Eng Joo Tan1,2, Victoria Brown3,4,5, Stavros Petrou3,6, Mario D'Souza7,8, Marjory L Moodie3,4,5, Li Ming Wen7,3,9, Louise A Baur7,3,10, Chris Rissel7,3, Alison J Hayes7,3. 1. The University of Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia. a.tan@sydney.edu.au. 2. The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia. a.tan@sydney.edu.au. 3. The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia. 4. Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, VIC, 3220, Australia. 5. Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia. 6. Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK. 7. The University of Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia. 8. Clinical Research Centre, Sydney Local Health District, Sydney, NSW, Australia. 9. Health Promotion Service, Sydney Local Health District, Sydney, Australia. 10. The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia.
Abstract
PURPOSE: Few studies focus on the health-related quality of life (HRQoL) of preschool children with overweight or obesity. This is relevant for evaluation of obesity prevention trials using a quality-adjusted life year (QALY) framework. This study examined the association between weight status in the preschool years and HRQoL at age 5 years, using a preference-based instrument. METHODS: HRQoL [based on parent proxy version of the Health Utilities Index Mark 3 (HUI3)] and weight status were measured in children born in Australia between 2007 and 2009. Children's health status was scored across eight attributes of the HUI3-vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain, and these were used to calculate a multi-attribute utility score. Ordinary least squares (OLS), Tobit and two-part regressions were used to model the association between weight status and multi-attribute utility. RESULTS: Of the 368 children for whom weight status and HUI3 data were available, around 40% had overweight/obesity. After adjusting for child's sex, maternal education, marital status and household income, no significant association between weight status in the preschool years and multi-attribute utility scores at 5 years was found. CONCLUSIONS: Alternative approaches for capturing the effects of weight status in the preschool years on preference-based HRQoL outcomes should be tested. The application of the QALY framework to economic evaluations of obesity-related interventions in young children should also consider longitudinal effects over the life-course. Clinical Trial Registration The Healthy Beginnings Trial was registered with the Australian Clinical Trial Registry (ACTRNO12607000168459).
PURPOSE: Few studies focus on the health-related quality of life (HRQoL) of preschool children with overweight or obesity. This is relevant for evaluation of obesity prevention trials using a quality-adjusted life year (QALY) framework. This study examined the association between weight status in the preschool years and HRQoL at age 5 years, using a preference-based instrument. METHODS: HRQoL [based on parent proxy version of the Health Utilities Index Mark 3 (HUI3)] and weight status were measured in children born in Australia between 2007 and 2009. Children's health status was scored across eight attributes of the HUI3-vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain, and these were used to calculate a multi-attribute utility score. Ordinary least squares (OLS), Tobit and two-part regressions were used to model the association between weight status and multi-attribute utility. RESULTS: Of the 368 children for whom weight status and HUI3 data were available, around 40% had overweight/obesity. After adjusting for child's sex, maternal education, marital status and household income, no significant association between weight status in the preschool years and multi-attribute utility scores at 5 years was found. CONCLUSIONS: Alternative approaches for capturing the effects of weight status in the preschool years on preference-based HRQoL outcomes should be tested. The application of the QALY framework to economic evaluations of obesity-related interventions in young children should also consider longitudinal effects over the life-course. Clinical Trial Registration The Healthy Beginnings Trial was registered with the Australian Clinical Trial Registry (ACTRNO12607000168459).
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