Introduction
Methods
Study population
Data collection
CHQ-CF Scales | Number of items | Description low score | Description high score |
---|---|---|---|
Physical functioning (PF) | 9 | Child is greatly limited in performing all physical activities, including self-care, due to health | Child performs all types of physical activities, including the most vigorous without limitations due to health |
Role functioning: Emotional (RE)
b
| 3 | Child is greatly limited in school work or activities with friends as a result of emotional problems | Child has no limitations in schoolwork or activities with friends as a result of emotional problem |
Role functioning: Behavioral (RB)
b
| 3 | Child is greatly limited in school work or activities with friends as a result of behavior problems | Child has no limitations in schoolwork or activities with friends as a result of behavior problems |
Role functioning: Physical (RP) | 3 | Child is greatly limited in school work or activities with friends as a result of physical health | Child has no limitations in schoolwork or activities with friends as a result of physical health |
Bodily pain (BP) | 2 | Child has extremely severe, frequent and limiting bodily pain | Child has no pain or limitations due to pain |
General behavior (BE) | 17 | Child very often exhibits aggressive, immature, delinquent behavior | Child never exhibits aggressive, immature, delinquent behavior |
Mental health (MH) | 16 | Child has feelings of anxiety and depression all of the time | Child feels peaceful, happy, and calm all of the time |
Self esteem (SE) | 14 | Child is very dissatisfied with abilities, looks, family/peer relationships and life overall | Child is very satisfied with looks, family/peer relationships and life abilities, overall |
General health perceptions (GH) | 12 | Child believes his/her health is poor and likely to get worse | Child believes his/her health is excellent and will continue to be so |
Change in health (CH)
c
| 1 | Child’s health is much worse now than 1 year ago | Child’s health is much better now than 1 year ago |
Family activities (FA) | 6 | The child’s health very often limits and interrupts family activities or is a source of family tension. | The child’s health never limits or interrupts family activities nor is family a source of tension |
Family cohesion (FC) | 1 | Family’s ability to get along is rated “poor– | Family’s ability to get along is rated “excellent– |
Randomization
Analysis
Results
Participants and randomization
Total study group (n = 933) | Group with paper mode of administration (n = 458) | Group with Internet administration (n = 475) | P-value | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Mean (SD) or Range |
n
| % of Participants | Mean (SD) or Range |
n
| % of Participants | Mean (SD) or Range |
n
| % of Participants | Internet versus paper mode | |
Demographic characteristics
| ||||||||||
Age (years) | ||||||||||
Mean (SD) | 14.7 (0.68) | 14.7 (0.68) | 14.7 (0.68) | 0.61
a
| ||||||
Range | 13–7 | 13–7 | 13–7 | |||||||
Gender | ||||||||||
Women | 501 | 54% | 244 | 51% | 257 | 56% | 0.17
b
| |||
Born in the Netherlands | ||||||||||
Yes | 866 | 93% | 441 | 93% | 425 | 93% | 0.90
b
| |||
Educational level of the school | ||||||||||
Lower secondary education | 545 | 58% | 274 | 58% | 271 | 59% | ||||
Intermediate secondary education | 179 | 19% | 94 | 20% | 85 | 19% | 0.88
c
| |||
Higher secondary education | 209 | 22% | 107 | 23% | 102 | 22% | ||||
Chronic conditions:
| ||||||||||
Asthma | ||||||||||
Yes | 76 | 8% | 40 | 8% | 36 | 8% | 0.81
b
| |||
Allergies | ||||||||||
Yes | 229 | 25% | 118 | 25% | 111 | 24% | 0.88
b
| |||
Problems with hearing | ||||||||||
Yes | 62 | 7% | 30 | 6% | 32 | 7% | 0.70
b
| |||
Problems with seeing | ||||||||||
Yes | 78 | 8% | 39 | 8% | 39 | 9% | 0.91
b
| |||
Headaches or migraine | ||||||||||
Yes | 159 | 17% | 81 | 17% | 78 | 17% | 1.00
b
| |||
Chronic low back pain | ||||||||||
Yes | 159 | 17% | 88 | 19% | 71 | 16% | 0.22
b
| |||
Depression and/or anxiety attacks | ||||||||||
Yes | 74 | 8% | 36 | 8% | 38 | 8% | 0.72
b
|
Difference in the number of missing answers between different modes of CHQ-CF administration
CHQ-CF scores by mode of administration
CHQ-CF scales
a
(range 0–00) |
Mode of admini stration
| Mean (SD) | Paper versus internet mode of administration | Range of scores | % max
d
| % min
e
| 25th %tile | 50th%tile | 75th%tile | Cronbach’s alpha | Average item-own scale correlation
f
| Average item-other scale correlation | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
P-value (MWU)
b
| Effect size d
c
| ||||||||||||
Physical Functioning |
Paper
| 96.0 (6.9) | 0.37 | 0.01 | 44–00 | 56 | 0 | 96 | 100 | 100 | 0.69 | 0.40 | 0.19 |
Internet
| 95.8 (7.2) | 37–00 | 53 | 0 | 93 | 100 | 100 | 0.72 | 0.44 | 0.18 | |||
Role funct.-Emo/beh |
Paper
| 89.4 (17.2) | 0.14 | 0.00 | 0–00 | 60 | 0 | 78 | 100 | 100 | 0.81 | 0.65 | 0.35 |
Internet
| 89.5 (15.1) | 0–00 | 54 | 0 | 86 | 100 | 100 | 0.70
g
| 0.51
g
| 0.28 | |||
Role funct.-Physical |
Paper
| 95.0 (12.9) | 0.02 | 0.05 | 22–00 | 81 | 0 | 100 | 100 | 100 | 0.86 | 0.74 | 0.30 |
Internet
| 94.4 (11.7) | 22–00 | 75 | 0 | 89 | 100 | 100 | 0.76
g
| 0.60
g
| 0.25 | |||
Bodily Pain |
Paper
| 73.5 (22.7) | 0.56 | –0.05 | 0–00 | 25 | 0 | 60 | 80 | 100 | 0.88 | 0.80 | 0.35 |
Internet
| 74.7 (21.4) | 0–00 | 24 | 1 | 60 | 80 | 90 | 0.89 | 0.81 | 0.30 | |||
General Behavior |
Paper
| 80.9 (10.6) | 0.00 | 0.21 | 25–00 | 1 | 0 | 75 | 82 | 88 | 0.83 | 0.44 | 0.26 |
Internet
| 78.6 (11.4) | 35–00 | 0 | 0 | 72 | 79 | 87 | 0.85 | 0.46 | 0.26 | |||
Mental Health |
Paper
| 76.5 (15.4) | 0.01 | 0.12 | 14–00 | 2 | 0 | 69 | 80 | 89 | 0.92 | 0.63 | 0.35 |
Internet
| 74.6 (14.8) | 14–00 | 0 | 0 | 67 | 77 | 84 | 0.90
h
| 0.60 | 0.31 | |||
Self Esteem |
Paper
| 74.7 (12.2) | 0.99 | 0.02 | 20–00 | 1 | 0 | 68 | 75 | 82 | 0.88 | 0.56 | 0.30 |
Internet
| 74.4 (11.6) | 25–00 | 0 | 0 | 70 | 76 | 82 | 0.87 | 0.55 | 0.28 | |||
General Health |
Paper
| 73.5 (16.5) | 0.59 | 0.05 | 19–00 | 3 | 0 | 63 | 76 | 86 | 0.82 | 0.50 | 0.28 |
Internet
| 72.6 (16.7) | 20–00 | 1 | 0 | 63 | 75 | 86 | 0.81 | 0.58 | 0.28 | |||
Family Activities |
Paper
| 80.0 (17.7) | 0.03 | 0.11 | 8–00 | 17 | 0 | 67 | 83 | 96 | 0.81 | 0.58 | 0.24 |
Internet
| 78.1 (16.9) | 25–00 | 13 | 0 | 67 | 79 | 92 | 0.78 | 0.54 | 0.24 | |||
Family Cohesion |
Paper
| 70.6 (23.5) | 0.91 | 0.00 | 0–00 | 18 | 2 | 60 | 85 | 85 | na | na | 0.36 |
Internet
| 70.7 (23.0) | 0–00 | 16 | 2 | 60 | 85 | 85 | na | na | 0.33 |
Internal consistency reliability of scales by mode of administration
Construct validity by mode of administration
Number of chronic conditions per participant | |||||||||
---|---|---|---|---|---|---|---|---|---|
CHQ-CF scales
a
(range 0–00): |
Mode of admini- stration
| 0 conditions | 1 or 2 conditions | ≥ conditions | 1 or 2 versus 0 conditions | ≥ versus 0 conditions | ANOVA P-value Number of chronic conditions | ANOVA P-value Internet versus paper mode | ANOVA P-value Interaction term Number of chronic conditions by mode of questionnaire administration |
n = 224 (Paper)n = 206 (Internet) Mean (SD) | n = 210 (Paper)n = 217 (Internet) Mean (SD) | n = 41 (Paper)n = 35 (Internet) Mean (SD) | Effect size d
b
| Effect size d
b
| |||||
Physical functioning |
Paper
| 97 (5) | 96 (7) | 90 (10) | 0.24 | 0.80* | |||
Internet
| 97 (5) | 95 (7) | 89 (12) | 0.28 | 0.64* | 0.00 | 0.95 | 0.52 | |
Role funct.-emo/behav |
Paper
| 93 (13) | 88 (18) | 77 (24) | 0.25 | 0.64* | |||
Internet
| 91 (14) | 89 (15) | 79 (18) | 0.15 | 0.66* | 0.00 | 0.20 | 0.72 | |
Role funct.-physical |
Paper
| 97 (11) | 94 (13) | 91 (17) | 0.19 | 0.34 | |||
Internet
| 96 (10) | 94 (13) | 91 (13) | 0.14 | 0.34 | 0.00 | 0.07 | 0.69 | |
Bodily pain |
Paper
| 82 (18) | 70 (22) | 47 (24) | 0.52* | 1.45* | |||
Internet
| 80 (18) | 72 (21) | 55 (24) | 0.39 | 1.03* | 0.00 | 0.20 | 0.32 | |
General behavior |
Paper
| 84 (9) | 80 (10) | 71 (13) | 0.40 | 0.98* | |||
Internet
| 81 (10) | 78 (11) | 69 (14) | 0.26 | 0.90* | 0.00 | 0.03 | 0.65 | |
Mental health |
Paper
| 83 (10) | 74 (16) | 57 (16) | 0.56* | 1.58* | |||
Internet
| 80 (11) | 72 (15) | 59 (18) | 0.50 | 1.20* | 0.00 | 0.26 | 0.29 | |
Self esteem |
Paper
| 79 (10) | 73 (12) | 61 (12) | 0.52* | 1.44* | |||
Internet
| 77 (9) | 73 (12) | 66 (14) | 0.33 | 0.80* | 0.00 | 0.26 | 0.06 | |
General health |
Paper
| 80 (14) | 71 (15) | 54 (14) | 0.57* | 1.82* | |||
Internet | 79 (13) | 70 (17) | 55 (18) | 0.54* | 1.29* | 0.00 | 0.74 | 0.58 | |
Family activities | Paper | 83 (16) | 79 (18) | 70 (20) | 0.26 | 0.67* | |||
Internet | 81 (16) | 78 (17) | 66 (15) | 0.17 | 0.97* | 0.00 | 0.03 | 0.51 | |
Family cohesion | Paper | 77 (21) | 68 (23) | 53 (26) | 0.38 | 0.89* | |||
Internet | 74 (20) | 68 (24) | 64 (28) | 0.24 | 0.38 | 0.00 | 0.18 | 0.05 |