title: An Examination of the Food Allergy Quality of Life Questionnaire Performance in a Countrywide American Sample of Children: Cross-Cultural Differences in Age and Impact in the United States and Europe.
abstract: BACKGROUND
  It is important to ensure that tools are valid and reliable in the context in which they are used. The development of age and country norms is part of this process.
  
  
  OBJECTIVE
  The primary aim of the present study was to examine the performance of the Food Allergy Quality of Life Questionnaire - Parent Form (FAQLQ-PF) in a countrywide American sample of children with food allergy. The secondary aim was to compare age differences in impact across 9 European countries.
  
  
  METHODS
  In a cross-sectional quantitative design, questionnaires were completed by the parents of 1029 food-allergic children (0-12 years). Participants were recruited via support groups and allergists. Data were analyzed by using multivariate analysis of variance and tests for internal consistency and validity. The average score was calculated for each age group in 15 studies in Ireland, Switzerland, the Netherlands, Spain, Portugal, Germany, Italy, Denmark, Israel, and the United Kingdom.
  
  
  RESULTS
  The FAQLQ-PF has high convergent validity (child: r = 0.49, n = 695, P = .01; parent: r = 0.36, n = 696, P = .01) and discriminant validity, parent: t (719) = 4.67, P = .001 (anaphylaxis yes vs no); t (513), P = .009 (single vs multiple allergens). Internal consistency was excellent (r = 0.96). US health-related quality of life was worse than European health-related quality of life, as indicated by higher FAQLQ-PF scores in US samples. Burden increased with age in all populations.
  
  
  CONCLUSIONS
  The FAQLQ-PF is appropriate for use in an American population. Findings will form the basis for further work in the development of an online manual with food allergy-normed age scores to allow for precise measurement, interpretation of scores, and comparison across countries and cultures, in clinical and research settings.
authors.affiliation: School of Capella University, School of Social and Behavioral Sciences, Minneapolis, Minn; Applied Psychology, University College Cork, Cork, Ireland. Electronic address: a.dunngalvin@ucc.ie.
authors.forename: Audrey
authors.initials: A
authors.lastname: DunnGalvin
authors.affiliation: School of Capella University, School of Social and Behavioral Sciences, Minneapolis, Minn.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Koman
authors.affiliation: School of Capella University, School of Social and Behavioral Sciences, Minneapolis, Minn.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Raver
authors.affiliation: School of Capella University, School of Social and Behavioral Sciences, Minneapolis, Minn.
authors.forename: Hayley
authors.initials: H
authors.lastname: Frome
authors.affiliation: School of Capella University, School of Social and Behavioral Sciences, Minneapolis, Minn.
authors.forename: Melissa
authors.initials: M
authors.lastname: Adams
authors.affiliation: Applied Psychology, University College Cork, Cork, Ireland.
authors.forename: Aisleen
authors.initials: A
authors.lastname: Keena
authors.affiliation: Department of Paediatrics and Child Health, Cork University Hospital, University College Cork, Cork, Ireland.
authors.forename: Jonathan O'B
authors.initials: JO
authors.lastname: Hourihane
authors.affiliation: Applied Psychology, University College Cork, Cork, Ireland; Department of Paediatrics and Child Health, Cork University Hospital, University College Cork, Cork, Ireland.
authors.forename: Patricia Leahy
authors.initials: PL
authors.lastname: Gallagher
authors.affiliation: Department of Pediatric Pulmonology and Pediatric Allergy, University Medical Center Groningen, University of Groningen, GRIAC Research Institute, Groningen, The Netherlands; Department of General Practice, University of Groningen, University Medical Centre Groningen, GRIAC Research Institute, Groningen, The Netherlands.
authors.forename: Bertine
authors.initials: B
authors.lastname: Flokstra-de Blok
authors.affiliation: Department of Pediatric Pulmonology and Pediatric Allergy, University Medical Center Groningen, University of Groningen, GRIAC Research Institute, Groningen, The Netherlands.
authors.forename: Anthony
authors.initials: A
authors.lastname: Dubois
authors.affiliation: Applied Psychology, University College Cork, Cork, Ireland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Pyrz
authors.affiliation: Odense Research Center for Anaphylaxis (ORCA), Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.
authors.forename: Cartsen
authors.initials: C
authors.lastname: Bindslev-Jensen
authors.affiliation: Odense Research Center for Anaphylaxis (ORCA), Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.
authors.forename: Anette
authors.initials: A
authors.lastname: Stensgaard
authors.affiliation: Faculty of Medicine, Department of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom.
authors.forename: Robert
authors.initials: R
authors.lastname: Boyle
authors.affiliation: Faculty of Medicine, Department of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom.
authors.forename: Bea
authors.initials: B
authors.lastname: Vickers
authors.affiliation: Faculty of Medicine, Department of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom.
authors.forename: Jared
authors.initials: J
authors.lastname: Smith
authors.affiliation: Faculty of Medicine, Department of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom.
authors.forename: Umasunthar
authors.initials: U
authors.lastname: Thisanayagam
authors.affiliation: University of Michigan, Food Allergy Centre, Michigan Medical School, Ann Arbor, Mich.
authors.forename: Matthew
authors.initials: M
authors.lastname: Greenhawt
mesh_terms: D000367:Age Factors; D002648:Child; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005512:Food Hypersensitivity / Q000201:enzymology / Q000453:epidemiology*; D006801:Humans; D015588:Observer Variation; D010290:Parents; D044382:Population Groups; D011788:Quality of Life; D015203:Reproducibility of Results; D012107:Research Design; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Food Allergy; Measurement precision; Normed scores; Quality of life; Quality of life Questionnaire