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

Waters, Elizabeth B; Salmon, Louisa A; Wake, Melissa; Wright, Martin; Hesketh, Kylie D

« PreviousJournal of Adolescent Health
Volume 29, Issue 2 , Pages 140-149, August 2001

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

Elizabeth B Waters (M.P.H.)
- Centre for Community Child Health, Royal Children’s Hospital (E.B.W., L.A.S., M.W., K.D.H.), Melbourne, Australia
- Department of Paediatrics (E.B.W., M.W.), University of Melbourne, Melbourne, Australia
- Address correspondence to: Elizabeth Waters, M.P.H., Director, Research and Public Health Unit, Centre for Community Child Health, Royal Children’s Hospital, Flemington Rd., Parkville, Victoria 3052, Australia
Louisa A Salmon, B.A. ((Hons.))
- Centre for Community Child Health, Royal Children’s Hospital (E.B.W., L.A.S., M.W., K.D.H.), Melbourne, Australia
Melissa Wake, M.D. (M.B.Ch.B.)
- Centre for Community Child Health, Royal Children’s Hospital (E.B.W., L.A.S., M.W., K.D.H.), Melbourne, Australia
Martin Wright, M.D. (M.P.H.)
- Department of Paediatrics (E.B.W., M.W.), University of Melbourne, Melbourne, Australia
Kylie D Hesketh (B.B.Sc.(Hons.))
- Centre for Community Child Health, Royal Children’s Hospital (E.B.W., L.A.S., M.W., K.D.H.), Melbourne, Australia

Accepted 20 December 2000.

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.

Keywords: Adolescent, Health status, Self-report, Child Health Questionnaire, Australia