Validation of Psychometric Tools for Assessing Fatigue, Mood, and Sleep Quality: Application in the PREVES-STOP Study

Background and Objectives: Environmental pollution in regions like the Sarno River Basin in southern Italy significantly affects physical and psychological health. This study aimed to validate three novel psychometric tools-REST, HEAL-BDLC, and PEACE-for assessing fatigue, mood disturbances, and sleep quality in environmentally exposed populations. While correlations with heavy metal exposure will be addressed in a separate manuscript, this study focuses solely on psychometric validation. Materials and Methods: The PREVES-STOP Initiative recruited 88 participants aged 30-65 years from the Sarno River Basin. Participants completed psychometric questionnaires tailored to measure fatigue (REST), symptoms of depression and anxiety (HEAL-BDLC), and sleep quality (PEACE). Internal consistency, construct validity, and reliability were analyzed using Cronbach's alpha, correlation analyses, and principal component analysis (PCA). A subgroup received a nutraceutical intervention for us to explore their responsiveness to change over a two-week period. Results: REST (α = 0.969), HEAL-BDLC (α = 0.962), and PEACE (α = 0.736) demonstrated strong reliability. PCA confirmed the unidimensional structure of REST and the two-component structure of HEAL-BDLC (depression and anxiety dimensions) and PEACE (insomnia and sleep quality). Correlations with established measures, such as the WHO Well-Being Index, supported construct validity. Among the intervention participants, significant improvements were observed in fatigue (-12.5 REST median score), mood (-13.0 HEAL-BDLC median score), sleep (+1.5 PEACE median score), and overall well-being (+4.0 WHO-5 median score). Conclusions: REST, HEAL-BDLC, and PEACE are reliable and valid instruments for assessing nuanced health outcomes in environmentally exposed populations. They hold potential for guiding public health interventions and evaluating environmental remediation impacts. These findings lay the groundwork for future studies linking psychometric outcomes with heavy metal exposure.