Wellness Beliefs Scale (WBS)

Abstract

The Wellness Beliefs Scale (WBS) is a psychometric instrument developed by Bishop and Yardley (2010) designed to measure lay definitions of health. This scale addresses the need for a standardized measure that captures how ordinary individuals conceptualize and define their own state of health and wellness, moving beyond purely clinical or objective indicators. The WBS comprises 21 items structured across three distinct subscales: Functional, Biomedical, and Wellbeing. It utilizes a 7-point Likert-type scale to assess the importance of these dimensions to an individual’s personal definition of health. The scale is valuable for researchers in health psychology and behavioral medicine seeking to understand the subjective experiences that drive health-related behaviors and coping mechanisms.

Keywords

Wellness Beliefs Scale, WBS, lay definitions of health, health psychology, functional health, biomedical model, subjective well-being, health assessment, psychometrics.

Authors

Bishop, F., & Yardley, L.

Purpose

The primary purpose of the Wellness Beliefs Scale (WBS) is the robust measurement of lay concepts of health. Historically, much of health measurement has focused on objective, clinical measures of disease or impairment. The WBS seeks to quantify the subjective standards individuals use to determine if they consider themselves healthy or well.

By capturing these personal standards, the instrument allows researchers to explore how these beliefs influence health-related decision-making, illness management, and adherence to medical advice. Understanding these personal definitions is crucial for developing effective health promotion and intervention strategies that resonate with the target population’s own understanding of health.

Construct

The WBS measures the psychological construct of lay definitions of health, conceptualized as a multi-dimensional structure. This approach acknowledges that individuals rarely define health based on a single criterion, but rather integrate concepts related to physical state, functional capacity, and subjective emotional well-being.

The construct is divided into three empirically derived dimensions, reflecting comprehensive standards of health:

• Functional Dimension: Focuses on the ability to perform daily activities, fulfill responsibilities, and maintain routines despite any underlying physical conditions.
• Biomedical Dimension: Focuses on the absence of disease, illness, medical signs, or diagnosed health problems, aligning with traditional medical models.
• Wellbeing Dimension: Focuses on subjective positive states, such as feeling energized, enjoying life, feeling strong (physically and emotionally), and experiencing balance.

Validity

Initial validation studies conducted by Bishop and Yardley (2010) established the structural and content validity of the WBS. Content validity was ensured through extensive development, drawing items from lay interviews and existing literature on health perceptions.

Construct validity was supported through the demonstration of the hypothesized three-factor structure using advanced statistical techniques, suggesting that the scale effectively measures the distinct dimensions of Functional, Biomedical, and Wellbeing beliefs. Furthermore, the scale demonstrated appropriate convergent and discriminant validity with established measures of quality of life and general health status, confirming its utility as a unique measure of personal health definitions.

Reliability

The WBS exhibits strong internal consistency across its subscales, indicating high reliability. In the original validation work, the Cronbach’s alpha coefficients for the three subscales—Functional, Biomedical, and Wellbeing—were consistently reported at acceptable or high levels (typically above .80).

This high level of internal reliability confirms that the items within each dimension are highly intercorrelated and measure a single, coherent underlying construct. Test-retest reliability data also supported the stability of the scale over time, suggesting that an individual’s core health beliefs remain relatively consistent.

Factor Analysis

The development of the WBS utilized factor analytic techniques to refine the item set and confirm the hypothesized dimensional structure. Exploratory Factor Analysis (EFA) was initially employed to identify the underlying factors from the pool of items derived from qualitative research.

The subsequent Confirmatory Factor Analysis (CFA) provided strong evidence for the three-factor model (Functional, Biomedical, and Wellbeing) as the best fit for the data. This robust statistical foundation ensures that the scale scores accurately reflect the three distinct components of lay health definitions, thereby improving the scale’s theoretical and practical utility in health research.

Instrument

Test Type: Self-report Psychological scale

Format: 21 items, scored on a 7-point Likert scale.

Language Available: Primarily English (original validation).

Population Group: General adult population (laypersons).

Age Group: Adults (typically 18+).

Population Details: The scale is designed for use with individuals without specialized medical training, focusing on subjective, non-expert health concepts or lay definitions.

Test Methodology: Respondents rate how important each belief (item) is to their personal definition of health, using a 7-point scale ranging from (1) Not Important At All to (7) Very Important.

Keywords

Health beliefs, health perception, subjective health, self-rated health, functional health, well-being, behavioral medicine, psychometric tool, Bishop and Yardley.

Authors

Author ORCID Identifier: Not specified in source materials (Requires external search of original paper).

Affiliation Email addresses: Not specified in source materials.

Correspondence Address: Not specified in source materials.

Permissions & Fee and Test Year

The Wellness Beliefs Scale was initially published and validated in 2010. Researchers interested in using the scale should consult the primary authors or the publishing journal (Psychology & Health) regarding specific permissions and potential licensing fees for commercial use. For academic research, the instrument is generally accessible, often without charge, provided proper citation is used.

The original PDF of the scale and related information can be downloaded here: https://eprints.soton.ac.uk/73650/1/Wellness_Beliefs_Scale_PostPrint.pdf

Reference’s

• Bishop, F., & Yardley, L. (2010). The development and initial validation of a new measure of lay definitions of health: The Wellness Beliefs Scale. Psychology & Health, 25(3), 271–287.
• Bishop & Yardley, (2010). Wellness Beliefs Scale. In: Simmons C. A., Lehmann P. (eds). Tools for strengths-based assessment and evaluation, New York, NY: Springer, pp. 141-142. (2013). Google Scholar

Items of the Wellness Beliefs Scale (WBS)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The 21 items are categorized into three subscales based on the factor structure: Functional, Biomedical, and Wellbeing. Respondents rate the importance of each item to their definition of health using the scale: (7) Very Important to (1) Not Important At All.

• 1. There is no evidence I have any health problems (Biomedical)
• 2. I can fulfill my everyday responsibilities (Functional)
• 3. I have no medical signs of illness (Biomedical)
• 4. I am enjoying life (Wellbeing)
• 5. I feel good (Wellbeing)
• 6. I can perform my regular chores (Functional)
• 7. There are no indications that I am ill (Biomedical)
• 8. I can carry out my normal activities (Functional)
• 9. I can do what I need to do (Functional)
• 10. I feel full of energy (Wellbeing)
• 11. I am free of disease (Biomedical)
• 12. Health problems do not stop me from carrying out my usual tasks (Functional)
• 13. I feel I am functioning to my full potential (Wellbeing)
• 14. I can keep up my daily routine (Functional)
• 15. I have a lot of get up and go (Wellbeing)
• 16. I do not have any illness (Biomedical)
• 17. I can carry on as usual in my life (Functional)
• 18. I have no warning signs of disease (Biomedical)
• 19. I feel physically and emotionally strong (Wellbeing)
• 20. I do not have any diagnosed health problems (Biomedical)
• 21. My life is in balance (Wellbeing)

The scoring key for the subscales is as follows: Functional (Items 2, 6, 8, 9, 12, 14, and 17); Biomedical (Items 1, 3, 7, 11, 16, 18, and 20); Wellbeing (Items 4, 5, 10, 13, 15, 19, and 21).