title: The health and well-being of adolescents: a school-based population study of the self-report Child Health Questionnaire.
abstract: OBJECTIVE
  To evaluate a new generic measure of adolescent health status, the self-report version of the Child Health Questionnaire (CHQ), and provide population-based data. Furthermore, we aimed to examine the impact of common adolescent illness and health concerns on their health and well-being.
  
  
  METHODS
  A stratified, two-stage, random cluster sampling design was used to obtain a cross-sectional sample of subjects through schools. A written questionnaire included the 80-item 12-scale self-report CHQ and items measuring health concerns, illnesses/health conditions, and sociodemographics.
  
  
  RESULTS
  A total of 2361 adolescents participated (response rate of 70%). Reliability was high: Tests of internal consistency and discriminant validity reported 90% of item-scale correlations >.4; all scales had Cronbach alpha coefficients >.7. Adolescents with illnesses/conditions or health concerns reported lower scores and larger differences for content-related scales, supporting content and construct validity. Statistically significant age and gender trends were observed for Mental Health, Self-Esteem, General Health, and Family Cohesion scales. Health status worsened as health concerns increased (X(2) linear trend, p =.00) with deterioration in health of 5-20% on all scales for emotional health concerns (40% of sample).
  
  
  CONCLUSIONS
  The self-report CHQ is a reliable and seemingly valid measure of health and well-being for adolescent health research, although additional measures may be required where scales have high ceiling values. The significantly lower scores reported by adolescents with illness and/or health concerns lend support to the use of standardized health measures and longitudinal research to further examine the impact of adolescent comorbidities and their causal determinants.
authors.affiliation: Centre for Community Child Health, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia. waterse@cryptic.rch.unimelb.edu.au
authors.forename: E B
authors.initials: EB
authors.lastname: Waters
authors.forename: L A
authors.initials: LA
authors.lastname: Salmon
authors.forename: M
authors.initials: M
authors.lastname: Wake
authors.forename: M
authors.initials: M
authors.lastname: Wright
authors.forename: K D
authors.initials: KD
authors.lastname: Hesketh
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D015203:Reproducibility of Results; D012574:Schools; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires