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Xie F, Xie S, Pullenayegum E, Ohinmaa A. Understanding Canadian stakeholders' views on measuring and valuing health for children and adolescents: a qualitative study. Qual Life Res 2024; 33:1415-1422. [PMID: 38438665 PMCID: PMC11045599 DOI: 10.1007/s11136-024-03618-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE Valuing child health is critical to assessing the value of healthcare interventions for children. However, there remain important methodological and normative issues. This qualitative study aimed to understand the views of Canadian stakeholders on these issues. METHODS Stakeholders from health technology assessment (HTA) agencies, pharmaceutical industry representatives, healthcare providers, and academic researchers/scholars were invited to attend an online interview. Semi-structured interviews were designed to focus on: (1) comparing the 3-level and 5-level versions of the EQ-5D-Y; (2) source of preferences for valuation (adults vs. children); (3) perspective of valuation tasks; and (4) methods for valuation (discrete choice experiment [DCE] and its variants versus time trade-off [TTO]). Participants were probed to consider HTA guidelines, cognitive capacity, and potential ethical concerns. All interviews were recorded and transcribed verbatim. Framework analysis with the incidence density method was used to analyze the data. RESULTS Fifteen interviews were conducted between May and September 2022. 66.7% (N = 10) of participants had experience with economic evaluations, and 86.7% (N = 13) were parents. Eleven participants preferred the EQ-5D-Y-5L. 12 participants suggested that adolescents should be directly involved in child health valuation from their own perspective. The participants were split on the ethical concerns. Eight participants did not think that there was ethical concern. 11 participants preferred DCE to TTO. Among the DCE variants, 6 participants preferred the DCE with duration to the DCE with death. CONCLUSIONS Most Canadian stakeholders supported eliciting the preferences of adolescents directly from their own perspective for child health valuation. DCE was preferred if adolescents are directly involved.
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Affiliation(s)
- Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada.
| | - Shitong Xie
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Eleanor Pullenayegum
- The Hospital for Sick Children, Toronto, Canada
- Dalla Lana School of Public Health, The University of Toronto, Toronto, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, Canada
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Kodali HP, Hitch L, Dunlap AF, Starvaggi M, Wyka KE, Huang TT. A systematic review on the relationship between the built environment and children's quality of life. BMC Public Health 2023; 23:2472. [PMID: 38082378 PMCID: PMC10714453 DOI: 10.1186/s12889-023-17388-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Evidence of the effects of the built environment on children has mainly focused on disease outcomes; however, quality of life (QoL) has gained increasing attention as an important health and policy endpoint itself. Research on built environment effects on children's QoL could inform public health programs and urban planning and design. OBJECTIVE We aimed to review and synthesize the evidence of the relationship between built environment features and children's QoL. METHODS Five research databases were searched for quantitative peer-reviewed studies on children between 2 and 18 years, published in English or German between January 2010 and August 2023. Only primary research was considered. Included studies (n = 17) were coded and methodologically assessed with the Joanna Briggs Critical Appraisal Checklists, and relevant data were extracted, analyzed, and synthesized, using the following built environment framework: (1) neighborhood green and blue space, (2) neighborhood infrastructure, and (3) neighborhood perception. RESULTS Green space was positively associated with children's QoL. Infrastructure yielded inconclusive results across all measured aspects. Overall neighborhood satisfaction was positively correlated with higher QoL but results on perceived environmental safety were mixed. CONCLUSIONS Most studies are correlational, making it difficult to infer causality. While the positive findings of green space on QoL are consistent, specific features of the built environment show inconsistent results. Overall perception of the built environment, such as neighborhood satisfaction, also shows more robust results compared to perceptions of specific features of the built environment. Due to the heterogeneity of both built environment and QoL measures, consistent measures of both concepts will help advance this area of research.
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Affiliation(s)
- Hanish P Kodali
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA
| | - Lisa Hitch
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA
| | - Ann F Dunlap
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA
| | - Marc Starvaggi
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA
| | - Katarzyna E Wyka
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA
| | - Terry Tk Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA.
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Liu ZH, Wang YL, Yu YS, Ren Y, Zhang T, Liu HQ, Wu XY. The individual and combined associations of health behaviours with health-related quality of life amongst junior high school students in China. Front Public Health 2023; 11:1283721. [PMID: 37900025 PMCID: PMC10602644 DOI: 10.3389/fpubh.2023.1283721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 09/20/2023] [Indexed: 10/31/2023] Open
Abstract
Objectives This study aimed to investigate the individual and joint associations of sedentary behaviour, physical activity (PA), sleep and breakfast eating on health-related quality of life (HRQoL) amongst Chinese junior high school students. Methods Data were from 783 junior high school students who participated in a health behaviour and health survey in Jining city of Shandong province of China. HRQoL was measured by the EuroQol five-dimensional questionnaire, youth version (EQ-5D-Y). Multivariable logistic and linear regressions were applied to examine the associations between health behaviours and HRQoL. Results Multivariable regression analyses showed that using a computer ≥ 2 h a day (vs. < 2 h/day) is associated with increased likelihood of having health problems in the three EQ-D-Y dimensions, including walking, looking after self and doing usual activities. Lower PA is associated with more problems in feeling worried, sad or unhappy, and with a lower visual analogue scale (VAS) score. Students who had insufficient sleep time (e.g., <7 h/day), and skipped eating breakfast were more likely to experience lower HRQoL in the dimensions of having pain or discomfort, and feeling worried, sad or unhappy, and a lower VAS score than those students who had longer sleep time and no breakfast skipping. Students who reported having the combined ≥ 2 unhealthy behaviours relative to the peers with 0-1 unhealthy behaviours were more likely to have lower HRQoL. Conclusion The findings in the present study underline the importance of promoting healthy behaviours in order to improve HRQoL amongst Chinese junior high school students.
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Affiliation(s)
- Ze Hua Liu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Yi Lin Wang
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Yue Shuang Yu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Yan Ren
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Tong Zhang
- Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Hong Qing Liu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Xiu Yun Wu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
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Hitch L, Kodali H, Starvaggi M, Wyka KE, Huang TT. A systematic review on the relationship between the built environment and children's quality of life. RESEARCH SQUARE 2023:rs.3.rs-2828550. [PMID: 37163113 PMCID: PMC10168438 DOI: 10.21203/rs.3.rs-2828550/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Evidence of the effects of the built environment on children has mainly focused on disease outcomes; however, quality of life (QoL) has gained increasing attention as an important health and policy endpoint itself. Research on built environment effects on children's QoL could inform public health programs and urban planning and design. Objective We aimed to review and synthesize the evidence of the relationship between built environment features and children's QoL. Methods Five research databases were searched for quantitative peer-reviewed studies on children between 2-18 years, published in English or German between 2010-2021. Only primary research was considered. Included studies (n=17) were coded and methodologically assessed with the Joanna Briggs Critical Appraisal Checklists, and relevant data were extracted, analyzed, and synthesized, using the following built environment thematic framework: 1) neighborhood natural environment, 2) neighborhood infrastructure, and 3) neighborhood perception. Results Green space was positively associated with children's QoL. Infrastructure yielded inconclusive results across all measured aspects. Overall neighborhood satisfaction was positively correlated with higher QoL but results on perceived environmental safety were mixed. Conclusions Most studies are correlational, making it difficult to infer causality. While the positive findings of green space on QoL are consistent, specific features of the built environment show inconsistent results. Overall perception of the built environment, such as neighborhood satisfaction, also shows more robust results compared to perceptions of specific features of the built environment. Due to the heterogeneity of both built environment and QoL measures, consistent definitions of both concepts will help advance this area of research.
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Affiliation(s)
- Lisa Hitch
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York
| | - Hanish Kodali
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York
| | - Marc Starvaggi
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York
| | - Katarzyna E Wyka
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York
| | - Terry Tk Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York
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Perez-Sousa MA, Olivares PR, Carrasco-Zahinos R, Garcia-Hermoso A. Normative Values and Psychometric Properties of EQ-5D-Y-3L in Chilean Youth Population among Different Weight Statuses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4096. [PMID: 36901107 PMCID: PMC10002306 DOI: 10.3390/ijerph20054096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study aimed to provide population norms among children and adolescents in Chile using the EQ-5D-Y-3L questionnaire and to examine its feasibility and validity among body weight statuses. METHODS This was a cross-sectional study in which 2204 children and adolescents (aged 8-18 years) from Chile completed a set of questionnaires providing sociodemographic, anthropometric and health-related quality of life (HRQoL) data using the five EQ-5D-Y-3L dimensions and its visual analogue scale (EQ-VAS). Descriptive statistics of the five dimensions and the EQ-VAS were categorized into body weight status groups for the EQ-5D-Y-3L population norms. The ceiling effect, feasibility and discriminant/convergent validity of the EQ-5D-Y-3L were tested. RESULTS The dimensions of the EQ-5D-Y-3L questionnaire presented more ceiling effects than the EQ-VAS. The validity showed that the EQ-VAS could discriminate among body weight statuses. However, the EQ-5D-Y-3L index (EQ-Index) demonstrated a non-acceptable discriminant validity. Furthermore, both the EQ-Index and the EQ-VAS presented an acceptable concurrent validity among weight statuses. CONCLUSIONS The normative values of the EQ-5D-Y-3L indicated its potential use as a reference for future studies. However, the validity of the EQ-5D-Y-3L for comparing the HRQoL among weight statuses could be insufficient.
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Affiliation(s)
- Miguel Angel Perez-Sousa
- Department of Physical Education, Faculty of Education, University of Córdoba, 14071 Cordoba, Spain
- Epidemiology of Physical Activity and Fitness Across Lifespan Research Group, University of Seville, 41004 Seville, Spain
| | - Pedro R. Olivares
- Faculty of Education, Psychology and Sport Sciences, University of Huelva, Avenida de las Fuerzas Armadas s/n 21007, 21004 Huelva, Spain
- Instituto de Actividad Fisica y Salud, Universidad Autonoma de Chile, Talca 3460000, Chile
| | - Rocio Carrasco-Zahinos
- Faculty of Education, Psychology and Sport Sciences, University of Huelva, Avenida de las Fuerzas Armadas s/n 21007, 21004 Huelva, Spain
| | - Antonio Garcia-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Spain
- Physical Activity, Sport and Health Sciences Laboratory, University of Santiago de Chile, Santiago 9170020, Chile
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Wang J, Jin W, Shi L, Geng Y, Zhu X, Hu W. Health-Related Quality of Life in Children: The Roles of Age, Gender and Interpersonal Trust. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15408. [PMID: 36430127 PMCID: PMC9690605 DOI: 10.3390/ijerph192215408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Health-related quality of life (HRQoL) is an interesting topic in health care sciences and psychology. Deeper insight into the internal mechanism of this effect through large samples is crucial to further understanding HRQoL and making targeted suggestions to improve HRQoL. The present study aims to investigate the mediating role of interpersonal trust between age and HRQoL from a developmental lens. The purpose of this study was to profile the Pediatric Quality of Life Inventory 4.0 generic scale in China and test the relationship between age and health-related quality of life, as well as the mediating role of interpersonal trust and the moderating role of gender. A sample of 6248 children completed measures of demography, health-related quality of life, and interpersonal trust. Regression analyses were performed to test the mediating role of interpersonal trust and the moderating role of gender. Age was associated with lower health-related quality of life and lower interpersonal trust. Similarly, gender differences were also noted, with boys reporting higher health-related quality of life and lower interpersonal trust than girls. Additionally, the health-related quality of life of girls declined more than that of boys with increasing age. Regression analyses revealed that age could predict decreased health-related quality of life via lower levels of interpersonal trust. What is more, the mediation effect was moderated by gender, with the observed mediation effect being stronger among boys than girls. The current study replicates age and gender differences in health-related quality of life and interpersonal trust. Moreover, this study explained how and when age affected the health-related quality of life of children, and provided a deeper understanding of the relation between age and health-related quality of life.
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Affiliation(s)
- Jing Wang
- School of Politics and Public Administration, Zhengzhou University, Zhengzhou 450001, China
| | - Wenjing Jin
- School of Marxism, Zhengzhou University, Zhengzhou 450001, China
| | - Liping Shi
- Department of Psychology, School of Social Development and Public Policy, Fudan University, Shanghai 200433, China
| | - Yaoguo Geng
- School of Marxism, Zhengzhou University, Zhengzhou 450001, China
- School of Education, Zhengzhou University, Zhengzhou 450001, China
| | - Xueli Zhu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Wanying Hu
- School of Education, Zhengzhou University, Zhengzhou 450001, China
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Perez-Sousa MA, Olivares PR, Gusi N. Psychometric Properties of the Spanish Versions of EQ-5D-Y-3L and EQ-5D-Y-5L in Children with Cancer: A Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11420. [PMID: 36141694 PMCID: PMC9517348 DOI: 10.3390/ijerph191811420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: The recent published version with five levels of response of EQ-5D-Y needs to be studied in children with chronic illness. For this, the aim of the present study was to assess and compare the psychometric properties of EQ-5D-Y-3L and EQ-5D-Y-5L in terms of feasibility, ceiling effect, redistribution properties, informativity and inconsistence responses in children with cancer. (2) Methods: A core set of self-report tools, including the Spanish version of EQ-5D-Y-3L and EQ-5D-Y-5L, were administered to children drawn from the population with cancer. EQ-5D-Y-3L and EQ-5D-Y-5L were evaluated in terms of feasibility, ceiling effects, redistribution properties and differences in absolute and relative informativity. (3) Results: A total of 73 children (9.7 ± 2.3 years old) from the population with cancer participated in the study. No missing data in the new EQ-5D-Y-5L were visualized, so the feasibility was acceptable. EQ-5D-Y-5L showed a low ceiling effect in all dimensions with relative changes from EQ-5D-Y-3L to EQ-5D-Y-5L of between 15.3% and 42.4% for the dimensions and 44.6% for the overall system. Compared to EQ-5D-Y-3L, EQ-5D-Y-5L provided a better distribution of the severity of the problem in the five levels of response. The absolute informativity (Shannon's index) did not show statistically significant differences between EQ-5D-Y-3L and EQ-5D-Y-5L in all dimensions and the overall system. (4) Conclusions: EQ-5D-Y-5L is feasible, presenting a low ceiling effect and high discriminative power.
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Affiliation(s)
- Miguel A. Perez-Sousa
- Department of Specific Didactics, Faculty of Education, University of Córdoba, 14071 Cordoba, Spain
- Epidemiology of Physical Activity and Fitness across Lifespan Research Group, University of Seville, 41004 Seville, Spain
| | - Pedro R. Olivares
- Faculty of Education, Psychology and Sport Sciences, University of Huelva, Avenida de las Fuerzas Armadas s/n, 21007 Huelva, Spain
- Instituto de Actividad Fisica y Salud, Universidad Autonoma de Chile, 3460000 Talca, Chile
| | - Narcis Gusi
- Faculty of Sport Sciences, University of Extremadura, Avenida de la Universidad s/n, 10003 Cáceres, Spain
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Golicki D, Młyńczak K. Measurement Properties of the EQ-5D-Y: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:S1098-3015(22)02001-0. [PMID: 35752534 DOI: 10.1016/j.jval.2022.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/16/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to perform a systematic review of published evidence on the psychometric properties of 3-level version of EQ-5D-Y and 5-level version of EQ-5D-Y (EQ-5D-Y-5L). METHODS A literature search on the MEDLINE, Embase, and EuroQol website (until June 2021) was conducted. Original studies on EQ-5D-Y psychometric properties such as feasibility, distribution properties (ceiling and floor effects), reliability (test-retest, interrater, intermodal), validity (known-groups, convergent), and responsiveness, published as full-text articles in English, were included. Studies on experimental EQ-5D-Y versions were excluded. The following data were pooled using random effects models: missing values, the ceiling effect, and correlations coefficients with other measures. RESULTS A total of 47 studies (inclusive of 7 on EQ-5D-Y-5L) containing data from 45 310 children and 2690 proxy respondents representing 15 countries were included. These studies were characterized as being high quality according to the quality index. The most represented areas were school populations and musculoskeletal diseases and orthopedics. The EQ-5D-Y dimensions, EQ visual analog scale, and EQ index were reported in 89%, 77%, and 26% of studies, respectively. Most articles addressed validity (known-groups, n = 27; convergent, n = 21) and reliability (test-retest and interrater, n = 10 each). Convergent validity studies showed that, where the assessment of the child's functioning at school is required, EQ-5D-Y should be supplemented with other school-specific measures. CONCLUSIONS This systematic review provides a summary of measurement properties and the psychometric performance of 3-level version of EQ-5D-Y and EQ-5D-Y-5L. The existing evidence supports using the EQ-5D-Y descriptive system and EQ visual analog scale in children and adolescent populations. Further research on test-retest reliability and the responsiveness of the EQ-5D-Y index obtained with child-specific value sets is needed.
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Affiliation(s)
- Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
| | - Katarzyna Młyńczak
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
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Kim E, Shin MH, Yang JH, Ahn SK, Na BJ, Nam HS. Associations of regional-level perceived stress and depression with health-related quality of life in Korean adults: a multilevel analysis of 2017 Korea Community Health Survey data. Epidemiol Health 2021; 43:e2021062. [PMID: 34525500 PMCID: PMC8611318 DOI: 10.4178/epih.e2021062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/08/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES We examined the associations of individual and regional-level perceived stress and depression with health-related quality of life (HRQOL) in Korean adults. METHODS We used data from the 2017 Korea Community Health Survey, which included 216,713 adults living within 254 municipal districts. As individual-level independent variables, perceived stress (higher vs. lower) and depression (Patient Health Questionnaire-9 ≥10) were defined. Regional-level age-adjusted rates of perceived stress (%) and depression (%) were created for 254 municipal districts and categorized into quartiles to generate regional levels of stress and depression. HRQOL was defined as the individual-level EuroQol 5-dimensional index×100. A multilevel analysis was performed to identify the relationship between individual or regional-level independent variables and individual HRQOL. RESULTS In the null model, the proportions of individual variation in the HRQOL explained by region were 1.7% and 2.7% for men and women, respectively. When adjusted with all individual-level variables, regional stress and depression, as well as individual-level perceived stress and depression, were significantly related to HRQOL for both genders. In the full model including all variables, the decrease in HRQOL from the first to the fourth quartile group of regional stress was greater in women (-1.09; 95% confidence interval [CI], -1.87 to -0.31) than in men (-0.65; 95% CI, -1.04 to -0.26). CONCLUSIONS Our results suggest that regional-level perceived stress and depression, as well as individual-level perceived stress and depression, are inversely associated with individual HRQOL.
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Affiliation(s)
- Eunsu Kim
- Department of Public Health, Graduate School, Chungnam National University, Daejeon, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jung-Ho Yang
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Soon-Ki Ahn
- Public Health and Medical Services Office, Chungnam National University Hospital, Daejeon, Korea
| | - Baeg-Ju Na
- Graduate School of Urban Health, University of Seoul, Seoul, Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
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Health-related quality of life is strongly associated with self-efficacy, self-esteem, loneliness, and stress in 14-15-year-old adolescents: a cross-sectional study. Health Qual Life Outcomes 2020; 18:352. [PMID: 33138833 PMCID: PMC7607747 DOI: 10.1186/s12955-020-01585-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/29/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND To enhance and better understand health-related quality of life (HRQOL) in adolescents, it is important to study factors associated with HRQOL. The present study aimed to assess possible associations between sociodemographic variables, self-efficacy, self-esteem, pain, sleep, loneliness, stress and HRQOL in 14 to 15-year-old adolescents. METHODS A cross-sectional study was performed among 696 adolescents (14-15 years) in a school-based setting. Sociodemographic variables, self-efficacy, self-esteem, pain, sleep, loneliness and stress were analyzed. The variables were all assessed with well-validated instruments. HRQOL was analyzed using KIDSCREEN 27. Analyses included Chi-square, independent t-tests, Mann-Whitney U tests, linear regression analyses and hierarchical regression analyses. The results from linear regression models were expressed as standardized beta. RESULTS The adolescents generally reported high levels of HRQOL. However, girls scored significantly worse on HRQOL, self-efficacy, self-esteem, pain, sleep, loneliness and stress compared to boys. Using hierarchical regression analyses we found that Self-efficacy (beta = 0.11-0.24), Self-esteem: (beta = 0.12-0.21), Loneliness: (beta = - 0.24 to - 0.45) and Stress: (beta = - 0.26 to - 0.34) revealed the strongest associations with the HRQOL dimensions. Sociodemographic-, pain- and sleep related covariates were all significantly associated with some of the KIDSCREEN subscales, however their effect on the outcome was smaller than for the psychosocial variables listed above. Being a girl, not living with both parents, not having both parents working, being absent from school more than 4 days, having pain and having lack of enough sleep were all independently negatively associated with HRQOL. CONCLUSIONS HRQOL is strongly associated with self-efficacy, self-esteem, loneliness and stress in 14 to 15-year-old adolescents. Our findings indicate that positive psychosocial factors such as self-efficacy and self-esteem might play a buffer role for negative psychosocial factors (e.g. stress) in adolescents. Further, our results show that girls score significantly worse on factors that are associated to HRQOL compared to boys. To improve HRQOL in school-based populations of adolescents, we suggest that future interventions should aim to strengthen self-efficacy and self-esteem. We recommend gender specific interventions.
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Kreimeier S, Greiner W. [Development of the German version of EQ-5D-Y-5L to measure health-related quality of life in children and adolescents: Identification of response labels and pilot testing]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2019; 144-145:24-34. [PMID: 31378708 DOI: 10.1016/j.zefq.2019.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/21/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE EQ-5D-Y-3L is a generic, youth-specific instrument to measure health-related quality of life (HRQoL). It contains five dimensions with three severity levels each. The aim of this study was to identify response levels to extend the German EQ-5D-Y version to four or five severity levels (4L or 5L) and to conduct a pilot test of both versions. METHODS In phase 1, we reviewed existing youth-specific HRQoL instruments and conducted focus group interviews with healthy children and adolescents to identify potential new labels. In individual sorting and response scaling interviews, participants aged 8 to 15 years rated the severity of the identified labels. Based on the results, a 4L and a 5L version were developed. In phase 2, the feasibility of those versions was tested in cognitive interviews with healthy children and adolescents as well as those with a health condition. RESULTS In phase 1, 12 to 16 labels were identified for each dimension. These were rated by 64 children and adolescents in the sorting and response scaling interviews. The included labels covered different severity levels of health impairments. In phase 2, 88% of the 33 children and adolescents preferred the 5L version as it was easier for them to report on their own health in more detail. CONCLUSION Involving the target group of children and adolescents, a German EQ-5D-Y version with five severity levels was developed (EQ-5D-Y-5L) that can be used in children and adolescents aged 8 to 15 years. However, the psychometric properties of the instrument need further investigation. In addition, value sets need to be to developed before the questionnaire is suitable for all fields of application.
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Affiliation(s)
- Simone Kreimeier
- Universität Bielefeld, Fakultät für Gesundheitswissenschaften, AG 5 Gesundheitsökonomie und Gesundheitsmanagement, 33615 Bielefeld, Deutschland.
| | - Wolfgang Greiner
- Universität Bielefeld, Fakultät für Gesundheitswissenschaften, AG 5 Gesundheitsökonomie und Gesundheitsmanagement, 33615 Bielefeld, Deutschland
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Kreimeier S, Åström M, Burström K, Egmar AC, Gusi N, Herdman M, Kind P, Perez-Sousa MA, Greiner W. EQ-5D-Y-5L: developing a revised EQ-5D-Y with increased response categories. Qual Life Res 2019; 28:1951-1961. [PMID: 30739287 PMCID: PMC6571085 DOI: 10.1007/s11136-019-02115-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE EQ-5D-Y is a generic measure of health status for children and adolescents aged 8-15 years. Originally, it has three levels of severity in each dimension (3L). This study aimed to develop a descriptive system of EQ-5D-Y with an increased number of severity levels and to test comprehensibility and feasibility. METHODS The study was conducted in Germany, Spain, Sweden and the UK. In Phase 1, a review of existing instruments and focus group interviews were carried out to create a pool of possible labels for a modified severity classification. Participants aged 8-15 rated the severity of the identified labels in individual sorting and response scaling interviews. In Phase 2, preliminary 4L and 5L versions were constructed for further testing in cognitive interviews with healthy participants aged 8-15 years and children receiving treatment for a health condition. RESULTS In Phase 1, a total of 233 labels was generated, ranging from 37 (UK) to 79 labels (Germany). Out of these, 7 to 16 possible labels for each dimension in the different languages were rated in 255 sorting and response scaling interviews. Labels covered an appropriate range of severity on the health continuum in all countries. In Phase 2, the 5L version was generally preferred (by 68-88% of the participants per country) over the 4L version. CONCLUSIONS This multinational study has provided a version of the EQ-5D-Y with 5 severity levels in each dimension. This extended version (EQ-5D-Y-5L) requires testing its psychometric properties and its performance compared to that of the original EQ-5D-Y-3L.
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Affiliation(s)
- Simone Kreimeier
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
| | - Mimmi Åström
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden
- Equity and Health Policy Research Group, Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
- Health Care Services, Stockholm County Council, 171 77, Stockholm, Sweden
| | - Kristina Burström
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden
- Equity and Health Policy Research Group, Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
- Health Care Services, Stockholm County Council, 171 77, Stockholm, Sweden
| | - Ann-Charlotte Egmar
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of Public Health and Medicine, Health-Promotion Interventions and Resilience, The Swedish Red Cross University College, 141 57, Huddinge, Sweden
| | - Narcis Gusi
- Faculty of Sport Sciences, University of Extremadura, Badajoz, Spain
| | | | - Paul Kind
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Centre for Health Economics, Management and Policy, Higher School of Economics, St Petersburg, Russia
| | | | - Wolfgang Greiner
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
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Baroudi M, Petersen S, Namatovu F, Carlsson A, Ivarsson A, Norström F. Preteen children's health related quality of life in Sweden: changes over time and disparities between different sociodemographic groups. BMC Public Health 2019; 19:139. [PMID: 30704442 PMCID: PMC6357483 DOI: 10.1186/s12889-019-6429-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 01/11/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Assessing disparities in health-related quality of Life (HRQoL) is important as a part of health-related disparities in the society. The aim of this study was to explore HRQoL among 12-year-olds in Sweden in terms of differences between years 2005 and 2009 and disparities related to sociodemographic background. METHODS During the school years 2005 and 2009, a total of 18,325 sixth grade students in Sweden were invited to a celiac disease screening study; 13,279 agreed to participate. Jointly with the celiac screening, the children answered a questionnaire that included EuroQol 5 Dimensions-youth (EQ-5D-Y) and their parents responded to separate questionnaires about their own and their child's country of birth, family structure, their employment status, occupation, and education. In total 11,009 child-parent questionnaires were collected. Logistic regression was used to study differences in HRQoL between 2005 and 2009, and between various sociodemographic subgroups. RESULTS Compared with 2005, children in 2009 reported more pain (OR: 1.20, 95% CI: 1.1-1.3) and more mood problems (OR: 1.35, 95% CI: 1.2-1.5). In general, girls reported more pain and mood problems and had more disparities than boys. There were no significant differences based on parents' occupation, however, children of parents with low or medium education levels reported less "mood problems" than those of parents with high education levels (OR: 0.65, 95% CI: 0.46-0.92) and (OR: 0.84, 95% CI: 0.73-0.96), respectively. A slight variation was seen in HRQoL between children with different migration background. Girls living in small municipalities reported more pain (OR: 1.51, 95% CI: 1.14-2.01), and problems performing usual activities (OR: 3.77, 95% CI: 2.08-6.84), compared to girls living in large municipalities. In addition, children living with two parents had less mood problems than children living in other family constellations. CONCLUSION More children reported pain and mood problems in 2009 compared with 2005. To study future trends, health outcomes among children in Sweden should continue to be reported periodically. More efforts should be invested to increase the awareness of health-related disparities as highlighted in this study especially for girls living in small municipalities and children of parents with high education level.
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Affiliation(s)
- Mazen Baroudi
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Solveig Petersen
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Fredinah Namatovu
- Department of Historical, Philosophical and Religious Studies, Umeå University, Umeå, Sweden
| | - Annelie Carlsson
- Department of Pediatrics, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Anneli Ivarsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Fredrik Norström
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
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Orru K, Orru H, Maasikmets M, Hendrikson R, Ainsaar M. Well-being and environmental quality: Does pollution affect life satisfaction? Qual Life Res 2015; 25:699-705. [PMID: 26289023 DOI: 10.1007/s11136-015-1104-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE We aimed to explore the effect of ambient air pollution on individual persons' levels of subjective well-being. Our research question was: to what extent is an individual's life satisfaction shaped by exposure to PM10? METHODS We used regression models to analyse data on subjective well-being indicators from the last two waves of the European social survey (ESS) and detailed information on local levels of the air pollutant PM10. RESULTS An increase in PM10 annual concentrations by 1 μg/m(3) was associated with a significant reduction in life satisfaction of .017 points on the ESS 10-point life satisfaction scale. CONCLUSIONS Our findings suggest that even in cases of relatively low levels of PM10 air pollution (mean annual concentration of 8.3 ± 3.9 μg/m(3)), in addition to the effects on physical health, exposure negatively affects subjective assessments of well-being.
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Affiliation(s)
- Kati Orru
- Institute of Social Studies, University of Tartu, Lossi 36-401, 51003, Tartu, Estonia.
| | - Hans Orru
- Department of Public Health, University of Tartu, Ravila 19, Tartu, Estonia
| | - Marek Maasikmets
- Estonian Environmental Research Centre, Marja 4D, Tallinn, Estonia
| | - Reigo Hendrikson
- Institute of Social Studies, University of Tartu, Lossi 36-401, 51003, Tartu, Estonia
| | - Mare Ainsaar
- Institute of Social Studies, University of Tartu, Lossi 36-401, 51003, Tartu, Estonia
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Thorrington D, Eames K. Measuring Health Utilities in Children and Adolescents: A Systematic Review of the Literature. PLoS One 2015; 10:e0135672. [PMID: 26275302 PMCID: PMC4537138 DOI: 10.1371/journal.pone.0135672] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 07/24/2015] [Indexed: 11/19/2022] Open
Abstract
Background The objective of this review was to evaluate the use of all direct and indirect methods used to estimate health utilities in both children and adolescents. Utilities measured pre- and post-intervention are combined with the time over which health states are experienced to calculate quality-adjusted life years (QALYs). Cost-utility analyses (CUAs) estimate the cost-effectiveness of health technologies based on their costs and benefits using QALYs as a measure of benefit. The accurate measurement of QALYs is dependent on using appropriate methods to elicit health utilities. Objective We sought studies that measured health utilities directly from patients or their proxies. We did not exclude those studies that also included adults in the analysis, but excluded those studies focused only on adults. Methods and Findings We evaluated 90 studies from a total of 1,780 selected from the databases. 47 (52%) studies were CUAs incorporated into randomised clinical trials; 23 (26%) were health-state utility assessments; 8 (9%) validated methods and 12 (13%) compared existing or new methods. 22 unique direct or indirect calculation methods were used a total of 137 times. Direct calculation through standard gamble, time trade-off and visual analogue scale was used 32 times. The EuroQol EQ-5D was the most frequently-used single method, selected for 41 studies. 15 of the methods used were generic methods and the remaining 7 were disease-specific. 48 of the 90 studies (53%) used some form of proxy, with 26 (29%) using proxies exclusively to estimate health utilities. Conclusions Several child- and adolescent-specific methods are still being developed and validated, leaving many studies using methods that have not been designed or validated for use in children or adolescents. Several studies failed to justify using proxy respondents rather than administering the methods directly to the patients. Only two studies examined missing responses to the methods administered with respect to the patients’ ages.
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Affiliation(s)
- Dominic Thorrington
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Ken Eames
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Houben-van Herten M, Bai G, Hafkamp E, Landgraf JM, Raat H. Determinants of health-related quality of life in school-aged children: a general population study in the Netherlands. PLoS One 2015; 10:e0125083. [PMID: 25933361 PMCID: PMC4416795 DOI: 10.1371/journal.pone.0125083] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/20/2015] [Indexed: 11/19/2022] Open
Abstract
Background Health related quality of life is the functional effect of a medical condition and/or its therapy upon a patient, and as such is particularly suitable for describing the general health of children. The objective of this study was to identify and confirm potential determinants of health-related quality of life in children aged 4-11 years in the general population in the Netherlands. Understanding such determinants may provide insights into more targeted public health policy. Methods As part of a population based cross sectional study, the Child Health Questionnaire (CHQ) Parental Form 28 was used to measure health-related quality of life in school-aged children in a general population sample. Parents of 10,651 children aged 4-11 years were interviewed from January 2001 to December 2009. Results Multivariate and regression analyses demonstrated a declined CHQ Physical Summary score for children who had >1 conditions, disorders or acute health complaints and who were greater consumers of healthcare; children with a non-western immigrant background; and children whose parents did not work. Lower CHQ Psychosocial Summary score was reported for children who had >1 conditions, disorders or acute health complaints, boys, children of single parents and obese children. Conclusion The best predictors of health-related quality of life are variables that describe use of health care and the number of disorders and health complaints. Nonetheless, a number of demographic, socio-economic and family/environmental determinants contribute to a child’s health-related quality of life as well.
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Affiliation(s)
| | - Guannan Bai
- Department of Public Health, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Esther Hafkamp
- Department of Public Health, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | | | - Hein Raat
- Department of Public Health, University Medical Centre Rotterdam, Rotterdam, the Netherlands
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The effect of measles on health-related quality of life: a patient-based survey. PLoS One 2014; 9:e105153. [PMID: 25202905 PMCID: PMC4159135 DOI: 10.1371/journal.pone.0105153] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 06/13/2014] [Indexed: 12/03/2022] Open
Abstract
Background Measles is a highly contagious and potentially fatal illness preventable through vaccination. Outbreaks in the UK and many other European countries have been increasing over recent years, with over 3,207 laboratory-confirmed cases reported by Public Health England from January 2012 to the end of June 2013. To aid rational decision making regarding measles control versus other use of healthcare resources, it is important to measure the severity of measles in units that are comparable to other diseases. The standard metric for this in the UK is the quality-adjust life year (QALY). To our knowledge, the impact of measles on health-related quality of life (HRQoL) in terms of QALYs has not been quantified. Methods and Findings Individuals with confirmed measles were sent questionnaires requesting information on the short-term impact of the illness on their HRQoL using the EuroQol EQ-5D-3L questionnaire. HRQoL was reported for the day the questionnaire was received, the worst day of infection and at follow-up three weeks later. 507 questionnaires were sent to individuals with confirmed measles with 203 returned (40%). The majority of respondents were not vaccinated. The mean time off work or school was 9.6 days. The mean duration of perceived illness was 13.8 days. The mean number of QALYs lost was 0.019 (equivalent to 6.9 days). The overall burden of disease in terms of QALYs lost in England based on the total number of confirmed cases in the twelve month period from 1st June 2012 was estimated to be 44.2 QALYs. Conclusion The short-term impact of measles infection on HRQoL is substantial, both at the level of the individual patient and in terms of the overall disease burden. This is the first attempt to quantify QALY-loss due to measles at a population level, and provides important parameters to guide future intervention and control measures.
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Kolodziejczyk JK, Gutzmer K, Wright SM, Arredondo EM, Hill L, Patrick K, Huang JS, Gottschalk M, Norman GJ. Influence of specific individual and environmental variables on the relationship between body mass index and health-related quality of life in overweight and obese adolescents. Qual Life Res 2014; 24:251-61. [PMID: 24980678 DOI: 10.1007/s11136-014-0745-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2014] [Indexed: 02/04/2023]
Abstract
PURPOSE Overweight and obese adolescents are at risk for low health-related quality of life (HRQOL). We examined the role of individual- and environmental-level variables on the relationship between body mass index (BMI kg/m(2)) and HRQOL in adolescents. METHODS Linear regressions were performed to conduct mediation and moderation analyses on the relationship between BMI and HRQOL in overweight and obese adolescents (N = 205). HRQOL was measured by the Pediatric Quality of Life Inventory. Hypothesized mediators included depression, measured by the Center for Epidemiologic Studies Depression Scale; body image, measured by the gender-specific body dissatisfaction subscale of the Eating Disorder Inventory; and self-esteem, measured by the Rosenberg Self-Esteem Scale. Mediation was assessed using Baron and Kenny's approach and Sobel's test of indirect effects. Anglo-acculturation, measured by the Short Acculturation Scale for Hispanics-Youth, and environmental perception, measured by parent-proxy report of the Neighborhood Environment Walkability Scale, were hypothesized moderators. RESULTS Body image mediated the relationship between BMI and HRQOL (b = -0.34, SE = 0.17, adj R (2) = 0.19, p = .051), and self-esteem was a partial mediator (b = -0.37, SE = 0.17, adj R (2) = 0.24, p = .027). Sobel's test confirmed these results (p < .05). No significant moderation effects were found. CONCLUSIONS The finding that individual-level factors, such as body image and self-esteem, influence the relationship between BMI and HRQOL while environmental factors, such as neighborhood environment and acculturation, do not extends previous research. The finding that body image and self-esteem partially mediate this relationship presents new areas to investigate in interventions that address BMI in youth.
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Affiliation(s)
- Julia K Kolodziejczyk
- Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, Dept 0811, La Jolla, CA, 92093-0811, USA,
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Audureau E, Rican S, Coste J. Worsening trends and increasing disparities in health-related quality of life: evidence from two French population-based cross-sectional surveys, 1995-2003. Qual Life Res 2014; 22:13-26. [PMID: 22298202 DOI: 10.1007/s11136-012-0117-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2012] [Indexed: 01/10/2023]
Abstract
PURPOSE To investigate time trends in health-related quality of life (HRQoL) in France and to report existing and changing demographic, socioeconomic, and geographic disparities. METHODS Data were drawn from two independent national cross-sectional surveys conducted in 1995 and 2003, including 3,243 individuals aged 18–84 in 1995 and 22,743 in 2003. HRQoL was measured with the 8 subscales of the French version of the SF-36. RESULTS After multiple linear regression, a significant decrease was observed between 1995 and 2003 in all scales scores, from −0.11 adjusted standard deviations for Social Functioning (95% CI: −0.15 to −0.08) to −0.23 for Vitality (−0.26 to −0.19). Increasing age, female gender, divorce/widowhood, lowest educational levels, chronic conditions, and living in the Northern region were identified as independent predictors of lower HRQoL scores. Testing interactions showed significantly greater differences between 1995 and 2003 for subjects aged 75–84 and for least educated subjects (Physical Functioning, General Health). The Gini index increased for all scales. CONCLUSIONS We report evidence of worsening trends and possibly increasing demographic, socioeconomic, and regional disparities in HRQoL between 1995 and 2003 in France. Monitoring HRQoL in populations can provide unique and sensitive data, complementary to classical indicators based on mortality and morbidity.
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Affiliation(s)
- Etienne Audureau
- Biostatistics and Epidemiology Unit, Assistance Publique-Hôpitaux de Paris, Hôtel-Dieu, Nancy-Université, Université Paris-Descartes, Université Metz Paul Verlaine, Research Unit APEMAC, EA 4360, 1 place du Parvis Notre-Dame, 75181 Paris Cedex 4, France.
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Wu XY, Ohinmaa A, Johnson JA, Veugelers PJ. Assessment of children's own health status using visual analogue scale and descriptive system of the EQ-5D-Y: linkage between two systems. Qual Life Res 2013; 23:393-402. [PMID: 23893344 DOI: 10.1007/s11136-013-0479-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The objective of the study is to derive a scoring system for the EQ-5D child-friendly version (EQ-5D-Y) from a population-based sample of children based on their own health state assessments on the descriptive system and the visual analogue scale (VAS). METHODS We used data from the 2008 and 2010 Raising Healthy Eating and Active Living Kids in Alberta surveys of grade five students aged primarily 10-11 years and their parents in the Canadian province of Alberta. We applied a random split sample approach. Two-thirds of the sample (modeling sample) was used for the estimation of the EQ-5D-Y VAS. The remaining one-third sample (validation sample) was used for the examination of the prediction accuracy of the estimation model. Multilevel linear regression was used to estimate EQ-5D-Y VAS score and produce EQ-5D-Y index values from the children's self-rated states described in the EQ-5D-Y and the accompanying VAS values. RESULTS The mean EQ-5D-Y VAS-based index value was 0.891 (SD 0.133) in the modeling sample and 0.885 (SD 0.134) in the validation sample. The own VAS-based index generally showed logical consistency, with lower values for health states that were logically worse. There was no statistically significant difference between the observed and the predicted VAS values in this sample. CONCLUSIONS This study elicited a value set for health states defined by the EQ-5D-Y that is based on respondents' own VAS ratings from a large representative sample of Canadian children. Future study is needed to validate this type of value set among different age groups of children.
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Affiliation(s)
- X Y Wu
- Department of Public Health Sciences, School of Public Health, University of Alberta, 8303-112 Street, Edmonton, AB, T6G 2 T4, Canada,
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Oluboyede Y, Tubeuf S, McCabe C. Measuring health outcomes of adolescents: report from a pilot study. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2013; 14:11-19. [PMID: 21785871 DOI: 10.1007/s10198-011-0340-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 07/05/2011] [Indexed: 05/31/2023]
Abstract
There is a need to understand the practicality, validity and reliability of using utility measures with children and adolescents. We designed a pilot study in order to help guide the selection of an appropriate health-related quality-of-life (HRQoL) questionnaire for adolescents to be used in the context of a large randomised controlled trial (RCT) of family therapy versus standard treatment for adolescents aged 11-17 years. The pilot study was carried out on a school sample of adolescents in the same age range as the RCT. Adolescents were asked to fill in three HRQoL questionnaires: the standard EQ-5D, the licensed Health Utilities Index HUI, and the child-friendly version of the standard EQ-5D: the EQ-5D for youth (EQ-5D-Y). This report explores the problems with the language and concepts embodied within those HRQoL questionnaires and open discussion regarding how we can value the health of adolescents for cost-utility analysis in a larger study.
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Affiliation(s)
- Yemi Oluboyede
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Charles Thackrah Building, Room 2.07, 101 Clarendon Road, Leeds LS2 9LJ, UK
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Wallander JL, Fradkin C, Chien AT, Mrug S, Banspach SW, Davies S, Elliott MN, Franzini L, Schuster MA. Racial/ethnic disparities in health-related quality of life and health in children are largely mediated by family contextual differences. Acad Pediatr 2012; 12:532-8. [PMID: 22884796 DOI: 10.1016/j.acap.2012.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 04/10/2012] [Accepted: 04/14/2012] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To examine (1) racial/ethnic disparities in health-related quality of life (HRQOL), and overall health status among African-American, Hispanic, and white 5th graders in the general population and (2) the extent to which socioeconomic status (SES) and other family contextual variables mediate any disparities. METHODS A total of 4824 African-American, Hispanic, and white fifth-graders participating in a population-based, cross-sectional survey conducted in 3 U.S. metropolitan areas reported their own HRQOL by using the Pediatric Quality of Life Inventory Version 4.0 and supplemental personal and social well-being scales. Parents reported these children's overall health status. SES was indexed by parent education and household income. Other family contextual variables included family structure and degree to which English is spoken at home. RESULTS Marked racial/ethnic disparities were observed across all measures of HRQOL and health status, favoring white children and especially disfavoring Hispanic children. Most of these disparities were no longer significant after adjusting for SES and other family contextual differences that were observed among these racial/ethnic groups. Only disparities in parent-reported overall health status and self-reported global self-worth remained. CONCLUSIONS Racial/ethnic disparities in children's health status are substantial but may be mediated by corresponding disparities in SES and other family contextual variables. Race/ethnicity and family context are related to one another and should be considered jointly in efforts to reduce health disparities in children.
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Affiliation(s)
- Jan L Wallander
- Psychological Sciences, Center of Excellence on Health Disparities, University of California, Merced, USA.
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Noyes J, Edwards RT. EQ-5D for the assessment of health-related quality of life and resource allocation in children: a systematic methodological review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2011; 14:1117-1129. [PMID: 22152182 DOI: 10.1016/j.jval.2011.07.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Revised: 06/23/2011] [Accepted: 07/01/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES EQ-5D is widely used in studies with adults as a source of generic health-related quality of life information and utility weights to inform resource allocation decisions. This methodological systematic review describes the extent to which EQ-5D has been used in the evaluation of children's health care, assesses psychometric properties, and makes recommendations for future good practice. METHODS Systematic searches of databases and the Internet to identify studies published during 2000-2010 that either used EQ-5D with children younger than age 19 years as an outcome measure or reported psychometric data. Study characteristics, including measures and psychometric data, were extracted into tables for analysis. RESULTS We identified 29 studies that used four versions of the EQ-5D: adult EQ-5D, EQ-5D-Y, Dutch EQ-5D child, and extended with cognitive dimension, EQ-5D+C. Twelve of 29 studies did not specify the EQ-5D version used. Existing literature lacks detail on the specific use of EQ-5D and its potential effects on findings. Version use and psychometric properties were inadequately reported. There are large gaps in current knowledge of psychometric properties across all versions when used with children. CONCLUSIONS For reasons of comparability with resource use across adult and children's services, there are arguments for continued use of EQ-5D in studies with children. We recommend use of EQ-5D alongside children-specific quality of life measures and disease-specific measures. Researchers are encouraged to undertake methodological and philosophical analyses to better understand and improve evidence as to how adults who make decisions about resource allocation can best take account of children in decision making.
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Affiliation(s)
- J Noyes
- Centre for Health-Related Research, School of Healthcare Sciences, Bangor University, Bangor, Gwynedd, UK
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Diet quality, physical activity, body weight and health-related quality of life among grade 5 students in Canada. Public Health Nutr 2011; 15:75-81. [DOI: 10.1017/s1368980011002412] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AbstractObjectiveTo assess how diet quality, physical activity and body weight are related to health-related quality of life (HRQOL) among children in the Canadian province of Alberta.DesignIn 2008, we surveyed 3421 grade 5 students and their parents from 148 randomly selected schools. Students completed the Harvard Food Frequency Questionnaire, questions on physical activities, and had their height and weight measured. The HRQOL of the students was assessed using the EQ-5D-Y. Parents completed questions on socio-economic background and children's lifestyle. We applied multilevel regression methods to examine the importance of children's diet quality, physical activity and weight status for the EQ-5D-Y Visual Analogue Scale and for the EQ-5D-Y dimensions.SettingThe province of Alberta, Canada.SubjectsGrade 5 students.ResultsStudents with better diet quality, higher physical activity levels and normal body weights were statistically significantly more likely to report better HRQOL than students who ate less healthily, were less active or were overweight or obese.ConclusionsThe importance of diet quality, physical activity and body weight status for HRQOL may help justify broader implementation of school health programmes that promote healthy eating and active living, as these programmes will help reduce the burden of childhood obesity and improve quality of life.
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