Health-related Quality Of Life In School Children

Abstract

Health- related quality of life (HRQoL) is a multidimensional construct, which in children includes measurements of physical and emotional well-being; and social and school functioning. HRQoL in children has been related to self-reported chronic diseases and health risk factors including higher body mass index (BMI) and physical inactivity. However, few studies have explored HRQoL in healthy population-based samples. PURPOSE: To determine the relationship between HRQoL and BMI, moderate to vigorous physical activity (MVPA), sedentary behavior and aerobic fitness. METHODS: We recruited 497 apparently healthy children from seven secondary schools in England (age range: 11 to 12 years old, 64% female, BMI = 20.1 ± 3.9 kg/m2). HRQoL was assessed through the self-reported Kidscreen-27 questionnaire over five dimensions (physical well-being; psychological well-being; autonomy and parent relation; social and peer support; and school environment). Aerobic fitness was measured by the 20m shuttle run test, while MVPA and sedentary behavior were assessed via a waist-mounted accelerometer over 8 days (Evenson cutpoints). Hierarchical multiple regression was used to assess the association between HRQoL and BMI, MVPA, sedentary behavior and aerobic fitness after adjusting for gender and school. RESULTS: The model explained 12% of variance in physical well-being (p < 0.001); 3% of psychological well-being (p= 0.04) and 6% of social and peer support (p=0.006). Aerobic fitness was the strongest and only significant influence variable for these three HRQoL dimensions: physical well-being (beta = 0.39; 95% confidence interval (CI) 0.13 to 0.32; p<0.001); psychological well-being (beta = 0.26; 95% CI 0.05 to 0.25; p = 0.003); and social and peer support (beta = 0.29, 95% CI 0.77 to 0.28, p = 0.001). CONCLUSIONS: Although the association between HRQoL and markers of body weight, fitness and physical activity and inactivity were not strong (3% to 12%), the results suggest that aerobic fitness had the strongest influence on physical and psychological well-being and social and peer support. The results do not provide information on whether aerobic fitness is the cause or consequence of higher HRQoL. Longitudinal studies exploring the long-term effect of aerobic fitness on HRQoL are needed.