2004) ArticleTitleAssessment of health-related quality of life in children: A review of conceptual, methodological, and regulatory issues Value Health 7 79–92 Occurrence Handle10.1111/j.1524-4733.2004.71273.x Occurrence Handle14720133

    Article  PubMed  Google Scholar 

  2. D Drotar (2004) ArticleTitleMeasuring child health: Scientific questions, challenges, and recommendations Ambul Pediatr 4 353–357 Occurrence Handle15264950

    PubMed  Google Scholar 

  3. C Eiser (2004) ArticleTitleUse of quality of life measures in clinical trials Ambul Pediatr 4 395–399 Occurrence Handle10.1367/A03-112R.1 Occurrence Handle15264945

    Article  PubMed  Google Scholar 

  4. HM Koot JL Wallander (2001) Quality of Life in Child and Adolescent Illness: Concepts, Methods and Findings Brunner-Routledge East Sussex, UK

    Google Scholar 

  5. JW Varni TM Burwinkle M Seid D Skarr (2003) ArticleTitleThe PedsQLTM 4.0 as a pediatric population health measure: Feasibility, reliability, and validity Ambul Pediatr 3 329–341 Occurrence Handle10.1367/1539-4409(2003)003<0329:TPAAPP>2.0.CO;2 Occurrence Handle14616041

    Article  PubMed  Google Scholar 

  6. E Waters L Salmon M Wake (2000) ArticleTitleThe parent-form Child Health Questionnaire in Australia: Comparison of reliability, validity, structure, and norms J Pediatr Psychol 25 381–391 Occurrence Handle10.1093/jpepsy/25.6.381 Occurrence Handle1:STN:280:DC%2BD3M%2FislOitQ%3D%3D Occurrence Handle10980043

    Article  CAS  PubMed  Google Scholar 

  7. B Starfield AW Riley BF Green et al. (1995) ArticleTitleThe adolescent Child Health and Illness Profile: A population-based measure of health Med Care 33 553–566 Occurrence Handle1:STN:280:ByqB2MjmtlA%3D Occurrence Handle7739277

    CAS  PubMed  Google Scholar 

  8. AW Riley (2004) ArticleTitleEvidence that school-age children can self-report on their health Ambul Pediatr 4 371–376 Occurrence Handle10.1367/A03-178R.1 Occurrence Handle15264962

    Article  PubMed  Google Scholar 

  9. TD Topolski TC Edwards DL Patrick (2004) ArticleTitleToward youth self-report of health and quality of life in population health monitoring Ambul Pediatr 4 387–394 Occurrence Handle10.1367/A03-131R.1 Occurrence Handle15264944

    Article  PubMed  Google Scholar 

  10. C McCowan FP Bryce RG Neville IK Crombie R Clark (1996) ArticleTitleSchool absence: A valid morbidity marker for asthma Health Bull 54 307–313 Occurrence Handle1:STN:280:BymA2sjms1Y%3D

    CAS  Google Scholar 

  11. M Weitzman (1986) ArticleTitleSchool absence rates as outcome measures in studies of children with chronic illness J Chron Dis 39 799–808 Occurrence Handle10.1016/0021-9681(86)90082-2 Occurrence Handle1:STN:280:BiiD3cfoslQ%3D Occurrence Handle3760108

    Article  CAS  PubMed  Google Scholar 

  12. PW Newacheck WR Taylor (1992) ArticleTitleChildhood chronic illness: Prevalence, severity, and impact Am J Public Health 82 364–371 Occurrence Handle1:STN:280:By2C287gs1Y%3D Occurrence Handle1536351

    CAS  PubMed  Google Scholar 

  13. EA McGlynn N Halfon (1998) ArticleTitleOverview of issues in improving quality of care for children Health Ser Res 33 977–1000 Occurrence Handle1:STN:280:DyaK1cvltVWjuw%3D%3D

    CAS  Google Scholar 

  14. RM Kaplan (2001) Quality of life in children: A health care policy perspective HM Koot JL Wallander (Eds) Quality of Life in Child and Adolescent Illness Concepts Methods and Findings Brunner-Routledge East Sussex, Great Britain 89–120

    Google Scholar 

  15. InstitutionalAuthorNameCenters for Disease Control and Prevention (2000) Measuring Healthy Days: Population Assessment of Health-Related Quality of Life CDC Atlanta Georgia

    Google Scholar 

  16. JW Varni M Seid PS Kurtin (2001) ArticleTitleThe PedsQLTM 4.0: Reliability and validity of the Pediatric Quality of Life InventoryTM Version 4.0 Generic Core Scales in healthy and patient populations Med Care 39 800–812 Occurrence Handle10.1097/00005650-200108000-00006 Occurrence Handle1:STN:280:DC%2BD3MvitVGgtw%3D%3D Occurrence Handle11468499

    Article  CAS  PubMed  Google Scholar 

  17. JW Varni TM Burwinkle MA Rapoff JL Kamps N Olson (2004) ArticleTitleThe PedsQLTM in pediatric asthma: Reliability and validity of the Pediatric Quality of Life InventoryTM Generic Core Scales and Asthma Module J Behav Med 27 297–318 Occurrence Handle10.1023/B:JOBM.0000028500.53608.2c Occurrence Handle15259457

    Article  PubMed  Google Scholar 

  18. JW Varni TM Burwinkle ER Katz K Meeske P Dickinson (2002) ArticleTitleThe PedsQLTM in pediatric cancer: Reliability and validity of the Pediatric Quality of Life InventoryTM Generic Core Scales, Multidimensional Fatigue Scale, and Cancer Module Cancer 94 2090–2106 Occurrence Handle10.1002/cncr.10428 Occurrence Handle11932914

    Article  PubMed  Google Scholar 

  19. JW Varni M Seid TS Knight TM Burwinkle J Brown IS Szer (2002) ArticleTitleThe PedsQLTM in pediatric rheumatology: Reliability, validity, and responsiveness of the Pediatric Quality of Life InventoryTM Generic Core Scales and Rheumatology Module Arthritis Rheum 46 714–725 Occurrence Handle10.1002/art.10095 Occurrence Handle11920407

    Article  PubMed  Google Scholar 

  20. K Uzark K Jones TM Burwinkle JW Varni (2003) ArticleTitleThe Pediatric Quality of Life InventoryTM in children with heart disease Prog Pediatr Cardiol 18 141–148

    Google Scholar 

  21. E Chen KA Matthews WT Boyce (2002) ArticleTitleSocioeconomic differences in children’s health: How and why do these relationships change with age? Psychol Bull 128 295–329 Occurrence Handle10.1037/0033-2909.128.2.295 Occurrence Handle11931521

    Article  PubMed  Google Scholar 

  22. LM Olson M Lara MP Frintner (2004) ArticleTitleMeasuring health status and quality of life for US children: Relationship to race, ethnicity, and income status Ambul Pediatr 4 377–386 Occurrence Handle10.1367/A03-156.1 Occurrence Handle15264941

    Article  PubMed  Google Scholar 

  23. ME Mansour U Kotagal B Rose et al. (2003) ArticleTitleHealth-related quality of life in urban elementary schoolchildren Pediatrics 111 1372–1381 Occurrence Handle10.1542/peds.111.6.1372 Occurrence Handle12777555

    Article  PubMed  Google Scholar 

  24. NE Adler T Boyce MA Chesney et al. (1994) ArticleTitleSocioeconomic status and health: The challenge of the gradient Am Psychol 49 15–24 Occurrence Handle10.1037/0003-066X.49.1.15 Occurrence Handle1:STN:280:ByuC28fjsFw%3D Occurrence Handle8122813

    Article  CAS  PubMed  Google Scholar 

  25. M Seid JW Varni LO Bermudez et al. (2001) ArticleTitleParent’s Perceptions of Primary Care: Measuring parent’s experiences of pediatric primary care quality Pediatrics 108 264–270 Occurrence Handle10.1542/peds.108.2.264 Occurrence Handle1:STN:280:DC%2BD3MvjvVWgtw%3D%3D Occurrence Handle11483786

    Article  CAS  PubMed  Google Scholar 

  26. DL Fairclough (2002) Design and Analysis of Quality of Life Studies in Clinical Trials: Interdisciplinary Statistics Chapman & Hall/CRC New York

    Google Scholar 

  27. JE Ware (1993) SF-36 Health Survey: Manual and Interpretation Guide The Health Institute Boston, MA

    Google Scholar 

  28. DL Fairclough DF Cella (1996) ArticleTitleFunctional Assessment of Cancer Therapy (FACT-G): Non-response to individual questions Qual Life Res 5 321–329 Occurrence Handle10.1007/BF00433916 Occurrence Handle1:STN:280:BymA387ns1M%3D Occurrence Handle8763800

    Article  CAS  PubMed  Google Scholar 

  29. ML Essink-Bot PFM Krabbe GJ Bonsel NK Aaronson (1997) ArticleTitleAn empirical comparison of four generic health status measures: The Nottingham Health Profile, the Medical Outcomes Study 36-Item Short-Form Health Survey, the COOP/WONCA Charts, and The EuroQol Instrument Med Care 35 522–537 Occurrence Handle10.1097/00005650-199705000-00008 Occurrence Handle1:STN:280:ByiB1crgs1I%3D Occurrence Handle9140339

    Article  CAS  PubMed  Google Scholar 

  30. CA McHorney JE Ware JFR Lu CD Sherbourne (1994) ArticleTitleThe MOS 36-item short-form health survey (SF-36): III Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 32 40–66 Occurrence Handle1:STN:280:ByuC3cvjs1M%3D Occurrence Handle8277801

    CAS  PubMed  Google Scholar 

  31. LJ Cronbach (1951) ArticleTitleCoefficient alpha and the internal structure of tests Psychometrika 16 297–334

    Google Scholar 

  32. JC Nunnally IR Bernstein (1994) Psychometric Theory EditionNumber3 McGraw-Hill New York

    Google Scholar 

  33. EJ Pedhazur LP Schmelkin (1991) Measurement, Design, and Analysis: An Integrated Approach Erlbaum Hillsdale, NJ

    Google Scholar 

  34. CA McHorney JE Ware AE Raczek (1993) ArticleTitleThe MOS 36-item short-form health survey (SF-36): II Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31 247–263 Occurrence Handle1:STN:280:ByyC1MnisVI%3D Occurrence Handle8450681

    CAS  PubMed  Google Scholar 

  35. CA McHorney JE Ware W Rogers AE Raczek JFR Lu (1992) ArticleTitleThe validity and relative precision of MOS short- and long-form health status scales and Dartmouth COOP charts: Results from the Medical Outcomes Study Med Care 30 MS253–MS265 Occurrence Handle1:STN:280:By2B287gvVc%3D Occurrence Handle1583937

    CAS  PubMed  Google Scholar 

  36. J Cohen (1988) Statistical Power Analysis For the Behavioral Sciences EditionNumber2 Erlbaum Hillsdale NJ

    Google Scholar 

  37. JJ Bartko (1966) ArticleTitleThe intraclass correlation coefficient as a measure of reliability Psychol Rep 19 3–11 Occurrence Handle1:STN:280:CCmC28%2FjvVE%3D Occurrence Handle5942109

    CAS  PubMed  Google Scholar 

  38. KA Wilson AJ Dowling M Abdolell IF Tannock (2001) ArticleTitlePerception of quality of life by patients, partners and treating physicians Qual Life Res 9 1041–1052

    Google Scholar 

  39. InstitutionalAuthorNameSPSS (1998) SPSS 8.0 for Windows SPSS, Inc. Chicago

    Google Scholar 

  40. RJ Thompson KE Gustafson (1996) Adaptation to Chronic Childhood Illness American Psychological Association Washington DC

    Google Scholar 

  41. JL Wallander JW Varni (1998) ArticleTitleEffects of pediatric chronic physical disorders on child and family adjustment J Child Psychol Psyc 39 29–46 Occurrence Handle1:STN:280:DyaK1c7psFGluw%3D%3D

    CAS  Google Scholar 

  42. RH Bradley RF Corwyn (2002) ArticleTitleSocioeconomic status and child development Annual Rev Psychol 53 371–399 Occurrence Handle11752490

    PubMed  Google Scholar 

  43. DA Dillman (2000) Mail and Internet Surveys: The Tailored Design Method EditionNumber2 Wiley New York

    Google Scholar 

  44. KL Carman PF Short DO Farley MA Schnaier DB Elliott PM Gallagher (1999) ArticleTitleEarly lessons from CAHPS demonstrations and evaluations Med Care 37 MS97–MS105 Occurrence Handle10.1097/00005650-199903001-00011 Occurrence Handle1:STN:280:DyaK1M7ps1ajsg%3D%3D Occurrence Handle10098564

    Article  CAS  PubMed  Google Scholar 

  45. FJ Fowler SuffixJr. PM Gallagher S Nederend (1999) ArticleTitleComparing telephone and mail responses to the CAHPS survey instrument Med Care 37 MS41–MS49 Occurrence Handle10.1097/00005650-199903001-00005 Occurrence Handle10098558

    Article  PubMed  Google Scholar 

  46. InstitutionalAuthorNameInstitute of Medicine (2004) Children’s Health, the Nation’s Wealth: Assessing and Improving Child Health National Academies Press Washington, D.C.

    Google Scholar 

  47. K Fiscella P Franks MR Gold CM Clancy (2000) ArticleTitleInequality in quality: Addressing socioeconomic, racial, and ethnic disparities in health care J Am Med Assoc 283 2579–2584 Occurrence Handle1:STN:280:DC%2BD3c3ns1ShtA%3D%3D

    CAS  Google Scholar 

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Varni, J.W., Burwinkle, T.M. & Seid, M. The PedsQLTM 4.0 as a School Population Health Measure: Feasibility, Reliability, and Validity. Qual Life Res 15, 203–215 (2006). https://doi.org/10.1007/s11136-005-1388-z

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