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

  • Author / Creator
    Wu, Xiu Yun
  • 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.

  • Subjects / Keywords
  • Graduation date
  • Type of Item
  • Degree
    Doctor of Philosophy
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
  • Institution
    University of Alberta
  • Degree level
  • Department
    • School of Public Health Sciences
  • Supervisor / co-supervisor and their department(s)
    • Dr. Arto Ohinmaa (Co-supervisor), Department of Public Health Sciences
    • Dr. Paul Veugelers (Supervisor), Department of Public Health Science
  • Examining committee members and their departments
    • Dr. Jeffrey Johnson (Supervisor committee member), Department of Public Health Sciences
    • Dr. Ambikaipakan Senthilselvan (Internal examiner), Department of Public Health Sciences
    • Dr. Jennifer Taylor (External examiner), Applied Human Sciences, University of Prince Edward Island