Food allergy QoL questionnaire for children aged 0-12 years: content, construct, and cross-cultural validity

Clin Exp Allergy. 2008 Jun;38(6):977-86. doi: 10.1111/j.1365-2222.2008.02978.x. Epub 2008 Apr 23.


Background: To date, there is no food allergy-specific questionnaire that allows parents to report children's health-related QoL (HRQL) from the child's perspective.

Objective: The aim of this study was to develop a sensitive, multi-dimensional measure to assess parental perception of HRQL in children aged 0-12 years with food allergy.

Methods: The Food Allergy QoL - Parent Form (FAQLQ-PF) was developed and validated in four stages: (1) item generation using focus groups, expert opinion, and literature review; (2) item reduction, using clinical impact and factor analysis; (3) internal and test-retest reliability and construct validity were evaluated using relevant scales of the Child Health Questionnaire (CHQ)-28 and the disease-specific food allergy independent measure (FAIM); and (4) cross-cultural and content validity was examined by administering the questionnaire in a US sample.

Results: Stage 1: Saturation was reached at 110 items. Stage 2: The reduced instrument has 14 items for children <4 years and 26 and 30 items for children aged 4-6 years and 7-12 years, respectively. Factor analysis revealed three subscales: emotional impact, food anxiety, and social and dietary limitations, accounting for 68% of the variance. Stage 3: Cronbach's alpha >0.7 for subscales and total score. Construct validity was demonstrated by significant correlations between relevant scales of the CHQ-28 and FAQLQ-PF subscales (r=0.69-0.77, P<0.01), and between FAQLQ-PF subscales and the FAIM. Sensitivity was shown by significant within-group differences in a sample of 124 food-allergic children. Stage 4: The FAQLQ-PF was validated in a sample of US children, Cronbach's alpha >0.7 for subscales and total score. Construct validity was demonstrated by significant correlations between FAQLQ-PF and the FAIM (parent report) and between the FAQLQ-PF and the FAIM (child report). No differences were observed between the US and Irish scores.

Conclusion: The FAQLQ-PF is psychometrically robust, with excellent reliability and validity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Anxiety / psychology
  • Child
  • Child, Preschool
  • Cross-Cultural Comparison
  • Feeding Behavior / psychology
  • Female
  • Focus Groups
  • Food Hypersensitivity* / pathology
  • Food Hypersensitivity* / psychology
  • Health Status
  • Humans
  • Infant
  • Ireland
  • Male
  • Multivariate Analysis
  • Parents
  • Psychology, Child
  • Psychometrics
  • Quality of Life*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Surveys and Questionnaires*
  • United States