ICF-based Functional Components and Contextual Factors as Correlates of Perceived Quality of Life for Youth With Chronic Conditions

Purpose: To explore International Classification of Functioning, Disability and Health (ICF)-based functional components and contextual factors associated with perceived quality of life (QOL) for youth with chronic conditions from the perspective of youth and parents. Method: Baseline data were obtained from a longitudinal study examining predictors of changes in perceived QOL for youth with chronic conditions. 439 youth aged 11–17 (and one of their parents) completed a questionnaire. Standardized tools were used to measure youth functioning, contextual factors and perceived QOL. Multivariate linear regression analyses, controlling for socio-demographic and health information, were conducted to explore correlations among youth functioning/contextual factors and youth and parent perceptions of youth QOL. Results: Significant (p0.05) negative correlates with both youth and parent perceptions of youth QOL included pain/other physical symptoms and emotional symptoms. Significant factors positively correlated with youth and parent perceptions of youth QOL included school productivity and spirituality. Other significant positive correlates of youth perspectives were family social support and school belongingness/safety. Family functioning was positively correlated, and youth social anxiety and environmental barriers were negatively correlated, with parent perceptions of youth QOL. Conclusions: This study provides preliminary evidence of factors upon which services aimed at improving perceived QOL of youth with chronic conditions could be based

A realist evaluation of a physical activity participation intervention for children and youth with disabilities: What works, for whom, in what circumstances, and how?

Background: The need to identify strategies that facilitate involvement in physical activity for children and youth with disabilities is recognised as an urgent priority. This study aimed to describe the association between context, mechanisms and outcome(s) of a participation-focused physical activity intervention to understand what works, in what conditions, and how. Methods: This study was designed as a realist evaluation. Participant recruitment occurred through purposive and theoretical sampling of children and parents participating in the Local Environment Model intervention at Beitostolen Healthsports Centre in Norway. Ethnographic methods comprising participant observation, interviews, and focus groups were employed over 15 weeks in the field. Data analysis was completed using the context-mechanism-outcome framework of realist evaluation. Context-mechanism-outcome connections were generated empirically from the data to create a model to indicate how the program activated mechanisms within the program context, to enable participation in physical activity. Results: Thirty one children with a range of disabilities (mean age 12y 6 m (SD 2y 2 m); 18 males) and their parents (n=44; 26 mothers and 18 fathers) participated in the study. Following data synthesis, a refined program theory comprising four context themes, five mechanisms, and six outcomes, were identified. The mechanisms (choice, fun, friends, specialised health professionals, and time) were activated in a context that was safe, social, learning-based and family-centred, to elicit outcomes across all levels of the International Classification of Functioning, Disability and Health. Conclusions: The interaction of mechanisms and context as a whole facilitated meaningful outcomes for children and youth with disabilities, and their parents. Whilst optimising participation in physical activity is a primary outcome of the Local Environment Model, the refined program theory suggests the participation-focused approach may act as a catalyst to promote a range of outcomes. Findings from this study may inform future interventions attempting to enable participation in physical activity for children and youth with disabilities

Development of a direct observation Measure of Environmental Qualities of Activity Settings.

AIM The aim of this study was to develop an observer-rated measure of aesthetic, physical, social, and opportunity-related qualities of leisure activity settings for young people (with or without disabilities). METHOD Eighty questionnaires were completed by sets of raters who independently rated 22 community/home activity settings. The scales of the 32-item Measure of Environmental Qualities of Activity Settings (MEQAS; Opportunities for Social Activities, Opportunities for Physical Activities, Pleasant Physical Environment, Opportunities for Choice, Opportunities for Personal Growth, and Opportunities to Interact with Adults) were determined using principal components analyses. Test–retest reliability was determined for eight activity settings, rated twice (4–6wk interval) by a trained rater. RESULTS The factor structure accounted for 80% of the variance. The Kaiser-Meyer-Olkin Measure of Sampling Adequacy was 0.73. Cronbach’s alphas for the scales ranged from 0.76 to 0.96, and interrater reliabilities (ICCs) ranged from 0.60 to 0.93. Test–retest reliabilities ranged from 0.70 to 0.90. INTERPRETATION Results suggest that the MEQAS has a sound factor structure and preliminary evidence of internal consistency, interrater, and test–retest reliability. The MEQAS is the first observer-completed measure of environmental qualities of activity settings. The MEQAS allows researchers to assess comprehensively qualities and affordances of activity settings, and can be used to design and assess environmental qualities of programs for young people.Canadian Institutes of Health Research (TWC-95045)Canadian Institutes of Health Research Vanier Canada Graduate Scholarshi

Domain-Based and Overall Life Satisfaction for Youth with Chronic Conditions: The Role of Personal, Interpersonal, and Environmental Factors Over a One-Year Period

This paper examined the differential influences of personal, interpersonal, and environmental level factors on domain-based and overall life satisfaction over one year for youth with chronic health conditions. Baseline and Time 2 follow-up data were used from a study examining quality of life for a sample of 439 youth with chronic conditions, aged 11 to 17 years. The Brief Multidimensional Students’ Life Satisfaction Scale measured youths’ life satisfaction in five domains (i.e., satisfaction with self, family life, friendships, school experiences, where one lives) and in overall life. Six multivariate linear regression analyses were performed, each exploring relations of the hypothesized correlates at baseline with one aspect of life satisfaction at follow-up controlling for youth gender, age, household income, and the corresponding aspect of life satisfaction at baseline. Factors at all three levels were found to be important to some aspect of life satisfaction. Emotional well-being played a notable role in life satisfaction across multiple domains and in overall life satisfaction. Family-related factors were also significantly related to life satisfaction across several domains. Social support from close friends and teachers and the school environment were important to specific domains of life satisfaction. Classmate social support emerged as a key factor related to overall life satisfaction. Implications for practice and future research are discussed