Johns Hopkins UniversityChild Health and Illness Profile
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Adolescent
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Background

The CHIP-AE is a generic measure of the health and quality of life of adolescents 11-17 years of age. It is a self-report questionnaire that assesses health in 5 domains experienced by adolescents that can be influenced by both health care systems and school health systems: Satisfaction, Comfort, Risk Avoidance, Resilience, and Achievement. There is also an optional Disorders domain.
 
The 108 CHIP-AE items are scored into the following 5 domains and 14 sub domains to describe adolescent health:

Domain
Sub-domain
Satisfaction
Satisfaction with Health
Self-esteem
Discomfort
Physical Comfort
Emotional Comfort
Limitations of Activity
Risk Avoidance
Individual Risks
Threats to Achievement
Peer Influences
Resilience
Family Involvement
Physical Activity
Problem Solving
Home Health and Safety
Achievement
Academic Performance
Work Performance
The optional “Disorders” domain includes
Acute Minor Disorders
Acute Major Disorders
Recurrent Disorders
Long-term Medical
Long-term Surgical
Psychosocial

These sub domains are not single-construct scales but instead assess broad ranges of characteristics that are conceptually similar but not necessarily found consistently in many individuals. We refer to them as indices.

Standardized mean scores for the domains and sub domains provide a comprehensive framework for reporting, monitoring and evaluating the health of groups of adolescents ages 11 through 17 years.

Higher scores indicate better health on each of the domains.
 
Description of the CHIP - AE
 
Adolescents report symptoms and signs of illness and of health-protective behaviors, satisfaction with health and with themselves, problem behavior, school performance, and involvement with family.

Response formats include:

Sample Questions

 

  • number of days a symptom or behavior occurred in the past 4 weeks in a five-response format ('no days' to '15 to 28 days')
  • level of agreement in a four-response format ('completely agree' to 'do not agree')
  • most recent occurrence in a five-response format ('never' to 'in the past week')
  • number of occurrences in the past 12 months in a five-response format ('none' to '4 or more times')
  • in Disorders, the occurrence of problems in a three-response format ('no, never' to 'yes, and had problems with it in the last 12 months')
  • in Disorders, severity of injury in a three-response format ('no' to 'yes, and I did see a doctor or nurse')
The following examples are:
 
one item included in the scoring of the CHIP-AE-Comfort Domain

In the past 4 weeks, on how many days were you nervous or uptight?
No
Days
 
 
1-3 Days
4-6 Days
7-14 Days
15-28 Days

and one scored in the Resilience Domain

When was the last time you smoked cigarettes?
Never
 
More than year ago
 
 
In the past year
In the past month
In the past week

Administration of the CHIP-AE
 
Adolescents can self-administer the CHIP-AE in clinic settings, at home, or in groups. After brief initial instructions, completion requires about 20 minutes depending on reading ability. If the Disorders domain is included, an additional 5-8 minutes is needed. The CHIP-AE is written on a fifth grade reading level. It is critical that respondents understand that their answers will be held in confidence. Assigned numbers, not names, should be used as identifiers on the questionnaires. Also, special provisions for privacy should be made for administration in group settings such as classrooms. In clinical settings, a separate room or closed-off area away from others (including parents) is desirable.
 
Psychometric Qualities of the CHIP-AE
 
Extensive reliability and validity analyses indicate that the CHIP-AE has good psychometric qualities. This indicates that adolescents are reliable and valid reporters of their health and that the CHIP-AE produces meaningful and useful assessments of their health status.
 
Scoring of the CHIP-AE
 
The optimal way to score the CHIP-AE is to use the computerized data entry and scoring programs. This set of programs allows the user to convert responses on the CHIP-AE to a report format and to establish a database for further analyses.
 
Data Entry: The data from the CHIP need to be entered into the available data entry program. Once the data are entered, the scoring program is run and the individual respondent and average scores are produced for the domains. Subdomain scores are also produced.
 
Reports: The CHIP provides a comprehensive description of the health status and quality of life of youth in 5 domains of health, typically over the past month. Optional modules can also be used to describe the adolescent and family sociodemographics and the adolescent's disorders and medical conditions.
 
The standard reports produced by the data entry and scoring programs provide a score on the domains of Satisfaction, Comfort, Risks, Resilience, and Achievement. The CHIP-AE also provides scores for the subdomains within each domain. Responses to individual items can also be obtained from the scoring program. All the CHIP data can be converted to another database or statistical package format.
 
Interpreting Scores: Health status is reported at the domain level and as a profile-type. 'Average' health on the CHIP domains is within 0.6 of a standard deviation of the mean of 50. That is, average/good health is in the range from 44 to 56 points (+/- 6 points, since the CHIP standard deviation = 0).
 
A score of 43 or below indicates poor health in that domain. A score of 57 or higher indicates excellent health.
 
Profiles or patterns of health can be described to more fully indicate the proportion of students who have good, fair and poor health (see articles below). The profiles also help indicate the types of interventions that are likely to be most helpful for groups of students within a profile-type.
 
Riley AW, Green BF, Forrest CB, Starfield B, Kang M, Ensminger ME. A taxonomy of adolescent health: development of the adolescent health profile-types. Medical Care 1998; 36(8): 1228-1236.
 
Riley AW, Forrest CB, Starfield B, Green B, Kang M, Ensminger M. Reliability and validity of the adolescent health profile-types. Medical Care 1998; 36(8): 1237-1248.