title: Development and Validation of an Instrument to Evaluate Perceived Wellbeing Associated with the Ingestion of Water: The Water Ingestion-Related Wellbeing Instrument (WIRWI).
abstract: BACKGROUND
  Ingestion of water has been associated with general wellbeing. When water intake is insufficient, symptoms such as thirst, fatigue and impaired memory result. Currently there are no instruments to assess water consumption associated with wellbeing. The objective of our study was to develop and validate such an instrument in urban, low socioeconomic, adult Mexican population.
  
  
  METHODS
  To construct the Water Ingestion-Related Wellbeing Instrument (WIRWI), a qualitative study in which wellbeing related to everyday practices and experiences in water consumption were investigated. To validate the WIRWI a formal, five-process procedure was used. Face and content validation were addressed, consistency was assessed by exploratory and confirmatory psychometric factor analyses, repeatability, reproducibility and concurrent validity were assessed by conducting correlation tests with other measures of wellbeing such as a quality of life instrument, the SF-36, and objective parameters such as urine osmolality, 24-hour urine total volume and others.
  
  
  RESULTS
  The final WIRWI is composed of 17 items assessing physical and mental dimensions. Items were selected based on their content and face validity. Exploratory and confirmatory factor analyses yielded Cronbach's alpha of 0.87 and 0.86, respectively. The final confirmatory factor analysis demonstrated that the model estimates were satisfactory for the constructs. Statistically significant correlations with the SF-36, total liquid consumption and simple water consumption were observed.
  
  
  CONCLUSIONS
  The resulting WIRWI is a reliable tool for assessing wellbeing associated with consumption of plain water in Mexican adults and could be useful for similar groups.
authors.affiliation: Nutritional Epidemiology, Nutrition and Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Morelos, México.
authors.forename: Juan
authors.initials: J
authors.lastname: Espinosa-Montero
authors.affiliation: Nutritional Epidemiology, Nutrition and Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Morelos, México.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Monterrubio-Flores
authors.affiliation: Academic Operation, Academic Secretary, Mexican National Institute of Public Health, Cuernavaca, Morelos, México.
authors.forename: Marcela
authors.initials: M
authors.lastname: Sanchez-Estrada
authors.affiliation: Kidney Health, Danone Research, Palaiseau, France.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Buendia-Jimenez
authors.affiliation: Independent consultant, Westwood, Massachusetts, United States of America.
authors.forename: Harris R
authors.initials: HR
authors.lastname: Lieberman
authors.affiliation: Medical Evaluation, ESC Dijon-Bourgogne, Dijon, France.
authors.forename: François-Andre
authors.initials: FA
authors.lastname: Allaert
authors.affiliation: Nutritional Epidemiology, Nutrition and Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Morelos, México.
authors.forename: Simon
authors.initials: S
authors.lastname: Barquera
mesh_terms: D000328:Adult; D004326:Drinking; D004435:Eating; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011203:Poverty; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D057185:Sedentary Behavior; D014505:Urban Population; D014867:Water; D055815:Young Adult
chemical_list: D014867:Water