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. 2004 Nov-Dec;119(6):577–584. doi: 10.1016/j.phr.2004.09.007

Evaluating the performance of the Centers for Disease Control and Prevention core Health-Related Quality of Life scale with adolescents.

Keith J Zullig 1, Robert F Valois 1, E Scott Huebner 1, J Wanzer Drane 1
PMCID: PMC1497669  PMID: 15504449

Abstract

OBJECTIVE: The purpose of this study was to evaluate the performance of the Centers for Disease Control and Prevention's core Health-Related Quality of Life (HRQOL) scale using data from 5,520 public high school students. METHODS: The 1997 South Carolina Youth Risk Behavior Survey was the source of data. Chi-square analysis was applied to assess scale construct validity. Adjusted multiple logistic regression with selected tobacco and substance use variables was used to assess known-groups validity of the scale's Healthy Days index (items regarding poor physical and mental health days during the past 30 days). RESULTS: Construct validity was supported for the core HRQOL scale by the associations between self-perceived health and physical health, mental health, and activity limitation days. A greater number of poor physical health days, poor mental health days, or activity limitation days was associated with poorer self-perceived health (p<0.0001); however, correlation coefficients for the associations between self-perceived health and physical health days (r=0.24; p<0.001), self-perceived health and mental health days (r=0.26; p<0.0001), and self-perceived health and activity limitation days (r=0.23; p<0.0001), although significant, were low in magnitude. Logistic regression analyses conducted with the Healthy Days index revealed significant (p<0.05) HRQOL differences between users and non- users of tobacco and other substance use variables. As hypothesized, as the usage of each substance increased, reported poor HRQOL days increased, supporting the known- groups validity of the scale. CONCLUSIONS: This study provides preliminary evidence that the HRQOL scale items are valid and potentially useful for adolescent surveillance. The results, however, are mixed regarding the inclusion of self-perceived health as a measure of HRQOL for adolescents, given the low correlation coefficients for the associations between self-perceived health and the other HRQOL scale items. These results suggest that adolescents may be rating two separate dimensions of health when rating their self-perceived health and HRQOL. Further research is needed to confirm these findings in different adolescent populations.

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Selected References

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  1. Andresen E. M., Catlin T. K., Wyrwich K. W., Jackson-Thompson J. Retest reliability of surveillance questions on health related quality of life. J Epidemiol Community Health. 2003 May;57(5):339–343. doi: 10.1136/jech.57.5.339. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Andresen E. M., Fouts B. S., Romeis J. C., Brownson C. A. Performance of health-related quality-of-life instruments in a spinal cord injured population. Arch Phys Med Rehabil. 1999 Aug;80(8):877–884. doi: 10.1016/s0003-9993(99)90077-1. [DOI] [PubMed] [Google Scholar]
  3. Bradley C. Importance of differentiating health status from quality of life. Lancet. 2001 Jan 6;357(9249):7–8. doi: 10.1016/S0140-6736(00)03562-5. [DOI] [PubMed] [Google Scholar]
  4. Brener N. D., Collins J. L., Kann L., Warren C. W., Williams B. I. Reliability of the Youth Risk Behavior Survey Questionnaire. Am J Epidemiol. 1995 Mar 15;141(6):575–580. doi: 10.1093/oxfordjournals.aje.a117473. [DOI] [PubMed] [Google Scholar]
  5. Hennessy C. H., Moriarty D. G., Zack M. M., Scherr P. A., Brackbill R. Measuring health-related quality of life for public health surveillance. Public Health Rep. 1994 Sep-Oct;109(5):665–672. [PMC free article] [PubMed] [Google Scholar]
  6. Idler E. L., Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997 Mar;38(1):21–37. [PubMed] [Google Scholar]
  7. Idler E. L., Kasl S. V., Lemke J. H. Self-evaluated health and mortality among the elderly in New Haven, Connecticut, and Iowa and Washington counties, Iowa, 1982-1986. Am J Epidemiol. 1990 Jan;131(1):91–103. doi: 10.1093/oxfordjournals.aje.a115489. [DOI] [PubMed] [Google Scholar]
  8. Irwin Charles E., Jr, Burg Scott J., Uhler Cart Courtney. America's adolescents: where have we been, where are we going? J Adolesc Health. 2002 Dec;31(6 Suppl):91–121. doi: 10.1016/s1054-139x(02)00489-5. [DOI] [PubMed] [Google Scholar]
  9. Mossey J. M., Shapiro E. Self-rated health: a predictor of mortality among the elderly. Am J Public Health. 1982 Aug;72(8):800–808. doi: 10.2105/ajph.72.8.800. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Raat H., Landgraf J. M., Bonsel G. J., Gemke R. J. B. J., Essink-Bot M. L. Reliability and validity of the child health questionnaire-child form (CHQ-CF87) in a Dutch adolescent population. Qual Life Res. 2002 Sep;11(6):575–581. doi: 10.1023/a:1016393311799. [DOI] [PubMed] [Google Scholar]
  11. Scales P. C. Reducing risks and building developmental assets: essential actions for promoting adolescent health. J Sch Health. 1999 Mar;69(3):113–119. doi: 10.1111/j.1746-1561.1999.tb07219.x. [DOI] [PubMed] [Google Scholar]
  12. Segovia J., Bartlett R. F., Edwards A. C. The association between self-assessed health status and individual health practices. Can J Public Health. 1989 Jan-Feb;80(1):32–37. [PubMed] [Google Scholar]
  13. Smith K. W., Avis N. E., Assmann S. F. Distinguishing between quality of life and health status in quality of life research: a meta-analysis. Qual Life Res. 1999 Aug;8(5):447–459. doi: 10.1023/a:1008928518577. [DOI] [PubMed] [Google Scholar]
  14. Valois R. F., Zullig K. J., Huebner E. S., Drane J. W. Relationship between life satisfaction and violent behaviors among adolescents. Am J Health Behav. 2001 Jul-Aug;25(4):353–366. doi: 10.5993/ajhb.25.4.1. [DOI] [PubMed] [Google Scholar]
  15. Vingilis E., Wade T. J., Adlaf E. What factors predict student self-rated physical health? J Adolesc. 1998 Feb;21(1):83–97. doi: 10.1006/jado.1997.0131. [DOI] [PubMed] [Google Scholar]
  16. Vingilis Evelyn R., Wade Terrance J., Seeley Jane S. Predictors of adolescent self-rated health. Analysis of the National Population Health Survey. Can J Public Health. 2002 May-Jun;93(3):193–197. doi: 10.1007/BF03404999. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Wade T. J., Pevalin D. J., Vingilis E. Revisiting student self-rated physical health. J Adolesc. 2000 Dec;23(6):785–791. doi: 10.1006/jado.2000.0359. [DOI] [PubMed] [Google Scholar]

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