Assessment of health-related quality of life and psychological well-being of children and adolescents with obesity enrolled in a New Zealand community-based intervention programme: an observational study

Abstract

ObjectiveTo describe health-related quality of life (HRQOL) and psychological well-being of children and adolescents at enrolment in a multidisciplinary community-based obesity programme and to determine association with ethnicity. This programme targeted indigenous people and those from most deprived households. Further, this cohort was compared with other populations/normative data.MethodsThis study examines baseline demographic data of an unblinded randomised controlled clinical trial. Participants (recruited from January 2012-August 2014) resided in Taranaki, New Zealand, and for this study we only included those with a body mass index (BMI) ≥98th percentile (obese). HRQOL and psychological well-being were assessed using the Pediatric Quality of Life Inventory (PedsQL V.4.0TM) (parent and child reports), and Achenbach’s Child Behavior Checklist (CBCL)/Youth Self Report (YSR).ResultsAssessments were undertaken for 233 participants (45% Māori, 45% New Zealand European, 10% other ethnicities, 52% female, 30% from the most deprived household quintile), mean age 10.6 years. The mean BMI SD score (SDS) was 3.12 (range 2.01–5.34). Total PedsQL generic scaled score (parent) was lower (mean=63.4, SD 14.0) than an age-matched group of Australian children without obesity from the Health of Young Victorians study (mean=83.1, SD 12.5). In multivariable models, child and parental generic scaled scores decreased in older children (β=−0.70 and p=0.031, β=−0.64 and p=0.047, respectively). Behavioural difficulties (CBCL/YSR total score) were reported in 43.5% of participants, with the rate of emotional/behavioural difficulties six times higher than reported norms (p<0.001).ConclusionsIn this cohort, children and adolescents with obesity had a low HRQOL, and a concerning level of psychological difficulties, irrespective of ethnicity. Obesity itself rather than ethnicity or deprivation appeared to contribute to lower HRQOL scores. This study highlights the importance of psychologist involvement in obesity intervention programmes.Trial registration numberAustralian NZ Clinical Trials Registry ANZCTR 12611000862943; Pre-results.

The effect of weight loss intervention programme on health-related quality of life among low income overweight and obese housewives in the MyBFF@home study

“…Other HRQOL questionnaires such as World Health Organization Quality of Life (WHOLQOL-BREF), Medical Outcome Study (MOS), Short Form-36 (SF-36) used a generic measure of HRQOL which do not specifically evaluate position as an obese person and their effort to lose weight. The questionnaire might only suitable for some cultures [ 29 ]. The present report only reported assessment of the HRQOL was at baseline and 6 months intervention.…”

A Novel Home‐Based Intervention for Child and Adolescent Obesity: The Results of the Whānau Pakari Randomized Controlled Trial

“…As reported in 2016, obesity is now considered the leading risk factor causing health loss in New Zealand, over tobacco . New Zealand children and adolescents with obesity have a concerning prevalence of weight‐related comorbidities, suboptimal eating behaviors, low physical activity, and psychological difficulties, irrespective of ethnicity . Approximately 11% of New Zealand children aged 2 to 14 years have obesity, with Māori (New Zealand's indigenous population) being 1.6 times more likely to have obesity compared with their non‐Māori counterparts .…”

Prediction Models for Early Childhood Obesity: Applicability and Existing Issues

“…In the long term, it is predictive of diabetes risk [20, 21], and it is associated with premature mortality [22] and increased cardiovascular risk [21, 22], predominantly as a result of a substantially greater risk of adult obesity [20, 23-26]. In the short term, childhood overweight and obesity are associated with psychosocial distress [22, 27-29], a lower health-related quality of life [30], and a range of physical comorbidities [29, 31]. For example, even among preschool children (aged 3–6 years), an increase in body mass index (BMI) of 1 kg/m 2 has been associated with increased systolic and diastolic blood pressure [32].…”