Linguistic Validation And Measurement Properties Of Chinese Version Of Youth Quality Of Life Instrument (YQOL-R)

ObjectivesThe study aimed to conduct a cross-cultural linguistic validation of YQOL-R following a standard protocol, and to evaluate the measurement properties of the Chinese Version of Youth Quality of Life Instrument (YQOL-R).MethodsPhasel Linguistic ValidationStrictly following methodology of YQOL-R Translation Manual, the linguistic validation of the instrument was conducted using forward translation and backward translation. We further checked conceptual comprehension and equivalence using cognitive interview methods including2panels,6children and adolescents.Phase2Field Testing-Measurement Properties1. Sample:The study was conducted in Hangzhou, Zhejiang Province of China in2012. The sample was stratified such that approximately equal numbers of participants were recruited with respect to gender (male, female), age (6-12grads, ranging from11-18YD), recruitment community (urban, migrant, rural) and body mass index (normal, overweight, obese). The participants were recruited from9schools and recruitment didn’t stop until the recruitment quotas were saturated.2. Survey instruments and contents:The participants were asked to fill the questionnaires including personal demographic statistics, Chinese Versions of YQOL-R and PedsQLTM4.0Generic Core Scales. A subset of90participants was selected at random to complete the YQOL-R7-10days after the baseline survey to assess test-retest reliability.3. Statistical analysis:All data were double entered, missing values were checked against the paper and pencil surveys and inconsistencies were corrected before analysis. Statistical analyses were carried out using SPSS version17. Descriptive analyses, multi-trait/multi-item analysis program, T-test, one-way analysis of variance (ANOVA), correlation analysis, exploratory factor analysis were employed for data analysis.ResultsLinguistic ValidationMost of item of YQOL-R can be precisely translated into Chinese with no difficulties. According to the results of cognitive interview, all the participants can understand the items and the completing time for the questionnaire ranged from10-16minutes, suggesting that the Chinese version of YQOL-R had conceptual equivalence with source version and can be used for field testing.Measurement Properties1. Multi-trait/Multi-item analysis:Item-scale correlation ranged from0.14to0.74. Items within a scale with bivariate correlations＜0.7with some exceptions. Items correlated significantly higher to its hypothesized scale than to its competing scales, inter-scale correlation ranging from0.59to0.85.2. Reliability:The instrument had robust internal consistency reliability with Cronbach’s a ranging from0.87to0.96and acceptable test-retest reliability with the intraclass correlation coefficients (ICCs) all higher than0.7. The SEM values ranged from7.92to11.57.3. Validity:Exploratory factor analysis with orthogonal varimax rotation achieved a four factor solution which fitted into theoretical expectation. The Pearson’s correlation coefficients between the YQOL-R and the PedsQLTM4.0General Core Scales were stronger between comparable dimensions than those between less comparable dimensions, demonstrating convergent and discriminant evidence of construct validity. Significant differences were found in subscale and total scores across BMI groups, age, gender and family income, supporting the known-group validity of this instrument. Besides, the Chinese version of YQOL-R had achieved content validity and cross-cultural validity.4、Measurement burden:Students actively took part in this field testing and840participants completed the questionnaire,534said that they want to participate in the youth quality of life research in the future. Survey lasted about12to15minutes, it showed that teenagers can accept batteries questionnaire.ConclusionThe Chinese version of YQOL-R has adequate psychometric properties and can be used to assess the generic quality of life for children and adolescents in China. Ability to detect weight change and interpretability of YQOL-R scores need to be further examined in longitudinal studies.