Health-related quality of life associated with bullying and aggression: a cross-sectional study in English secondary schools

  • Catherine Fantaguzzi
  • Elizabeth Allen
  • Alec Miners
  • Deborah Christie
  • Charles Opondo
  • Zia Sadique
  • Adam Fletcher
  • Richard Grieve
  • Chris Bonell
  • Russell M. Viner
  • Rosa Legood
Original Paper

DOI: 10.1007/s10198-017-0908-4

Cite this article as:
Fantaguzzi, C., Allen, E., Miners, A. et al. Eur J Health Econ (2017). doi:10.1007/s10198-017-0908-4

Abstract

Background

Associations between adolescent health-related quality of life (HRQoL), bullying, and aggression are not well understood. We used baseline data from a large-cluster randomized school trial to study the relationship between HRQoL, bullying experience, and other demographic factors.

Methods

Cross-sectional self-reported questionnaires collected pre-randomization from the on-going INCLUSIVE trial. The questionnaires were completed in the classroom. The Gatehouse Bullying Scale measured bullying victimization and the Edinburgh Study of Youth Transitions and Crime school misbehavior subscale (ESYTC) measured aggressive behaviors. HRQoL was assessed using the Child Health Utility 9 Dimensions (CHU-9D) and general quality of life using the Pediatric Quality of Life Inventory (PedsQL). Participants were a cohort of year 7 students (age 11–12 years) from 40 state secondary schools in England. Descriptive statistics for the CHU-9D and PedsQL were calculated using standard methods with tests for differences in median scores by sex assessed using quantile regression. Correlation between HRQoL measures was conducted using Spearman’s rank correlation coefficients. Predictors of HRQoL were identified using univariate and multiple regressions.

Results

A total of 6667 students filled out the questionnaire. The CHU-9D was correlated with the PedsQL (0.63, p < 0.001). The multivariable regression results suggest that if students were bullied frequently and upset it resulted in a decrement in CHU-9D scores of (−0.108) and fall in PedsQL score of (−16.2). The impact of the antisocial/aggressive behavior on the ESYTC scale resulted in a utility decrement of −0.004 and fall of −.5 on the PedsQL.

Conclusions

Adolescents’ involvement in bullying and aggression is a strong correlate of HRQoL. These data have important implications for the potential cost-effectiveness of reducing bullying and aggression in schools.

Keywords

Utility CHU-9D Health-related quality of life Bullying Aggression 

Abbreviations

95% CI

95% Confidence interval

CHU-9D

Child Health Utility 9 Dimensions

ESYTC

Edinburgh Study of Youth Transitions and Crime school antisocial/aggressive behavior subscale

GBS

Gatehouse Bullying Scale

HRQoL

Health-related quality of life

INCLUSIVE

Initiating change locally in bullying and aggression through the school environment

IOE

Institute of Education

IQR

Interquartile range

LSHTM

London School of Hygiene and Tropical Medicine

NICE

National Institute for Health and Clinical Excellence

PedsQL

Pediatric Quality of Life Inventory

QALY

Quality-adjusted life year

SD

Standard deviation

SE

Standard error

UCL

University College London

UK

United Kingdom

WHO

World Health Organization

Supplementary material

10198_2017_908_MOESM1_ESM.docx (23 kb)
Supplementary material 1 (DOCX 22 kb)

Funding information

Funder NameGrant NumberFunding Note
Public Health Research Programme
  • 12_153_60

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Catherine Fantaguzzi
    • 1
  • Elizabeth Allen
    • 1
  • Alec Miners
    • 1
  • Deborah Christie
    • 2
  • Charles Opondo
    • 1
  • Zia Sadique
    • 1
  • Adam Fletcher
    • 3
  • Richard Grieve
    • 1
  • Chris Bonell
    • 1
  • Russell M. Viner
    • 4
  • Rosa Legood
    • 1
  1. 1.London School of Hygiene and Tropical MedicineLondonUK
  2. 2.University College London Hospitals NHS Foundation TrustLondonUK
  3. 3.School of Social SciencesCardiff UniversityCardiffUK
  4. 4.UCL Institute of Child HealthLondonUK

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