International article
The health and well-being of adolescents: a school-based population study of the self-report Child Health Questionnaire

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Abstract

Purpose: To evaluate a new generic measure of adolescent health status, the self-report version of the Child Health Questionnaire (CHQ), and provide population-based data. Furthermore, we aimed to examine the impact of common adolescent illness and health concerns on their health and well-being.

Methods: A stratified, two-stage, random cluster sampling design was used to obtain a cross-sectional sample of subjects through schools. A written questionnaire included the 80-item 12-scale self-report CHQ and items measuring health concerns, illnesses/health conditions, and sociodemographics.

Results: A total of 2361 adolescents participated (response rate of 70%). Reliability was high: Tests of internal consistency and discriminant validity reported 90% of item-scale correlations >.4; all scales had Cronbach alpha coefficients >.7. Adolescents with illnesses/conditions or health concerns reported lower scores and larger differences for content-related scales, supporting content and construct validity. Statistically significant age and gender trends were observed for Mental Health, Self-Esteem, General Health, and Family Cohesion scales. Health status worsened as health concerns increased (X2 linear trend, p = .00) with deterioration in health of 5–20% on all scales for emotional health concerns (40% of sample).

Conclusions: The self-report CHQ is a reliable and seemingly valid measure of health and well-being for adolescent health research, although additional measures may be required where scales have high ceiling values. The significantly lower scores reported by adolescents with illness and/or health concerns lend support to the use of standardized health measures and longitudinal research to further examine the impact of adolescent comorbidities and their causal determinants.

Section snippets

Methodology

The data were collected within the Health of Young Victorians Study (HOYVS), a school-based epidemiologic study of children and adolescents conducted between July and November 1997 in Victoria, Australia. Questionnaires were provided to adolescents and their parents; this study reports the adolescent self-reported data.

Results

A total of 2361 adolescents completed the CHQ self-report form (CHQ CF80), representing a response rate of 70% (53% male). Mean age of the sample was 15.13 years (SD 1.75). Eighty-eight percent of adolescents were born in Australia, with higher proportions of the remaining adolescents being born in the United Kingdom and Ireland, Vietnam, Hong Kong, the Philippines, and China; 0.01% of the sample was of Aboriginal or Torres Strait Islander descent.

Discussion

This study evaluated a new generic self-report measure of adolescent health status (CHQ CF80) and provides comprehensive evidence from a large population-based cross-sectional sample of its reliability and validity. In doing so, the CHQ enabled us to describe the impact common illnesses and frequently reported health concerns have on the health and well-being of adolescents. Population-based normative data of the CHQ mean scale scores, attained from this large representative sample of

Acknowledgements

This project was funded by the Public Health Branch, Victorian Government Department of Human Services.

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    Copyright © 2001 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.