Instrument Development and Evaluation

Quality of Life Research

, Volume 15, Issue 2, pp 203-215

First online:

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

  • James W. VarniAffiliated withDepartment of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M UniversityDepartment of Pediatrics, College of Medicine, Texas A&M University Email author 
  • , Tasha M. BurwinkleAffiliated withDepartment of Anesthesiology, University of Washington
  • , Michael SeidAffiliated withRAND Health

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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.


Health-related quality of life PedsQLTM Schools Socioeconomic status Health Children