Assessing the psychometric properties of the WHO-5 Well-being Index in conflict-affected humanitarian contexts

Children and adolescents living in conflict-driven humanitarian contexts face heightened risks of violence and abuse, which can significantly affect their immediate and long-term well-being. The evaluation of interventions to support adolescent well-being in these settings requires a validated, simple, yet robust measure of the broad construct of psychological well-being.

This study aimed to validate the WHO-5 Well-being Index, a short, self-reported instrument designed to assess subjective psychological well-being, for use with adolescents in two conflict- affected humanitarian contexts, including Colombia and Nigeria.

Participants (N = 172) were aged 13 to 17 years and resided in Colombia (n = 90) or Nigeria (n = 82). Exploratory and confirmatory factor analyses were conducted to assess the WHO-5 Index psychometric properties.

A one-factor structure of the WHO-5 Well-being Index was supported, showing high internal consistency (α and ω > 0.80), excellent convergent validity (assessed with the Kidscreen-27 scale, r = 0.797, p < 0.01), and acceptable discriminant validity (assessed with the PHQ-9 scale, r = -0.343, p < 0.001). Confirmatory factor analysis supported the one-factor model, initially with poor fit (CFI = 0.972, TLI = 0.944, RMSEA = 0.105). After accounting for covariance between items 3 and 4, the model fit improved significantly (CFI = 0.998, TLI = 0.994, RMSEA = 0.034).

This study reaffirms the WHO-5 Well-being Index as a valid instrument to assess the well-being of Spanish- and Hausa-speaking adolescents who have experienced family separation, abuse, violence, neglect, and/or exploitation in humanitarian contexts.