title: Warwick-Edinburgh Mental Well-being Scale (WEMWBS): validated for teenage school students in England and Scotland. A mixed methods assessment.
abstract: BACKGROUND
  Understanding and measuring mental health and wellbeing amongst teenagers has recently become a priority. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is validated for measuring mental wellbeing in populations aged 16 years and over in the UK. We report here a study designed to establish the validity and reliability of WEMWBS in teenagers in the UK.
  
  
  METHODS
  WEMWBS and comparator scales, together with socio-demographic information and self-reported health, were incorporated into a self-administered questionnaire given to pupils aged 13 to 16 years in six schools in Scotland and England. Psychometric properties including internal consistency, correlations with comparator scales, test-retest stability and unidimensionality were investigated for WEMWBS. Twelve focus groups were undertaken to assess acceptability and comprehensibility of WEMWBS and were taped, transcribed and analysed thematically.
  
  
  RESULTS
  A total of 1,650 teenagers completed the questionnaire (response rate 80.8%). Mean WEMWBS score was 48.8 (SD 6.8; median 49). Response scores covered the full range (from 14 to 70). WEMWBS demonstrated strong internal consistency and a high Cronbach's alpha of 0.87 (95% CI (0.85-0.88), n = 1517). Measures of construct validity gave values as predicted. The correlation coefficient for WEMWBS total score and psychological wellbeing domain of the Kidscreen-27 was 0.59 (95% CI [0.55; 0.62]); for the Mental Health Continuum Short Form (MHC-SF) was 0.65, 95% CI [0.62; 0.69]; and for the WHO (WHO-5) Well-being Index 0.57 (95% CI [0.53; 0.61]). The correlation coefficient for the Strengths and Difficulties Questionnaire (SDQ) was -0.44 (95% CI [-0.49; -0.40]) and for the 12-item General Health Questionnaire (GHQ12) -0.45 (95% CI [-0.49; -0.40]). Test-retest reliability was acceptable (Intraclass correlation coefficient (ICC) 0.66 (95% CI [0.59; 0.72] n = 212)). Confirmatory factor analysis demonstrated one underlying factor. WEMWBS was significantly associated with the Family Affluence Score (WEMWBS increased with increasing household socio-economic status) and had a positive association with the physical health dimension of the Kidscreen-27, but was unrelated to age, gender or location/school. Eighty students took part in focus groups. In general, although some students considered some items open to misunderstanding or misinterpretation, WEMWBS was received positively and was considered comprehensible, and acceptable.
  
  
  CONCLUSIONS
  WEMWBS is a psychometrically strong population measure of mental wellbeing, and can be used for this purpose in teenagers aged 13 and over.
authors.affiliation: Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK. aileen.clarke@warwick.ac.uk
authors.forename: Aileen
authors.initials: A
authors.lastname: Clarke
authors.forename: Tim
authors.initials: T
authors.lastname: Friede
authors.forename: Rebecca
authors.initials: R
authors.lastname: Putz
authors.forename: Jacquie
authors.initials: J
authors.lastname: Ashdown
authors.forename: Steven
authors.initials: S
authors.lastname: Martin
authors.forename: Amy
authors.initials: A
authors.lastname: Blake
authors.forename: Yaser
authors.initials: Y
authors.lastname: Adi
authors.forename: Jane
authors.initials: J
authors.lastname: Parkinson
authors.forename: Pamela
authors.initials: P
authors.lastname: Flynn
authors.forename: Stephen
authors.initials: S
authors.lastname: Platt
authors.forename: Sarah
authors.initials: S
authors.lastname: Stewart-Brown
mesh_terms: D000293:Adolescent; D004739:England; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008603:Mental Health; D010549:Personal Satisfaction; D011594:Psychometrics; D012606:Scotland; D011795:Surveys and Questionnaires / Q000592:standards*