Assessing mental well-being in a Sinhala speaking Sri Lankan population: validation of the WHO-5 well-being index

Abstract

Purpose The WHO-5 well-being index is a widely used, short rating scale that measures subjective well-being. We translated the WHO-5 index into Sinhala and tested its psychometric properties including measurement invariance among diverse groups in a community sample in Sri Lanka. Methods The sample of 267 persons aged between 16 and 75 years was recruited from a semi-urban area. 219 completed a paper-based questionnaire and 48 responded to an online survey. Construct validity was tested for factorial validity (Confirmatory Factor Analysis -CFA), convergent validity and known group validity. Composite reliability for congeneric measures and test-retest reliability were also tested. Multi-group CFA (MG-CFA) was used to test measurement invariance. Results The translated Sinhala version demonstrated good content and face validity. Internal consistency reliability of the five items had a Cronbach’s alpha of 0.85 and test-retest reliability over 2 weeks was satisfactory (Pearson r = 0.72, p < 0.001, ICC = 0.82). Confirmatory factor analysis supported factorial validity with a $$ {\chi}_5^2 $$ χ 5 2 =4.99 (p = 0.28), a RMSEA of 0.03 (90% C.I. =0.00–0.10), a SRMR of 0.02, a TLI of 0.99 and a CFI of 0.99; factor loadings were between 0.55 and 0.89. Measurement invariance was acceptable for configural, metric and scalar invariance for gender. WHO-5 scores were significantly negatively correlated with the Patient Health Questionnaire (PHQ-9) (Pearson’s r = − 0.45, p < 0.001) scores and the Kessler Psychological Distress Scale (K10) scores (Pearson’s r = − 0.56, p < 0.001). Conclusion The Sinhala translation of WHO-5 well-being index has shown acceptable psychometric properties and can be used for assessing mental well-being in the community in Sri Lanka. Further testing of the measure with larger and diverse (including different ethnic/cultural) groups are indicated to test measurement invariance of the measure.

Validity and Psychometric Evaluation of the Chinese Version of the 5-Item WHO Well-Being Index

“…Specifically, the results of this study showed that the Chinese version of the WHO-5 has good psychometric properties. Indeed, the results indicated that the scale has good internal consistency, with Cronbach's alpha values of 0.85 and 0.81 in Study 1 and Study 2, respectively, similar to the values reported in recent WHO-5 studies (ranging from 0.78 to 0.85) based on adolescents and adults in various settings ( 8 , 11 , 12 , 19 , 73 ). The unidimensional factor structure of the Chinese version of the WHO-5 replicated that of the original WHO-5 ( 5 , 16 , 23 ).…”

“…However, the following two indices failed to fit the model: χ 2 (50.536)/5 = 10.107 and RMSEA = 0.100. Following recent studies on the WHO-5 ( 73 ), Model 2 re-evaluated the scale, with the error correlations based on the modification indices. It included one covariance factor between the error terms for the WHO5-1 and WHO5-2.…”

Validation and Optimal Cut-Off Score of the WHO-5 as a Screening Tool for Depression among Young Adults in Malaysia

“…The WHO-5 also showed good reliability and concurrent validity in the present study. Our nding is consistent with those studies conducted with clinical and community samples (e.g., Halliday et al, 2017;Omani-Samani et al, 2019;Perera et al, 2020).…”

Validation of the WHO-5 as a screening tool for depression among young adults in Malaysia

“…The WHO-5 also showed good reliability and concurrent validity among young adults in Malaysia. Our finding is similar to those studies conducted with clinical and community samples (e.g., Halliday et al, 2017;Omani-Samani et al, 2019;Perera et al, 2020).…”