Associations among positive child health measures in the environmental influences on child health outcomes (ECHO) cohort
Recommended Citation
Taylor GL, Burjak M, Ray D, Blackwell CK, Santos HP, Ganiban J, Dunlop AL, Elliott AJ, Aschner JL, Stroustrup A, Bekelman TA, Barone C, Camargo CA, Jr., McEvoy CT, Tung I, Schweitzer JB, Herbstman J, Wright RO, Wright RJ, Akinkugbe AA, Kelly RS, Hartert TV, Patterson BL, Bendixsen C, Cassidy-Bushrow AE, O'Shea TM, and Fry RC. Associations among positive child health measures in the environmental influences on child health outcomes (ECHO) cohort. Qual Life Res 2025.
Document Type
Article
Publication Date
2-4-2025
Publication Title
Quality of life research
Abstract
PURPOSE: Effective measurement of positive child health is critical in improving public health. A proposed measure of positive health, a positive child health index (PCHI), is based on how many of 11 specific physical, developmental, and mental health conditions a child has (ranging from 0 to 11). Accepted measures of positive health, Patient-Reported Outcome Measurement Information System (PROMIS®) measures of global health, meaning and purpose, and life satisfaction, are based on child and caregiver perceptions.
METHODS: The sample comprised 3713 children aged 5 to 17 years from the NIH Environmental influences on Child Health Outcomes (ECHO) Cohort with data to calculate PCHI and at least 1 child- or caregiver-reported PROMIS measure. Linear regressions were performed to test the associations between each PROMIS measure T-score and the PCHI, adjusting for gestational age, child sex, child age, and maternal factors (age, education, income).
RESULTS: The PROMIS measure associated most strongly with PCHI was caregiver-reported global health, followed by child-reported global health. Caregiver-reported life satisfaction and child-reported meaning and purpose were higher for children with a PCHI = 0 compared with children with 3 or more health conditions but not when compared with children with only 1 or 2 conditions. Among children with 4 or more conditions, girls reported lower global health than boys. Sex differences were not found for caregiver-reported measures.
CONCLUSION: PROMIS measures and PCHI offer complementary information on positive child health. PROMIS measures are intended as measures of a person's perception of their health, whereas PCHI reflects a cumulative impact of chronic health conditions from the perspective of health care systems. Both viewpoints are informative in public health promotion.
PubMed ID
39904821
ePublication
ePub ahead of print
