Measuring positive mental health and flourishing in Denmark: validation of the mental health continuum-short form (MHC-S
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(2020) 18:297
RESEARCH
Open Access
Measuring positive mental health and flourishing in Denmark: validation of the mental health continuum-short form (MHCSF) and cross-cultural comparison across three countries Ziggi Ivan Santini1* , Manuel Torres-Sahli2, Carsten Hinrichsen1, Charlotte Meilstrup1, Katrine R. Madsen1, Signe Boe Rayce3, Melissa M. Baker4, Margreet Ten Have5, Marijke Schotanus-Dijkstra6 and Vibeke Koushede7
Abstract Background: The Mental Health Continuum–Short Form (MHC-SF) is a measure of positive mental health and flourishing, which is widely used in several countries but has not yet been validated in Denmark. This study aimed to examine its qualitative and quantitative properties in a Danish population sample and compare scores with Canada and the Netherlands. Methods: Three thousand five hundred eight participants aged 16–95 filled out an electronic survey. Both the unidimensional and multidimensional aspects of the Danish MHC-SF were studied through bifactor modelling. Cognitive interviews examined face validity and usability. Results: The general score of the Danish MHC-SF was reliable for computing unit-weighted composite scores, as well as using a bifactor model to compute general factor scores or measurement models in an SEM context. Nonetheless, subscale scores were unreliable, explaining very low variance beyond that explained by the general factor. The participants of the qualitative interviews observed problems with wording and content of the items, especially from the social subscale. The general score correlated with other scales as expected. We found substantial variation in flourishing prevalence rates between the three cultural settings. Conclusions: The Danish MHC-SF produced reliable general scores of well-being. Most of the issues observed regarding the subscale scores have been shown in previous research in other contexts. The further analysis of indices of the bifactor model and the inclusion of qualitative interviews allowed for a better understanding of the possible sources of problems with the questionnaire’s subscales. The use of subscales, the substantive understanding of the general score, as well as the operationalization of the state of flourishing, require further study. Keywords: Mental health, Positive psychology, Public health, Epidemiologic measurements, Psychometrics
* Correspondence: [email protected] 1 The Danish National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's
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