TABLE 2.
Wellness assessment instruments
| NAME | ITEMS | DETAILS | TIME | ACCESSIBILITY | RELIABILITY | VALIDITY | NOTES |
|---|---|---|---|---|---|---|---|
| LAQ)/ TestWell | 100 | Assesses 10 wellness domains on a 5-point Likert scale: 1) physical fitness; 2) physical-nutritional; 3) physical-self-care; 4) drugs and driving; 5. social-environment; 6) emotional awareness; 7) emotional control; 8) intellectual; 9) occupational;10) spiritual | >1 hour | Includes a charge for the assessment, which ranges from $0.23 to $1.20 per instrument per year to administer | Demonstrated strong internal consistency upon analysis (Palombi, 1992)21 | Hunter & Leeder (2013) found minimal support for the external validity of specific LAQ scales as specific measurements of wellness, especially those of the physical dimension. Demonstrated content validity. (Palombi, 1992)21 | This scale is not used regularly today. It was used in 4 studies that assessed undergraduate college students, college freshmen, wellness professionals. |
| WI | 120 | Examines 12 domains: 1.) self-responsibility and love; 2) breathing; 3) sensing; 4) eating; 5) moving; 6) feeling; 7) thinking; 8) playing and working; 9) communicating; 10) sex; 11) finding meaning; 12)transcending | >2 hours | N/A | Demonstrated strong internal consistency upon analysis (Palombi, 1992)21 | Demonstrated content validity (Palombi, 1992)21 | This scale is not used regularly today. It was used in 3 studies that assessed college undergraduate students, wellness professionals. |
| LCI | 142 | Assesses 7 distinct dimensions: 1) coping style actions; 2) nutritional actions; 3) physical care actions; 4) cognitive and emotional; 5) actions, low-risk actions; 6) environmental actionsl; 7) social support actions | >2 hours | N/A | Demonstrated strong internal consistency upon analysis (Palombi, 1992)21 | Demonstrated content validity (Palombi, 1992)21 | This scale is not used regularly today. It was used in 1 study that assessed undergraduate students age 18–50 years. |
| WEL | 123 | Comprises 5 second-order and 17 third-order dimensions— all are integrated into Wellness, a single higher order factor: 1) Creative Self (problem solving and creativity, sense of control, sense of humor, work, and emotional awareness); 2) Coping Self (realistic beliefs, leisure, stress management, and sense of worth); 3) Social Self (friendship and love); 4) Essential Self (spirituality, self-care, gender identity, and cultural identity); 5) Physical Self (exercise and nutrition) | >2 hours | 1) Our reviewers unable to find publicly available copy of 4F-Wel; 2) Not readily accessible; developers require a $15 charge for use; 3) 5F-Wel developers charge $15 fee | All the questions (items) reliably measured with internal consistency | The most validated wellness assessment tool to date; considered the gold standard of evidence-based wellness measurement | Thorough analysis of the WEL led to the development of an updated WEL: the Five-Factor WEL (5F-Wel) (91 items), which has demonstrated substantially improved psychometric properties over the original WEL. The 5F-Wel has been further paired down into a newer and shorter instrument: The Four-Factor WEL (4F-Wel) (56 items). The 4F-Wel can provide reliable scores for 4 distinct aspects of wellness: cognitive-emotional, relational, physical, and spiritual. It was used in 7 studies that assessed Korean American adolescents, undergraduate students, military cadets, midlife women, and adolescents 12–15 years old. |
| PWS | 36 | Dynamic and bi-directional PWS founded upon 3 core aspects that are inherently shared across all models of wellness: 1) multidimensionality; 2) balance among dimensions; 3) autogenesis and measures of wellness in 6 different dimensions: A) physical; B) spiritual; C) psychological; D) social; E) emotional; F) intellectual | <30 min | Free online | N/A | Evaluated for internal validity; consistent with previous wellness studies in an outpatient setting; demonstrated construct validity (Adams TB et al, 199830) | The PWS measures perceived health, not wellness, a problem that can be pinpointed in its failure to address health-risk behaviors common among college students, such as alcohol/ drug use, safety factors, and sexual behaviors (disadvantage); however, it has excellent utility in a clinical medical setting and is well-researched and supported (advantage). It was used in 3 studies that assessed military cadets and undergraduate students. |
| OLP | 131 | Focuses on self-discovery, preventive care, and healthy lifestyle habits, including measurements evaluating the dimensions 1) intellectual, 2) emotional, 3) social, 4) spiritual, 5) physical, 6) environmental health | 15– 20 min | Free online | Four of the 6 scales had test-retest stability above r=0.820 | Evaluated for internal validity and found to be consistent with previous wellness studies in an outpatient setting; Hunter & Leeder (2013)8 reported OLP had poor reliability and validity measures, indicating that more research needed to validate its use | The OLP was designed for a specific organization (Canyon Ranch) and has less literature supporting its use. It was used in 2 studies assessing military cadets. |
| HRA | N/A | Evaluates behaviors that contribute to health problems (e.g., smoking, drug use, alcohol use) | <1 hour | N/A | No data found within search parameters for the reliability | No data found withinsearch parameters for the validity | Because our working definition of wellness depends on the absence of disease or illness, something these tools do not assess or account for, HRAs cannot accurately measure wellness. It was used in 2 studies, assessing Highmark Inc. employees and patients in community primary care practices. |
| BMSWBCI | 44 | Measures 1) physical, 2) emotional, 3) intellectual, 4) occupational, 5) social, and 6) spiritual wellness dimensions | <1 hour | N/A | N/A | Researchers supported use of this instrument for evaluation of wellness among college population | The BMS-WBCI has been shown to be a strong and consistent measure of wellness among college students, although the assessment is limited to the population it addresses. It was used in 2 population studies, assessing college undergraduate students. |
| SWLS | 5 | Evaluates an individual’s satisfaction with his or her life | 5 mins | N/A | No data found within search parameters for the reliability | No data found within search parameters for the validity | It was used in 2 studies, assessing first-year family medicine residents and midlife women. |
| The Wellness Behavior Survey | 14 | Measures 1) diet/nutrition, 2) physical, 3) activity/exercise, 4) mind-body activities, 5) nurturing relationships, 6) sleep, 7) prayer, 8) being outdoors in nature, 9) tobacco and alcohol use, 10) prescription medication for mood or sleep | 15 mins | N/A | No data found within search parameters for the reliability | No data found within search parameters for the validity | The Wellness Behavior Survey reflects an evaluation of the operational definition of wellness of Rachele et al (2013),42 which emphasizes lifestyle behaviors that promote optimal states of being across multiple dimensions. It was used in 1 study, assessing first-year family medicine residents. |
| PWB | 42 item | Measures 6 dimensions of wellness: 1) autonomy, 2) environmental mastery, 3) personal growth, 4) positive relations with others, 5) purpose in life, 6) self-acceptance Data suggest possible 5-factor model, which would combine indicators of Self-Acceptance and Environmental Mastery because they were highly correlated; originally, each dimension was operationalized with 20 items to be 120 items in total, but there are 18-item versions (each dimension is 3 items) and 42-item versions (each dimension is 7 items). The response scale was a 6-point continuum, ranging from completely disagree to completely agree. | <1 hour | N/A | The 120-item scale showed high internal consistency and test-retest reliability. In the 18-item scale, estimates of internal consistency were low to modest, which likely reflects the small number of indicators per scale. Therefore, the 42-item scale shows more internal consistency than the 18-item scale but still less than the original 120-item scale. | The 120-item scale showed convergent and discriminant validity with other measures; In the 18-item scale, 18 items continue to meet psychometric criteria, with each item correlating strongly and positively with only its own scale; comparison of the theory-based indicators of well-being with other frequently used measures indicated moderate-to-strong associations between 2 scales (Self-Acceptance and Environmental Mastery) and single- and multi-item scales of happiness, life satisfaction, and depression; the remaining 4 dimensions of well-being (Positive Relations With Others, Purpose in Life, Personal Growth, Autonomy) showed mixed or weak relationships with these prior indicators. | As mentioned above, there is a difference between wellness and well-being. It is possible for someone to be in a state of well-being but not wellness. Well-being is not as encompassing as wellness. This scale was used in 1 study assessing noninstitutionalized English-speaking adults ≥25 years of age. |
N/A: not applicable; LAQ)/TestWell: Lifestyle Assessment Questionnaire; WI: Wellness Inventory; LCI: Life Coping Inventory; WEL: Wellness Evaluation of Lifestyle; PWS: Perceived Wellness Survey; OLP: Optimal Living Profile; HRA: Web-based Health Risk Assessment programs; BMS-WBCI: Body-Mind-Spirit Wellness Behavior and Characteristic Inventory; SWLS: The Satisfaction With Life Survey; PWB: Ryff’s psycological Well-being Scales