Quality of life in children and adolescents: a European public health perspective

Objectives: The measurement of health-related quality of life (HRQOL) is in creasingly important as a means of monitoring population health status over time, of detecting sub-groups within the general population with poor HRQO L, and of assessing the impact of public health interventions within a give n population. At present, no standardised instrument exists which can be ap plied with equal relevance in pediatric populations in different European p opulations. The collaborative European KIDSCREEN project aims to develop a standardised screening instrument for children's quality of life which will be used in representative national and European health surveys. Participants of the pr oject are centres from Austria, France, Germany, Netherlands, Spain, Switze rland, and United Kingdom, By including the instrument in health services r esearch and health reporting, it also aims at identifying children at risk in terms of their subjective health, thereby allowing the possibility of ea rly intervention. Methods: instrument development will be based on constructing a psychometri cally sound HRQOL instrument taking into account the existing state of the art. Development will centre on literature searches, expert consultation (D elphi Methods) and focus groups with children and adolescents (8-17 years). According to international guidelines, items will be translated into the l anguages of the seven participating countries for a pilot test with 2100 ch ildren and their parents in Europe. The final instrument will be used in representative mail and telephone surv eys of HRQOL in 1800 children and their parents per country (total n = 2520 0) and normative data will be produced. The potential for implementing the measurement tool in health services and health reporting will also be evalu ated in several different research and public health settings. The final an alysis will involve national and cross cultural-arl lysis of the instrument . Results: The international, collaborative nature of the KIDSCREEN project m eans it is likely to provide many challenges in terms of producing an instr ument which is conceptually and linguistically appropriate for use in many different countries, but it will also provide the opportunity to develop, t est and implement the first truly cross-national HRQOL instrument developed for use in children and adolescents. This will help to contribute to a bet ter understanding of perceived health in children and adolescents and to id entify populations at risk.