A Factor Structure of Wellness: Theory, Assessment, Analysis, and Practice

Health measurement instruments and their applicability to military veterans: a systematic review

INTRODUCTION

Accurate measurement of health status is essential to assess veterans' needs and the effects of interventions directed at improving veterans' well-being. We conducted a systematic review to identify instruments that measure subjective health status, considering four components (ie, physical, mental, social or spiritual well-being).

METHODS

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we searched CINAHL, MEDLINE, Embase, PsycINFO, Web of Science, JSTOR, ERIC, Social Sciences Abstracts and ProQuest in June 2021 for studies reporting on the development or evaluation of instruments measuring subjective health among outpatient populations. We assessed risk of bias with the Consensus-based Standards for the Selection of Health Measurement Instruments tool and engaged three veteran partners to independently assess the clarity and applicability of identified instruments.

RESULTS

Of 5863 abstracts screened, we identified 45 eligible articles that reported health-related instruments in the following categories: general health (n=19), mental health (n=7), physical health (n=8), social health (n=3) and spiritual health (n=8). We found evidence for adequate internal consistency for 39 instruments (87%) and good test-retest reliability for 24 (53%) instruments. Of these, our veteran partners identified five instruments for the measurement of subjective health (Military to Civilian Questionnaire (M2C-Q), Veterans RAND 36-Item Health Survey (VR-36), Short Form 36, Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and Sleep Health Scale) as clear and very applicable to veterans. Of the two instruments developed and validated among veterans, the 16-item M2C-Q considered most components of health (mental, social and spiritual). Of the three instruments not validated among veterans, only the 26-item WHOQOL-BREF considered all four components of health.

CONCLUSION

We identified 45 health measurement instruments of which, among those reporting adequate psychometric properties and endorsed by our veteran partners, 2 instruments showed the most promise for measurement of subjective health. The M2C-Q, which requires augmentation to capture physical health (eg, the physical component score of the VR-36), and the WHOQOL-BREF, which requires validation among veterans.

Well-being as Need Fulfillment: Implications for Theory, Methods, and Practice

The most prominent concept championed by human resource professionals, point solution providers, and the mental health care industry is the construct of holistic well-being. Despite the tremendous attention focused on well-being, the concept lacks theoretical consensus among its proponents. Like the concept of engagement, this field cries out for clearly stated definitions that embed the concept within a theoretical framework, allowing theory development to avoid the prolific category errors of the past 50 years. This paper argues for a more sophisticated approach to the concept of well-being, grounding it in the vast psychological literature on human motivation. Herein lies the contribution of our paper; we argue that the apparent diversity of operational definitions employed by academics and practitioners can be understood as tentative attempts to draw ever nearer to key motivational concepts, without ever quite getting there. We review the leading definitions of well-being in the literature and find that they are reducible to a core set of human motives, each backed by full research traditions of their own, which populate a comprehensive model of twelve human motivations. We propose that there is substantial value in adopting a comprehensive motivational taxonomy over current approaches, which have the effect of "snowballing" ever more dimensions and elements. We consider the impact of setting well-being concepts in existing motivational constructs for each of the following: (a) theory, especially the development of well-being frameworks; (b) methods, including the value of applying a comprehensive, structural approach; and (c) practice, where we emphasize the practical advantages of clear operational definitions.

Building Consensus on Domains of Wellness Using Finnish and International Expert Panels: A Delphi-Method Study

PURPOSE

The paper investigates whether we can build consensus on wellness domains and create a more universal conceptual framework for wellness.

DESIGN

A modified ranking type of Delphi method.

PARTICIPANTS

Two separate panels consisting of 23 Finnish and 11 international experts.

METHODS

Panels were asked to rate the importance of 61 systematic review-based wellness domains and to eventually form a wellness model in both panels. The similarities between the resulting models were investigated and a new conceptual framework for wellness was created.

RESULTS

The Finnish model included 8 themes and 20 domains, and the international model 5 themes and eleven domains. Eight of the eleven domains were an exact match for the Finnish model (namely mental health, cognitive health, exercise, nutrition, community, life satisfaction, meaningfulness, work-life balance). There were also 2 similar domains that could be found in both models (namely self-care and lifestyle habits, social networks). A new conceptual framework for wellness was created based on these ten domains.

CONCLUSION

The lack of consensus on the wellness construct has made it difficult to find comparable measures that could assess and improve the level of wellness of individuals, organizations, and society. This study offers a conceptual framework that can be further validated and turned into a more universal measurement instrument.

Measuring wellness change in undergraduate students

STUDY PURPOSE

This study was undertaken to establish if the Holistic Wellness Assessment (HWA) can detect intra-individual changes following a 12-week undergraduate course in holistic wellness (N = 235).

METHODS

A single-group pretest post-test non-experimental design was used to evaluate changes in the eight HWA factors; concurrent collection of demographic variables enabled a limited moderation analysis.

RESULTS

Dependent t-tests adjusted for a false discovery rate revealed significant changes in six of the eight HWA factors indicating curriculum sensitivity in these HWA factors.

CONCLUSIONS

Interpretations are offered at the HWA factor level that discuss relationships between curriculum activities and student artifacts with changes in factor and item responses over time. Using the HWA as a pre/post-test instrument helps instructors and students evaluate the changes that have been made as a result of the curriculum.

Thriving amidst adversity: Flourishing and grit in Ukrainian college students with strong life purpose before and after the onset of the Russian war in Ukraine

This multi-study examined the role of life purpose in the well-being of Ukrainian university students before (Study 1) and during the Russian war in Ukraine (Study 2) during the 2021-22 academic year using a cross-sectional design. University students from a city highly affected by the war, a region which borders Russia, completed measures of sense of purpose in life (awakening to purpose, awareness to purpose, altruistic purpose), specific purpose orientations (others-growth, self-growth, career-focused), flourishing, and grit (consistency of interests, perseverance of effort). Structural equation modeling was used to test four alternative path models. In Study 1 (N = 159), flourishing was positively predicted by all measures of purpose, except for awareness of purpose, which was a negative but weak predictor. Similar to flourishing, both dimensions of grit were positively predicted by career-focused purpose orientation above and beyond the overall sense of life purpose. Additionally, perseverance of effort was predicted positively by awakening to purpose. Consistent with Study 1, in Study 2 (N = 107), flourishing and perseverance of effort were positively predicted by career-focused purpose orientation above and beyond the overall sense of life purpose. Additionally, flourishing was positively predicted by awakening to purpose and others-growth purpose orientation. Overall, students with a strong life purpose reported high sense of flourishing and grit. Findings also highlighted the salient role of career-focused purpose orientation in students' well-being. It is thereby important to support students in exploring and connecting life's purpose with their career aspirations.

Counseling students' experiences and interpretations of purpose development

The aim of this study was to explore the lived experiences of counseling students regarding their development of sense of purpose in life and further seek their recommendations for fostering sense of purpose within educational settings. In this study, we have used pragmatism as our research paradigm and Interpretative Phenomenological Analysis (IPA) as our data analysis approach to gain deeper insights into the phenomenon of purpose development and further use the findings of this study to suggest specific purpose-strengthening educational approaches. Based on the interpretative phenomenological analysis, we identified five themes that revealed purpose development as a non-linear process that involves exploring, engaging with, reflecting upon, articulating, and actualizing one's purpose, and is influenced by both internal and external factors. In light of these findings, we discussed implications for counselor education programs that aspire to cultivate counseling students' sense of purpose in life as an important dimension for their personal wellness, which research has shown could further promote their professional development and career success.

The impact of COVID-19 on adolescent wellness in Chicago

PURPOSE

This study aimed to understand the impact of the initial COVID-19 pandemic remote schooling period on self-reported wellness among adolescents in Chicago.

METHODS

Students (n = 55) completed a 22-item wellness questionnaire before (February 2020) and shortly after the onset of the COVID-19 outbreak (April 2020). Precomparisons/postcomparisons (overall and by survey item) were evaluated using two-sided paired t-tests with an alpha level of 0.05. Descriptive statistics were used to evaluate mean scores overall by demographic variables.

RESULTS

Significant differences were found in the following areas: Balance (Pre: 7.3, During: 6.4, p = 0.02), Education (Pre: 8.4, During 7.7, p = 0.03) and Friends (Pre:8.0, During: 6.3, p = 0.001). Overall wellness scores varied by demographic variables, though not significantly.

CONCLUSIONS

Results suggest the onset of the pandemic impacted students' ability to effectively learn, as well as to maintain balance in their lives and social relationships. Comprehensive support is needed in these areas to promote adolescent wellness.

Regional well-being inequalities arising from healthcare expenditure public policies in Spain

Well-being inequalities arising from different healthcare expenditure public policies is currently a hot topic at a national scale, but especially so at a sub-national level because the inequalities in question are among citizens of the same country. Spain is an optimal study area to carry out research on this topic because it is considered to have one of the best health systems in the world, it is one of the top-ranking countries in terms of life expectancy rates (the indicators we use for well-being), and it has a decentralized public health system with significantly different regional healthcare expenditure public policies. Given that the factors involved in the complex direct, indirect, and second-order relationships between well-being and health spending are latent in nature, and that there are more hypotheses than certainties regarding these relationships, we propose a partial least squares structural equation modeling specification to test the research hypotheses and to estimate the corresponding impacts. These constructs are proxied by a set of 26 indicators, for which annual values at a regional scale were used for the period 2005-2018. From the estimation of this model, it can be concluded that mortality, expenditure and resources are the factors that have the greatest impact on well-being. In addition, a cluster analysis of the indicators for the constructs included in this research reveals the existence of three clearly differentiated groups of autonomous communities: the northern part of the country plus Extremadura (characterized by the lowest well-being and the highest mortality rates), Madrid (with the best results in well-being and mortality, the lowest public health expenditure per inhabitant and percentage of pharmaceutical spending, and the highest percentage in specialty care services and medical staff spending), and the rest of the country (south-eastern regions, with similar well-being values to those of the first group but with less health expenditure). Finally, a principal component analysis reveals that "healthiness" and "basic spending" are the optimal factors for mapping well-being and health spending in Spain.

Attribute Framework Validation for Wellness Tourism within the Context of Thailand

Background: Research on the theoretical integration of attributes of wellness tourism in the form of the physical, mental, spiritual, and environmental (PMSE) attribute framework and the effect of cultural differences on the framework validation has not been conducted before. Objectives: This study developed and validated the key underlying attributes of the wellness tourism experience framework within the Thailand context. Methods: From reviewing the related literature to identify potential sub attributes under the four dimensions of the PMSE framework, themes were developed using a theory- and prior research-driven method within different cultural contexts. The fitness of the PMSE attribute framework model within the context of Thailand wellness tourism was confirmed through a survey design with a quantitative approach from the generalities of the sample groups. The entire dataset was statistically tested with descriptive statistics and confirmatory factor analysis (CFA). Results and Conclusions: After adjustments, the four-factors with a 28-item model substantiated the data. The results validated that the mental experience dimension accounted for the most variance, with an indicator value of 0.99 in the framework, predicting the effective wellness tourism experience better than the other attributes. Experience design should involve the participation of all stakeholders in the wellness tourism system in terms of managerial contribution. Recommendations for the planning of wellness experiences concerning each four-factor will be investigated in future studies.

Expanding the purview of wellness indicators: validating a new measure that includes attitudes, behaviors, and perspectives

Objective

The present study validated the DeltaQuest Wellness Measure (DQ Wellness), a new 15-item measure of wellness that spans relevant attitudes, behaviors, and perspectives.

Design

This cross-sectional web-based study recruited chronically-ill patients and/or caregivers (n = 3,961) and a nationally representative comparison group (n = 855).

Main Outcome Measures

The DQ Wellness assesses: a way of being in the world that involves seeing and embracing the good and expressing kindness toward others; engagement in one's activities and self-care; downplaying negative thoughts that reduce one's energy; and an ability to feel joy. Six widely used measures of physical and mental health, cognition, and psychological well-being enabled construct-validity comparisons. Item-response theory (IRT) methods evaluated reliability, factor structure, and differential item functioning (DIF) by gender.

Results

The DQ Wellness showed strong cross-sectional reliability (marginal reliability = 0.89) and fit a bifactor model (RMSEA = 0.063, CFI = 0.982, TLI = 0.983). The DQ Wellness general score demonstrated construct validity, convergent and divergent validity, unique variance, and known-groups validity, and minimal gender DIF. The study is limited to addressing cross-sectional reliability and validity, and response rates are not known due to the recruitment source.

Conclusion

The DQ Wellness is a relatively brief measure, taps novel content, and could be useful for observational or interventional studies.

Rethinking Strategies and Programs to Improve Physical and Emotional Well-being Among Healthcare Professionals: Facing the New Normalcy

Background

With the advent of coronavirus disease 2019 (COVID-19), a different perspective on the future of humanity has emerged that emphasizes the importance of building the capacities of healthcare providers in order to assist them with the heavy burden that these changes have placed on them both now and in the future. A reduction in the quality of life and the presence of prolonged fatigue are some of the most imminent problems that emerge among these professionals.

Objective

The aim of this study was to determine the effectiveness of a holistic intervention (workshop) for health science students aimed at developing skills that will enable them to obtain a better self-assessment of their quality of life, and prolonged fatigue.

Methods

Pre- and post-measures of quality of life, and prolonged fatigue were obtained from 130 health science students, including a group of 96 attendees (cases) of a 4-h wellness workshop and 34 students who did not attend (controls).

Results

Paired t tests indicated a significant improvement in nearly all dimensions related to quality of life, and prolonged fatigue in the case group who attended the workshop.

Conclusions

A comprehensive wellness strategy that utilizes a holistic approach can play an important role in improving and promoting essential skills to improve healthcare provider's self-assessment about the quality of life and reduce their prolonged fatigue. The critical importance of these needs has long been recognized, and this will also be crucial for addressing new challenges and emerging realities.

Can leader humility enhance employee wellbeing? The mediating role of employee humility

Purpose

The purpose of this paper is to explore the relationship between leader humility and employee well-being. Based on social information processing (SIP) theory and previous literature concerning leader humility, this paper identifies employee humility as the mediator and suggests that perceived leader effectiveness moderates these relationships.

Design/methodology/approach

This study employed a survey involving 228 employees to test the hypothesized moderated-mediation model.

Findings

Leader humility is positively related to employee well-being. Employee humility mediates leader humility and employee well-being, except for emotional exhaustion. Moreover, the effect of leader humility on employee humility and the indirect effect of leader humility on employee job satisfaction and work engagement are stronger under high perceptions of leader effectiveness.

Originality/value

Based on the framework of SIP theory, this paper contributes to the literature on humble leadership and employee well-being by treating employee humility as the mechanism and perceived leader effectiveness as the moderator. Few previous studies have investigated the influence of leader humility on employee well-being.

Organizational Wellness Program Implementation and Evaluation: A Holistic Approach to Improve the Wellbeing of Middle Managers

: Employee wellness programs can provide benefits to institutions as well as employees and their families. Despite the attempts of some organizations to implement programs that take a holistic approach to improve physical, mental, and social wellness, the most common programs are exclusively comprised of physical and nutritional components. In this study, we implemented a wellness program intervention, including training using a holistic approach to improve the wellbeing of middle managers in several multinational organizations. We included control and experimental groups to measure wellness and teamwork with two repeated measures. Our results indicated that employees receiving the intervention had improved measures of wellness and teamwork. A positive relationship was found between wellness and teamwork in the experimental group when compared with the control group. Taken together, the data suggest that implementation of these programs would provide valuable outcomes for both employees and organizations.

Uncovering a health and wellbeing gap among professional nurses: situated experiences of direct care nurses in two Canadian cities

Understanding the drivers of nurses' poor health and the implications for quality of care are important in sustaining a healthy workforce, stimulating professional nursing practice, and ensuring healthy lives while promoting the wellbeing of nurses of all ages. Previous scholarship has identified factors influencing nurses' wellbeing, but have neglected to take a comprehensive approach to assessing the multiple dimensions of nurses' wellbeing and their collective, syndemic effects. Neither have these studies explored the context within which these experiences occur, or how these experiences differ for nurses with multiple marginalized identities in spite of an increasingly diverse workforce. Using the six dimensions of wellness framework, we examined the distinct and interrelated dimensions of nurses' wellbeing that were either enhanced or aggravated by professional practice and how it changed by nurses' race and ethnicity using their situated experiences. The study was conducted using a qualitative research design, which drew on phenomenology and in-depth interviews with Registered and Practical Nurses (n = 70) in two Canadian cities. Of the six dimensions of wellbeing identified, direct care practice enhanced nurses' occupational, intellectual, and spiritual wellbeing, but worsened their physical, emotional and social health. A health gap was found along racial lines, as ethnic minority nurses reported more detrimental effects of direct care nursing on their physical, emotional, occupational, and social wellbeing than their white counterparts. Nurses resorted to institutional structures, social and emotional support from supervisors, coworkers and family members, and engaged in spiritual activities to cope with these adverse health effects. These findings highlight the utility of an adaptable framework in identifying the multiple dimensions and gaps in nurses' wellbeing. Furthermore, our findings echo the urgent need for workplace and safety policies that address issues of diversity and make the work environment safe, equitable and promote nurse productivity and quality care.

Self-managing individual wellness for the health professional: A somatology perspective

BACKGROUND

Health professionals play a vital role in the stability and sustainability of any healthcare system. However, the well-documented long working hours, lack of wellness support structures, regular occurrence of burnout and low retention rates are concerning.

AIM

The aim of this research study was to understand how a group of therapists self-manage their own individual wellness, to provide insight on how other health professionals, working in a demanding environment, could potentially address their individual wellness more effectively.

SETTING

The research was conducted in a private room at the place of participant employment, in two metropolitans in Gauteng, South Africa.

METHOD

Qualitative, explorative, descriptive and contextual designs were used within the paradigm of constructivism. Purposive sampling was used to select participants. Data were collected through in-depth interviews, field notes and reflective practices, and analysed through open coding.

RESULTS

This study revealed disequilibrium between the theoretical knowledge and practical realities of therapists, and indicated that these therapists experience various personal obstacles that hinder the self-management of their individual wellness.

CONCLUSIONS

Somatology therapists use various personal strategies that allow them to better self-manage their individual wellness. Individual wellness seems to be a personal phenomenon, indicating the need to self-reflect on personal perceptions of wellness, individual wellness obstacles and individual wellness strategies to effectively self-manage individual wellness.

The State of Data in Healthcare: Path Towards Standardization

Coupled with the rise of data science and machine learning, the increasing availability of digitized health and wellness data has provided an exciting opportunity for complex analyses of problems throughout the healthcare domain. Whereas many early works focused on a particular aspect of patient care, often drawing on data from a specific clinical or administrative source, it has become clear such a single-source approach is insufficient to capture the complexity of the human condition. Instead, adequately modeling health and wellness problems requires the ability to draw upon data spanning multiple facets of an individual's biology, their care, and the social aspects of their life. Although such an awareness has greatly expanded the breadth of health and wellness data collected, the diverse array of data sources and intended uses often leave researchers and practitioners with a scattered and fragmented view of any particular patient. As a result, there exists a clear need to catalogue and organize the range of healthcare data available for analysis. This work represents an effort at developing such an organization, presenting a patient-centric framework deemed the Healthcare Data Spectrum (HDS). Comprised of six layers, the HDS begins with the innermost micro-level omics and macro-level demographic data that directly characterize a patient, and extends at its outermost to aggregate population-level data derived from attributes of care for each individual patient. For each level of the HDS, this manuscript will examine the specific types of constituent data, provide examples of how the data aid in a broad set of research problems, and identify the primary terminology and standards used to describe the data.

Beyond deficit and harm reduction: Incorporating the spectrum of wellness as an interpretive framework for cannabis consumption

The cannabis academic literature is informed by dominant deficit, public health and harm reduction frameworks. However, a large majority of cannabis consumption appears to place outside the scope of these models that prioritise the identification and limitation of negative impacts. As such there are apparent analytical blind spots pertaining to: non-problematic use of cannabis (as defined by Global Commission on Drug Policy); the intersection of medical and recreational intents of use; and pleasure. This paper explores the academic and grey literature relating to the spectrum of wellness to assess its suitability as a framework for cannabis scholars. For millennia cannabis use has been associated with wellness models, particularly at the nexus of mind, body, and spirit. Despite this seemingly obvious match, the academic literature that incorporates cannabis consumption patterns into wellness conceptions is thin. The spectrum of wellness has both advantages and disadvantages compared to existing models and may be useful as a complementary framework that allows for broader examination of cannabis consumer activity.

GROW: Green Organic Vegetable Gardens to Promote Older Adult Wellness: a Feasibility Study

Protecting older adult's cognitive health is a public health priority. Wellness behaviors within 6 domains have demonstrated effectiveness in protecting older adult's cognitive abilities. Interventions targeted to low-income older adults are needed because these populations experience greater social and physical health disparities compared to adults in higher socioeconomic statuses. This study examined the feasibility of engaging independent, community-dwelling older adults living in low-income senior housing in cultivating raised-bed gardens and reviewed the improvements in cognition and nutrition. Ten participants received ergonomic garden tools, seeds, waist-height garden beds, and weekly garden education. Participants planted vegetables of their choosing and tended to their garden beds for 17 weeks. Cognition and nutrition outcomes were measured before and after the intervention. Adults successfully engaged in the intervention throughout the duration and experienced improvement in cognitive and nutrition outcomes.

An examination of college student wellness: A research and liberal arts perspective

Promoting wellness within academia reduces disease frequency and enhances overall health. This study examined wellness factors among undergraduate students attending a research university (n = 85) or a small liberal arts college (n = 126). Participants were administered surveys which measured physical, emotional, social, intellectual, and occupational wellness. Significant institutional differences emerged on measures of physical and social wellness. When collapsed across academic institutions, students who were gainfully employed reported greater self-efficacy compared with unemployed students. Gender differences emerged on measures of physical and social well-being. Our findings support the need for targeted interventions that facilitate enhanced college student development and well-being.

Psychosocial well-being of people living with HIV and the community before and after a HIV stigma-reduction community "hub" network intervention

The purpose of the research was to determine whether an HIV stigma-reduction community "hub" network intervention in a South African urban area would bring about a difference in the psychosocial well-being of people living with HIV (PLWH), as well as their community (living in the same municipal ward). A single case pre-test post-test design was implemented. The sample for this study included 62 PLWH who were selected through accessibility sampling and 570 community members who were selected through random voluntary sampling. Participants completed the Patient Health Questionnaire (PHQ-9) and the Mental Health Continuum-Short Form (MHC-SF) before and after the intervention. A dependent t-test as well as Cohen's d-values were used to calculate the differences between the pre- and post-test results for depression and well-being. Levels of languishing, moderate mental health and flourishing before and after the intervention were determined. Although the focus of the HIV stigma-reduction community "hub" intervention that was followed in this study was on the involvement of PLWH and people living close to them (PLC) to share their knowledge as community mobilisers and to mobilise and empower their own community to reduce HIV stigma, it can be concluded that a secondary gain was the effect it had on both depression and mental health of the PLWH as well as the community. Of interest is how these effects differed for PLWH and the community. It is thus recommended that future interventions should give special attention to aspects of depression and well-being.

Measuring Well-Being

Interest in the study of psychological health and well-being has increased significantly in recent decades. A variety of conceptualizations of psychological health have been proposed including hedonic and eudaimonic well-being, quality-of-life, and wellness approaches. Although instruments for measuring constructs associated with each of these approaches have been developed, there has been no comprehensive review of well-being measures. The present literature review was undertaken to identify self-report instruments measuring well-being or closely related constructs (i.e., quality of life and wellness) and critically evaluate them with regard to their conceptual basis and psychometric properties. Through a literature search, we identified 42 instruments that varied significantly in length, psychometric properties, and their conceptualization and operationalization of well-being. Results suggest that there is considerable disagreement regarding how to properly understand and measure well-being. Research and clinical implications are discussed.

[Development of a Wellness Index for Workers]

PURPOSE

The purpose of this study was to develop a wellness index for workers (WIW) and examine the validity and reliability of the WIW for assessing workers' wellness.

METHODS

The developmental process for the instrument included construction of a conceptual framework based on a wellness model, generation of initial items, verification of content validity, preliminary study, extraction of final items, and psychometric testing. Content validity was verified by 4 experts from occupational health nursing and wellness disciplines. The construct validity, convergent validity and discriminant validity were examined with confirmatory factor analysis. The reliability was examined with Cronbach's alpha. The participants were 494 workers from two workplaces.

RESULTS

Eighteen items were selected for the final scale, and the results of the confirmatory factor analysis supported a five-factor model of wellness with acceptable model fit, and factors named as physical · emotional · social · intellectual · occupational wellness. The convergent and discriminant validity were also supported. The Cronbach's alpha coefficient was .91.

CONCLUSION

The results indicate that the WIW is a valid and reliable instrument to comprehensively assess workers' wellness, and to provide basic directions for developing workplace wellness program.

A systematic review of measurement tools of health and well-being for evaluating community-based interventions

BACKGROUND

Those interested in evaluating the effectiveness of community interventions on health and well-being need information about what tools are available and best suited to measure improvements that could be attributed to the intervention.This study evaluated published measurement tools of health and well-being that have the potential to be used before and after an intervention.

METHODS

A literature search of health and sociological databases was undertaken for articles that utilised measurement tools in community settings to measure overall health, well-being or quality of life. Articles were considered potentially relevant because they included use of measurement tools related to general health or well-being. These tools were evaluated by further searching of the literature to assess each tool's properties including: reliability; validity; responsiveness; length; use in cross-cultural settings; global health or well-being assessment; use of subjective measures; clarity and cost. A composite score was made based on the average rating of all fields.

RESULTS

Of 958 abstracts that were screened, 123 articles were extracted for review. From those articles, 27 measurement tools were selected and assessed. Based on the composite score assessing across all domains, five tools were rated as excellent.

CONCLUSIONS

While tools may need to be selected for particular aims and interventions, a range of potential well-described tools already exist and should be considered for use in preference to ad hoc or bespoke tools. Any of the five tools rated as excellent are recommended to assess the impact of a community intervention.

Structural Validation of the Holistic Wellness Assessment

The Holistic Wellness Assessment (HWA) is a relatively new assessment instrument based on an emergent transdisciplinary model of wellness. This study validated the factor structure identified via exploratory factor analysis (EFA), assessed test–retest reliability, and investigated concurrent validity of the HWA in three separate samples. The hypothesized eight-factor structure was validated via confirmatory factor analysis (CFA), individually for each factor and overall in a multifactor analysis. Test–retest reliability estimates over a 1- to 3-week interval were appropriate for this assessment type. Concurrent validity estimates indicated that the HWA measures were similar, but not redundant, to wellness constructs found in other wellness instruments, specifically the TestWell® and Wellness Evaluation of Lifestyle, Version S (WEL-S). As young adults are exposed to a broader base of wellness in educational and related contexts, the use of the wellness assessments such as the HWA can identify areas of personal need for balance and healthy choice making.