Validation of the Bangla WHO-5 well-being index among gender and sexually diverse people in Bangladesh.

BACKGROUND

One of the core features of mental health is psychological well-being, which includes enjoyment, pleasure, happiness, fulfillment, and resilience. Assessing psychological well-being might be a useful indicator in determining the effectiveness of a research study or the appropriateness of a clinical intervention. The gender and sexually diverse people (GSDP), including men who have sex with men (MSM), male sex workers (MSW), and transgender women (hijra), are subject to widespread stigma and discrimination in Bangladesh that imposes a great mental health burden by compromising their mental health and well-being. The Bangla WHO-5 Well-being Index may be considered a promising and useful instrument for assessing the well-being of GSDP. However, the psychometric properties of the Bangla WHO-5 Well-being Index on GSDP have never been explored in Bangladesh.

METHODS

Data were collected from 229 GSDP, including self-identified gay men, during their screening for enrollment in a Pre-exposure prophylaxis (PrEP) pilot intervention. The WHO-5 Well-being Index (WHO-5) was administered between February 2022 and August 2022. Confirmatory factor analysis, along with reliability and validity assessments of the WHO-5, were conducted using IBM SPSS software version 24 and AMOS 18.

RESULTS

The scale showed very good results with regard to internal consistency, where Cronbach's alpha value was found to be 0.856. With regard to divergent validity, the scale manifested a significant negative correlation with depression (r= -0.753, p < 0.01), anxiety (r= -0.614, p < 0.01), and stress (r= -0.702, p < 0.01) subscales of the Bangla Depression Anxiety and Stress (DASS-21) scale. Convergent validity was supported by Average Variance Extracted (0.64) and Composite Reliability (0.89) values. The single-factor structure of the scale was confirmed by the confirmatory factor analysis (χ = 8.244, χ/df = 1.648, GFI = 0.989, RMSEA = 0.053, TLI = 0.986, CFI = 0.993, and SRMR = 0.0218).

CONCLUSIONS

Findings of the present analysis indicate that the Bangla WHO-5 Well-being Index is a valid and reliable instrument to assess psychological well-being among GSDP in Bangladesh and is comparable with the original version of the scale in terms of psychometric properties.