Skip to main content
Log in

Multiple Dimensions of Wellness: Development and Psychometric Properties of the Anschutz Wellness Evaluation 360 (AWE 360)

  • Original Research
  • Published:
Journal of Well-Being Assessment

Abstract

Wellness is a construct that is commonly employed in the social and health science lexicon and has gained increased popular acceptance through the advent of wellness centers and programs. Though it is agreed that wellness is multidimensional, previous conceptualizations and assessments of wellness vary in both number and type of dimensions as well as in the psychometric adequacy of the assessments. This study’s purpose was to improve the current state of the wellness research by demonstrating the reliability and validity of the newly developed Anschutz Wellness Evaluation 360 (AWE 360), a comprehensive assessment of wellness that includes seven dimensions: perceived wellness, stress, financial stress, occupational wellness, sleep quality, diet quality, and physical activity. Three samples (Sample 1: N = 427; Sample 2: N = 100; Sample 3: N = 1711) completed the AWE 360 scales as well as commonly used measures of relevant constructs. Analyses included exploratory and confirmatory factor analyses, reliability analyses, and assessment of convergent and discriminant validity. After exploratory and confirmatory factor analyses, the final measure included eight scales. Reliability analyses indicated that the scales demonstrated adequate internal consistency. Correlational analyses provided early evidence for construct validity of the AWE 360. Results suggest the AWE 360 is an empirically supported measure with initial evidence for both reliability and validity. Future research should continue to explore the criterion validity and other psychometric properties of the AWE 360 as well as its practical ecological validity in applied and clinical settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Adams, T., Bezner, J., & Steinhardt, M. (1997). The conceptualization and measurement of perceived wellness: Integrating balance across and within dimensions. American Journal of Health Promotion, 11, 208–218. https://doi.org/10.4278/0890-1171-11.3.208.

    Article  Google Scholar 

  • Adams, T. B., Bezner, J. R., Drabbs, M. E., Zambarano, R. J., & Steinhardt, M. A. (2000). Conceptualization and measurement of the spiritual and psychological dimensions of wellness in a college population. College Health, 48, 165–173. https://doi.org/10.1080/07448480009595692.

    Article  Google Scholar 

  • Antonovsky, A. (1993). The structure and properties of the sense of coherence scale. Social Science & Medicine, 36, 725–733. https://doi.org/10.1016/0277-9536(93)90033-Z.

    Article  Google Scholar 

  • Appels, A., Bosma, H., Grabauskas, V., Gostautas, A., & Sturmans, F. (1996). Self-rated health and mortality in a Lithuanian and a Dutch population. Social Science & Medicine, 42(5), 681–689. https://doi.org/10.1016/0277-9536(95)00195-6.

    Article  Google Scholar 

  • Ardell, D. B. (1977). High level wellness strategies. Health Education, 8, 2–4.

    Article  Google Scholar 

  • Beauducel, A., & Herzberg, P. Y. (2006). On the performance of maximum likelihood versus means and variance adjusted weighted least squares estimation in CFA. Structural Equation Modeling, 13, 186–203. https://doi.org/10.1207/s15328007sem1302_2.

    Article  Google Scholar 

  • Block, G., & Subar, A. F. (1992). Estimates of nutrient intake from a food frequency questionnaire: The 1987 National Health Interview Survey. Journal of the American Dietetic Association, 92, 969–977.

    Google Scholar 

  • Brick, C. A., Seely, D. L., & Palermo, T. M. (2010). Association between sleep hygiene and sleep quality in medical students. Behavioral Sleep Medicine, 8, 113–121. https://doi.org/10.1080/15402001003622925.

    Article  Google Scholar 

  • Bureau of Labor Statistics. (2014, December). American time use survey: Charts from the American time use survey. Retrieved from http://www.bls.gov/tus/charts/#work. Accessed 27 Aug 2019.

  • Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh sleep quality index (PSQI): A new instrument for psychiatric research and practice. Psychiatry Research, 28(2), 193–213.

    Article  Google Scholar 

  • Campbell-Sills, L., & Stein, M. B. (2007). Psychometric analysis and refinement of the Connor-Davidson resilience scale (CD-RISC): Validation of a 10-item measure of resilience. Journal of Traumatic Stress, 20, 1019–1028. https://doi.org/10.1002/jts.20271.

  • Centers for Disease Control and Prevention (CDC). (2005). Behavioral risk factor surveillance system survey questionnaire. Atlanta: U.S. Department of Health and Human Services Centers for Disease Control and Prevention.

    Google Scholar 

  • Chipperfield, J. G. (1993). Incongruence between health perceptions and health problems: Implications for survival among seniors. Journal of Aging and Health, 5, 475–496. https://doi.org/10.1177/089826439300500404.

    Article  Google Scholar 

  • Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396. https://doi.org/10.2307/2136404.

    Article  Google Scholar 

  • Cohen, S., Janicki-Deverts, D., & Miller, G. E. (2007). Psychological stress and disease. The Journal of the American Medical Association, 14, 1685–1687. https://doi.org/10.1001/jama.298.14.1685.

    Article  Google Scholar 

  • Cooper, S. E. (1990). Investigation of the lifestyle assessment questionnaire. Measurement and Evaluation in Counseling and Development, 23, 83.

    Google Scholar 

  • Craig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., et al. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine & Science in Sports & Exercise, 35, 1381–1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB.

    Article  Google Scholar 

  • Crowne, D. P., & Marlowe, D. (1960). A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology, 24, 349–354. https://doi.org/10.1037/h0047358.

    Article  Google Scholar 

  • de Cabo, R., & Mattson, M. P. (2019). Effects of intermittent fasting on health, aging, and disease. New England Journal of Medicine, 381(26), 2541–2551. https://doi.org/10.1056/NEJMra1905136.

    Article  Google Scholar 

  • Diener, E., Emmons, R., Larsen, R., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75. https://doi.org/10.1207/s15327752jpa4901_13.

    Article  Google Scholar 

  • Dunn, H. L. (1959). What high-level wellness means. Canadian Journal of Public Health, 50, 447–457.

    Google Scholar 

  • Edinger, J., & Carney, C. (2008). Overcoming insomnia: A cognitive-behavioral therapy approach: Therapist guide. New York: Oxford University Press.

    Google Scholar 

  • Ellison, C. (1983). Spiritual well-being: Conceptualization and measurement. Journal of Psychology and Theology, 11, 330–340.

    Article  Google Scholar 

  • Frank, C., Davis, C. G., & Elgar, F. J. (2014). Financial strain, social capital, and perceived health during economic recession: A longitudinal survey in rural Canada. Anxiety, Stress, and Coping, 27, 422–438. https://doi.org/10.1080/10615806.2013.864389.

    Article  Google Scholar 

  • Godin, G., & Shephard, R. J. (1985). A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sport Sciences, 10, 141–146.

    Google Scholar 

  • Godin, G., Jobin, J., & Bouillon, J. (1986). Assessment of leisure time exercise behavior by self-report: A concurrent validity study. Canadian Journal of Public Health, 77, 359–362.

    Google Scholar 

  • Grigsby, M. (2015). Psychometric analysis of a new measure of religious homogamy within a couple: The spiritual homogamy and religious experiences (SHARE) scale (Master's thesis, University of Colorado Denver, Denver, USA). Available from ProQuest Dissertations & Theses Global database. (UMI No. 1598283).

  • Gutter, M., & Copur, Z. (2011). Financial behaviors and financial well-being of college students: Evidence from a national survey. Journal of Family and Economic Issues, 32, 699–714. https://doi.org/10.1007/s10834-011-9255-2.

    Article  Google Scholar 

  • Hackman, J. R., & Oldham, G. R. (1980). Work redesign. Reading: Addison-Wesley.

    Google Scholar 

  • Harari, M. J., Waehler, C. A., & Rogers, J. R. (2005). An empirical investigation of a theoretically based measure of perceived wellness. Journal of Counseling Psychology, 52, 93–103. https://doi.org/10.1037/0022-0167.52.1.93.

    Article  Google Scholar 

  • Harter, J. K., Schmidt, F. L., Killham, E. A., & Asplund, J. W. (2006). Q12® meta-analysis. Omaha: The Gallup Organization.

    Google Scholar 

  • Hattie, J. A., Myers, J. E., & Sweeney, T. J. (2004). A factor structure of wellness: Theory, assessment, analysis, and practice. Journal of Counseling & Development, 82, 354–364. https://doi.org/10.1002/j.1556-6678.2004.tb00321.x.

    Article  Google Scholar 

  • Hayton, J. C., Allen, D. G., & Scarpello, V. (2004). Factor retention decisions in exploratory factor analysis: A tutorial on parallel analysis. Organizational Research Methods, 7(2), 191–205. https://doi.org/10.1177/1094428104263675.

    Article  Google Scholar 

  • Hettler, B. (1984). Wellness: Encouraging a lifetime pursuit of excellence. Health Values, 8(4), 13–17.

  • Horn, J. L. (1965). A rationale and test for the number of factors in factor analysis. Psychometrika, 32, 179–185.

    Article  Google Scholar 

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55. https://doi.org/10.1080/10705519909540118.

    Article  Google Scholar 

  • Idler, E. L., & Angel, R. J. (1990). Self-rated health and mortality in the NHANES-I epidemiologic follow-up study. American Journal of Public Health, 80(4), 446–452. https://doi.org/10.2105/AJPH.80.4.446.

    Article  Google Scholar 

  • Jefferson, C. D., Drake, C. L., Scofield, H. M., Myers, E., McClure, T., Roehr, T., & Roth, T. (2005). Sleep hygiene practices in a population-based sample of insomniacs. Sleep, 28, 611–615.

    Article  Google Scholar 

  • Kelly, J. G. (2000). Wellness as an ecological enterprise. In D. Cicchetti, J. Rappaport, I. Sandler, & R. P. Weissberg (Eds.), Promotion of wellness in children and adolescents (pp. 101–131). Washington, DC: CWLA Press.

    Google Scholar 

  • Ladabaum, U., Mannalithara, A., Myer, P. A., & Singh, G. (2014). Obesity, abdominal obesity, physical activity, and caloric intake in US adults: 1988 to 2010. The American Journal of Medicine, 127, 717–727. https://doi.org/10.1016/j.amjmed.2014.02.026.

    Article  Google Scholar 

  • Lai, K., & Green, S. B. (2016). The problem with having two watches: Assessment of fit when RMSEA and CFI disagree. Multivariate Behavioral Research, 51, 220–239. https://doi.org/10.1080/00273171.2015.1134306.

    Article  Google Scholar 

  • Li, C.-H. (2016). Confirmatory factor analysis with ordinal data: Comparing robust maximum likelihood and diagonally weighted least squares. Behavior Research Methods, 48, 936–949. https://doi.org/10.3758/s13428-015-0619-7.

    Article  Google Scholar 

  • Linton, M.-J., Dieppe, P., & Medina-Lara, A. (2016). Review of 99 self-report measures for assessing well-being in adults: Exploring dimensions of well-being developments over time. BMJ Open, 6, e010641. https://doi.org/10.1136/bmjopen-2015-010641.

    Article  Google Scholar 

  • Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sydney: Psychology Foundation.

    Google Scholar 

  • Lucini, D., Zanuso, S., Blair, S., & Pagani, M. (2015). A simple healthy lifestyle index as a proxy of wellness: a proof of concept. Acta Diabetologica, 52(1), 81–89. https://doi.org/10.1007/s00592-014-0605-z.

  • Malone, K., Stewart, S. D., Wilson, J., & Korsching, P. F. (2010). Perceptions of financial well-being among American women in diverse families. Journal of Family and Economic Issues, 31, 63–81. https://doi.org/10.1007/s10834-009-9176-5.

    Article  Google Scholar 

  • Meng, Y., Bai, H., Wang, S., Li, Z., Wang, Q., & Chen, L. (2017). Efficacy of low carbohydrate diet for type 2 diabetes mellitus management: A systematic review and meta-analysis of randomized controlled trials. Diabetes Research and Clinical Practice, 131, 124–131. https://doi.org/10.1016/j.diabetes.2017.07.006.

    Article  Google Scholar 

  • Muthén, L. K., & Muthén, B.O. (1998-2017). Mplus user’s guide. Eighth Edition. Los Angeles, CA: Muthén & Muthén.

  • Myers, J. E., & Sweeney, T. J. (2004). The indivisible self: An evidence-based model of wellness. Journal of Individual Psychology, 60(3), 234–245.

  • Myers, J. E., Sweeney, T. J., & Witmer, J. M. (2000). The wheel of wellness counseling for wellness: A holistic model for treatment planning. Journal of Counseling & Development, 78, 251–266. https://doi.org/10.1002/j.1556-6676.2000.tb01906.x.

    Article  Google Scholar 

  • National Wellness Institute. (1983). Lifestyle Assessment Questionnaire (2nd ed.). Stevens Point: National Wellness Institute.

    Google Scholar 

  • O’Neill, B., Sorhanido, B., Xiao, J. J., & Garman, E. T. (2005). Financially distressed consumers: Their financial practices, financial well-being, and health. Financial Counseling and Planning, 16, 73–87.

    Google Scholar 

  • Okura, Y., Urban, L. H., Mahoney, D. W., Jacobsen, S. J., & Rodeheffer, R. J. (2004). Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. Journal of Clinical Epidemiology, 57, 1096–1103. https://doi.org/10.1016/j.jclinepi.2004.04.005.

    Article  Google Scholar 

  • Peterman, A. H., Fitchett, G., Brady, M. J., Hernandez, L., ∓ Cella, D. (2002). Measuring spiritual well-being in people with cancer: The functional assessment of chronic illness therapy - spiritual well-being sclae (FACIT-Sp). Annals of Behavioral Medicine, 24(1), 49–58.

  • Peel, N. M., McClure, R. J., & Bartlett, H. P. (2005). Behavioral determinants of healthy aging. American Journal of Preventative Medicine, 28, 298–304. https://doi.org/10.1016/j.amepre.2004.12.002.

    Article  Google Scholar 

  • Pond, S. B., & Geyer, P. D. (1991). Differences in the relation between job satisfaction and perceived work alternatives among older and younger blue-collar workers. Journal of Vocational Behavior, 39, 251c262. https://doi.org/10.1016/0001-8791(91)90012-B.

  • Poslusna, K., Ruprich, J., de Vries, J. H., Jakubikova, M., & van't Veer, P. (2009). Misreporting of energy and micronutrient intake estimated by food records and 24 hour recalls, control and adjustment methods in practice. British Journal of Nutrition, 101(S2), S73–S85. https://doi.org/10.1017/s0007114509990602.

    Article  Google Scholar 

  • Prawitz, A. D., Garman, E. T., Sorhaindo, B., O’Neill, B., Kim, J., & Drentea, P. (2006). InCharge financial distress/financial well-being scale: Development, administration, and score interpretation. Financial Counseling and Planning, 17, 34–50.

    Google Scholar 

  • R Core Team. (2020). R: A language and environment for statistical computing [compute software]. In R Foundation for statistical computing. Vienna: Austria.

    Google Scholar 

  • Renger, R. F., Midyett, S. J., Soto Mas, F. G., Erin, T. D., McDermott, H. M., Papenfuss, R. L., ...Hewitt, M. J. (2000). Optimal living profile: An invenotry to assess health and wellness. American Journal of Health Behavior, 24(6), 403–412.

  • Reynolds, W. M. (1982). Development of reliable and valid short forms of the Marlowe-Crowne social desirability scale. Journal of Clinical Psychology, 38, 119–125. https://doi.org/10.1002/1097-4679(198201)38:1%3C119::AID-JCLP2270380118%3E3.0.CO;2-I.

    Article  Google Scholar 

  • Roehleder, N. (2014). Stimulation of systemic low-grade inflammation by psychosocial stress. Psychosomatic Medicine, 76, 181–189. https://doi.org/10.1097/psy.0000000000000049.

    Article  Google Scholar 

  • Roscoe, L. J. (2009). Wellness: A review of theory and measurement for counselors. Journal of Counseling and Development, 87, 216–226. https://doi.org/10.1002/j.1556-6678.2009.tb00570.x.

    Article  Google Scholar 

  • Rutherford, L. G., & Fox, W. S. (2010). Financial wellness of young adults age 18-30. Family and Consumer Sciences Research Journal, 38, 468–484. https://doi.org/10.1111/j.1552-3934.2010.00039.x.

    Article  Google Scholar 

  • Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57(6), 1069–1081. https://doi.org/10.1037/0022-3514.57.6.1069.

    Article  Google Scholar 

  • SAS Institute Inc. (2012). The SAS system for windows (version 9.4) [computer software]. Cary: SAS Institute, Inc..

    Google Scholar 

  • Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the life orientation test. Journal of Personality and Social Psychology, 67, I063–I1078. https://doi.org/10.1037//0022-3514.67.6.1063.

  • Scheier, M. F., Wrosch, C., Baum, A., Cohen, S., Martire, L. M., Matthews, K. A., et al. (2006). The life engagement test: Assessing purpose in life. Journal of Behavioral Medicine, 29, 291–298. https://doi.org/10.1007/s10865-005-9044-1.

    Article  Google Scholar 

  • Schoenfeld, D. E., Malmrose, L. C., Blazer, D. G., Gold, D. T., & Seeman, T. E. (1994). Self-rated health and mortality in the high-functioning elderly–a closer look at healthy individuals: MacArthur field study of successful aging. Journal of Gerontology, 49(3), M109–M115.

    Article  Google Scholar 

  • Sears, L. E., Agrawal, S., Sidney, J. A., Castle, P. H., Rula, E. Y., Coberley, C. R., et al. (2014). The well-being 5: Development and validation of a diagnostic instrument to improve population well-being. Population Health Management, 17, 357–365. https://doi.org/10.1089/pop.2013.0119.

    Article  Google Scholar 

  • Segal-Isaacson, C. J., Wylie-Rosett, J., & Gans, K. M. (2004). Validation of a short dietary assessment questionnaire: The rapid eating and activity assessment for participants short version (REAP-S). The Diabetes Educator, 30, 774–781. https://doi.org/10.1177/014572170403000512.

    Article  Google Scholar 

  • Shapiro, G. L., & Burchell, B. J. (2012). Measuring financial anxiety. Journal of Neuroscience, Psychology, and Economics, 5, 92–103. https://doi.org/10.1037/a0027647.

    Article  Google Scholar 

  • Smith, A., Johal, S., Wadsworth, E., Smith, G. D., & Peters, T. (2000). The scale of occupational stress: The Bristol Stress and Health at Work Study. Bristol: Health and Safety Executive (HSE) Books.

    Google Scholar 

  • Spector, P. E. (1985). Measurement of human service staff satisfaction: Development of the job satisfaction survey. American Journal of Community Psychology, 13, 693–713. https://doi.org/10.1007/BF00929796.

    Article  Google Scholar 

  • Steger, M. F., Frazier, P., Oishi, S., & Kaler, M. (2006). The meaning in life questionnaire: Assessing the presence of and search for meaning in life. Journal of Counseling Psychology, 53, 80–93. https://doi.org/10.1037/0022-0167.53.1.80.

    Article  Google Scholar 

  • Strahan, R., & Gerbasi, K. C. (1972). Short, homogenous versions of the Marlowe-Crowne social desirability scale. Journal of Clinical Psychology, 28, 191–193.

    Article  Google Scholar 

  • U.S. Department of Health and Human Services and U.S. Department of Agriculture. (2015). 2015–2020 Dietary Guidelines for Americans. 8th Edition. Available at http://health.gov/dietaryguidelines/2015/guidelines/. Accessed 27 Aug 2019.

  • Wright, F. L., Green, J., Reeves, G., Beral, V., & Cairns, B. J. (2015). Validity over time of self-reported anthropometric variables during follow-up of a large cohort of UK women. BMC Medical Research Methodology, 15, 81. https://doi.org/10.1186/s12874-015-0075-1.

    Article  Google Scholar 

  • Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30–41. https://doi.org/10.1207/s15327752jpa5201_2.

    Article  Google Scholar 

  • Zong, G., Gao, A., Hu, F. B., & Sun, Q. (2016). Whole grain intake and mortality from all causes, cardiovascular disease, and cancer: A meta-analysis of prospective cohort studies. Circulation, 133, 2370–2380. https://doi.org/10.1161/CIRCULATIONHA.115.021101.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank Ella Chrenka for her assistance in running parallel analysis in R. We express our appreciation to the late Dr. Denise McGuire, whose contribution to this work was of great significance.

Funding

This research was supported by internal funds at the Anschutz Health and Wellness Center, University of Colorado Denver Anschutz Medical Campus.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephanie A. Hooker.

Ethics declarations

Disclosure of Conflicts of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance of the ethical standards of the Colorado Multiple Institutional Review Board and with the 1964 Helsinki declaration and its later amendments.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

ESM 1

(DOCX 467 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hooker, S.A., Masters, K.S., Ross, K.M. et al. Multiple Dimensions of Wellness: Development and Psychometric Properties of the Anschutz Wellness Evaluation 360 (AWE 360). J well-being assess 4, 95–119 (2020). https://doi.org/10.1007/s41543-020-00028-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41543-020-00028-y

Keywords

Navigation