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Determinants of Health-related Quality of Life among Grade Five Students in Canada and Application to School Based Promotion of Healthy Eating and Active Living Open Access


Other title
Grade Five Student
Health-related Quality of Life
Type of item
Degree grantor
University of Alberta
Author or creator
Wu, Xiu Yun
Supervisor and department
Dr. Arto Ohinmaa (Co-supervisor), Department of Public Health Sciences
Dr. Paul Veugelers (Supervisor), Department of Public Health Science
Examining committee member and department
Dr. Jennifer Taylor (External examiner), Applied Human Sciences, University of Prince Edward Island
Dr. Ambikaipakan Senthilselvan (Internal examiner), Department of Public Health Sciences
Dr. Jeffrey Johnson (Supervisor committee member), Department of Public Health Sciences
School of Public Health Sciences

Date accepted
Graduation date
Doctor of Philosophy
Degree level
Childhood overweight and obesity have become a global public health problem that threatens children’s future health. The impaired influence of childhood overweight and obesity on their health-related quality of life (HRQOL) has been documented using clinical and population-based samples among children. Very few studies have analyzed socio-demographic and neighbourhood determinants of HRQOL and underlying influencing factors of diet quality and physical activity (PA) for HRQOL among primary school children. While the beneficial effects of school-based programs on promoting healthy behaviors and some aspects of health among children have been documented, the impact of such interventions on their HRQOL has yet to be evaluated. The purpose of the present study included: (1) to assess associations between socio-demographic and neighbourhood characteristics and the HRQOL among grade five students in Alberta; (2) to investigate how diet quality, PA and weight status correlate with their HRQOL; (3) to construct a scoring system for the EQ-5D-Y (youth) that can be used to derive health state index values for grade five students; and (4) to assess the influence of a school-based program promoting active living and healthy eating on HRQOL of the students. These objectives were addressed using population based data collected in 2008 and 2010 with the Raising Healthy Eating and Active Living Kids in Alberta surveys, and intervention data collected as part of the Alberta Project Promoting Active Living & Healthy Eating in Schools (APPLE Schools). The results revealed that socio-demographic and neighbourhood characteristics were determinants of HRQOL in grade five students, and students with better diet quality, higher physical activity levels, and normal weights reported better HRQOL than students who ate less healthy, were less active or were overweight or obese. The index value set for the EQ-5D-Y that was based on child self-rated Visual Analogue Scale (VAS) values resulted in parameter estimates that followed the expectation for different levels of EQ-5D-Y health states. Analysis of primary intervention of the APPLE Schools program did not show a statistically significant improvement in HRQOL of grade five students between 2008 and 2010. The results suggest a need to take into account of the important determinants for HRQOL among children in school based health interventions, and to further examine factors that could contribute to the observed variation in the HRQOL in this study. This will help inform public health policy to the benefits of both weight-related health and quality of life among children.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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