Confirmatory factor analysis of the proxy version of Kidscreen-27 and relationships between health-related quality of life dimensions and body mass index and physical activity in young schoolchildren

The aim of the study was to perform a confirmatory factor analysis (CFA) to investigate the psychometric properties of the proxy version of Kidscreen-27 in order to determine whether the instrument can be used to assess health-related quality of life (HRQoL) in young children (five to six years of age). Furthermore, we aimed to examine the relationships between the HRQoL dimensions and the body mass index (BMI), physical activity (PA), age, and gender. Altogether, 276 children from schools in eastern Norway were included (September 2016). HRQoL was measured using the Kidscreen-27 proxy version. CFA was conducted to examine the factorial validity of the five-dimension instrument. Structural equation modelling was used to estimate the relationship between the independent variables and the HRQoL subscales that showed an acceptable fit; physical well-being, social support and peers, and school environment. PA was positively, and BMI negatively associated with physical well-being (p < 0.5). Parents of the youngest children reported more negatively on the school environment subscale (p < 0.5). The full 27-item proxy version of Kidscreen should be used with caution for children as young as five to six years as two of the subscales were found to have unsatisfactory factor loadings. The physical well-being, the social support and peers, and the school environment subscales can provide valid and valuable data for research and practice. Even though the associations are small, it is worrying that adverse relationships between PA and BMI and physical well-being are detectable in such a young sample as included here.