Development and Preliminary Evaluation of a Positive Health Scale

Abstract

Background: Health educators have long advocated health promotion, yet their health measurement techniques have a pathogenic focus. Pathogenesis refers to the origin of a disease and the chain of events (precursors) leading to that disease. Traditional health measurement tools with this focus therefore measure health by assessing for the absence of disease or associated risk factors. Salutogenesis, as proposed by Aaron Antonovsky, refers to associated factors and precursors of good health similar to how pathogenesis focuses on associated factors and precursors of bad health. Purpose: This study proposes a health measurement scale with a salutogenic focus that measures health by assessing for the multidimensional capacity or potential for good health. Methods: Two samples of university students (N=226, N=365) were surveyed to develop and test the psychometric properties of the Salutogenic Wellness Promotion Scale (SWPS). Results: The SWPS demonstrated a multidimensional structure with good internal consistency, that positively correlated with and predicted perceived health (p<.001), and did not invoke socially desirable responses. Discussion: The SWPS demonstrated preliminary evidence of reliability and validity in its measurement of health potential. Translation to Health Education Practice: Using the SWPS could assist health educators in developing methodologies and practices that facilitate improved health status.

Validity Evidence for the Salutogenic Wellness Promotion Scale (SWPS)

“…44,45 In the first step, exploratory factor analysis (EFA) was used to determine if the new sample's responses on the SWPS yielded the same factor structure for the SWPS as was determined with the original sample group that was used to develop the scale. 19 In the second step, the factor structure was confirmed using confirmatory factor analysis (CFA) to document the scale's goodness of fit.…”

“…Results of the EFA suggested the existence of 7 factors that were consistent with the theoretical factor structure that was assumed a priori and was consistent with the structure originally found in studies using this scale. 19 The criteria factors were based upon eigenvalues greater than 1 and through examination of the scree plot. The pattern matrix along with the eigenvalue and the percentage of variance explained after the rotation by each factor are presented in Table 2.…”

“…Although there are currently numerous reliable and valid methods to measure pathogenesis, reliable and valid measurement tools to assess salutogenesis and positive health potential are needed. 6,16,[18][19][20]36 Ultimately, a comprehensive assessment of health status that includes the use of both salutogenic and pathogenic tools may reveal the usefulness of interrelated factors for health similar to what has been discovered for motivation 29 and psychology. 31,33 To this end, the Salutogenic Wellness Promotion Scale (SWPS) was developed to assess healthpromoting positive components of health.…”

“…6,15,[18][19][20][21] These difficulties have been recognized in the European Union, and the European Public Health Alliance funded a project to develop new health promotion indicators. 22 A review of literature indicates Aaron Antonovsky developed and introduced the most recognized model in 1979 when he published Health, Stress and Coping.…”

“…The SWPS assesses positive health by collecting data about healthpromoting actions in 7 unique but interrelated dimensions: physical, social, emotional, intellectual, vocational, spiritual, and environmental. 19,20 The purpose of this study is 2-fold: (1) to retest and confirm the psychometric properties of the SWPS; and (2) to assess the validity, versatility, and value of the SWPS's multidimensional structure. Purpose 1 was completed with factor analysis and reliability calculations of data from a new sample.…”