Agreement between adolescent self‐report and parent reports of health and well‐being: results of an epidemiological study

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Abstract
Objective To examine parent and adolescent agreement on physical, emotional, mental and social health and well‐being in a representative population. Methodology An epidemiological design was used to obtain parent–child/adolescent dyad data on comparable items and scales of a generic measure of health and well‐being, the Child Health Questionnaire (parent/proxy report 50 item, self‐report 80 item). Scale analysis included intraclass correlations (ICCs) to examine strength of parent–child associations and independent t‐tests for differences between adolescents (with or without an illness). Where there were significant differences in scale scores, analysis of variance and two sample t‐tests were used to examine the influence of social, demographic, health concern and school variables. Single items were examined for trends in response categories. Results 2096 parent–adolescent dyads (adolescent mean age of 15.1 years, males 50%, maternal parent 83.2%, biological parent 93.5%). ICCs were strong. Overall, adolescents reported poorer emotional and social health, and clinically significant differences were observed for perceptions of general health (mean difference 8.1/100), frequency and amount of body pain (5.94/100), experience of mental health (5.14/100), and impact of health on family activities (12.43/100), which widen significantly for adolescents with illness. Social, health and school enjoyment and performance significantly widened parent–child differences. Conclusions All adolescents were much less optimistic about their health and well‐being than their parents, and were only in close agreement on aspects of health and well‐being they rated highly. Adolescent reports are more likely to be sensitive to pain, mental health problems, health in general and the impact of their health on family activities.