Development of the What Matters 2 Adults (WM2A) wellbeing measure for Aboriginal and Torres Strait Islander adults

K Howard; G Garvey; K Anderson; M Dickson; R Viney; J Ratcliffe; M Howell; A Gall; J Cunningham; L J Whop; A Cass; A Jaure; B Mulhern

doi:10.1016/j.socscimed.2024.116694

Development of the What Matters 2 Adults (WM2A) wellbeing measure for Aboriginal and Torres Strait Islander adults

Soc Sci Med. 2024 Apr:347:116694. doi: 10.1016/j.socscimed.2024.116694. Epub 2024 Feb 16.

Authors

K Howard¹, G Garvey², K Anderson², M Dickson³, R Viney⁴, J Ratcliffe⁵, M Howell⁶, A Gall², J Cunningham⁷, L J Whop⁸, A Cass⁷, A Jaure⁹, B Mulhern⁴

Affiliations

¹ Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia. Electronic address: kirsten.howard@sydney.edu.au.
² The First Nations Cancer & Wellbeing Research Team, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane Qld 4072, Australia.
³ Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; The Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia.
⁴ The Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Ultimo, NSW, 2007, Australia.
⁵ Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, 5001, Australia.
⁶ Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia.
⁷ Menzies School of Health Research, Charles Darwin University, Darwin NT, Australia.
⁸ National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, 2600, Australia.
⁹ Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia.

PMID: 38569315
DOI: 10.1016/j.socscimed.2024.116694

Abstract

Purpose: As wellbeing is culturally bound, wellbeing measures for Aboriginal and Torres Strait Islander peoples must be culturally relevant and grounded in Aboriginal and Torres Strait Islander values and preferences. We describe the development of a nationally-relevant and culturally grounded wellbeing measure for Aboriginal and Torres Strait Islander adults: the What Matters to Adults (WM2A) measure.

Methods: We used a mixed methods approach to measure development, combining Indigenist methodologies and psychometric methods. Candidate items were derived through a large national qualitative study. Think-aloud interviews (n = 17) were conducted to assess comprehension, acceptability, and wording of candidate items. Two national surveys collected data on the item pool (n = 312, n = 354). Items were analysed using exploratory factor analysis (EFA), and item response theory (IRT) to test dimensionality, local dependence and item fit. A Collaborative Yarning approach ensured Aboriginal and Torres Strait Islander voices were privileged throughout.

Results: Fifty candidate items were developed, refined, and tested. Using EFA, an eight factor model was developed. All items met pre-specified thresholds for maximum endorsement frequencies, and floor and ceiling effects; no item redundancy was identified. Ten items did not meet thresholds for aggregate adjacent endorsement frequencies. During Collaborative Yarning, six items were removed based on low factor loadings (<0.4) and twelve due to conceptual overlap, high correlations with other items, endorsement frequencies, and/or low IRT item level information. Several items were retained for content validity. The final measure includes 32 items across 10 domains (Balance & control; Hope & resilience; Caring for others; Culture & Country; Spirit & identity; Feeling valued; Connection with others; Access; Racism & worries; Pride & strength).

Conclusions: The unique combination of Indigenist and psychometric methodologies to develop WM2A ensures a culturally and psychometrically robust measure, relevant across a range of settings and applications.

MeSH terms

Adult
Australian Aboriginal and Torres Strait Islander Peoples*
Emotions
Factor Analysis, Statistical
Health Services, Indigenous*
Humans
Indigenous Peoples
Psychometrics