Self and parent-proxy rated health-related quality of life (HRQoL) in youth with obesity: are parents good surrogates?

Ooi, Delicia Shu Qin; Loke, Kah Yin; Ho, Cindy Wei Li; Lim, Y.C.; Tay, Veronica; Karuppiah, Vijaya; Sng, Andrew Anjian; Lai, Lester Yousheng; Lee, Yung Seng; Griva, Konstadina

doi:10.1007/s11136-020-02472-y

Cited by 18 publications

(9 citation statements)

References 33 publications

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“…Although the observed difference in total HRQoL score was significant, the effect size was poor, indicating that the total difference between adolescents and parents was negligible. A similar phenomenon has been reported by Ooi et al [ 29 ], where the child-mother total HRQoL difference in the obese population was significant but with no minimal clinically important difference. Therefore, statistical significance should not be the only criterion for child-parent agreement.…”

Section: Discussionsupporting

confidence: 86%

“…Studies have shown that adolescents in various pediatric populations with chronic illness and their parents may rate the questionnaires differently [ 17 , 29 , 30 ]. The discrepancy may be associated with observable/non-observable symptoms that parents tend to underestimate the psychosocial functioning and overestimate the physical functioning [ 31 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

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Psychometric evaluation of the traditional Chinese version of PedsQL™ 3.0 cardiac module scale in adolescents with congenital heart disease: reliability, validity, measurement invariance, and adolescent-parent agreement

Huang

Chen

Gau

et al. 2023

Health Qual Life Outcomes

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Background In recent decades, 95% of children with congenital heart disease (CHD) can survive to adolescence and adulthood. However, adolescents with CHD are prone to poorer health-related quality of life (HRQoL). It is imperative to develop a reliable and valid instrument for health professionals to monitor the HRQoL. This study aims to: (1) evaluate the psychometric properties of the traditional Chinese version of Pediatric Quality of Life™ 3.0 Cardiac Module (PedsQL-CM) and measurement invariance across adolescents with CHD and their parents; and (2) investigate the adolescent-parent agreement in HRQoL. Methods A total of 162 adolescents and 162 parents were recruited. Internal consistency was examined using Cronbach’s alpha and McDonald’s Omega. The criterion-related validity was evaluated with intercorrelations between the PedsQL-CM and PedsQL™ 4.0 Generic Core (PedsQL-GC) Scale. The construct validity was examined by second-order confirmatory factor analysis (CFA). Measurement invariance was evaluated using the multi-group CFA. The adolescent-parent agreement was analyzed with the intraclass correlation (ICC), paired t-tests, and Bland–Altman plots. Results PedsQL-CM showed acceptable internal consistency (self-reports 0.88, proxy-reports 0.91). The intercorrelations were medium to large effect size (self-reports 0.34–0.77, proxy-reports 0.46–0.68). The CFA supported the construct validity (CFI = 0.967, TLI = 0.963, RMSEA = 0.036, 90% CI = 0.026–0.046, SRMR = 0.065). The multi-group CFA proved scalar invariance between self and parent proxy-reports. Parents significantly underestimated their adolescents’ HRQoL in cognitive problems (Cohen’s d = 0.21) and communication (Cohen’s d = 0.23) subscales, while there was a negligible difference in total HRQoL (Cohen’s d = 0.16). ICCs were poor to moderate effect size with the highest and lowest agreement in heart problems and treatment subscale (ICC = 0.70) and communication subscale (ICC = 0.27), respectively. The Bland–Altman plots showed lesser variability in the heart problem and treatment subscale and the total scale. Conclusion The traditional Chinese version of PedsQL-CM has acceptable psychometric properties to measure disease-specific HRQoL in adolescents with CHD. Parents may be proxies for adolescents with CHD to rate total HRQoL. When the patient-reported score is the primary outcome, the proxy-reported score could serve as a secondary outcome for research and clinical evaluation.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Psychometric evaluation of the traditional Chinese version of PedsQL™ 3.0 cardiac module scale in adolescents with congenital heart disease: reliability, validity, measurement invariance, and adolescent-parent agreement

Huang

Chen

Gau

et al. 2023

Health Qual Life Outcomes

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“…Generally speaking, parents reported lower child HRQoL scores than children, with fewer reported clinically important improvements in both physical and psychosocial HRQoL summary scores from baseline to the 6-month follow-up. Differences in parent and child HRQoL scores are not uncommon in the literature [57] and are important to acknowledge as it has been suggested that parents' perceptions of their child's HRQoL often influence treatment-seeking behaviors [58].…”

Section: Discussionmentioning

confidence: 99%

Using the RE-AIM framework to evaluate the feasibility of a parent-focused intervention targeting childhood obesity

Briatico

Reilly

Tucker

et al. 2023

Pilot Feasibility Stud

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Background Childhood obesity remains a serious public health concern. Community-based childhood obesity treatment interventions have the potential to improve health behaviors and outcomes among children, but require thorough evaluation to facilitate translation of research into practice. The purpose of the current study was to determine the feasibility of a community-based, parent-focused childhood obesity intervention (“C.H.A.M.P. Families”) using the RE-AIM framework, an evaluation tool for health interventions. Methods A single-group, non-randomized, repeated measures feasibility study was conducted. Participants (n = 16 parents/caregivers of 11 children with obesity) completed a 13-week parent-focused education intervention. The intervention consisted of three main components: (a) eight group-based (parent-only) education sessions; (b) eight home-based (family-centered) activities; and (c) two group-based follow-up support sessions for parents and children. The five dimensions of RE-AIM—reach, effectiveness, adoption, implementation, and maintenance—were assessed using various measures and data sources (e.g., child, parent/caregiver, costing, census) obtained throughout the study period. Outcome variables were measured at baseline, mid-intervention, post-intervention, and at a 6-month follow-up. Results Overall, the C.H.A.M.P. Families intervention reached approximately 0.09% of eligible families in London, Ontario. Despite the small number, participants were generally representative of the population from which they were drawn, and program participation rates were high (reach). Findings also suggest that involvement in the program was associated with improved health-related quality of life among children (effectiveness/individual-level maintenance). In addition, the intervention had high fidelity to protocol, attendance rates, and cost-effectiveness (implementation). Lastly, important community partnerships were established and maintained (adoption/setting-level maintenance). Conclusions Based on a detailed and comprehensive RE-AIM evaluation, the C.H.A.M.P. Families intervention appears to be a promising parent-focused approach to the treatment of childhood obesity. Trial registration ISRCTN Registry, Study ID ISRCTN 10752416. Registered 24 April 2018.

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“…The agreement between child self-reported and parent proxy-reported HS differs between studies. While some studies found that parents reported their child’s HS higher than did the child itself [ 29 ], other studies reported opposite findings [ 30 , 31 ], or found differences in both directions – depending on the subscale [ 25 , 32 ]. To make things even more complicated, previous research in children with chronic conditions has shown that sex – either that of the parent or the child – may affect parent–child agreement.…”

Section: Discussionmentioning

confidence: 99%

“…To make things even more complicated, previous research in children with chronic conditions has shown that sex – either that of the parent or the child – may affect parent–child agreement. Ooi et al, for instance, reported that parent–child agreement in children with obesity was higher with mothers than with fathers as proxies [ 31 ]. Blake et al studied adolescents with sickle cell disease and found that parents of girls reported a higher HS than did the girls themselves, whereas parents of boys reported a lower HS than did the boys themselves [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Sex differences in children's health status as measured by the Pediatric Quality of Life Inventory (PedsQL)™: cross-sectional findings from a large school-based sample in the Netherlands

et al. 2021

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Background Previous research has shown that female adolescents and adults report lower health status than their male peers. Possibly, this discrepancy already develops during childhood. We collected sex-specific data with the Pediatric Quality of Life Inventory (PedsQL) in a large school-based sample. Methods The online version of the PedsQL was administered to healthy Dutch children aged 5–7 years (parent proxy-report), 8–12 years (parent proxy-report and child self-report), and 13–17 years (parent proxy-report and child self-report), recruited through regular primary and secondary schools. Sex differences were assessed using t-tests or Mann–Whitney U-tests. Wilcoxon signed-rank tests and intraclass correlation coefficients served to compare parent proxy-reports with child self-reports. Multivariable linear regression analyses were used to assess the associations of sex of the child, age, and parental educational level with PedsQL scores. Results Eight hundred eighty-two parents and five hundred eighty one children were recruited from 15 different schools in the Netherlands. Parents of 8-to-12-year-olds reported higher scores on School Functioning for girls than for boys (mean difference [MD]: 6.56, p < 0.001). Parents of 13-to-17-year-olds reported lower scores on Physical and Emotional Functioning for girls than for boys (MDs: 2.14 and 5.79, p = 0.014 and p < 0.001, respectively). Girls aged 8–12 years reported lower scores than boys in this age group on Physical Functioning (MD: 3.09, p = 0.005). Girls aged 13–17 years reported lower scores than boys in this age group on Physical Functioning (MD: 3.67, p < 0.001), Emotional Functioning (MD: 8.11, p < 0.001), and the Total Score (MD 3.26, p = 0.004). No sex differences were found in children aged 5–7 years. Agreement between child self-reports and parent proxy-reports was poor to moderate. Conclusions Girls generally had lower PedsQL scores than boys, both in parent proxy-reports and in child self-reports. We recommend to apply sex-specific data when assessing health status using the PedsQL.

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Self and parent-proxy rated health-related quality of life (HRQoL) in youth with obesity: are parents good surrogates?

Cited by 18 publications

References 33 publications

Psychometric evaluation of the traditional Chinese version of PedsQL™ 3.0 cardiac module scale in adolescents with congenital heart disease: reliability, validity, measurement invariance, and adolescent-parent agreement

Psychometric evaluation of the traditional Chinese version of PedsQL™ 3.0 cardiac module scale in adolescents with congenital heart disease: reliability, validity, measurement invariance, and adolescent-parent agreement

Using the RE-AIM framework to evaluate the feasibility of a parent-focused intervention targeting childhood obesity

Sex differences in children's health status as measured by the Pediatric Quality of Life Inventory (PedsQL)™: cross-sectional findings from a large school-based sample in the Netherlands

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