Quality Of Life In Youth Research Articles

Number of Borderline Personality Disorder Criteria and Depression Predict Poor Functioning and Quality of Life in Outpatient Youth.

This study aimed to investigate which factors contribute to poor functioning and poor quality of life in youth (aged 15-25 years) with borderline personality disorder (BPD), and whether the number of BPD criteria might be an independent predictor of these outcomes. A sample of 499 help-seeking outpatient youth, aged 15-25 years, was assessed. Stepwise multiple regression analyses showed that the number of BPD criteria was the best predictor of poor functioning, followed by number of mental health visits in the past month, female sex, and a current diagnosis of depression. Current depression was the best predictor of Assessment of Quality of Life utility score, followed by the number of BPD criteria. These findings underscore the clinical significance of DSM-IV BPD features (even when subthreshold for a categorical diagnosis) in youth and their effects upon social and occupational functioning and quality of life early in the course of BPD.

Quality of life in children and adolescents in Central Kenya: associations with emotional and behavioral problems

PurposeTo assess the quality of life (QoL) of children and adolescents in Kenya as rated by parents and youth themselves, and examine how QoL is related to emotional and behavioral problems (EBP).MethodQoL and EBP reports were obtained from 1022 Kenyan parents and 533 adolescents living in the country’s Central Province. Parents with children between 6 and 18 years completed the Pediatric Quality of Life Inventory (PedsQL) and the Child Behavior Checklist, while the adolescents (12–18) completed the PedsQL and the Youth Self-Report.ResultsParent-reported QoL in Kenyan youth was somewhat above that of US standardization samples, while levels of adolescent self-reports were well within the range of those from most high- and middle-income countries. Average adolescent girls’ self-reports were lower on all QoL scales than boys. QoL in children/adolescents with clinical to borderline levels of EBP (cf. multicultural norms, Achenbach and Rescorla, 2007) was lower than QoL in agemates with normal levels of EBP. Regression analyses indicated unique associations of QoL with parent-reported withdrawn/depressed, somatic complaints, attention problems, and aggressive behavior, and with adolescent self-reported somatic complaints, attention problems, and rule-breaking behavior.ConclusionQoL levels were well within ranges of other countries. Moreover, associations of QoL with EBP indicated that those with borderline/clinical levels of EBP had a much lower QoL most notable for those with somatic complaints and attention problems. Mental health providers might focus on interventions that reduce EBP in Kenyan children and adolescents and simultaneously reduce the risk of lowered QoL.

Parental Distress and Stress in Association with Health-Related Quality of Life in Youth with Spina Bifida: A Longitudinal Study.

This study examined associations between 3 distinct parent factors (parent personal distress, parenting stress, and spina bifida (SB)-specific parenting stress) and youth and parent proxy reports of youth health-related quality of life (HRQOL) over time. Participants were recruited as part of a longitudinal study, and data were collected at 3 time points, spaced 2 years apart. Parents and youth completed questionnaires, and youth completed neuropsychological assessment tasks to determine youth intelligence quotient during home visits. Analyses revealed that higher levels of maternal SB-specific parenting stress were related to lower levels of youth-reported HRQOL at time 1. Other parent factors were not associated with youth report of HRQOL at the earlier time points, although higher levels of maternal SB-specific parenting stress and paternal parenting stress were associated with lower levels of youth HRQOL at time 3. For mothers and fathers, increased parent personal distress, parenting stress, and SB-specific parenting stress were associated with decreased proxy report of youth HRQOL. Of these three parent factors, SB-specific parenting stress was consistently the most strongly associated with parent proxy-report of youth HRQOL. Parenting stress and distress are important targets for interventions, and these interventions may improve youth outcomes, especially as youth age. Future research is needed to identify other factors influencing youth HRQOL over time.

Factors associated with diabetes-specific health-related quality of life in youth with T1DM: the global TEENs study

Factors associated with diabetes-specific health-related quality of life in youth with T1DM: the global TEENs study

Executive Functioning Mediates the Relationship Between Pain Coping and Quality of Life in Youth With Sickle Cell Disease.

Sickle cell disease (SCD) is a lifelong condition characterized by pain, which is associated with reduced health-related quality of life (HRQL). Data suggest that patients with SCD vary in how they cope and their neurocognitive abilities. This study aimed to characterize executive functioning and pain coping styles in children with SCD experiencing a range of pain frequency (i.e., chronic, episodic, and asymptomatic) and to examine whether executive functioning mediates the relationship between pain coping and HRQL. Participants included 100 children and adolescents with SCD between the ages of 8 and 18 years (M = 13.53, SD = 2.8) and their parents who were recruited during outpatient SCD clinic visits in a children's hospital. Children completed questionnaires related to pain experience and pain coping. Parents completed questionnaires about demographic information, their child's executive functioning, and HRQL. Pain intensity, executive dysfunction, and engagement in emotion-focused coping (i.e., internalizing/catastrophizing and externalizing) predicted poor HRQL. In addition, engagement in emotion-focused coping predicted executive dysfunction. Multivariate analysis of covariance revealed executive functioning did not differ based on pain frequency; however, executive functioning was a significant mediator that helped explain the relationships between distraction and emotion-focused coping techniques on HRQL. Findings support that executive functioning is an important factor in understanding the relationship between pain coping and HRQL in youth with SCD. Future research is warranted to examine the potential impact of executive functioning on the utility of interventions targeting adaptive pain coping in youth with SCD.

Association between Participants' Characteristics, Patient-Reported Outcomes, and Clinical Outcomes in Youth with Sickle Cell Disease.

Background Sickle cell disease (SCD) is a chronic debilitating illness. SCD-related complications result in substantial impairment in quality of life (QOL). Our study objective was to assess the relationship of participants' characteristics, QOL, hydroxyurea adherence, and SCD-related clinical outcomes in youth with SCD. Procedure A single-center cross-sectional study. Thirty-four youth with SCD enrolled from clinic between January and December 2015. Participants completed PROMIS® measures and ©Modified Morisky Adherence Scale. Results Participants had a mean age of 14.8 (SD 2.9) years and 41% were female. Participants' age correlated with fatigue (rs=0.48; P=0.006), pain (rs=0.32; P=0.07), and anxiety (rs=0.33; P=0.06) scores. Participants with chronic pain had worse upper extremity physical function (P=0.05), pain (P=0.04), anxiety (P=0.05), and depression (P=0.05). Males reported significantly higher hydroxyurea adherence (5.4 versus 3.6, P=0.02) compared to females. Participants with chronic pain had more frequent hospitalizations (P=0.02), emergency room visits (P=0.04), and longer total length of hospital stays over 12-month period (P=0.01). Conclusions Older and female participants had worse QOL scores, and males reported higher hydroxyurea adherence. Participants with chronic pain reported significant impairment in different QOL domains and had increased healthcare utilization. Future longitudinal studies examining the relationship between participants' characteristics, QOL, hydroxyurea adherence, and SCD-related clinical outcomes are needed.

Establishing a Clinically Meaningful Cut-Point for the PAID-PR (Problem Areas in Diabetes-Parent Revised) Survey

Managing type 1 diabetes (T1D) in youth can create substantial family distress and affect diabetes care efforts. The current study aimed to establish a cut-point on the PAID-PR, a previously validated measure of diabetes distress in parents of youth with T1D. The 18-item PAID-PR has shown construct validity with BGM frequency, A1c, and measures of diabetes-specific family conflict (DSFC) and general quality of life (QoL). Higher PAID-PR scores (range 0-100) indicate more diabetes distress. We applied a standard approach to identify a meaningful cut-point: scores ≥75th percentile of the distribution of PAID-PR scores obtained from 2 large clinic samples. Cutoff score was confirmed by convergent validity, including demographics, diabetes data from youth, and parent reported psychosocial measures (DSFC and QoL). The sample included 527 parents of youth with T1D. Youth (50% male, 84% white) were aged (M±SD) 14.0±2.5 years with T1D duration 6.3±3.6 years; 86% were from 2-parent families. Youth checked BG 5.3±2.5 x/day; A1c was 8.4±1.1% and 69% were pump-treated. PAID-PR score was 43.3±18.5 (range 0-92, IQR 31-56). Analyses determined a cut-point of 56. Youth whose parents scored in the upper quartile vs. lower 3 quartiles were similar with respect to sex and racial distributions, age, percent 2-parent families, T1D duration, and BG checks/day. There were significant differences in A1c (8.6±1.2 vs. 8.3±1.1%) and pump use (60 vs. 71%) (p<.01 for both) between youth whose parents were in the upper vs. lower 3 quartiles of the PAID-PR. Parents in the upper quartile vs. lower 3 quartiles reported more DSFC and poorer youth QoL (p<.001 for both). As youth-onset T1D may engender diabetes distress in families, pediatric diabetes teams recognize the need to identify parents experiencing extreme symptoms. A cut-point of 56 on the PAID-PR appears to identify families in need of additional medical and psychological support in order to improve biomedical and psychosocial outcomes. Disclosure L.J. Tinsley: None. P.V. Commissariat: None. L. Volkening: None. B. Anderson: Advisory Panel; Self; Sanofi-Aventis. M. Katz: None. L.M. Laffel: Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi US, MannKind Corporation, Roche Diagnostics Corporation, Dexcom, Inc., Insulet Corporation, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Johnson & Johnson Diabetes Institute, LLC..

To Study the Integrated Yoga Therapy (IAYT) Effect on Quality of Life and Positive and Negative Emotions in Tribal Adolescent Girls – A Single Group and Pre-Post Design

The tribal community faces problems by way of Poverty, Malnutrition, Low literacy, Lack of Sanitation and Quality drinking water, Lack of basic health services, Social – Traditional belief and customs etc., an overall environment will be resulted in to poor quality of life; leads to poor mental health. This research study has planned to know the effect of short term integrated yoga module for to know the effect of Quality of Life and Positive Negative Emotions of the Tribal Adolescent School Girls; living in Chhatralaya. Tribal adolescent girls; aged 10 to 19, total 46 nos. of adolescent girls were participated and attended yoga classes taught by trained yoga therapist for 15 days. The module included loosening, Suryanamaskara, asanas, breathing exercises, Krida yoga, and meditation and relaxation techniques. The assessment was carried out one prior intervention as wells as on 15 th day. All the participants were asked practice regularly. The Quality of Life was measured by using Youth Quality of Life (YQOL-SF). This contains 15 perpetual items measuring the domain of sense of self, social relationship, environment and general quality of life. The Positive Negative Emotions were measured by using Positive Negative Affects Schedule (PANAS-SF). The PANAS is a 20 items self-report measure of positive and negative effects. This contains two 10 items mood scale and was developed to provide brief measure of positive and negative effects. For the results, normality test was carried out for consideration of parametric / non-parametric test. The data was found that it was normally distributed; Shapiro Wilk test; paired ‘t’ test at 95% confidence interval level was carried out for hypothesis testing to measure the effects after 15 days IAYT. Quality of Life Results: The results showed significant improvement: t (34) = -2.202, P = 0.035. PANAS Results: PANASSF Score: For Positive Affects Mean Scores = 33.3 (S.D. ± 7.2). The results showed that there was no significant improvement (p = 0.187). The Mean Score and Standard Deviation before and after IAYT: Before: M = 39.97 (S.D. ± 5.71), After: M = 41.285 (S.D. ± 6.355). For Negative Affects: The Mean Scores according to PANAS-SF for NA is: M = 17.4 (S.D. ± 6.2). The results showed that there was no significant improvement (p = 0.068). The Mean Score and Standard Deviation before and after IAYT: Before: M=29.37 (S.D. ± 4.81), After: M = 26.91 (S.D. ± 6.96). For Positive Affect (PA): Parameters Showed significant improvement: t (9) = -2.709, P = 0.024. For Negative Affect (NA) Parameters Showed no significant improvement: t (9) = -2.022, P = 0.074. Combine Effect of Quality of Life and Positive Negative Emotions: Increased effect on Positive Affects leads to improvement in Quality of Life and decrease the Negative Affects. Improvement in Quality of Life leads to increase in Positive Affects and decrease in Negative Affects. Thus, change in Quality of Life impacts over Emotions and Change in Emotions impacts over Quality of Life. Conclusion: Study shows the general dominants problems in tribal adolescent girls is due to their lower Quality of Life and Emotional imbalances. These can be improved with the application of regular practice of IAYT and for that awareness of about Yoga is essential for them. Finding shows that 15 days short duration Yoga intervention has significant effect on Quality of Life and Positive Affect parameters; reduction in Negative Affect found faster than Positive Affect. It is to be concluded that for overall improvement in Quality of Life and Positive and Negative Emotions, long term IAYT would be required for better to best.

A Time-Friendly, Feasible Measure of Nutrition Knowledge in Type 1 Diabetes: The Electronic Nutrition and Carbohydrate Counting Quiz (eNCQ).

Greater knowledge about nutrition and carbohydrate counting are associated with improved glycemic control and quality of life in youth with type 1 diabetes (T1D). However, limited assessments of nutrition and carbohydrate knowledge have been developed, and existing measures can be time-consuming, overly broad, or not conducive to routine clinical use. To fill this gap, we developed and examined the feasibility of administering the electronic Nutrition and Carbohydrate Counting Quiz (eNCQ). Ninety-two caregivers and 70 youth with T1D (mean age 12.5 years; mean time since diagnosis 5 years; English speaking) completed the 19-item eNCQ via tablet during a routine clinical visit. Completion time and item completion rates were used to assess feasibility. Relationships between eNCQ scores and patient demographics, diabetes management, and health outcomes were examined. Participants took 10 minutes, on average, to complete the eNCQ. Total and Carbohydrate subscale scores (youth report) were negatively correlated with youth hemoglobin A1c (total r = -.38, carbohydrate r = -.38, Ps < .05), indicating that greater nutrition knowledge related to better glycemic control. Nutrition knowledge scores were generally high, but knowledge was negatively related to time since diabetes diagnosis ( r = -.276, P < .05). Findings support feasibility of the eNCQ to assess nutrition knowledge in routine clinical care. Following additional acceptability and validity testing, the eNCQ may identify families in need of further nutrition education. Nutrition assessment is particularly indicated for youth over one year since T1D diagnosis, as these families displayed lower nutrition knowledge and may need continuing education to maintain diabetes-specific nutrition knowledge over time.

Effectiveness of Disease-Specific Cognitive Behavioral Therapy on Anxiety, Depression, and Quality of Life in Youth With Inflammatory Bowel Disease: A Randomized Controlled Trial.

To evaluate the effectiveness of a disease-specific cognitive behavioral therapy (CBT) protocol on anxiety and depressive symptoms and health-related quality of life (HRQOL) in adolescents and young adults with inflammatory bowel disease (IBD). A parallel group randomized controlled trial was conducted in 6 centers of (pediatric) gastroenterology. Included were 70 patients and young adults (10-25 years) with IBD and subclinical anxiety and/or depressive symptoms. Patients were randomized into 2 groups, stratified by center: (a) standard medical care (care-as-usual [CAU]) plus disease-specific manualized CBT (Primary and Secondary Control Enhancement Training for Physical Illness; PASCET-PI), with 10 weekly sessions, 3 parent sessions, and 3 booster sessions (n = 37), or (b) CAU only (n = 33). Primary analysis concerned the reliable change in anxiety and depressive symptoms after 3 months (immediate posttreatment assessment). Exploratory analyses concerned (1) the course of anxiety and depressive symptoms and HRQOL in subgroups based on age, and (2) the influence of age, gender, and disease type on the effect of the PASCET-PI. Overall, all participants improved significantly in their anxiety and depressive symptoms and HRQOL, regardless of group, age, gender, and disease type. Primary chi-square tests and exploratory linear mixed models showed no difference in outcomes between the PASCET-PI (n = 35) and the CAU group (n = 33). In youth with IBD and subclinical anxiety and/or depressive symptoms, preliminary results of immediate post-treatment assessment indicated that a disease-specific CBT added to standard medical care did not perform better than standard medical care in improving psychological symptoms or HRQOL. ClinicalTrials.gov: NCT02265588.

Predictors of Long-Term Psychosocial Functioning and Health-Related Quality of Life in Children and Adolescents With Prior Concussions.

Individual differences in long-term psychosocial functioning after concussions in children and adolescents are poorly understood. The aim of the study was to investigate potential predictors of long-term psychosocial functioning and health-related quality of life in youth after prior concussion. Participants (N=75; mean age=14.3 years old; 52% girls) with one prior concussion (n=24), multiple prior concussions (n=24), or a prior orthopedic injury and no concussion (n=27) were seen on average 2.7 years after their most recent injury. Psychosocial functioning was assessed using the self-report versions of the Behavior Assessment System for Children (BASC-2; Anxiety and Depression scales only), the Strengths and Difficulties Questionnaire, and the Pediatric Quality of Life Inventory TM 4.0. Pre-existing conditions (attention problems, learning difficulties, mood concerns, anxiety concerns, and migraines) were reported by parents using a checklist and examined as predictors of long-term functioning. Other potential predictors included age at testing, sex, time between most recent injury and testing, and number of prior concussions. The groups did not differ significantly on long-term psychosocial functioning. Moreover, only pre-existing mood concerns or attention problems significantly predicted psychosocial adjustment. Children's functioning before a concussion is critical to understanding outcome. Pre-injury attention and mood concerns should be assessed in clinical settings to prevent and treat long-term psychosocial problems after concussion. (JINS, 2018, 24, 540-548).

HABIT, a Randomized Feasibility Trial to Increase Hydroxyurea Adherence, Suggests Improved Health-Related Quality of Life in Youths with Sickle Cell Disease

To examine the effect of a community health worker (CHW) intervention, augmented by tailored text messages, on adherence to hydroxyurea therapy in youths with sickle cell disease, as well as on generic and disease-specific health-related quality of life (HrQL) and youth-parent self-management responsibility concordance. We conducted a 2-site randomized controlled feasibility study (Hydroxyurea Adherence for Personal Best in Sickle Cell Treatment [HABIT]) with 2:1 intervention allocation. Youths and parents participated as dyads. Intervention dyads received CHW visits and text message reminders. Data were analyzed using descriptive statistics, the Wilcoxon signed-rank test, and growth models adjusting for group assignment, time, and multiple comparisons. Changes in outcomes from 0 to 6 months were compared with their respective minimal clinically important differences. A total of 28 dyads (mean age of youths, 14.3 ± 2.6 years; 50% Hispanic) participated (18 in the intervention group, 10 in the control group), with 10.7% attrition. Accounting for group assignment, time, and multiple comparisons, at 6 months intervention youths reported improved generic HrQL total score (9.8 points; 95% CI, 0.4-19.2) and Emotions subscale score (15.0 points; 95% CI, 1.6-28.4); improved disease-specific subscale scores for Worry I (30.0 points; 95% CI, 8.5-51.5), Emotions (37.0 points, 95% CI, 9.4-64.5), and Communication I (17.8 points; 95% CI, 0.5-35.1); and 3-month dyad self-management responsibility concordance (3.5 points; 95% CI, -0.2 to 7.1). There were no differences in parent proxy-reported HrQL measures at 6 months. These findings add to research examining effects of behavioral interventions on HrQL outcomes in youths with sickle cell disease. ClinicalTrials.gov: NCT02029742.

(228) - Predicting trajectories of disability and quality of life in youth with acute musculoskeletal pain

Prior studies have demonstrated that a sizeable proportion (35%) of youth with acute musculoskeletal (MSK) pain do not recover and continue with persistent MSK pain. Little is known about the biopsychosocial factors that predict the trajectory of recovery over time. To fill this gap, we tested how changes in psychological symptoms, sleep quality, and pain inhibition over 3 months post injury, predicted changes in disability and quality of life (QOL) over that same time period. Participants were 69 youth with new-onset MSK pain (ages 10–17) taking part in a longitudinal study examining risk for developing chronic pain. Youth were recruited from the emergency department or orthopedic clinic after presenting for evaluation of a new-onset musculoskeletal pain complaint (e.g., leg, back, arm pain). Participants attended two in-person lab visits, the first within one month after pain-onset and a second at four month follow-up. During each visit youth completed questionnaires assessing pain, disability, sleep and mood symptoms (pain catastrophizing, pain-related fear, depressive symptoms). Conditioned pain modulation was assessed using an experimental paradigm. Linear mixed effects models controlling for sex and pain intensity were used to examine changes in psychological, behavioral factors, and pain modulation over 3 months as predictors of longitudinal pain-related disability and QOL outcomes. In support of hypotheses, results revealed that increases in depressive symptoms (β = .26, P < .001) and pain-related fear (β = .24, P < .05) over 3 months predicted increases in pain-related disability over that same time period. Similarly, increases in depressive symptoms over time predicted a worsening of QOL (β = −.83, P < .001). Contrary to hypotheses, changes in sleep quality, pain catastrophizing and pain modulation over time were not associated with longitudinal changes in disability or QOL. Findings highlight the importance of depressive symptoms and pain-related fear in short-term recovery following acute injury and point to intervention targets.

Erratum. Factors Associated With Diabetes-Specific Health-Related Quality of Life in Youth With Type 1 Diabetes: The Global TEENs Study. Diabetes Care 2017;40:1002-1009.

In the article cited above, the Supplementary Data file for the “TEENs—List of Contributors” was …

The Effect of iCook 4-H, a Childhood Obesity Prevention Program, on Blood Pressure and Quality of Life in Youth and Adults: A Randomized Control Trial

Objective: Obesity increases the risk of developing hypertension and from population-based samples with estimations that of 2-4% of the U.S. pediatric population has hypertension, which may affect quality of life. This study examined the effects of an obesity prevention program on blood pressure and quality of life in youth and adult participants. Methods: A multi-state research team recruited treatment dyads (youth and their adult meal preparer) to participate in a 12-week randomized control trial and follow-up through 24 months. The treatment group received a cooking and physical activity intervention, followed by booster sessions and mailed newsletters over the remaining two-year period. The control group received no intervention. Resting blood pressure and health related quality of life (HRQOL) surveys were administered at 0,4,12 and 24 months. Results: 228 dyads were recruited (n=77 control and n=151 for treatment). Youth and adult systolic blood pressure (SBP) increased over the 24 months (p=0.003 and p=0.03, respectively) with no differences between groups. From baseline to 24 months both control and treatment youths’ physical and psychological HRQOL increased (p=0.01 and p=0.002, respectively). At 0 and 4 months, youth and adult SBP was positively correlated (r=0.24, p=0.003 and r=0.33, p<0.001, respectively). In the treatment group, there was an inverse association between adult SBP and youth psychological HRQOL at 4 months (r=-0.20, p=0.04), and a similar trend in adult SBP and youth physical HRQOL at 4 months in the treatment group (r=-0.19, p=0.05). Conclusion: A youth-adult dyad obesity prevention program consisting of culinary, mealtime and physical activity education, elicited improvements in HRQOL in youth participants.

Habit, a Feasibility Trial to Improve Hydroxyurea Adherence, Improves Quality of Life in Youth with Sickle Cell Disease

Background: Daily hydroxyurea (HU) adherence is often suboptimal for youth with sickle cell disease (SCD). Adolescence is a critical time to improve HU adherence as youth assume greater responsibility for medication self-management. While QOL is higher among youth prescribed HU compared to those who are not,1little is known about how participation in an intervention to improve HU adherence is related to self- and parent-proxy reported QOL.Methods: We conducted a 2-site randomized controlled feasibility trial with 2:1 randomization, “Hydroxyure Adherence for Personal Best in Sickle Cell Treatment: HABIT,” to estimate the effect of a community health worker (CHW) intervention for youth-parent dyads, augmented by tailored text messages, on HU adherence in youth 10-18 years of age with SCD.2 The secondary outcomes, reported here, were: generic QOL (PedsQL; total score and 4 subscales); disease-specific QOL (PedsQL SCD Module; total score and 9 additional subscales), and youth-parent concordance regarding self-management responsibility (Sickle Cell Family Responsibility Scale, adapted from the Diabetes Family Responsibility Questionnaire). Each outcome was measured at 0, 3 and 6 months. Descriptive statistics were used to profile each measure including a Cronbach alpha to assess scale reliability in this sample. A minimally clinically important difference (MCID) was computed for each total and subscale score as a criterion to assess clinically meaningful improvements. A linear individual growth model incorporating group assignment and time was used to examine the difference in each outcome over time. Where outcomes achieved statistical significance (p<0.05), we compared the intervention group's absolute score change from 0 to 6 months to the MCID to assess a clinically meaningful change. Data were analyzed using SAS 9.4 (Cary, NC) statistical software.Results: Of 48 eligible dyads, 28 (youth age 14.3±2.6 years, 50% Hispanic) participated (18 intervention dyads, 10 control dyads), with 10.7% attrition. The intervention was feasible (58% enrolled), acceptable to dyads and demonstrated a trend to HU adherence improvement at 4 months.3 Cronbach alphas ranged between 0.71 and 0.97 for parent and youth measures. Incorporating group assignment and time, intervention youth reported improved generic QOL total score (p=0.04; change 9.2 [95% CI 5.7, 12.7]) and its emotional subscale (p=0.034; change 14.4 [95% CI 10.2, 18.6]), 3 disease-specific QOL subscales: worry I (p=0.009; 26.1 [95% CI 18.0, 34.2), emotions (p=0.01; change 33.0 [95% CI 23.8, 42.2]), and communication I (p=0.048; change 15.3 [95% CI 8.5, 22.1]), and a trend for improved dyad concordance regarding self-management responsibility at 3 months (p=0.07; change 1.6 [95% CI 1.0, 2.2]). In each case, score improvement exceeded its MCID. No differences were found in parent-proxy reported QOL measures.Conclusions: HABIT improved two generic and three disease-specific youth-reported QOL outcomes in the psychosocial domain. Whether QOL improvement stemmed from greater HU adherence, CHW support and/or improved dyad self-management concordance is uncertain. These findings add to a growing body of research examining effects of interventions on QOL outcomes in youth with SCD. To confirm these findings, a multi-site HABIT randomized controlled trial powered to test intervention efficacy is planned.

Quality Of Life Post Traffic Accidents Among Youth

Introduction: Traffic accidents cause more than 1.2 million deaths every year, and the leading cause of death among youth aged 15-24 years in Egypt. Aim :This study aimed to evaluate Quality of life post traffic accidents among youth. Design: A descriptive analytical design was utilized to conduct this study . Setting: The study was conducted at outpatient clinic orthopedic hospital Ain Shams University Hospitals, and El Helal Hospital. Sample: A purposive sample consists of 250 cases available of youth post traffic accidents after three months from accidents. Tools: three tools were used for data collection, the first tool: An interviewing questionnaire. The second tools: Medical record. Third tool, Universal pain assessment tool. Results: The result found that 71.2% of the total sample of youth post traffic accidents was male and 28.8% of them were female and 80.8%aged for 21-24 years. Most of them had poor quality of life as 90.8% for physical, 99.2% for psychological, 98.8% for social, and 97.2% for spiritual dimension .There were 33.2% of study sample achieved their total health needs while 66.8% of them couldn’t achieve them . Also there were a highly statistical significant association between sociodemographic characteristics of youth post traffic accidents and their health needs and problems at P= 0.001. Conclusion: The study concluded that there was a highly significant relation between quality of life for youth post traffic accidents and their total independency level for all daily living activities where p =0.001. Recommendation: Health education program for youth post traffic accident and their family to secure them and help them to cope effectively with their disabilities which may have positive effect on improvement of their quality of life

Disease-Related Predictors of Health-Related Quality of Life in Youth With Eosinophilic Esophagitis.

To evaluate relations between health-related quality of life (HRQoL) and clinical symptom presentation in youth with eosinophilic esophagitis (EoE). We hypothesized that presence of dysphagia, reflux, nausea/vomiting, and epigastric pain would be related to poorer HRQoL. In predictive models, it was hypothesized that dysphagia, reflux, nausea/vomiting, and epigastric pain would each significantly and uniquely predict poorer HRQoL. This cross-sectional, two-study design included 91 dyads comprised children with EoE and their respective caregivers across two tertiary children's hospitals, Site 1 in the Midwest (N = 47) and Site 2 in the Deep South (N = 44). Youth and their caregivers both completed questionnaires addressing HRQoL and EoE symptoms during clinic visits. Per youth self-report, epigastric pain was found to be a significant predictor of poor physical and psychosocial HRQoL. Per caregiver-proxy reports, epigastric pain was found to be a significant predictor of poor physical HRQoL. The clinical symptoms of EoE, specifically epigastric pain, were found to be predictive of the youth's HRQoL. Targeted interventions to help youth with EoE better manage their specific symptom experiences could ultimately improve HRQoL.

Finding Silver Linings: A Preliminary Examination of Benefit Finding in Youth With Chronic Pain.

Chronic pain is a pervasive condition in adolescence and is associated with significant psychological distress, functional disability, social isolation, and decreased quality of life for a subset of affected youth. There is a paucity of research examining potential resilience factors and adaptive processes in pediatric chronic pain. Benefit finding refers to the process of perceiving positive consequences in the face of adversity. Previous research on benefit finding in pediatric samples (e.g., oncology; acute injury) has yielded inconsistent results. This is the first study to examine this construct in youth with chronic pain. The objective of the current investigation was to extend previous research on benefit finding to adolescents with chronic pain and to assess relationships between benefit finding, internalizing mental health symptoms (i.e., anxiety, depression, and posttraumatic stress disorder [PTSD]), pain outcomes (pain intensity and interference), and quality of life. Psychometrically sound self-report measures of benefit finding, anxiety, depressive, and PTSD symptoms, pain intensity, pain interference, and quality of life were completed by 145 youth (67.4% female, Mage = 13.3 years, SD = 2.6), referred to a tertiary-level chronic pain program. Benefit finding was significantly correlated with internalizing mental health symptoms, pain outcomes, and quality of life. Further, benefit finding significantly predicted children's self-reported pain intensity, pain interference, and quality of life when controlling for age and sex. Findings suggest that benefit finding is associated with internalizing mental health symptoms, pain outcomes, and quality of life in youth with chronic pain. Future research examining this construct is warranted.

Unhealthy lifestyle habits and diabetes-specific health-related quality of life in youths with type 1 diabetes.

Management of type 1 diabetes mellitus (T1DM) influences several aspects of life, such as adherence to healthy lifestyle habits and health-related quality of life (HRQoL). Our aim was to evaluate the association between unhealthy lifestyle habits and HRQoL in adolescents and young adults with T1DM. Two hundred and forty-two Caucasian patients (13-19years) consecutively enrolled over a 12-month period in three Regional Pediatric Diabetes Centers in Italy. Demographics, clinical, and laboratory parameters, adherence to lifestyle habits (Mediterranean Diet assessed by KIDMED, Physical Activity levels and sedentary behavior by questionnaire) considered either separately or in cluster, and HRQoL by Pediatric Quality of Life Inventory Diabetes Module (PedsQL 3.0 DM) were collected. Metabolic control was determined by HbA1cmean of previous year. Only 15 (6.2%) patients fulfilled the cluster of three healthy lifestyle habits without gender differences (p=0.353); 62 (25.6%) had 1 unhealthy lifestyle habit, and 165 (68.2%) had≥2. Adolescents meeting physical activity recommendations had better PedsQL scores than those who did not meet. PedsQL total score and specific sub-scales decreased in patients with unhealthy lifestyle habits. High PedsQL was significantly associated with being male, living in South Italy, having lower HbA1c mean levels, and reporting lower adherence to unhealthy lifestyle habits. The clustering of unhealthy lifestyle habits is associated with reduced HRQoL in adolescents and young adults with T1DM. Promoting multiple behavior changes may be a useful approach to improve the health status and the HRQoL in youths with T1DM.