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Longitudinal factorial invariance of the PedsQL™ 4.0 Generic Core Scales Child Self-Report Version: One year prospective evidence from the California State Children’s Health Insurance Program (SCHIP)

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Abstract

Background

The measurement of health-related quality of life (HRQOL) in pediatric medicine and health services research has grown significantly over the past decade. The paradigm shift toward patient-reported outcomes (PROs) has provided the opportunity to emphasize the value and critical need for pediatric patient self-report. In order for changes in HRQOL/PRO outcomes to be meaningful over time, it is essential to demonstrate longitudinal factorial invariance. This study examined the longitudinal factor structure of the PedsQL™ 4.0 Generic Core Scales over a one-year period for child self-report ages 5–17 in 2,887 children from a statewide evaluation of the California State Children’s Health Insurance Program (SCHIP) utilizing a structural equation modeling framework.

Methods

Specifying four- and five-factor measurement models, longitudinal structural equation modeling was used to compare factor structures over a one-year interval on the PedsQL™ 4.0 Generic Core Scales.

Results

While the four-factor conceptually-derived measurement model for the PedsQL™ 4.0 Generic Core Scales produced an acceptable fit, the five-factor empirically-derived measurement model from the initial field test of the PedsQL™ 4.0 Generic Core Scales produced a marginally superior fit in comparison to the four-factor model. For the five-factor measurement model, the best fitting model, strict factorial invariance of the PedsQL™ 4.0 Generic Core Scales across the two measurement occasions was supported by the stability of the comparative fit index between the unconstrained and constrained models, and several additional indices of practical fit including the root mean squared error of approximation, the non-normed fit index, and the parsimony normed fit index.

Conclusion

The findings support an equivalent factor structure on the PedsQL™ 4.0 Generic Core Scales over time. Based on these data, it can be concluded that over a one-year period children in our study interpreted items on the PedsQL™ 4.0 Generic Core Scales in a similar manner.

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Acknowledgments

Preparation of this manuscript was supported by an intramural grant from the Texas A&M University Research Foundation. Data collection was supported by a grant from the David and Lucille Packard Foundation.

Competing Interests

Dr. Varni holds the copyright and the trademark for the PedsQL™ and receives financial compensation from the Mapi Research Trust, which is a nonprofit research institute that charges distribution fees to for-profit companies that use the Pediatric Quality of Life Inventory™.

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Authors and Affiliations

  1. Department of Pediatrics, College of Medicine, Texas A&M University, College Station, TX, USA

    James W. Varni

  2. Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX, 77843-3137, USA

    James W. Varni

  3. Department of Psychology College of Liberal Arts, Texas A&M University, College Station, TX, USA

    Christine A. Limbers

  4. Department of Psychology, University of Illinois at Urbana-Champaign, 603 East Daniel St, Champaign, IL, USA

    Daniel A. Newman

  5. Division of Pulmonary Medicine and Center for Health Care Quality, Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH, USA

    Michael Seid

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  1. James W. Varni
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Correspondence to James W. Varni.

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The PedsQL™ is available at http://www.pedsql.org.

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Varni, J.W., Limbers, C.A., Newman, D.A. et al. Longitudinal factorial invariance of the PedsQL™ 4.0 Generic Core Scales Child Self-Report Version: One year prospective evidence from the California State Children’s Health Insurance Program (SCHIP). Qual Life Res 17, 1153–1162 (2008). https://doi.org/10.1007/s11136-008-9389-3

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