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Development and psychometric evaluation of the public health surveillance well-being scale



To develop and psychometrically evaluate the brief Public Health Surveillance Well-Being Scale (PHS-WB) that captures mental, physical, and social components of well-being.


Using data from 5,399 HealthStyles survey respondents, we conducted bi-factor, item response theory, and differential item functioning analyses to examine the psychometric properties of a pool of 34 well-being items. Based on the statistical results and content considerations, we developed a brief 10-item well-being scale and assessed its construct validity through comparisons of demographic subgroups and correlations with measures of related constructs.


Based on the bi-factor analyses, the items grouped into both an overall factor and individual domain-specific factors. The PHS-WB scale demonstrated good internal consistency (alpha = 0.87) and correlated highly with scores for the entire item pool (r = 0.94). The well-being scale scores differed as expected across demographic groups and correlated with global and domain-specific measures of similar constructs, supporting its construct validity.


The 10-item PHS-WB scale demonstrates good psychometric properties, and its high correlation with the item pool suggests minimal loss of information with the use of fewer items. The brief PHS-WB allows for well-being assessment on national surveys or in other situations where a longer form may not be feasible.

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Fig. 1


  1. About 68% of a population sample will have T scores that range between 40 and 60, 1 standard deviation above and below the mean.

  2. SAS and SPSS programs for computing the scores are available by contacting the authors.



Healthy People 2020


Centers for Disease Control and Prevention


Behavioral Risk Factor Surveillance System


World Health Organization


Patient-Reported Outcomes Measurement Information System


Comparative Fit Index


Tucker-Lewis Fit Index


Standardized Root Mean Square Residual


Item response theory


Differential item functioning


Classification and regression tree


Socioeconomic status


National Health Interview Survey


Health-related quality of life


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Correspondence to C. M. Bann.

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Bann, C.M., Kobau, R., Lewis, M.A. et al. Development and psychometric evaluation of the public health surveillance well-being scale. Qual Life Res 21, 1031–1043 (2012).

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  • Well-being
  • Scale development
  • Quality of life
  • Item response theory
  • Factor analysis
  • Differential item functioning