Readability of Commonly Used Quality of Life Outcome Measures for Youth Self-Report

Abstract

Self-report measures are central in capturing young people’s perspectives on mental health concerns and treatment outcomes. For children and adolescents to complete such measures meaningfully and independently, the reading difficulty must match their reading ability. Prior research suggests a frequent mismatch for mental health symptom measures. Similar analyses are lacking for measures of Quality of Life (QoL). We analysed the readability of 13 commonly used QoL self-report measures for children and adolescents aged 6 to 18 years by computing five readability formulas and a mean reading age across formulas. Across measures, the mean reading age for item sets was 10.7 years (SD = 1.2). For almost two-thirds of the questionnaires, the required reading age exceeded the minimum age of the target group by at least one year, with an average discrepancy of 3.0 years (SD = 1.2). Questionnaires with matching reading ages primarily targeted adolescents. Our study suggests a frequent mismatch between the reading difficulty of QoL self-report measures for pre-adolescent children and this group’s expected reading ability. Such discrepancies risk undermining the validity of measurement, especially where children also have learning or attention difficulties. Readability should be critically considered in measure development, as one aspect of the content validity of self-report measures for youth.

Danish translation and cultural adaptation of the ‘What do you think of hospital’ patient reported experience measure for children and adolescents in outpatient settings

“…This is in line with the findings of Kalfoss (2019), who identified that language issues often are relate to the ambiguity about the meaning of a word or where phrasing is idiomatic. When designing or translating a questionnaire it is important to identify unfamiliar words and replace these words or expressions with more family ones (Krause et al, 2022).…”

Barriers and facilitators to social prescribing in child and youth mental health: Perspectives from the frontline

“…For example, previous research has identi ed that some measures have higher readability ages than the stated age range [44,45]. Co-developing a common measurement framework, with young person approved and age-appropriate measures, will allow for the better monitoring of SP and can help increase usage from those tasked with administration.…”

A Scoping Review of Mental Health and Wellbeing Outcome Measures for Children and Young People: Implications for Children in Out-of-home Care

“…While it is important that there are robust measures for all aspects of mental wellbeing, common mental health problems and severe mental illness, the lack of consistency in the measures used means that important opportunities to compare findings across studies, settings and time are being missed. Additionally, the increase in the numbers of measures available has also led to concerns about the quality of measures that are used and the absence of independent evaluation of their psychometric properties (Addington et al, 2015 ; Howe et al, 2020 ), as well as if measures accurately reflect the different mental health outcome domains claimed (Krause et al, 2022 ).…”