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Paediatrics
Research
Assessment of health-related quality of life and psychological well-being of children and adolescents with obesity enrolled in a New Zealand community-based intervention programme: an observational study
  1. Yvonne C Anderson1,2,
  2. Lisa E Wynter1,
  3. Katharine F Treves1,
  4. Cameron C Grant3,4,5,
  5. Joanna M Stewart6,
  6. Tami L Cave2,
  7. Trecia A Wouldes7,
  8. José G B Derraik2,8,
  9. Wayne S Cutfield2,4,8,
  10. Paul L Hofman2,4
  1. 1 Department of Paediatrics, Taranaki District Health Board, New Plymouth, Taranaki, New Zealand
  2. 2 Liggins Institute, University of Auckland, Auckland, New Zealand
  3. 3 Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
  4. 4 Starship Children’s Hospital, Auckland District Health Board, Auckland, New Zealand
  5. 5 Centre for Longitudinal Research : He Ara ki Mua, University of Auckland, Auckland, New Zealand
  6. 6 Department of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
  7. 7 Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
  8. 8 A Better Start, National Science Challenge, University of Auckland, Auckland, New Zealand
  1. Correspondence to Dr. Yvonne C Anderson; yvonne.anderson{at}tdhb.org.nz

Abstract

Objective To describe health-related quality of life (HRQOL) and psychological well-being of children and adolescents at enrolment in a multidisciplinary community-based obesity programme and to determine association with ethnicity. This programme targeted indigenous people and those from most deprived households. Further, this cohort was compared with other populations/normative data.

Methods This study examines baseline demographic data of an unblinded randomised controlled clinical trial. Participants (recruited from January 2012-August 2014) resided in Taranaki, New Zealand, and for this study we only included those with a body mass index (BMI) ≥98th percentile (obese). HRQOL and psychological well-being were assessed using the Pediatric Quality of Life Inventory (PedsQL V.4.0TM) (parent and child reports), and Achenbach’s Child Behavior Checklist (CBCL)/Youth Self Report (YSR).

Results Assessments were undertaken for 233 participants (45% Māori, 45% New Zealand European, 10% other ethnicities, 52% female, 30% from the most deprived household quintile), mean age 10.6 years. The mean BMI SD score (SDS) was 3.12 (range 2.01–5.34). Total PedsQL generic scaled score (parent) was lower (mean=63.4, SD 14.0) than an age-matched group of Australian children without obesity from the Health of Young Victorians study (mean=83.1, SD 12.5). In multivariable models, child and parental generic scaled scores decreased in older children (β=−0.70 and p=0.031, β=−0.64 and p=0.047, respectively). Behavioural difficulties (CBCL/YSR total score) were reported in 43.5% of participants, with the rate of emotional/behavioural difficulties six times higher than reported norms (p<0.001).

Conclusions In this cohort, children and adolescents with obesity had a low HRQOL, and a concerning level of psychological difficulties, irrespective of ethnicity. Obesity itself rather than ethnicity or deprivation appeared to contribute to lower HRQOL scores. This study highlights the importance of psychologist involvement in obesity intervention programmes.

Trial registration number Australian NZ Clinical Trials Registry ANZCTR 12611000862943; Pre-results.

  • paediatric
  • obesity
  • adolescent
  • quality of life
  • lifestyle intervention
  • Whānau Pakari

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-015776

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    Footnotes

    • Contributors YCA designed the study, was involved with data interpretation and drafted this manuscript. LEW recruited participants and undertook assessments and data entry. KFT provided psychologist oversight and analysis of patient data. CCG is secondary supervisor for the research team and assisted with the design of the study. JMS was involved in study design. TLC assisted with data entry and analysis. TAW was involved in interpretation of data. JGBD analysed the data and drafted the manuscript. WSC contributed to study design. PLH contributed to study design and supervises the research team. All authors critically revised the manuscript, gave final approval for the version to be published and are accountable for all aspects of the work.

    • Funding This work has been funded by grants from the Health Research Council of New Zealand, Royal Australasian College of Physicians, the Maurice and Phyllis Paykel Trust, Taranaki Medical Foundation and Lotteries Health Research.

    • Competing interests YCA and PLH have been recipients of these grants to undertake clinical research in relation to Whānau Pakari, YCA has been paid in a fellowship capacity from the Health Research Council of New Zealand, TLC has been paid as a research assistant, JGBD has been paid for data analysis.

    • Patient consent Obtained.

    • Ethics approval Ethics approval for the programme was granted by the New Zealand Health and Disability Ethics Committee (CEN/11/09/054). Written and verbal informed consents were obtained from all participants or their guardians. The trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR: 12611000862943).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Anonymised and deidentified data will be made available to other investigators upon request. Interested readers should contact the senior author PH (p.hofman@auckland.ac.nz) to obtain the data.