Development and Validation of a Brief Measure of Sexual Wellbeing for Population Surveys

The Natsal Sexual Wellbeing Measure (Natsal-SW)

Bibliographic Data

ID6457527
AuthorsKirstin R Mitchell (0000-0002-4409-6601, University of Glasgow, corresponding author), Melissa Palmer (0000-0003-3937-8070, Royal Society of Tropical Medicine and Hygiene), Melissa J Palmer (London School of Hygiene & Tropical Medicine), Ruth Lewis (0000-0002-6768-6188, University of Glasgow), Raquel Bosó Pérez (0000-0001-7342-4566, University of Glasgow), Karen Maxwell (0000-0002-2264-6510, Glasgow Caledonian University), Wendy Macdowall (0000-0001-5868-8336, London School of Hygiene & Tropical Medicine), David Reid (0000-0002-8743-2070, London School of Hygiene & Tropical Medicine), Chris Bonell (0000-0002-6253-6498, London School of Hygiene & Tropical Medicine), Catherine H Mercer (0000-0002-4220-5034, University College London), Pam Sonnenberg (0000-0002-1067-1583, University College London), J Dennis Fortenberry (0000-0001-6612-176X, Indiana University), The Natsal-4 team
Year2023
Volume62
Issue1
Pages1-11
Publication date2023-12-21
Open AccessYes
TypeARTICLE
VenueThe Journal of Sex Research (JOURNAL)
Journal identifiersISSN: 0022-4499 • E-ISSN: 1559-8519
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/00224499.2023.2278530
PMID38127808
OpenAlexW4390062730
LanguageEN
Citations received9
References cited43

Sexual wellbeing is an important aspect of population health. Addressing and monitoring it as a distinct issue requires valid measures. Our previous conceptual work identified seven domains of sexual wellbeing: security; respect; self-esteem; resilience; forgiveness; self-determination; and comfort. Here, we describe the development and validation of a measure of sexual wellbeing reflecting these domains. Based on the analysis of 40 semi-structured interviews, we operationalized domains into items, and refined them via cognitive interviews, workshops, and expert review. We tested the items via two web-based surveys (n = 590; n = 814). Using data from the first survey, we carried out exploratory factor analysis to assess and eliminate poor performing items. Using data from the second survey, we carried out confirmatory factor analysis to examine model fit and associations between the item reduced measure and external variables hypothesized to correlate with sexual wellbeing (external validity). A sub-sample (n = 113) repeated the second survey after 2 weeks to evaluate test-retest reliability. Confirmatory factor analysis indicated that a "general specific model" had best fit (RMSEA: 0.064; CFI: 0.975, TLI: 0.962), and functioned equivalently across age group, gender, sexual orientation, and relationship status. The final Natsal-SW measure comprised 13 items (from an initial set of 25). It was associated with external variables in the directions hypothesized (all p < .001), including mental wellbeing (0.454), self-esteem (0.564), body image (0.232), depression (-0.384), anxiety (-0.340), sexual satisfaction (0.680) and sexual distress (-0.615), and demonstrated good test-retest reliability (ICC = 0.78). The measure enables sexual wellbeing to be quantified and understood within and across populations

Confirmatory factor analysis · Construct validity · Developmental psychology · Exploratory factor analysis · Mental health · Population · Psychiatry · Psychometrics · Reproductive health · Statistics · Structural equation modeling · Adolescent Sexual and Reproductive Health · Clinical Psychology · LGBTQ Health, Identity, and Policy · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Psychology

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