Advertisement

Quality of Life Research

, Volume 27, Issue 8, pp 2165–2176 | Cite as

Giving voice to the child perspective: psychometrics and relative precision findings for the Child Health Questionnaire self-report short form (CHQ-CF45)

  • Jeanne M. Landgraf
  • Amy van Grieken
  • Hein Raat
Article

Abstract

Purpose

To derive and evaluate a shorter self-report Child Health Questionnaire (CHQ) legacy measure for use in research and clinical trials/care.

Methods

Stepwise regression, factor analysis, and item scaling principles were used to derive and guide item selection, using data from a large general sample in the Netherlands (n = 933). Feasibility was assessed in a school sample (n = 114) and item internal consistency, discriminant validity, floor, and ceiling effects were evaluated using an external larger validation sample in the US (n = 1468). Reliabilities were estimated using Cronbach’s alpha. Relative precision (RP), the ability to distinguish between clinical subgroups, was computed by comparing the proportion of variance explained by the short-form scales vs. respective full-length scales.

Results

The CHQ-CF was reduced from 87 to 45 items. The median alpha coefficient was 0.89. Ninety-seven to 100% scaling successes for item discriminant validity were observed. Floor effects were not observed; some ceiling effects were detected. RP estimates ranged from 0.73 to 1.37.

Conclusion

The CHQ-SF45 is reliable and valid and exceeds item level scaling criteria.

Keywords

Psychometrics Children Adolescents Health-related Quality of life PRO Child-centered 

Notes

Acknowledgements

The principal author would like to thank Suzanne Fitch, D. Ed., Mr. Mike Collins, P., teachers, and parents for their overwhelming support for this work and most especially, the students for their enthusiastic participation and insights.

Compliance with ethical standards

Conflict of interest

None of the authors received financial compensation for this work nor do they have a conflict of interest to report. Ms. Landgraf is the Vice President and Chief Scientific Officer at HealthActCHQ, Inc., which owns the intellectual property rights to the CHQ-CF45.

References

  1. 1.
    Starfield, B., Bergner, M., Ensminger, M., et al. (1993). Adolescent health status measurement: development of the Child Health and Illness Profile. Pediatrics, 91(2), 430–435.PubMedGoogle Scholar
  2. 2.
    Feeny, D., Furlong, W., Boyle, M., & Torrance, G. W. (1995). Multi-attribute health status classification systems: Health Utilities Index. Pharmacoeconomics, 7, 490–502.CrossRefPubMedGoogle Scholar
  3. 3.
    Landgraf, J. M., Maunsell, E., Nixon-Speechley, K. N., Bullinger, M., Campbell, S., Abetz, L., & Ware, J. E. (1998). Canadian-French, German and United Kingdom versions of the Child Health Questionnaire (CHQ-PF50): Methodology and preliminary item scaling results. Quality of Life Research, 7(5), 433–445.CrossRefPubMedGoogle Scholar
  4. 4.
    Drotar, D. (1998). Measuring health-related quality of life in children and adolescents: Implications of research and practice. New Jersey: Lawrence Erlbaum Associates.Google Scholar
  5. 5.
    Eiser, C., & Morse, R. (2001). Quality-of-life measures in chronic diseases of childhood. Health Technology Assessment, 5(4), 1–157.CrossRefPubMedGoogle Scholar
  6. 6.
    Kurtin, P., Landgraf, J. M., & Abetz, L. (1994). Patient-based health status measures in pediatric dialysis: Expanding the assessment of outcome. American Journal of Kidney Diseases, 24(2), 376–382.CrossRefPubMedGoogle Scholar
  7. 7.
    Landgraf, J. M., & Abetz, L. (1997). Functional Status and well-being of children representing three cultural groups: Initial self-reports using the CHQ-CF87. Journal of Psychology and Health, 12, 839–854.CrossRefGoogle Scholar
  8. 8.
    Landgraf, J. M. & Abetz, L. (1996). Measuring health outcomes in pediatric populations: Issues in psychometrics and application. In B. Spilker (Ed.), Quality of life and pharmacoeconomics in clinical trials (pp. 793–802). Philadelphia: Lipincott-Raven.Google Scholar
  9. 9.
    Landgraf, J. M. (2005). Practical considerations in the measurement of health-related quality of life in child/adolescent clinical trials. In P. Fayers & R. D. Hays (Eds.), Eds.), Assessing the quality of life in clinical trials (2nd edn., pp. 339–356). Oxford: Oxford University Press.Google Scholar
  10. 10.
    Riley, A. (2004). Evidence that school-age children can self-report on their health. Ambulatory Pediatrics, 4(Suppl), 371–376.CrossRefPubMedGoogle Scholar
  11. 11.
    Olson, L. M., Radecki, L., Frintner, M. P., Weiss, K. B., Korfmacher, J., & Siegel, R. M. (2007). At what age can children report dependably on their asthma health status. Pediatrics, 119(1), e93–e102.Google Scholar
  12. 12.
    Bevans, K. A., Riley, A. W., Moon, J., & Forrest, C. B. (2010). Conceptual and methodological advances in child-reported outcomes measurement. Expert Review of Pharmaeconomics & Outcomes Research, 10(4), 385–396.  https://doi.org/10.1586/erp/10.52/.CrossRefGoogle Scholar
  13. 13.
    Forrest, C. B., & Riley, A. W. (2004). Childhood origins of adult health: A basis for life-course health policy. Health Affairs (Milwood), 23(5), 155–164.CrossRefGoogle Scholar
  14. 14.
    Bevans, K. B., Riley, A. W., Landgraf, J. M., Carle, A. C., Teneralli, R. E., Fiese, B. H., Meltzer, L. J., Ettinger, A. K., Becker, B. D., & Forrest, C. B. (2017). Children’s family experiences: Development of the PROMIS® pediatric family relationships measures. Quality of Life Research, 26, 3011.  https://doi.org/10.1007/s11136-017-1629-y. (Epub ahead of print).CrossRefPubMedGoogle Scholar
  15. 15.
    Pediatric Patient Reported Outcomes in Chronic Diseases (PEPR) https://www.peprconsortium.org/. Accessed 10 Jan 2018.
  16. 16.
    Environmental Influences on Child Health Outcomes (ECHO) Program https://www.nih.gov/echo. Accessed 10 Jan 2018.
  17. 17.
    Landgraf, J. M., Abetz, L., & Ware, J. E. (1996). The Child Health Questionnaire (CHQ): A user’s manual. Boston, MA: The Health Institute, New England Medical Center.Google Scholar
  18. 18.
  19. 19.
    Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., & Erikson, P. (2005). Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: Report of the ISPOR task force for translation and cultural adaptation. Value in Health, 8(2):94–104.CrossRefPubMedGoogle Scholar
  20. 20.
    Raat, H., Landgraf, J. M., Bonsel, G. J., Gemke, R. J., & Essink-Bot, M. L. (2002). Reliability and validity of the Child Health Questionnaire-Child Form (CHQ-CF87) in a Dutch adolescent population. Quality of Life Research, 11(6), 575–581.CrossRefPubMedGoogle Scholar
  21. 21.
    de Wit, M., Delemarre-van de Waal, H. A., Bokma, J. A., Haasnoot, K., Houdijk, M. C., Gemke, R. J., & Snoek, F. J. (2007). Self-report and parent-report of physical and psychosocial well-being in Dutch adolescents with type 1 diabetes in relation to glycemic control. Health Quality of Life Outcomes, 5, 10.CrossRefPubMedGoogle Scholar
  22. 22.
    Buysse, C. M., Raat, H., Hazelzet, J. A., Hop, W. C., Maliepaard, M., & Joosten, K. F. (2007). Long-term health-related quality of life in survivors of meningococcal septic shock in childhood and their parents. Quality of Life Research, 16, 1567–1576.  https://doi.org/10.1007/s11136-007-9271-8.CrossRefPubMedGoogle Scholar
  23. 23.
    de Wit, M., Delemarre-van de Waal, H. A., Pouwer, F., Gemke, R. J., & Snoek, F. J. (2007). Monitoring health related quality of life in adolescents with diabetes: A review of measures. Archieves of Disease in Childhood, 92(5), 434–439.CrossRefGoogle Scholar
  24. 24.
    Hosli, E. J., Detmar, S. B., Raat, H., Bruil, J., Vogels, T. G. C., & Verrips, E. H. W. (2007). Reliability, validity, and structure of the self-report form of the Child Health Questionnaire (CHQ-CF87) in a Dutch adolescent population. Expert Review of Pharmacoeconomics & Outcomes Research, 7(4), 393–401. ( https://doi.org/10.1586/14737167.7.4.393).CrossRefGoogle Scholar
  25. 25.
    Raat, H., Mangunkusumo, R. T., Landgraf, J. M., Kloek, G., & Brug, J. (2007). Feasibility, reliability and validity of adolescent health status measurement by the Child Health Questionnaire Child Form (CHQ-CF87): Internet administration compared with the standard paper version. Quality of Life Research, 16, 675–685.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Coons, S. J., Gwaltney, C. J., Hays, R. D., Lundy, J. J., Sloan, J. A., Revicki, D. A., Lenderkinbg, W. R., Cella, D., & Basch, E. on behalf of the ISPOR ePRO Task Force. (2009). Recommendations on evidence needed to support measurement equivalence between electronic and paper-based patient reported outcome (PRO) measures: ISPOR ePRP good research practices task force report. Value in Health 12 (4):419–429.CrossRefPubMedGoogle Scholar
  27. 27.
    World Health Organization. (1948). Constitution of the World Health Organization. Geneva: WHO Basic Documents.Google Scholar
  28. 28.
    Landgraf, J. M., Vogel, I., Oostenbrink, R., van Baar, M. E., & Raat, H. (2013). Parent-reported health outcomes in infants/toddlers: Measurement properties and clinical validity of the ITQOL-SF47. Quality of Life Research, 22(3), 635–646.  https://doi.org/10.1007/s11136-012-0177-8. (Epub 2012 April).CrossRefPubMedGoogle Scholar
  29. 29.
    Landgraf, J. M. (2007). Precision and sensitivity of the short-form pediatric enuresis module to assess quality of life (PEMQOL). Journal of Pediatric Urology, 3(2), 109–117.  https://doi.org/10.1016/j.jpurol.2006.04.004.CrossRefPubMedGoogle Scholar
  30. 30.
    Stewart, A., & Ware, J. E. (1992). Measuring functioning and well-being the medical outcomes study approach. Durham: Duke University Press.CrossRefGoogle Scholar
  31. 31.
    HealthActCHQ. (2018). CHQ-CF45 scoring manual. Boston, MA: HealthActCHQ.Google Scholar
  32. 32.
    Ware, J. E., Harris, W. J., Gandek, B., Rogers, B. W., & Reese, P. R. (1997). MAPR for windows version 1.1. Boston, MA: Health Assessment Lab.Google Scholar
  33. 33.
    Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.CrossRefGoogle Scholar
  34. 34.
    The GfK Group Confidential Proprietary Project Report for the HealthActCHQ (HACHQ) Norming Surveys (2015). GfK: East Hanover, NJ; HACHQ: Boston, MA.Google Scholar
  35. 35.
    HealthActCHQ Inc (2018). CHQ-CF45 US Norms. Boston, MA, USA: HealthActCHQ, Inc.Google Scholar
  36. 36.
    Hays, R. D., Honghu, L., & Kapteyn, A. (2015). Use of Internet panels to conduct surveys. Behaviour Research Methods.  https://doi.org/10.3758/s13428-015-0617-9. (Published Online 14 July)Google Scholar
  37. 37.
    Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd edn.). New York: McGraw-Hill.Google Scholar
  38. 38.
    Buckstein, D. A., McGrath, M. M., Buchner, D. A., Landgraf, J. M., & Goss, T. P. (2000). Evaluation of a short-form for measuring health related quality of life among pediatric wheezing illness patients. Journal of Allergy Clinical Immunology 105, 245–251.CrossRefGoogle Scholar
  39. 39.
    McHorney, C. A., Ware, J. E., Rogers, W., Racek, A. E., & Lu, J. F. R. (1992). The validity and relative precision of MOS short-and-long-form health status scales and Dartmouth COOP Charts. Medical Care, 30, 253–265.CrossRefGoogle Scholar
  40. 40.
    Lapp, D., Flood, J., Brock, C. H., & Fisher, D. (2007). Teaching reading to every child (4th edn.). New York: Routledge Taylor and Francis Group.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Jeanne M. Landgraf
    • 1
  • Amy van Grieken
    • 2
  • Hein Raat
    • 2
  1. 1.HealthActCHQBostonUSA
  2. 2.Department of Public Health, Erasmus MCUniversity Medical CenterRotterdamThe Netherlands

Personalised recommendations