Health-Related Quality of Life and its Determinants among School-going Adolescents: A Cross-sectional Study

Background: Adolescents experience rapid physical, cognitive, and psychosocial growth in their transition from childhood to adulthood, affecting health outcomes and well-being. Health-related quality of life (HRQoL) is a useful indicator of health outcomes, assessed in the current study along with associated determinants.

Methods: A cross-sectional study was conducted among 634 randomly selected adolescents from 13 randomly selected schools in Gharwal division, Uttarakhand, India, from August 2019 to September 2020. The students studying in the 8^th-11^th standard and those providing assent and consent from their parents were included in the study. They were screened using the short version of the Physical Activity Readiness Questionnaire. Along with physical activity and fitness assessment, the Global School-based Student Health Survey questionnaire was administered. The transformed HRQoL domain scores were calculated using the WHOQOL-BREF questionnaire. A univariate and multivariable linear regression model was applied to identify the determinants of HRQoL using SPSS version 23.

Results: The study included 324 (51.1%) boys and 310 (48.9%) girls. The mean age of the students was 14.4±1.4 years. The highest mean score was 72.3±21.0 for the social relationship domain and the lowest was 55.6±15.0 for the physical domain. The age, parents using any form of tobacco, a history of ever-use of alcohol and physical fitness were significantly associated with HRQoL domain scores. The non-dominant back stretch test was also significantly associated (Beta coefficient; SE, P-value) with physical (-4.1; 1.4, 0.002), psychosocial (-3.9; 1.5, 0.010) and environmental (-3.5; 1.4, 0.014) domain scores.

Conclusion: All domains of HRQoL need to be improved and should address the psychological, social, and mental well-being of adolescents. Physical activity and fitness of students emerged as a strong modifiable predictor affecting almost all the domains of HRQoL, warranting its promotion in schools and the promotion of healthy behavior among parents and adolescents.