Validation Study and Outcomes of the Diabetes Quality of Life in Youth Instrument in Haitian Youth With Type 1 Diabetes Residing in Haiti

Health-related quality of life (HRQL) in type 1 diabetes is a critical health outcome but has not been studied in many low-income countries. In this study we evaluated the validity of 2 HRQL instruments, measured the HRQL and explored the association between HRQL and glycemic control. This was a cross-sectional study of Haitian youth with diabetes between 0 and 25 years of age and living in Haiti. We administered the 51-item Diabetes Quality of Life for Youth (DQOLY) questionnaire and the EuroQol Visual Analogue Scale (EQ-VAS). Psychometric analyses evaluated internal consistency and construct validity of the DQOLY and its 21-item short form, the DQOLY-SF. Linear regression was used to identify predictors of HRQL and glycated hemoglobin (A1C). In 85 youth (59% female; mean age, 17.5 years; mean diabetes duration, 3.7 years; mean A1C, 11.3%), DQOLY and DQOLY-SF had adequate internal consistency with Cronbach’s alpha values of 0.86 and 0.84, respectively. Confirmatory factor analysis revealed adequate validity for the DQOLY-SF and DQOLY Satisfaction subscale. HRQL, as measured using the DQOLY-SF, was 62±16 (mean ± standard deviation) out of 100. Mean EQ-VAS score was 78±24 out of 100. Older age (p=0.004), female sex (p=0.02) and lower socioeconomic status (SES) (p=0.03) were risk factors for lower DQOLY score, and older age (p=0.02) and marginally female sex (p=0.06) for lower DQOLY-SF score. No predictors of EQ-VAS were identified. HRQL measures were not associated with glycemic control. The DQOLY-SF and DQOLY Satisfaction subscale are valid measures of HRQL in Haitian youth with diabetes. HRQL is low and was worse in older, female and low-SES youth, but was not associated with glycemic control. La qualité de vie liée à la santé (QVLS) des jeunes atteint de diabéte de type 1 est un résultat important, mais n’a pas fait l’objet d’études dans de nombreux pays à faible revenu. Dans ces travaux, nous avons évalué la validité de 2 instruments de mesure de la QVLS, mesuré la QVLS et examiné l’association entre la QVLS et contrôle glycémique. Il s’agissait d’une étude transversale auprès de jeunes haïtiens diabétiques de 0 à 25 ans qui vivaient en Haïti. Nous avons fait remplir les questionnaires 51-item Diabetes Quality of Life in Youth (DQOLY) et Échelle visuelle analogique EQ-VAS (de l’anglais, EuroQol Visual Analogue Scale). Les analyses psychométriques ont permis d’évaluer la cohérence interne et la validité de construit du DQOLY et sa forme courte de 21 ques