Academic journal article Childhood Obesity

Factor Structure of Sizing Me Up, a Self-Reported Weight-Related Quality of Life Instrument, in Community Children across Weight Status

Academic journal article Childhood Obesity

Factor Structure of Sizing Me Up, a Self-Reported Weight-Related Quality of Life Instrument, in Community Children across Weight Status

Article excerpt

[Author Affiliation]

Carol Strong. 1 Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Yi-Ching Lin. 2 Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.

Meng-Che Tsai. 3 Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Chung-Ying Lin. 4 Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.

(Current affiliation for Yi-Ching Lin, PhD: Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan.)

Address correspondence to: Chung-Ying Lin, PhD, Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, E-mail: cylin36933@gmail.com

Introduction

Childhood obesity is a rising global public health problem of increased significance since 1990s, especially in high-income countries.1,2 While ∼11.7% of children in developed countries suffered from overweight and obesity in 2010, the problems are projected to increase to ∼14.1% by as quickly as 2020.1 This increase in global trends of childhood obesity may result in long-term adverse health outcomes, such as cardiovascular disease and diabetes.2

In response to the childhood obesity crisis, researchers have started investigating the quality of life (QoL) for obese and overweight children,3,4 and impaired QoL has been found in clinical samples across countries.5-7 These studies, however, used a generic QoL instrument such as PedsQL to assess the QoL for obese or overweight children, and possible biases may have occurred: an obese child may rate a low QoL because of problems not related to body weight (e.g., chronic disease such as type I diabetes, acute symptoms such as stomach ache).8 Therefore, using a weight-related QoL instrument can help healthcare providers better understand the impact of obese/overweight on children's QoL.

Sizing Me Up, developed in 2009, is a 22-item instrument designed for measuring children's weight-related QoL.9 Sizing Me Up has been validated among two samples in the United States: obese children aged 5-13 years seeking treatment and being referred by physicians in a hospital-based pediatric weight management program9 and a community sample comprising fourth and fifth graders.10 Based on the concepts of classical test theory (CTT), Zellar and Modi9 demonstrated sound psychometric properties of Sizing Me Up; Cushing and Steele10 further used confirmatory factor analysis (CFA) to verify its structure.

The psychometrics of Sizing Me Up, however, can still be further evaluated, considering some limitations from the previous two studies.9,10 First, this instrument has only been tested using a sample of children within a relatively small age range (fourth to fifth graders) in a community.10 Although Zellar and Modi9 recruited children 5-13 years of age, they used a clinical sample and their results may not be generalizable to a community.

Second, considering that obesity is a global trend and that those individuals may encounter different obesity-related life difficulties in various countries and social contexts, this measure requires cross-cultural validation. The impact of obesity on children's QoL can be largely influenced by the cultural norm. In cultures that considered obesity is an individual's responsibility and thinness is highly associated with beauty, the cultural environment might foster stigma against obese children and result in poor QoL for them. …

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