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ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Health Education and Promotion
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1452738

Development and validation of the multi-dimensional Health Resilience Scale for community-dwelling adults

Provisionally accepted
Lixia Ge Lixia Ge 1*Wan Fen Yip Wan Fen Yip 1Ruijie Li Ruijie Li 1Eric Chua Siang Seng Eric Chua Siang Seng 1Moon-Ho R Ho Moon-Ho R Ho 2Andy Hau Yan Ho Andy Hau Yan Ho 3Evon Chua Yiwen Evon Chua Yiwen 4Dolly Cheng Dolly Cheng 5Ian Leong Yi Onn Ian Leong Yi Onn 6Pann Pei Chieh Pann Pei Chieh 1Woan Shin Tan Woan Shin Tan 1
  • 1 Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore
  • 2 School of Social Sciences, Nanyang Technological University, Singapore, Singapore
  • 3 Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
  • 4 Population Health & Community Transformation, Yishun Health, Singapore, Singapore
  • 5 Clinical Operations (Integration Care), Woodlands Health, Singapore, Singapore
  • 6 Continuing and Community Care, Tan Tock Seng Hospital, Singapore, Singapore

The final, formatted version of the article will be published soon.

    Introduction: Resilience measures generally are not health specific, nor do they account for the multiple dimensions required for individuals to overcome health challenges. To bridge this gap, we developed and validated a multi-dimensional Health Resilience Scale (HRS) for community-dwelling adults in Singapore. Methods: We followed standard procedures to develop health resilience construct, identify dimensions, and generate potential items. Expert review and cognitive interviews were conducted to assess content validity and item clarity. The refined 35-item HRS was administered to 650 eligible community-dwelling adults in a cross-sectional survey, along with validation measures, to assess construct validity (including factorial, concurrent, convergent, and divergent validity) and internal consistency reliability. Results: Exploratory factor analysis revealed five factors with 22 items, each factor containing 3 to 5 items. Confirmatory factor analysis confirmed the five-factor structure with good model fit. The five factors identified in the analysis were conceptualised as the following dimensions of the HRS: “Health mindset”, “Perceived health access”, “Social resourcefulness”, “Relational support”, and “Adaptive adjustment”. The dimensions of “Health mindset”, “Perceived health access”, and “Adaptive adjustment” exhibited moderate and positive correlations with psychological resilience (concurrent validity) as well as hope and self-efficacy (convergent validity). All dimensions had weak or no correlation with maladaptive coping, depression, and anxiety measures (divergent validity). Individuals with better health status scored higher, while those with recent health adversity scored lower on the HRS, confirming divergent validity. Internal consistency reliability was confirmed with Cronbach's alpha exceeding 0.80 for the total scale and ranging from 0.73 to 0.88 for individual dimensions. Conclusions: The 22-item multi-dimensional HRS demonstrated good reliability and validity, making it an effective tool for assessing health resilience and guiding initiatives aimed to enhance well-being among community members.

    Keywords: Health resilience, scale, measure, assessment, psychometric properties, Validation

    Received: 21 Jun 2024; Accepted: 10 Jan 2025.

    Copyright: © 2025 Ge, Yip, Li, Chua Siang Seng, Ho, Ho, Chua Yiwen, Cheng, Leong Yi Onn, Chieh and Tan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Lixia Ge, Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.