Heba Yaagoub AlNujaidi, Saja A Al-Rayes, Arwa Alumran, Omar Y Almukhadhib, Danya Y AlNujaidi, Ibrahim A Alhafid, Ghada F Alyousif
ER-WELL demonstrates strong psychometric properties as a culturally validated measure of holistic wellness for Saudi women. The bifactor ESEM solution supports the simultaneous use of overall wellness scores alongside domain-specific profiles for Physical, Financial, Mental, and Occupational wellness for research, surveillance, and intervention evaluation in Saudi Arabia and similar Arab and Muslim-majority contexts.
BACKGROUND: Wellness is a multidimensional latent construct whose valid assessment requires psychometrically robust, culturally adapted instruments; however, existing scales have been predominantly developed in Western contexts and remain inadequate for capturing the gendered and sociocultural dimensions of women's wellness in non-Western settings. This study aimed to develop and psychometrically validate the HER-WELL scale, a culturally adapted multidimensional measure of holistic wellness for Saudi women.
METHODS: Scale development followed Boateng et al.'s (2018) framework, and construct validity was tested in RStudio and Mplus by comparing six measurement models (final CFA, ESEM, second-order CFA, bifactor CFA, second-order ESEM, bifactor ESEM) estimated with robust WLSMV and TARGET rotation in a stratified community sample of Saudi women (N = 1,068; 531 employed, 537 non-employed), with model fit (CFI, TLI, RMSEA, SRMR) evaluated against conventional and Dynamic Fit Index cutoffs.
RESULTS: HER-WELL items showed adequate variability, with the highest endorsement for Home Environment, social, and spiritual wellness and the lowest for physical wellness. Across employed, non-employed, and full samples, bifactor ESEM consistently provided the best representation of the data, with excellent fit (CFI ≈.99, TLI ≈.98, RMSEA ≈.03, SRMR ≈.02) that exceeded both conventional and DFI-tailored cutoffs. This structure supported a strong general women's wellness factor, with Physical, Financial, Mental, and Occupational wellness retaining sufficient domain-specific variance, while Emotional, Social, Spiritual, and Home Environmental wellness were more strongly saturated by the general factor and are best interpreted as expressions of overall wellness. Internal consistency was acceptable for most domains (ω and α typically ≥.80), with Home Environmental wellness showing the weakest reliability and specific-factor indices of any domain (ω ≈.77; AVE =.070-.122), and should be interpreted only via the total score.
CONCLUSION: ER-WELL demonstrates strong psychometric properties as a culturally validated measure of holistic wellness for Saudi women. The bifactor ESEM solution supports the simultaneous use of overall wellness scores alongside domain-specific profiles for Physical, Financial, Mental, and Occupational wellness for research, surveillance, and intervention evaluation in Saudi Arabia and similar Arab and Muslim-majority contexts.