Validation of the Chinese Version of the Children’s ChronoType Questionnaire (CCTQ) in school-aged children

Abstract

The Children's ChronoType Questionnaire (CCTQ) is a valid and reliable measure for assessing prepubertal children aged 4-11 years. The CCTQ is a parent-reported, 27-item questionnaire consisting of sleep-wake parameters for scheduled and free days (16 items), a morningness/eveningness scale (M/E, 10 items), and a five-point, single-item, chronotype score. The CCTQ has been translated into different languages, but a Chinese version is not available. In the present study, we aimed to produce a Chinese version of the CCTQ and test its validity and reliability on school-aged children. A total of 555 children aged 7-11 years were recruited from five primary schools. The parents were told to complete the CCTQ and record their child's sleep pattern in a 7-day sleep diary. Sixty-six children and their parents were invited to participate in determining the test-retest reliability of the CCTQ over a 2-week interval, and their sleep patterns were assessed using a sleep diary. The internal consistency of the Chinese CCTQ M/E score as measured by Cronbach's alpha was acceptable (0.74). Regarding the test-retest reliability of the instrument, moderate to strong Spearman's correlation coefficients were found for most of the CCTQ -sleep-wake items (ρ = 0.52 -0.86) and for the CCTQ-M/E total score (ρ = 0.78). For the concurrent validity, Spearman's correlations between the sleep-wake parameters of the CCTQ and the sleep diary were moderate to high on both the scheduled days (ρ = 0.54 to 0.87) and free days (ρ = 0.36 to 0.60). For the correlations measured with actigraphs, significant correlations were found in the CCTQ sleep-wake parameters, including bedtime, get-up time, sleep latency, sleep period, time in bed, and mid-sleep point on both the scheduled (ρ = 0.31 to 0.76) and free days (ρ = 0.27 to 0.52), but not in sleep latency and sleep period on free days. The results of the present study suggest that the Chinese version of the CCTQ is a reliable and valid tool for assessing chronotypes in Chinese school-aged children in Hong Kong.

Associations between the Chronotypes and Eating Habits of Hong Kong School-Aged Children

“…This is a secondary analysis of an existing dataset from the validation study of the Chinese version of Children Chronotype Questionnaire (CCTQ) in Hong Kong school-aged children [20]. Yeung et al examined the reliability and validity of the Chinese version of the CCTQ and explored the distribution of chronotypes in Hong Kong children using a convenience sample recruited from April 2017 to July 2018.…”

“…Yeung et al examined the reliability and validity of the Chinese version of the CCTQ and explored the distribution of chronotypes in Hong Kong children using a convenience sample recruited from April 2017 to July 2018. Details of the study procedures are available in the primary study [20]. The participants were children aged 7-11 years attending five mainstream primary schools in Hong Kong, as well as their parents, who had to be able to comprehend traditional Chinese characters.…”

“…Those with an M/E score of below 24 points are regarded as being of the morning type (M-type); those scoring 24-32 points as the intermediate type (N-type); and those scoring at least 33 points as the evening type (E-type) [8]. The Chinese version of the CCTQ was translated and validated in our previous study [20]. The Chinese CCTQ demonstrated test-retest good reliability, with r = 0.52-0.86 and a Cronbach's alpha of 0.74.…”