Risk and protective factors of health-related quality of life in children and adolescents: Results of the longitudinal BELLA study

Christiane Otto; Anne-Catherine Haller; Fionna Klasen; Heike Hölling; Monika Bullinger; Ulrike Ravens-Sieberer; BELLA study group

doi:10.1371/journal.pone.0190363

Risk and protective factors of health-related quality of life in children and adolescents: Results of the longitudinal BELLA study

PLoS One. 2017 Dec 28;12(12):e0190363. doi: 10.1371/journal.pone.0190363. eCollection 2017.

Authors

Christiane Otto¹, Anne-Catherine Haller¹, Fionna Klasen¹, Heike Hölling², Monika Bullinger³, Ulrike Ravens-Sieberer¹; BELLA study group

Affiliations

¹ Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
² Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany.
³ Institute and Outpatients Clinic Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Abstract

Aims: Cross-sectional studies demonstrated associations of several sociodemographic and psychosocial factors with generic health-related quality of life (HRQoL) in children and adolescents. However, little is known about factors affecting the change in child and adolescent HRQoL over time. This study investigates potential psychosocial risk and protective factors of child and adolescent HRQoL based on longitudinal data of a German population-based study.

Methods: Data from the BELLA study gathered at three measurement points (baseline, 1-year and 2-year follow-ups) were investigated in n = 1,554 children and adolescents aged 11 to 17 years at baseline. Self-reported HRQoL was assessed by the KIDSCREEN-10 Index. We examined effects of sociodemographic factors, mental health problems, parental mental health problems, as well as potential personal, familial, and social protective factors on child and adolescent HRQoL at baseline as well as over time using longitudinal growth modeling.

Results: At baseline, girls reported lower HRQoL than boys, especially in older participants; low socioeconomic status and migration background were both associated with low HRQoL. Mental health problems as well as parental mental health problems were negatively, self-efficacy, family climate, and social support were positively associated with initial HRQoL. Longitudinal analyses revealed less increase of HRQoL in girls than boys, especially in younger participants. Changes in mental health problems were negatively, changes in self-efficacy and social support were positively associated with the change in HRQoL over time. No effects were found for changes in parental mental health problems or in family climate on changes in HRQoL. Moderating effects for self-efficacy, family climate or social support on the relationships between the investigated risk factors and HRQoL were not found.

Conclusion: The risk factor mental health problems negatively and the resource factors self-efficacy and social support positively affect the development of HRQoL in young people, and should be considered in prevention programs.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Cross-Sectional Studies
Humans
Longitudinal Studies
Quality of Life*
Risk Factors
Self Efficacy
Social Support

Grants and funding

This article is part of a dissertation project supported by the Foundation for Science in Hamburg (Stiftung Wissenschaft in Hamburg), part of the Donors' Association for the Promotion of Humanities and Sciences in Germany (Stifterverband für die Deutsche Wissenschaft). The funders had no role in the study design, the data collection and analyses, the preparation and writing of the manuscript, or the decision to publish. The BELLA study has been financially supported by the German Science Foundation and by the Federal Ministry of Health (BMG).