# The Health-Related Quality of Life and Putative Factors of Icelandic and American Youth with Multiple Disabilities Including Visual Impairments: A Preliminary Investigation

**Authors:** Ali Brian, Andrea Taliaferro, Pamela Beach, Benjamin Lytle, Adam Pennell, Lauren Lieberman, Ingi Einarsson

PMC · DOI: 10.3390/children13030351 · 2026-02-28

## TL;DR

This study compares health-related quality of life and influencing factors among youth with multiple disabilities in Iceland and the U.S., highlighting differences in physical and self-reported health indicators.

## Contribution

The study provides preliminary insights into cross-cultural differences in health indicators among youth with multiple disabilities.

## Key findings

- Icelandic boys and girls showed significant differences in BMI and STS performance.
- American boys and girls differed significantly in physical activity and perceived physical competence.
- Context-specific patterns in health indicators suggest the need for culturally tailored assessments.

## Abstract

Background/Objectives: Health-related quality of life (HRQoL) is a critical indicator of developmental progress, educational engagement, and psychosocial resilience. By identifying both shared and context-specific differences in HRQoL, we aim to contribute to a more nuanced understanding of well-being that can inform the development of assessment approaches and future research tailored to the diverse contexts in which children with disabilities live and learn. Thus, the purpose of this study is to explore HRQoL and its putative influencing factors among youth with multiple disabilities across two distinct cultural settings, the United States and Iceland. Methods: Participants (N = 26; Icelandic = 50%; Mage = 16.34 ± 2.33 years) completed height, weight, the Test of Perceived Physical Competence (TPPC), Supine-to-Stand (STS), Rapid Assessment of Physical Activity (RAPA), and VISIONS QL. We conducted five, 2 group × 2 sex ANOVA and several independent samples t-tests within groups by sex for our variables of interest. Results: There was a significant difference between Icelandic boys and girls for BMI (p = 0.087, d = 0.65) and STS (p = 0.027, d = 1.04). Conversely, a significant difference was found in the American group between boys and girls for RAPA (p = 0.092, d = 0.81) and TPPC (p = 0.068, d = 0.92). Conclusions: Preliminary findings suggest that patterns in objective and self-reported health indicators may vary by context. These results highlight the importance of considering both measured performance and self-perceived health when examining HRQoL among adolescents with multiple disabilities, while underscoring the need for further research in larger samples to clarify these relationships.

## Full-text entities

- **Diseases:** Multiple Disabilities (MESH:D003147), Visual Impairments (MESH:D014786), disabilities (MESH:D009069)

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC13025296/full.md

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Source: https://tomesphere.com/paper/PMC13025296