title: Food allergy QoL questionnaire for children aged 0-12 years: content, construct, and cross-cultural validity.
abstract: BACKGROUND
  To date, there is no food allergy-specific questionnaire that allows parents to report children's health-related QoL (HRQL) from the child's perspective.
  
  
  OBJECTIVE
  The aim of this study was to develop a sensitive, multi-dimensional measure to assess parental perception of HRQL in children aged 0-12 years with food allergy.
  
  
  METHODS
  The Food Allergy QoL - Parent Form (FAQLQ-PF) was developed and validated in four stages: (1) item generation using focus groups, expert opinion, and literature review; (2) item reduction, using clinical impact and factor analysis; (3) internal and test-retest reliability and construct validity were evaluated using relevant scales of the Child Health Questionnaire (CHQ)-28 and the disease-specific food allergy independent measure (FAIM); and (4) cross-cultural and content validity was examined by administering the questionnaire in a US sample.
  
  
  RESULTS
  Stage 1: Saturation was reached at 110 items. Stage 2: The reduced instrument has 14 items for children <4 years and 26 and 30 items for children aged 4-6 years and 7-12 years, respectively. Factor analysis revealed three subscales: emotional impact, food anxiety, and social and dietary limitations, accounting for 68% of the variance. Stage 3: Cronbach's alpha >0.7 for subscales and total score. Construct validity was demonstrated by significant correlations between relevant scales of the CHQ-28 and FAQLQ-PF subscales (r=0.69-0.77, P<0.01), and between FAQLQ-PF subscales and the FAIM. Sensitivity was shown by significant within-group differences in a sample of 124 food-allergic children. Stage 4: The FAQLQ-PF was validated in a sample of US children, Cronbach's alpha >0.7 for subscales and total score. Construct validity was demonstrated by significant correlations between FAQLQ-PF and the FAIM (parent report) and between the FAQLQ-PF and the FAIM (child report). No differences were observed between the US and Irish scores.
  
  
  CONCLUSIONS
  The FAQLQ-PF is psychometrically robust, with excellent reliability and validity.
authors.affiliation: Department of Paediatrics and Child Health, University College, Cork, Ireland. a.dunngalvin@ucc.ie
authors.forename: A
authors.initials: A
authors.lastname: DunnGalvin
authors.forename: B M J
authors.initials: BM
authors.lastname: de BlokFlokstra
authors.forename: A W
authors.initials: AW
authors.lastname: Burks
authors.forename: A E J
authors.initials: AE
authors.lastname: Dubois
authors.forename: J O'B
authors.initials: JO
authors.lastname: Hourihane
mesh_terms: D001007:Anxiety / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003431:Cross-Cultural Comparison; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D017144:Focus Groups; D005512:Food Hypersensitivity / Q000473:pathology / Q000523:psychology; D006304:Health Status; D006801:Humans; D007223:Infant; D007494:Ireland; D008297:Male; D015999:Multivariate Analysis; D010290:Parents; D002666:Psychology, Child; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014481:United States