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      Warwick-Edinburgh Mental Well-being Scale (WEMWBS): Validated for teenage school students in England and Scotland. A mixed methods assessment

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          Abstract

          Background

          Understanding and measuring mental health and wellbeing amongst teenagers has recently become a priority. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is validated for measuring mental wellbeing in populations aged 16 years and over in the UK. We report here a study designed to establish the validity and reliability of WEMWBS in teenagers in the UK.

          Methods

          WEMWBS and comparator scales, together with socio-demographic information and self-reported health, were incorporated into a self-administered questionnaire given to pupils aged 13 to 16 years in six schools in Scotland and England. Psychometric properties including internal consistency, correlations with comparator scales, test-retest stability and unidimensionality were investigated for WEMWBS. Twelve focus groups were undertaken to assess acceptability and comprehensibility of WEMWBS and were taped, transcribed and analysed thematically.

          Results

          A total of 1,650 teenagers completed the questionnaire (response rate 80.8%). Mean WEMWBS score was 48.8 (SD 6.8; median 49). Response scores covered the full range (from 14 to 70). WEMWBS demonstrated strong internal consistency and a high Cronbach's alpha of 0.87 (95% CI (0.85-0.88), n = 1517). Measures of construct validity gave values as predicted. The correlation coefficient for WEMWBS total score and psychological wellbeing domain of the Kidscreen-27 was 0.59 (95% CI [0.55; 0.62]); for the Mental Health Continuum Short Form (MHC-SF) was 0.65, 95% CI [0.62; 0.69]; and for the WHO (WHO-5) Well-being Index 0.57 (95% CI [0.53; 0.61]). The correlation coefficient for the Strengths and Difficulties Questionnaire (SDQ) was -0.44 (95% CI [-0.49; -0.40]) and for the 12-item General Health Questionnaire (GHQ12) -0.45 (95% CI [-0.49; -0.40]). Test-retest reliability was acceptable (Intraclass correlation coefficient (ICC) 0.66 (95% CI [0.59; 0.72] n = 212)). Confirmatory factor analysis demonstrated one underlying factor.

          WEMWBS was significantly associated with the Family Affluence Score (WEMWBS increased with increasing household socio-economic status) and had a positive association with the physical health dimension of the Kidscreen-27, but was unrelated to age, gender or location/school. Eighty students took part in focus groups. In general, although some students considered some items open to misunderstanding or misinterpretation, WEMWBS was received positively and was considered comprehensible, and acceptable.

          Conclusions

          WEMWBS is a psychometrically strong population measure of mental wellbeing, and can be used for this purpose in teenagers aged 13 and over.

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          Most cited references 10

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          Coefficient alpha and the internal structure of tests

           Lee Cronbach (1951)
          Psychometrika, 16(3), 297-334
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            The KIDSCREEN-27 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries.

            To assess the construct and criterion validity of the KIDSCREEN-27 health-related quality of life (HRQoL) questionnaire, a shorter version of the KIDSCREEN-52. The five-dimensional KIDSCREEN-27 was tested in a sample of 22,827. For criterion validity the correlation with and the percentage explained variance of the scores of the KIDSCREEN-52 instrument were examined. Construct validity was assessed by testing a priori expected associations with other generic HRQoL measures (YQOL-S, PedsQL, CHIP), indicators of physical and mental health, and socioeconomic status. Age and gender differences were investigated. Correlation with corresponding scales of the KIDSCREEN-52 ranged from r = 0.63 to r = 0.96, and r2 ranged from 0.39 to 0.92. Correlations between other HRQoL questionnaires and KIDSCREEN-27 dimensions were moderate to high for those assessing similar constructs (r = 0.36 to 0.63). Statistically significant and sizeable differences between physically and mentally healthy and ill children were found in all KIDSCREEN-27 dimensions together with strong associations with psychosomatic complaints (r = -0.52). Most of the KIDSCREEN-27 dimensions showed a gradient according to socio-economic status, age and gender. The KIDSCREEN-27 seems to be a valid measure of HRQoL in children and adolescents. Further research is needed to assess longitudinal validity and sensitivity to change.
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              Evaluation of the mental health continuum-short form (MHC-SF) in setswana-speaking South Africans.

              A continuous assessment and a categorical diagnosis of the presence of mental health, described as flourishing, and the absence of mental health, characterized as languishing, is applied to a random sample of 1050 Setswana-speaking adults in the Northwest province of South Africa. Factor analysis revealed that the mental health continuum-short form (MHC-SF) replicated the three-factor structure of emotional, psychological and social well-being found in US samples. The internal reliability of the overall MHC-SF Scale was 0.74. The total score on the MHC-SF correlated 0.52 with a measure of positive affect, between 0.35 and 0.40 with measures of generalized self-efficacy and satisfaction with life, and between 0.30 and 0.35 with measures of coping strategies, sense of coherence, and community collective self-efficacy. The total score on the MHC-SF correlated -0.22 with the total score on the General Health Questionnaire. Criteria for the categorical diagnosis were applied, and findings revealed that 20% were flourishing, 67.8% were moderately mentally healthy, and 12.2% were languishing. Confirmatory factor analysis supported the hypothesized two-continua model of mental health and mental illness found in the USA. Copyright (c) 2008 John Wiley & Sons, Ltd.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2011
                21 June 2011
                : 11
                : 487
                Affiliations
                [1 ]Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
                [2 ]University Medical Center, Göttingen, Dept. of Medical Statistics, 37073 Göttingen, Germany
                [3 ]NHS Birmingham East and North,4th Floor, Waterlinks House Richard Street.Aston, Birmingham, B7 4AA, UK
                [4 ]The Caludon Centre, Coventry and Warwickshire Partnership Trust, Clifford Bridge Road, Coventry CV2 2TE, UK
                [5 ]College of Medicine, King Saud University; Shaikh Abdullah Bahamdan Research Chair for Evidence-Based Health Care and Knowledge Translation; P.O.Box 2925, Riyadh 11461, Saudi Arabia
                [6 ]NHS Health Scotland, Elphinstone House, 65 West Regent Street, Glasgow G2 2AF, UK
                [7 ]Department of Sports Studies, University of Stirling, Stirling, FK9 4LA, UK
                [8 ]Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
                Article
                1471-2458-11-487
                10.1186/1471-2458-11-487
                3141456
                21693055
                24c078df-e056-41b4-9043-59ce064ebb14
                Copyright ©2011 Clarke et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research Article

                Public health

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