Abstract
PurposeTo explore the association of academic performance and general health status with health-related quality of life (HRQoL) in school-aged children and adolescents in China.MethodsIn this cross-sectional study conducted in 2018, students (grade 4–12) were randomly chosen from primary and high schools in Nanjing, China. HRQoL, the outcome measure, was recorded using the Child Health Utility 9D, while self-rated academic performance and general health were the independent variables. Mixed-effects regression models were applied to compute mean difference (MD) and 95% confidence interval (CI) of HRQoL utility score between students with different levels of academic performance and general health.ResultsTotally, 4388 participants completed the study, with a response rate of 97.6%. The mean HRQoL utility score was 0.78 (SD: 0.17). After adjustment for socio-demographic attributes, physical activity, sedentary behavior, dietary patterns, body weight status and class-level clustering effects, students with fair (MD = 0.048, 95% CI 0.019, 0.078) and good (MD = 0.082, 95% CI 0.053, 0.112) self-rated academic performance reported higher HRQoL utility scores than those with poor academic performance, respectively. Meanwhile, students with fair (MD = 0.119, 95% CI 0.083, 0.154) and good (MD = 0.183, 95% CI 0.148, 0.218) self-assessed general health also recorded higher HRQoL utility scores than those with poor health, separately. Consistent findings were observed for participants by gender, school type and residential location.ConclusionsBoth self-rated academic performance and general health status were positively associated with HRQoL among Chinese students, and such relationships were independent of lifestyle-related behaviors and body weight status.
Highlights
Health related quality of life (HRQoL) is a subjective concept frequently applied to describe people’s physical, mental, social, psychological and functional aspects of health [1, 2]
*Correspondence: huifenaqiao@163.com; frankxufei@163.com †Shengxiang Qi and Zhenzhen Qin contributed to this work and they are co-first authors 1 Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing 210003, China 3 Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264, Guangzhou Road, Nanjing 210029, China
It is documented that children and adolescents under the age of 18 could self-perceive the HRQoL stably in the absence of significant health/life events [4], and lifestyle and behavior factors were associated with HRQoL among children and adolescents at population level [3, Qi et al Health Qual Life Outcomes (2020) 18:339
Summary
Health related quality of life (HRQoL) is a subjective concept frequently applied to describe people’s physical, mental, social, psychological and functional aspects of health [1, 2]. HRQoL has been used to assess the public health effects of population-based lifestyle and behavior intervention programs [12, 13]. While the key task for school-aged children and adolescents is academic/curriculum learning, some students spend a great deal of time in leisure-time physical activity (PA) but many others possess sedentary behavior (SB) and poor habits of sleeping and dietary intake. These unhealthy lifestyle-related behaviors are risk factors for some chronic conditions (e.g., obesity and cardiovascular diseases) tracking from childhood to adulthood [14, 15]. HRQoL has been found to be associated with lifestyle-related behaviors and excess body weight [3, 5,6,7,8,9,10], but little is known about its link with the academic performance/achievement and general health status among children and adolescents
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