The Multidimensional Health Questionnaire (MHQ)

Abstract

The Multidimensional Health Questionnaire (MHQ) is a comprehensive psychometric instrument designed to assess the complex range of cognitive, affective, and behavioral dimensions related to an individual’s physical health. Developed by Snell and Johnson in 1997, the MHQ utilizes a 100-item, 5-point Likert scale format to measure various facets of health perception, including perceived health status, motivation, anxiety, and Locus of Control regarding physical well-being. This scale provides researchers and practitioners with a detailed profile of how individuals think about, feel about, and manage their physical health, moving beyond simple objective measures to capture subjective health experience.

Keywords

Multidimensional Health Questionnaire, MHQ, Physical Health, Health Motivation, Health Anxiety, Health Behavior, Self-Efficacy, Health Status, Psychological scale

Authors

William E. Snell, Jr., Georgette Johnson

Purpose

The primary purpose of the Multidimensional Health Questionnaire (MHQ) is to provide a comprehensive, nuanced assessment of individuals’ orientations toward their own physical health. Unlike instruments that focus solely on health outcomes or singular psychological aspects, the MHQ was constructed to capture the multifaceted nature of physical health perception and management.

The instrument is intended for use in health psychology research, behavioral medicine, and clinical settings where a detailed understanding of the factors driving individual health maintenance and illness perception is required. By assessing multiple dimensions simultaneously, the MHQ facilitates the identification of specific psychological targets for health interventions, such as low self-efficacy or high health-related anxiety.

Construct

The MHQ is based on the premise that physical health is influenced by a diverse set of psychological factors, which can be categorized into several distinct constructs. These constructs typically include, but are not limited to:

• Health Status and Satisfaction: The individual’s subjective evaluation and satisfaction with their current physical condition.
• Health Motivation and Importance: The degree of desire and effort an individual dedicates to maintaining or improving their physical health.
• Health Locus of Control: Assessing whether the individual believes their health is controlled internally (by their own actions and efforts), by powerful others (doctors, family), or by external factors (chance, luck).
• Health Anxiety and Worry: The level of nervousness, preoccupation, or negative affect associated with thinking about one’s health or potential future illness.
• Health Self-Efficacy: Beliefs regarding one’s competence and ability to handle health issues and maintain physical well-being.
• Health Preoccupation: The extent to which one constantly thinks about and monitors their physical state.

Validity

The establishment of validity for the MHQ relies on demonstrating that the scale measures the constructs it purports to measure. Typically, validation studies of the MHQ focus on three key areas: construct validity, criterion validity, and face validity.

Construct Validity is primarily supported through factor analytic techniques, confirming that the 100 items load onto theoretically distinct subscales corresponding to the intended multidimensional constructs (e.g., Locus of Control, Motivation). Criterion Validity is often established by correlating MHQ subscale scores with established measures of related psychological variables (such as general anxiety or self-esteem) and with objective health outcomes or documented health behaviors (e.g., exercise frequency, diet adherence).

Reliability

Reliability refers to the consistency and stability of the MHQ scores over time and across items. High internal consistency is crucial for a multidimensional scale, ensuring that items within each specific subscale measure the same underlying trait.

The MHQ typically demonstrates acceptable to high levels of Internal Consistency, measured using Cronbach’s Alpha, across its various subscales. Additionally, Test-Retest Reliability studies confirm the temporal stability of the scores, indicating that an individual’s orientation toward their physical health remains consistent over reasonable periods, assuming no major health events intervene.

Factor Analysis

Given the scale’s name, Multidimensional Health Questionnaire, factor analysis is integral to its structure. The 100 items are structured to capture several distinct dimensions, suggesting that the scale is not unidimensional.

Exploratory and Confirmatory Factor Analysis (EFA/CFA) studies conducted during the development and subsequent validation of the MHQ confirmed the presence of multiple underlying factors. These factors allow researchers to calculate separate scores for specific aspects of health psychology, providing a richer data set than a single global health score. This factorial structure is essential for confirming the theoretical framework that health perception is a complex, multi-layered construct.

Instrument

Test Type: Self-report psychometric instrument

Format: 100 items administered using a 5-point Likert-type response scale. Responses range from A (Not at all characteristic of me) to E (Very characteristic of me).

Language Available: English (Original version)

Population Group: General adult population, frequently utilized among college student samples in early research.

Age Group: Generally 18 years and older.

Population Details: Suitable for assessing subjective physical health perceptions and related psychological constructs in non-clinical and research settings.

Test Methodology: Respondents indicate the extent to which each statement is characteristic of them by circling one of the five letters (A, B, C, D, or E).

Keywords

Health Perception, Self-Report Scale, Psychometrics, Affective Health, Health Responsibility, Physical Fitness, Health Anxiety, Health Locus of Control

Authors

Author ORCID Identifier: Not provided in the source material.

Affiliation Email addresses: [email protected] (Original correspondence email)

Correspondence Address: Not provided in the source material.

Permissions & Fee and Test Year

The test was published in 1997. The authors explicitly state that the instrument, or any part thereof, may not be reproduced in any form without prior permission. Permission requests should be directed to the corresponding author via the provided email address. Information regarding fees is not detailed in the source content.

Reference’s

• Snell, William E., Jr., & Johnson, Georgette. (1997). The Multidimensional Health Questionnaire. American Journal of Health Behavior, 21(1), 33.

Items of the The Multidimensional Health Questionnaire (MHQ)

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

EXAMPLE: Suppose you read the following statement:

….A..B..C..D..E……(1. I am in great physical health.

If you were not in great physical health, then you would circle the letter "A" to indicate that this statement is "not at all characteristic" of you. If the statement was "slightly characteristic" of you, then you would circle the letter "B." If the statement were "somewhat characteristic" of you, then you would circle the letter "C." By contrast, if you considered the statement to be "moderately characteristic" of you, then you would circle the letter "D" for that item. And finally, if the statement was "very characteristic" of you then you would indicate your response by circling the letter "E."

• 1. I feel anxious when I think about my health.
• 2. I have the ability to take care of any health problems that I may encounter.
• 3. I am very aware of how healthy my body feels.
• 4. I do things that keep me from becoming physically unhealthy.
• 5. The status of my physical health is determined mostly by chance happenings.
• 6. I think about my physical health all the time.
• 7. I’m very assertive when it comes to looking out for my own physical health.
• 8. I expect that my health will be excellent in the future.
• 9. I am to blame for those times when I become sick or don’t feel well.
• 10. I sometimes wonder what others think of my physical health.

• 11. I’m very motivated to be physically healthy.
• 12. When I am ill, I myself am in control of whether my health improves.
• 13. I derive a sense of self-pride from the way I handle my own physical health.
• 14. I am very satisfied with my own physical health.
• 15. The status of my physical health is determined largely by other more powerful people.
• 16. Not only am I in good physical health, but it’s quite important to me that I be in good health.
• 17. I am in good physical health.
• 18. If I am careful to avoid becoming ill, then I will be in good physical health-shape.
• 19. I am depressed about my current physical health.
• 20. I feel like my physical health is something that I myself am in charge of.
• 21. I’m worried about how healthy my body is.
• 22. I am competent enough to make sure that my physical health is in good shape.
• 23. I notice immediately when my body doesn’t feel healthy.
• 24. I am motivated to keep myself from becoming physically unhealthy.
• 25. The status of my physical health is controlled by accidental happenings.
• 26. I think about my physical health more than anything else.
• 27. I’m very direct with people when it comes to my own physical health needs.

• 28. I believe that the future status of my physical health will be positive.
• 29. When I become sick or ill, I am the person to blame.
• 30. I’m very concerned with how others evaluate my physical health.
• 31. I’m strongly motivated to devote time and effort to my physical health.
• 32. During times when I am sick, my own behavior determines whether I get well.
• 33. I am proud of the way I deal with and handle my health.
• 34. I am very satisfied with the status of my physical health.
• 35. My physical health is largely controlled by people other than myself (e.g., friends, family).
• 36. Not only do I take care of my physical health, but its very important to me that I do so.
• 37. My body is in good physical shape.
• 38. I can pretty much prevent myself from becoming ill by taking good care of myself.
• 39. I am disappointed about the quality of my physical health.
• 40. My health is something that I alone am responsible for.
• 41. Thinking about my physical health leaves me with an uneasy feeling.
• 42. I have the skills and ability to ensure good physical health for myself.
• 43. I’m sensitive to internal bodily cues about my physical health.
• 44. I try to avoid engaging in behaviors that undermine my physical health.
• 45. Whether (or not) I am in good physical health is just a matter of luck.

• 46. I tend to be preoccupied with my own physical health.
• 47. I am somewhat passive about getting my health needs met.
• 48. I do not expect to suffer health problems in the future.
• 49. If I were to become ill, then I’m to blame for not taking good care of myself.
• 50. I’m very aware of what others think of my physical health.
• 51. I have a strong desire to keep myself physically healthy.
• 52. If I were to become ill, I myself would be responsible for making myself better.
• 53. I am pleased with how well I handle my own physical health.
• 54. My present degree of physical health is personally satisfying to me.
• 55. My health is largely determined by the actions of powerful others (e.g., health professionals).
• 56. Not only am I in good physical health, but it’s important to me that I stay physically healthy.
• 57. I am a well-exercised person.
• 58. If I look out for my health, then I will stay in good physical healthy and avoid illness.
• 59. When I think about my current physical health, I feel really down in the dumps.
• 60. The status of my physical health is determined largely by what I do (and don’t do).
• 61. I usually worry about whether I am in good health.
• 62. I am able to cope with and to handle my physical health needs.
• 63. I know immediately when I’m not feeling physically well.

• 64. I really want to prevent myself from getting out of shape.
• 65. My physical health and shape have little or nothing to do with luck.
• 66. I’m constantly thinking about my physical fitness.
• 67. I do not hesitate to ask for what I need for my physical health.
• 68. I will probably experience a number of health problems in the future.
• 69. If I were to start feeling sick, then it would be my own fault for letting it happen.
• 70. I’m concerned about how my physical health appears to others.
• 71. It’s really important to me that I keep myself in proper physical health.
• 72. Whether I recover from an illness depends in large part on what I myself do.
• 73. I have positive feelings about the way I approach my own physical health.
• 74. My current level of physical fitness is very pleasing to me.
• 75. In order to have good health, I have to act in a pleasing way to other more powerful individuals.
• 76. I keep myself physically healthy, and it’s very important to me that I stay fit and healthy.
• 77. My body needs a lot of work in be in excellent physical shape.
• 78. I will be able to avoid any illnesses, if I just take care of myself.
• 79. I feel unhappy about my physical health.
• 80. What happens to my physical health is my own doing.
• 81. I feel nervous when I think about the status of my physical health.
• 82. I have the capability to take care of my own physical health.
• 83. I’m very aware of changes in my physical health.
• 84. I am really motivated to avoid being in terrible physical shape.

• 85. I don’t believe that chance or luck play any role in the status of my physical health.
• 86. I think about my physical health the majority of the time.
• 87. When it comes to my own physical health requirements, I ask for what I need.
• 88. I anticipate that my physical health will deteriorate in the future.
• 89. When something goes wrong with my own physical health, it’s my own fault.
• 90. I’m concerned about what other people think of my physical health.
• 91. I strive to keep myself in tip-top physical shape.
• 92. If I were ill, my recovery would depend on how I myself deal with the problem.
• 93. I feel good about the way I cope with my own physical health needs.
• 94. When I think about my present physical health, I am very satisfied.
• 95. My physical health is largely determined by people who have influence and control over me.
• 96. I try to stay in good physical condition, and its extremely important to me that I do so.
• 97. My physical health is in need of attention.
• 98. If I just pay attention to my health, I will be able to prevent myself from becoming sick.
• 99. I feel sad when I think about my present physical health.
• 100. Being in good physical health is a matter of my own ability and effort.

The original instrument can be found online at: http://www4.semo.edu/snell/scales/MHQ.htm

A = Not at all characteristic of me.

B = Slightly characteristic of me.

C = Somewhat characteristic of me.

D = Moderately characteristic of me.

E = Very characteristic of me.