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Measurement Invariance of the WHO-5 Well-Being Index: Evidence from 15 European Countries

Author

Listed:
  • Alina Cosma

    (Department of Sociology, Trinity College Dublin, D01 Dublin, Ireland)

  • András Költő

    (Health Promotion Research Centre, School of Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland)

  • Yekaterina Chzhen

    (Department of Sociology, Trinity College Dublin, D01 Dublin, Ireland)

  • Dorota Kleszczewska

    (Foundation of the Institute of Mother and Child, 01-211 Warsaw, Poland)

  • Michal Kalman

    (Department of Recreation and Leisure Studies, Faculty of Physical Culture, Palacký University Olomouc, 779 00 Olomouc, Czech Republic)

  • Gina Martin

    (Faculty of Health Disciplines, Athabasca University, Athabasca, AB T9S 3A3, Canada)

Abstract

(1) Background: The World Health Organization (WHO)-5 Well-Being Index has been used in many epidemiological studies to assess adolescent mental well-being. However, cross-country comparisons of this instrument among adolescents are scarce and, so far, no good-fitting, common invariant measurement model across countries has been reported. The present study aims to evaluate and establish a version of the WHO-5 Well-Being Index that allows for a valid cross-country comparison of adolescent self-reported mental well-being. (2) Methods: Using data from the 2018 Health Behaviour in School-aged Children study, we evaluated the measurement model and measurement invariance of the five items of the WHO-5 Well-Being Index. We used nationally representative samples of 11-, 13-, and 15-year-old adolescents ( N = 74,071) from fifteen countries and regions in Europe. Measurement invariance of the WHO-5 was assessed using a series (country, gender, and age) of multi-group confirmatory factor analyses. In addition, we evaluated the convergent validity of the measure by testing its correlations with psychosomatic complaints, life satisfaction, and self-rated health. (3) Results: We found that WHO-5 does not show good psychometric properties or good measurement invariance fit. However, by excluding the first item of the scale (“I have felt cheerful and in good spirits”), the WHO-4, consisting of the other four original items, had good psychometric properties, and demonstrated good suitability for cross-national comparisons (as well as age and gender) in adolescent mental well-being. (4) Conclusions: The present study introduces the WHO-4—a revised version of the WHO-5—, that allows for a valid comparison of mental well-being across fifteen countries and regions in Europe. The WHO-4 proved to be a reliable and valid instrument to assess mental well-being in the adolescent population.

Suggested Citation

  • Alina Cosma & András Költő & Yekaterina Chzhen & Dorota Kleszczewska & Michal Kalman & Gina Martin, 2022. "Measurement Invariance of the WHO-5 Well-Being Index: Evidence from 15 European Countries," IJERPH, MDPI, vol. 19(16), pages 1-12, August.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:16:p:9798-:d:883682
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    References listed on IDEAS

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    1. Judit Balázs & Mónika Miklósi & Agnes Keresztény & Christina W. Hoven & Vladimir Carli & Camilla Wasserman & Gergö Hadlaczky & Alan Apter & Julio Bobes & Romuald Brunner & Paul Corcoran & Doina Cosman, 2018. "Comorbidity of Physical and Anxiety Symptoms in Adolescent: Functional Impairment, Self-Rated Health and Subjective Well-Being," IJERPH, MDPI, vol. 15(8), pages 1-12, August.
    2. K. Levin & C. Currie, 2014. "Reliability and Validity of an Adapted Version of the Cantril Ladder for Use with Adolescent Samples," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 119(2), pages 1047-1063, November.
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