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Background: The Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) is validated for measuring mental wellbeing in populations aged 11 + and has been translated into 30 + languages. The aims of this study were a) to translate and validate WEMWBS for use in Swahili-speaking populations to facilitate measurement and understanding of wellbeing, evaluation of policy and practice, and enable international comparisons; and b) to examine sociodemographic characteristics associated with higher and lower mental wellbeing in participants in the Girls' Education Challenge (GEC) project in Tanzania., Methods: A short questionnaire including WEMWBS and similar scales for comparison, socio-demographic information, and self-reported health was translated into Swahili using gold standard methodology. This questionnaire was used to collect data from secondary school students, learner guides, teacher mentors and teachers taking part in the GEC project in Tanzania. Focus groups were used to assess acceptability and comprehensibility of WEMWBS and conceptual understanding of mental wellbeing. These were audio-taped, transcribed and analysed thematically. Internal consistency of WEMWBS, correlation with comparator scales and confirmatory factor analysis were completed as quantitative validation. Finally, multivariable logistic regression was used to explore associations between individual characteristics and 'high' and 'low' mental wellbeing, defined as the highest and lowest quartile of WEMWBS scores., Results: 3052 students and 574 adults were recruited into the study. Participants reported that WEMWBS was understandable and relevant to their lives. Both WEMWBS and its short form met quantitative standards of reliability and validity, were correlated with comparator scales and met the criteria to determine a single factor structure. For students in the GEC supported government schools: mental wellbeing was higher in students in the final two 'forms' of school compared with the first two. In addition: being male, urban residence, the absence of markers of social marginality and better self-reported health were all significantly associated with better mental wellbeing. For adults, urban residence and better self-reported health were associated with better mental wellbeing., Conclusions: The Swahili translation of WEMWBS is available for use. Further work to explore how to intervene to increase mental wellbeing in vulnerable GEC participants is needed., (© 2023. The Author(s).)

Background: Previous literature has examined the societal costs of mental illness, but few studies have estimated the costs associated with mental well-being. In this study, a prospective analysis was conducted on Danish data to determine 1) the association between mental well-being (measured in 2016) and government expenditure in 2017, specifially healthcare costs and sickness benefit transfers., Methods: Data stem from a Danish population-based survey of 3,508 adults (aged 16 + years) in 2016, which was linked to Danish registry data. A validated scale (WEMWBS) was used for the assessment of mental well-being. Costs are expressed in USD PPP. A two-part model was applied to predict costs in 2017, adjusting for sociodemographics, health status (including psychiatric morbidity and health behaviour), as well as costs in the previous year (2016)., Results: Each point increase in mental well-being (measured in 2016) was associated with lower healthcare costs ($- 42.5, 95% CI = $- 78.7, $- 6.3) and lower costs in terms of sickness benefit transfers ($- 23.1, 95% CI = $- 41.9, $- 4.3) per person in 2017., Conclusions: Estimated reductions in costs related to mental well-being add to what is already known about potential savings related to the prevention of mental illness. It does so by illustrating the savings that could be made by moving from lower to higher levels of mental well-being both within and beyond the clinical range. Our estimates pertain to costs associated with those health-related outcomes that were included in the study, but excluding other social and economic outcomes and benefits. They cover immediate cost estimates (costs generated the year following mental well-being measurement) and not those that could follow improved mental well-being over the longer term. They may therefore be considered conservative from a societal perspective. Population approaches to mental health promotion are necessary, not only to potentiate disease prevention strategies, but also to reduce costs related to lower levels of mental well-being in the non-mental illness population. Our results suggest that useful reductions in both health care resource use and costs, as well as in costs due to sick leave from the workplace, could be achieved from investment in mental well-being promotion within a year., (© 2021. The Author(s).)

Background: Childhood adversity (CA) has previously been linked to various health problems in adulthood. Investigations into the differential impact of distinct types of CA on a wide range of outcomes are scarce. This study aimed to assess the impact of self-reported childhood family conflict and/or financial strain on health and social functioning in adulthood among Europeans, while taking into account the mediating role of adulthood socioeconomic disadvantage (SED) in these associations., Methods: Using the European Social Survey (ESS) collected in 2014, nationally representative cross-sectional data from 35 475 participants aged 15 years and older in 19 European countries were analysed. Logistic regressions were conducted to assess associations of retrospectively reported family conflict and/or financial strain in childhood with physical and mental health as well as health behaviours and social functioning in adulthood., Results: A quarter of the European population reported having experienced family conflict, financial strain or both in childhood. Financial strain was reported more among older age groups and conflict more among younger age groups. A dose-response pattern with increased risk was demonstrated for almost all physical, behavioral, mental and social outcomes for these aspects of CA compared with no CA, with the highest risk observed in those who experienced both financial strain and family conflict. Adulthood SED mediated a significant proportion of the associations with financial strain (ranging from 5.4% to 72.4%), but did not mediate the associations with conflict., Conclusion: Individuals reporting family conflict or financial strain during childhood are at increased risk of developing a wide range of health and social problems. Those who report financial strain in childhood are more likely to experience SED in adulthood, which in turn increases their risk of experiencing health and social problems. Reported family conflict during childhood conferred increased risk of health and social problems, but adulthood SED did not appear to operate as an indirect pathway., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Mental well-being is fundamental for a good life. Previous literature has examined the predictors of mental disorders and continuous measures of positive mental health. Very few studies have specifically focused on the predictors of different levels of mental well-being, but those that have suggest a different picture. This study aimed to compare socioeconomic and relational/recreational behaviour predictors of different levels of mental well-being as well as common mental disorders (CMDs)., Methods: Data from 3508 adults aged 16+ years old from the Danish Mental Health and Well-Being Survey 2016 were linked to Danish national register-based data. Mental well-being was assessed using the Warwick-Edinburgh Mental Well-being Scale, and information on CMDs was assessed using the Patient Health Questionnaire (PHQ-4). Regression analyses were conducted to estimate the predictors of low and high mental well-being compared to moderate mental well-being and also of CMDs., Results: Lower socioeconomic position (education, income and employment status) was associated with increased odds of low mental well-being and the presence of CMDs, but did not significantly predict high mental well-being. Relational/recreational behaviours (informal and formal social participation, social support and recreational activity) were associated with reduced odds of low mental well-being and CMDs, and also with increased odds of high mental well-being., Conclusions: Socioeconomic predictors of high mental well-being do not mirror those of low mental well-being and CMDs, whereas relational/recreational predictors of high mental well-being do mirror those of low mental well-being and CMDs. These findings have important implications for public mental health strategies., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association.)

This study examined the psychometric properties of the Danish WEMWBS and its short version (SWEMWBS) in a Danish population sample, and compared scores in Denmark with scores representative of three other European settings. A total of 3,508 Danish men and women aged 16-95 filled out an electronic survey. Face validity was examined by cognitive interviews. Content validity was assessed by examining response distributions and construct validity by confirmatory factor analysis, measurement invariance, and relations to other or similar measures. Overall mental well-being scores were calculated, as well as stratified by sex and age. Support was found for the single-factor hypothesis, yielding good model fits for both versions of the scale. Both scales have high internal consistency. Correlations with mental health measures were largely in line with expectations. The highest mental well-being scores were reported for Catalonia, followed by Denmark, Iceland, and England. The (S)WEMWBS appear to be appropriate instruments to measure mental well-being in the Danish population. The present findings encourage the use of the scales, particularly SWEMWBS, in epidemiological, intervention and evaluation studies in research and practice. Cross-cultural comparisons like the one reported here may be essential to inform international mental health policy., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: SWEMWBS is a popular measure of mental wellbeing, shown to be valid in clinical populations. Responsiveness to change has not yet been formally assessed., Methods: Analysis of data from a clinical sample of 172 clients undergoing up to 4 sessions of cognitive hypnotherapy. Cohen's D effect size (ES), Standardised response mean (SRM), probability of change statistic (P^) were used to evaluate whether SWEMWBS detected statistically important changes at the group level. Cohen's D effect size (ES) and Standard error of measurement (SEM) and were used to evaluate whether SWEMWBS detected statistically important changes at the individual level., Results: Mean (SD) SWEMWBS scores increased from baseline to therapy 4 from 19.28 (3.921) to 23.32 (4.873). At group level, using Cohen's D effect size, improvement ranges from ES = 0.20-1.41 and using SRM, ranged from 0.30-0.88, increasing with number of therapy sessions. (P^) ranged from 0.65-0.8. At individual level, use of Cohens D ES > 0.5 indicated statistically important improvement in 29.9-86.1% cf. 20.1-80.6% using a standard of 2.77 SEM (2.87 points). The lower threshold of 1 SEM (1.03 points) indicated statistically important improvement in 43.0-81.0%., Conclusion: SWEMWBS is responsive to change at individual and group level. At individual level a change of between 1 and 3 points meets thresholds for statisticially important change, depending on standard used. Anchor based studies are necessary to confirm that such change represents minimally important change from the perspective of study participants.

Background: To establish the validity and reliability of the Short Warwick Edinburgh Mental Well-being Scale (SWEMWBS) in service users with schizophrenia, depression and anxiety spectrum disorders in Singapore and estimate SWEMWBS scores across socio-demographic and the three psychiatric diagnostic groups in the sample., Methods: This secondary analysis was conducted using data from a study among outpatients of a tertiary psychiatric hospital. In addition to the SWEMWBS, socio-demographic data and current psychiatric diagnosis were collected. Service users were also administered the Global Assessment of Functioning (GAF), Patient Health Questionnaire (PHQ)-8, Generalised Anxiety Disorder (GAD)-7, Satisfaction with Life Scale (SWLS) and the Positive Mental Health (PMH) instrument. The SWEMWBS was tested for factorial validity, reliability and convergent and divergent validity., Results: In total, 350 service users with a mean (SD) age of 39.1 (11.1) years were included in this study of which 39.4%, 38.9% and 21.7% had schizophrenia, depression and anxiety spectrum disorders, respectively. The single factor structure of the SWEMWBS was confirmed by confirmatory factor analysis (CFI = 0.969, TLI = 0.954, RMSEA = 0.029). The internal consistency reliability was high (Cronbach's alpha = 0.89). The convergent and divergent validity testing revealed that the SWEMWBS scores had significant moderate to high positive correlations with GAF, SWLS and PMH scores and moderate negative correlations with (PHQ)-8 and (GAD)-7 scores. SWEMWBS scores were higher in married participants (22.2 (5.4) versus never married: 20.7 (5.3) and divorced/separated/widowed: 20.4 (5.1), p = 0.049) and among those with schizophrenia (22.8 (5.5) versus depression:19.6 (4.7) and anxiety spectrum disorders 20.9 (5.2), p < 0.001)., Conclusion: These results demonstrate adequate validity and reliability of the SWEMWBS in people with schizophrenia, depression and anxiety spectrum disorders in Singapore.

Purpose: The Warwick-Edinburgh Mental Well-being Scale (WEMWBS), 14 positively worded statements, is a validated instrument to measure mental wellbeing on a population level. Less is known about the population distribution of the shorter seven-item version (SWEMWBS) or its performance as an instrument to measure wellbeing., Methods: Using the Health Survey for England 2010-2013 (n = 27,169 adults aged 16+, nationally representative of the population), age- and sex-specific norms were estimated using means and percentiles. Criterion validity was examined using: (1) Spearman correlations (ρ) for SWEMWBS with General Health Questionnaire (GHQ-12), happiness index, EQ-VAS (2) a multinomial logit model with SWEMWBS (low, medium and high wellbeing) as the outcome and demographic, social and health behaviours as explanatory variables. Relative validity was examined by comparing SWEMWBS with WEMWBS using: (1) Spearman correlations (continuous data), and (2) the weighted kappa statistic (categorical), within population subgroups., Results: Mean (median) SWEMWBS was 23.7 (23.2) for men and 23.2 (23.2) for women (p = 0.100). Spearman correlations were moderately sized for the happiness index (ρ = 0.53, P < 0.001), GHQ-12 (ρ = -0.52, p < 0.001) and EQ-VAS (ρ = 0.40, p < 0.001). Participants consuming <1 portion of fruit and vegetables a day versus ≥5 (odds ratio = 1.43 95% Confidence Interval = (1.22-1.66)) and current smokers versus non-smokers (1.28 (1.15-1.41)) were more likely to have low vs medium wellbeing. Participants who binge drank versus non-drinkers were less likely to have high versus medium wellbeing (0.81 (0.71-0.92)). Spearman correlations between SWEMWBS and WEMWBS were above 0.95; weighted kappa statistics showed almost perfect agreement (0.79-0.85)., Conclusion: SWEMWBS distinguishes mental wellbeing between subgroups, similarly to WEMWBS, but is less sensitive to gender differences.

The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) has been validated in general population samples in many countries. Interest in using this measure in clinical populations is growing, particularly for tertiary prevention and mental health promotion. This paper reports validation of the French WEMWBS in healthy and chronic remitted schizophrenia populations. The French WEMWBS was administered to 319 workers, 75 students and 121 patients. For non-patients, self-reported Trait- and State-Anxiety, Mindfulness, Positive and Negative Affect and the General Health Questionnaire were completed. For patients, the Positive and Negative Syndrome Scale, Clinical Global Impression Severity Scale, Birchwood Insight Scale, Social Adjustment Scale, and Global Assessment of Functioning scale were completed. Test-retest reliability and responsiveness to intervention was assessed at 6 months. Whatever the sample, response frequencies showed normal distributions, and internal consistency was good (Cronbach's α). Scree plots of eigenvalues suggested a single factor in the samples. The one-dimensional solution yielded suboptimal fit indices. Construct validity was confirmed. Significant improvement in scores was observed before and after intervention. Test-retest variation was non-significant. Impairment of insight and cognition in the assessed patients implies that attention must be paid before applying WEMWBS to all patients. Nevertheless, WEMWBS proved valid and reliable in a further European population, suggesting transcultural validity for both monitoring and evaluation of interventions in healthy as well as chronic remitted schizophrenia populations., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background: The Quality-Adjusted Life Year (QALY) is a measure that combines life extension and health improvement in a single score, reflecting preferences around different types of health gain. It can therefore be used to inform decision-making around allocation of health care resources to mutually exclusive options that would produce qualitatively different health benefits. A number of quality-of-life instruments can be used to calculate QALYs. The EQ-5D is one of the most commonly used, and is the preferred option for submissions to NICE ( https://www.nice.org.uk/process/pmg9/ ). However, it has limitations that might make it unsuitable for use in areas such as public and mental health where interventions may aim to improve well-being. One alternative to the QALY is a Wellbeing-Adjusted Life Year. In this study we explore the need for a Wellbeing-Adjusted Life Year measure by examining the extent to which a measure of wellbeing (the Warwick-Edinburgh Mental Well-being Scale) maps onto the EQ-5D-3L., Methods: Secondary analyses were conducted on data from the Coventry Household Survey in which 7469 participants completed the EQ-5D-3L, Warwick-Edinburgh Mental Well-being Scale, and a measure of self-rated health. Data were analysed using descriptive statistics, Pearson's and Spearman's correlations, linear regression, and receiver operating characteristic curves., Results: Approximately 75 % of participants scored the maximum on the EQ-5D-3L. Those with maximum EQ-5D-3L scores reported a wide range of levels of mental wellbeing. Both the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were able to detect differences between those with higher and lower levels of self-reported health. Linear regression indicated that scores on the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were weakly, positively correlated (with R(2) being 0.104 for the index and 0.141 for the visual analogue scale)., Conclusion: The Warwick-Edinburgh Mental Well-being Scale maps onto the EQ-5D-3L to only a limited extent. Levels of mental wellbeing varied greatly amongst participants who had the maximum score on the EQ-5D-3L. To evaluate the relative effectiveness of interventions that impact on mental wellbeing, a new measure - a Wellbeing Adjusted Life Year - is needed.

Background: Research on mental well-being is relatively new and studies of its determinants are rare., Aims: To investigate whether the socioeconomic correlates of mental well-being mirror those for mental illness., Method: Using logistic regression analyses, the independent odds ratios of high and low mental well-being, compared with middle-range mental well-being, were estimated for a number of sociodemographic variables known to be associated with mental illness from 13 983 participants in the 2010 and 2011 Health Surveys for England., Results: Independent odds ratios for low mental well-being were as expected from studies of mental illness with increased odds for the unemployed (OR = 1.46, 95% CI 1.01-2.10) and those aged 35-54 years (OR = 1.58, 95% CI 1.35-1.84) and reduced odds for the married (OR = 0.78, 95% CI 0.62-0.97). A linear trend was observed with education and equivalised income. Odds ratios for high mental well-being differed from those for low mental well-being with regard to age (55+ years: OR = 1.48, 95% CI 1.23-1.79); employment status where there was an association only with retirement (OR = 1.35, 95% CI 1.09-1.69); education where there was no association; and equivalised income for which the association was non-linear., Conclusions: Odds ratios for low mental well-being mirrored those for mental illness, but not those for high mental well-being, suggesting that the socioeconomic factors associated with positive mental health are different from those associated with mental illness., (© The Royal College of Psychiatrists 2015.)

Objectives: Establishing the cross-cultural equivalence of the mental well-being construct, as measured with the Warwick-Edinburg Mental Well-being Scale (WEMWBS), by studying potential construct validity biases in two countries with previously reported score differences., Study Design and Setting: We compared the WEMWBS total scores and item responses in Scotland (N = 779) and Catalonia (N = 1,900) general population samples. To assess whether the questionnaire spuriously favored higher scores in Catalonia, we tested for differential item functioning (DIF) by applying ordinal logistic regression on Item Response Theory scores. DIF was tested with likelihood ratio tests and standard effect measures (McFadden Pseudo R(2), >0.13; relative parameter change, >5%), and differential test functioning (DTF) was tested by plotting differences between full-test and purified (i.e., without DIF items) score estimates., Results: Catalonia showed higher levels of mental well-being than Scotland (Cohen d = 0.84). Three of 14 WEMWBS items showed small amounts of DIF. DIF did not accrue to DTF, as shown by intraclass correlation coefficient (ICC, 0.999) and case-by-case differences (maximum, 0.12 SD) between total and purified scores. Population differences remained mainly constant across sociodemographics and health outcomes., Conclusion: The WEMWBS measures a distinct well-being construct that is stable across countries, implying that Scotland and Catalonia populations are effectively different in the distribution of mental well-being. This result adds to previous psychometric information and supports WEMWBS as a valid unbiased measures for individual and cross-cultural comparisons., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Major behavioural risk factors are known to adversely affect health outcomes and be strongly associated with mental illness. However, little is known about the association of these risk factors with mental well-being in the general population. We sought to examine behavioural correlates of high and low mental well-being in the Health Survey for England., Methods: Participants were 13,983 adults, aged 16 years and older (56% females), with valid responses for the combined 2010 and 2011 surveys. Mental well-being was assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). ORs of low and high mental well-being, compared to the middle-range category, were estimated for body mass index (BMI), smoking, drinking habits, and fruit and vegetable intake., Results: ORs for low mental well-being were increased in obese individuals (up to 1.72, 95% CI 1.26 to 2.36 in BMI 40+ kg/m(2)). They increased in a linear fashion with increasing smoking (up to 1.98, 95% CI 1.55 to 2.53, >20 cigarettes/day) and with decreasing fruit and vegetable intake (up to 1.53, 95% CI 1.24 to 1.90, <1 portion/day); whereas ORs were reduced for sensible alcohol intake (0.78, 95% CI 0.66 to 0.91, ≤4 units/day in men, ≤3 units/day in women). ORs for high mental well-being were not correlated with categories of BMI or alcohol intake. ORs were reduced among ex-smokers (0.81, 95% CI 0.71 to 0.92), as well as with lower fruit and vegetable intake (up to 0.79, 95% CI 0.68 to 0.92, 1 to <3 portions/day)., Conclusions: Along with smoking, fruit and vegetable consumption was the health-related behaviour most consistently associated with mental well-being in both sexes. Alcohol intake and obesity were associated with low, but not high mental well-being., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Purpose: Mental well-being has aroused interest in Europe as an indicator of population health. The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) was developed in the United Kingdom showing good face validity and has been previously adapted into Spanish. The aim of this study is to assess the validity and reliability of the Spanish version of WEMWBS in the general population., Methods: Cross-sectional home face-to-face interview survey with computer-assisted personal interviewing was administered with the 2011 Catalan Health Interview Survey Wave 3, which is representative of the non-institutionalized general population of Catalonia, Spain. A total of 1,900 participants 15+ years of age were interviewed. The Spanish version of WEMWBS was administered together with socioeconomic and health-related variables, with a hypothesized level of association., Results: Similar to the original, confirmatory factor analysis fits a one-factor model adequately (CFI = 0.974; TLI = 0.970; RMSEA = 0.059; χ (2) = 584.82; df = 77; p < .001) and has a high internal consistency (Cronbach's alpha = 0.930; Guttman's lambda 2 = 0.932). The WEMWBS discriminated between population groups in all health-related and socioeconomic variables, except in gender (p = 0.119), with a magnitude similar to that hypothesized. Overall, mental well-being was higher for the general population of Catalonia (average and whole distribution) than that for Scotland general population., Conclusions: The Spanish version of WEMWBS showed good psychometric properties similar to the UK original scale. Whether better mental well-being in Catalonia is due to methodological or substantive cultural, social, or environmental factors should be further researched.

Background: We aimed to validate the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) among English speaking adults representing two of the minority ethnic groups living in the UK, self-identified as Chinese or Pakistani by background, in a mixed methods study., Methods: Quantitative data were collected in two cities in the West Midlands, UK. Item response, dimensionality, internal consistency, and construct validity of the WEMWBS were assessed in Chinese and Pakistani groups separately, using data from both cities combined.Qualitative data were collected in the first city in eight focus groups of different ages recruited by the community workers. Three mixed sex Chinese and five single sex Pakistani groups discussed ease of completion and comprehension of items, together with overall reactions to the scale and underlying concept.Results of quantitative and qualitative analysis were examined for commonalities and differences., Results: Item completion and item total correlations were satisfactory in both groups. In the Chinese data, Exploratory Factor Analysis showed a single factor with loadings ranging from 0.60 to 0.82 for all 14 items. In the Pakistani data, three factors reached statistical significance; however, a substantial drop in eigenvalues between the first and second factors and the limited variance explained by the second and third factors supported a one-factor model. All items loaded on this factor from 0.51 to 0.83.In the Chinese and Pakistani data respectively, Cronbach's alpha was 0.92 (0.89 - 0.94) and 0.91 (0.88 - 0.94); Spearman's correlation with GHQ-12 was - 0.63 (-0.73 to -0.49) and -0.55 (-0.70 to -0.36), and with the WHO-5 0.62 (0.46-0.75) and 0.64 (0.50 to 0.76).Qualitative analysis revealed good comprehension and ease of completion of almost all items. Some culturally determined differences in understanding of mental well-being, which varied both between and within communities, emerged., Conclusions: The WEMWBS was well received by members of both Pakistani and Chinese communities. It showed high levels of consistency and reliability compared with accepted criteria. Data were sufficiently strong to recommend the WEMWBS for use in general population surveys.

Background: Mental well-being now features prominently in UK and international health policy. However, progress has been hampered by lack of valid measures that are responsive to change. The objective of this study was to evaluate the responsiveness of the Warwick Edinburgh Mental Well-being Scale (WEMWBS) at both the individual and group level., Methods: Secondary analysis of twelve different interventional studies undertaken in different populations using WEMWBS as an outcome measure. Standardised response mean (SRM), probability of change statistic (P(^)) and standard error of measurement (SEM) were used to evaluate whether WEMWBS detected statistically important changes at the group and individual level, respectively., Results: Mean change in WEMWBS score ranged from -0.6 to 10.6. SRM ranged from -0.10 (95% CI: -0.35, 0.15) to 1.35 (95% CI: 1.06, 1.64). In 9/12 studies the lower limit of the 95% CI for P(^) was greater than 0.5, denoting responsiveness. SEM ranged from 2.4 to 3.1 units, and at the threshold 2.77 SEM, WEMWBS detected important improvement in at least 12.8% to 45.7% of participants (lower limit of 95% CI>5.0%)., Conclusions: WEMWBS is responsive to changes occurring in a wide range of mental health interventions undertaken in different populations. It offers a secure base for research and development in this rapidly evolving field. Further research using external criteria of change is warranted.

The last decade has witnessed increasing interest in the promotion of mental health and well-being because of its importance for health and social functioning at individual level and for the social and economic well-being of societies. Recent research from a range of disciplines (including neurodevelopment, developmental psychology and genetics) has highlighted the importance of childhood, and particularly the first few years of life, for future mental, social and emotional development. The quality of the parent-child relationship and parenting more generally is one of the factors in determining outcomes. The objective of this review was to identify effective interventions to support parents, parenting and the parent-child relationship from the ante-natal period to adolescence. A systematic search of key electronic databases was undertaken to identify systematic reviews evaluating approaches to parenting support; 52 systematic reviews were identified. Results were synthesized qualitatively and reported under the following headings: (i) perinatal programmes; (ii) parenting support programmes in infancy and early years focused on enhancing caregiver sensitivity and attunement; (iii) formal parenting programmes focused on children's behaviour; (iv) parenting support for highest risk groups. The review provides a robust international evidence base of programmes which have been demonstrated to improve parenting and the mental health and well-being of children. Policies and programmes to support parenting offer much scope for improving mental health. Effective provision requires a skilled workforce and careful application of approaches that have been found to work. More research is needed to develop and identify interventions for some of the highest risk groups.

Background: Mental well-being underpins many aspects of health and social functioning, and is economically important., Aims: To describe mental well-being in a general population sample and to determine the extent to which mental well-being and mental illness are independent of one another., Method: Secondary analysis of a survey of 7293 adults in England. Nine survey questions were identified as possible indicators of mental well-being. Common mental disorders (ICD-10) were ascertained using the Revised Clinical Interview Schedule (CIS-R). Principal components analysis was used to describe the factor structure of mental well-being and to generate mental well-being indicators., Results: A two-factor solution found eight out of nine items with strong loadings on well-being. Eight items corresponding to hedonic and eudaemonic well-being accounted for 36.9% and 14.3% of total variance respectively. Separate hedonic and eudaemonic well-being scales were created. Hedonic well-being (full of life; having lots of energy) declined with age, while eudaemonic well-being (getting on well with family and friends; sense of belonging) rose steadily with age. Hedonic well-being was lower and eudaemonic well-being higher in women. Associations of well-being with age, gender, income and self-rated health were little altered by adjustment for symptoms of mental illness., Conclusions: In a large nationally representative population sample, two types of well-being were distinguished and reliably assessed: hedonic and eudaemonic. Associations with mental well-being were relatively independent of symptoms of mental illness. Mental well-being can remain even in the presence of mental suffering.

Background: Understanding and measuring mental health and wellbeing amongst teenagers has recently become a priority. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is validated for measuring mental wellbeing in populations aged 16 years and over in the UK. We report here a study designed to establish the validity and reliability of WEMWBS in teenagers in the UK., Methods: WEMWBS and comparator scales, together with socio-demographic information and self-reported health, were incorporated into a self-administered questionnaire given to pupils aged 13 to 16 years in six schools in Scotland and England. Psychometric properties including internal consistency, correlations with comparator scales, test-retest stability and unidimensionality were investigated for WEMWBS. Twelve focus groups were undertaken to assess acceptability and comprehensibility of WEMWBS and were taped, transcribed and analysed thematically., Results: A total of 1,650 teenagers completed the questionnaire (response rate 80.8%). Mean WEMWBS score was 48.8 (SD 6.8; median 49). Response scores covered the full range (from 14 to 70). WEMWBS demonstrated strong internal consistency and a high Cronbach's alpha of 0.87 (95% CI (0.85-0.88), n = 1517). Measures of construct validity gave values as predicted. The correlation coefficient for WEMWBS total score and psychological wellbeing domain of the Kidscreen-27 was 0.59 (95% CI [0.55; 0.62]); for the Mental Health Continuum Short Form (MHC-SF) was 0.65, 95% CI [0.62; 0.69]; and for the WHO (WHO-5) Well-being Index 0.57 (95% CI [0.53; 0.61]). The correlation coefficient for the Strengths and Difficulties Questionnaire (SDQ) was -0.44 (95% CI [-0.49; -0.40]) and for the 12-item General Health Questionnaire (GHQ12) -0.45 (95% CI [-0.49; -0.40]). Test-retest reliability was acceptable (Intraclass correlation coefficient (ICC) 0.66 (95% CI [0.59; 0.72] n = 212)). Confirmatory factor analysis demonstrated one underlying factor. WEMWBS was significantly associated with the Family Affluence Score (WEMWBS increased with increasing household socio-economic status) and had a positive association with the physical health dimension of the Kidscreen-27, but was unrelated to age, gender or location/school. Eighty students took part in focus groups. In general, although some students considered some items open to misunderstanding or misinterpretation, WEMWBS was received positively and was considered comprehensible, and acceptable., Conclusions: WEMWBS is a psychometrically strong population measure of mental wellbeing, and can be used for this purpose in teenagers aged 13 and over.

Background: Sub-optimal parenting is a common risk factor for a wide range of negative health, social and educational outcomes. Most parenting programmes have been developed in the USA in the context of delinquency prevention for targeted or indicated groups and the main theoretical underpinning for these programmes is behaviour management. The Family Links Nurturing Programme (FLNP) focuses on family relationships as well as behaviour management and is offered on a universal basis. As a result it may be better placed to improve health and educational outcomes. Developed in the UK voluntary sector, FLNP is popular with practitioners, has impressed policy makers throughout the UK, has been found to be effective in before/after and qualitative studies, but lacks a randomised controlled trial (RCT) evidence base., Methods/design: A multi-centre, investigator blind, randomised controlled trial of the FLNP with a target sample of 288 south Wales families who have a child aged 2-4 yrs living in or near to Flying Start/Sure Start areas. Changes in parenting, parent child relations and parent and child wellbeing are assessed with validated measures immediately and at 6 months post intervention. Economic components include cost consequences and cost utility analyses based on parental ranking of states of quality of life. Attendance and completion rates and fidelity to the FLNP course delivery are assessed. A nested qualitative study will assess reasons for participation and non-participation and the perceived value of the programme to families. By the end of May 2010, 287 families have been recruited into the trial across four areas of south Wales. Recruitment has not met the planned timescales with barriers including professional anxiety about families entering the control arm of the trial, family concern about video and audio recording, programme facilitator concern about the recording of FLNP sessions for fidelity purposes and delays due to the new UK research governance procedures., Discussion: Whilst there are strong theoretical arguments to support universal provision of parenting programmes, few universal programmes have been subjected to randomised controlled trials. In this paper we describe a RCT protocol with quantitative and qualitative outcome measures and an economic evaluation designed to provide clear evidence with regard to effectiveness and costs. We describe challenges implementing the protocol and how we are addressing these., Trial Registration: Current Controlled Trials ISRCTN13919732.

Background: The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) was developed to meet demand for instruments to measure mental well-being. It comprises 14 positively phrased Likert-style items and fulfils classic criteria for scale development. We report here the internal construct validity of WEMWBS from the perspective of the Rasch measurement model., Methods: The model was applied to data collected from 779 respondents in Wave 12 (Autumn 2006) of the Scottish Health Education Population Survey. Respondents were aged 16-74 (average 41.9) yrs., Results: Initial fit to model expectations was poor. The items 'I've been feeling good about myself', 'I've been interested in new things' and 'I've been feeling cheerful' all showed significant misfit to model expectations, and were deleted. This led to a marginal improvement in fit to the model. After further analysis, more items were deleted and a strict unidimensional seven item scale (the Short Warwick Edinburgh Mental Well-Being Scale (SWEMWBS)) was resolved. Many items deleted because of misfit with model expectations showed considerable bias for gender. Two retained items also demonstrated bias for gender but, at the scale level, cancelled out. One further retained item 'I've been feeling optimistic about the future' showed bias for age. The correlation between the 14 item and 7 item versions was 0.954.Given fit to the Rasch model, and strict unidimensionality, SWEMWBS provides an interval scale estimate of mental well-being., Conclusion: A short 7 item version of WEMWBS was found to satisfy the strict unidimensionality expectations of the Rasch model, and be largely free of bias. This scale, SWEMWBS, provides a raw score-interval scale transformation for use in parametric procedures. In terms of face validity, SWEMWBS presents a more restricted view of mental well-being than the 14 item WEMWBS, with most items representing aspects of psychological and eudemonic well-being, and few covering hedonic well-being or affect. However, robust measurement properties combined with brevity make SWEMWBS preferable to WEMWBS at present for monitoring mental well-being in populations. Where face validity is an issue there remain arguments for continuing to collect data on the full 14 item WEMWBS.

Background: There is increasing international interest in the concept of mental well-being and its contribution to all aspects of human life. Demand for instruments to monitor mental well-being at a population level and evaluate mental health promotion initiatives is growing. This article describes the development and validation of a new scale, comprised only of positively worded items relating to different aspects of positive mental health: the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS)., Methods: WEMWBS was developed by an expert panel drawing on current academic literature, qualitative research with focus groups, and psychometric testing of an existing scale. It was validated on a student and representative population sample. Content validity was assessed by reviewing the frequency of complete responses and the distribution of responses to each item. Confirmatory factor analysis was used to test the hypothesis that the scale measured a single construct. Internal consistency was assessed using Cronbach's alpha. Criterion validity was explored in terms of correlations between WEMWBS and other scales and by testing whether the scale discriminated between population groups in line with pre-specified hypotheses. Test-retest reliability was assessed at one week using intra-class correlation coefficients. Susceptibility to bias was measured using the Balanced Inventory of Desired Responding., Results: WEMWBS showed good content validity. Confirmatory factor analysis supported the single factor hypothesis. A Cronbach's alpha score of 0.89 (student sample) and 0.91 (population sample) suggests some item redundancy in the scale. WEMWBS showed high correlations with other mental health and well-being scales and lower correlations with scales measuring overall health. Its distribution was near normal and the scale did not show ceiling effects in a population sample. It discriminated between population groups in a way that is largely consistent with the results of other population surveys. Test-retest reliability at one week was high (0.83). Social desirability bias was lower or similar to that of other comparable scales., Conclusion: WEMWBS is a measure of mental well-being focusing entirely on positive aspects of mental health. As a short and psychometrically robust scale, with no ceiling effects in a population sample, it offers promise as a tool for monitoring mental well-being at a population level. Whilst WEMWBS should appeal to those evaluating mental health promotion initiatives, it is important that the scale's sensitivity to change is established before it is recommended in this context.

Background: Well-being is an important determinant of health and social outcomes. Measures of positive mental health states are needed for population-based research. The 12-item General Health Questionnaire (GHQ-12) has been widely used in many settings and languages, and includes positively and negatively worded items. Our aim was to test the hypothesis that the GHQ-12 assesses both positive and negative mental health and that these domains are independent of one another., Method: Exploratory (EFA) and confirmatory (CFA) factor analyses were conducted using data from the British Household Panel Survey (BHPS) and the Health Survey for England (HSE). Regression models were used to assess whether associations with individual and household characteristics varied across positive and negative mental health dimensions. We also explored higher-level variance in these measures, between electoral wards., Results: We found a consistent, replicable factor structure in both datasets. EFA results indicated a two-factor solution, and CFA demonstrated that this was superior to a one-factor model. These factors correspond to 'symptoms of mental disorder' and 'positive mental health'. Further analyses demonstrated independence of these factors in associations with age, gender, employment status, poor housing and household composition. Statistically significant ward-level variance was found for symptoms of mental disorder but not positive mental health., Conclusions: The GHQ-12 measures both positive and negative aspects of mental health, and although correlated, these dimensions have some independence. The GHQ-12 could be used to measure positive mental health in population-based research.

Objective: To validate Affectometer 2 for use in the UK, derive population norms and assess its potential for monitoring positive mental health., Methods: 722 adults aged 16-74 living in Scotland completed Affectometer 2 and the General Health Questionnaire (GHQ) and provided data on socio-economic factors known to be associated with mental health status. Principal component analysis was used to explore the underlying structure of Affectometer 2. Internal reliability was tested using Cronbach's alpha. Construct validity was tested by comparing associations between Affectometer 2 scores and socio-economic factors with expected performance from other surveys and with the GHQ., Results: 89% of participants completed Affectometer 2 suggesting a high level of public acceptability. Both total scale and subscales showed a high level of internal consistency (0.944). Correlations between Affectometer 2 score and key socio-economic variables were consistent with the findings of other population mental health surveys. Correlation with the GHQ was moderate (0.60). Affectometer 2 did not show a ceiling effect in this general population sample. Principal component analysis provided some evidence consistent with a single underlying construct, although this needs further testing., Conclusions: Affectometer 2 met accepted criteria for validity and reliability in this representative UK population and demonstrated potential for use in monitoring positive mental health. The results provide support for the development of a shortened version of the scale which would be advantageous for population surveys.

An appreciation of the role of social and emotional well-being in determining health outcomes is important in advancing the equity agenda.(1) These aspects of health are adversely affected by inequity. They also are important as potential causal factors. Low levels of emotional and social well-being among the rich may be important in perpetuating health and social inequity. In the past, most research on inequity has focused on the negative end of the continuum of emotional and social health (eg, child abuse, conduct disorder, mental illness, drug and alcohol abuse) and concentrated on the problems of the poor, not the rich. The prevalence of emotional and social well-being has not been well studied. At the other end of the spectrum, emotional and behavioral problems now are the most important cause of disability in childhood,(2) affecting between 10% and 20% of children.(3) In between these 2 extremes, some children are socially competent, are liked by their peers, are resilient in the face of problems, know their own minds, are kind to others, and are able to handle conflict in a way that leads to resolution. Others are prone to aggression and deceit, are ostracized by their peer group, and create conflict and distress. These children may have very low self-esteem. They often are manifestly unhappy and anxious and certainly make others unhappy and anxious. This group may not meet the Diagnostic and Statistical Manual of Mental Disorders-defined criteria for emotional and behavioral problems; teachers therefore may be more aware of them and their impact on others than physicians. As a result, teachers and educational psychologists have been at the forefront of developing interventions to help this group.

Purpose: Prior research on relations between mental health and pain has focused on negative mental health aspects (e.g. depression), while the literature is scarce in terms of positive aspects, such as mental well-being. This study aims to investigate prospective associations of mental well-being at baseline with pain and functional impairment due to pain in the following year. Design/methodology/approach: Data stem from a Danish nationally representative survey of 5,000 adults (aged 15+) conducted in 2019 and 2020, which was linked to register data. The Short Warwick–Edinburgh Mental Well-being Scale was used to assess mental well-being, both continuously (range 7–35) and categorically (low, moderate, high). Logistic regressions were conducted to assess associations between mental well-being in 2019 and pain and functional impairment due to pain (among those reporting any pain) in 2020. Findings: In the fully adjusted models, each point increase in mental well-being was inversely associated with pain (OR = 0.97, 95%CI 0.95–0.99) and functional impairment due to pain (OR = 0.96, 95%CI 0.94–0.99). As compared to low mental well-being, moderate mental well-being was associated with an OR of 0.76 (95%CI 0.58–0.99) for pain and an OR of 0.63 (95%CI 0.46–0.87) of functional impairment due to pain, while high mental well-being was associated with an OR of 0.56 (95%CI 0.40–0.77) for pain and an OR of 0.53 (95%CI 0.34–0.79) for functional impairment due to pain. Originality/value: Higher mental well-being levels may be protective against pain and functional impairment due to pain. Wider mental health promotion may be considered to prevent pain and associated functional impairments in the general population. [ABSTRACT FROM AUTHOR]

PURPOSE Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) is a complex primary care program aimed at assisting older adults to stay healthier for longer. This study evaluated the feasibility of implementation across multiple sites, and the reproducibility of the effects found in the previous randomized controlled trial. METHODS This was a pragmatic, unblinded, 6-month parallel group randomized controlled trial. Participants were randomized (intervention or control) using a computer-generated system. Eligible patients, aged 70 years and older, were rostered to 1 of 6 participating interprofessional primary care practices (urban and rural). In total, 599 (301 intervention, 298 control) patients were recruited from March 2018 through August 2019. Intervention participants received a home visit from volunteers to collect information on physical and mental health, and social context. An interprofessional care team created and implemented a plan of care. The primary outcomes were physical activity and number of hospitalizations. RESULTS Based on the Reach, Effectiveness, Adoption, Implementation, Maintenance (REAIM) framework, Health TAPESTRY had widespread reach and adoption. In the intention-totreat analysis (257 intervention, 255 control), there were no statistically significant betweengroup differences for hospitalizations (incidence rate ratio = 0.79; 95% CI, 0.48-1.30; P = .35) or total physical activity (mean difference = -0.26; 95% CI, -1.18 to 0.67; P = .58). There were 37 non-study related serious adverse events (19 intervention, 18 control). CONCLUSIONS We found Health TAPESTRY was successfully implemented for patients in diverse primary care practices; however, implementation did not reproduce the effect on hospitalizations and physical activity found in the initial randomized controlled trial. [ABSTRACT FROM AUTHOR]

Purpose: To identify patterns and problems in completing composite time trade-off (C-TTO) and discrete choice experiment (DCE) exercises for the valuation of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) to inform the optimisation of a valuation protocol. Methods: Fourteen cognitive interviews were conducted in the UK using concurrent and retrospective think-aloud and probing techniques. Each participant completed 8 C-TTO tasks and 8 DCE tasks within a computer-assisted personal interview setting. Verbal information was transcribed verbatim. Axial coding and thematic analysis were used to organise the qualitative data and identify patterns and problems with the completion of tasks. Results: While participants found the tasks generally manageable, five broad themes emerged to explain and optimise the response to the tasks. (1) Format and structure: attention to the design of practice examples, instructions, and layout were needed. (2) Items and levels: underlying relationships were discovered across different combinations of levels of SWEMWBS items. (3) Decision heuristics: participants engaged in diverse strategies to assist trade-off decisions. (4) Valuation feasibility: certain states were difficult to imagine, compare and quantify. (5) Valuation outcome: the data quality was affected by participants' discriminatory ability across states and their time trade-off decisions. Conclusion: The interviews contributed insights regarding the robustness of the proposed methods. The application of C-TTO and DCE valuation techniques was practical and suitable for capturing individual attitudes towards different mental well-being scenarios. A modified protocol informed by the results is being tested in a larger sample across the UK. [ABSTRACT FROM AUTHOR]

Measures of mental health are heavily relied upon to identify at-risk individuals. However, self-reported mental health metrics might be unduly affected by mis-reporting (perhaps stemming from stigma effects). In this article, we consider this phenomenon by focusing upon the mis-reporting of mental health using UK panel data from 1991 to 2018. In separate analyses of males and females, we examine how inaccurate reporting of the General Health Questionnaire (GHQ - 12) measure, specifically its sub-components, can adversely affect the distribution of the index. The analysis suggests that individuals typically over report their mental health (especially so for males). The results are then used to adjust the GHQ - 12 score to take mis-reporting into account. We then compare the effects of the adjusted/unadjusted GHQ - 12 index when modelling a number of important economic transitions. Using the original index typically leads to an underestimate of the effect of poor mental health on transitions into improved economic states, for example, unemployment to employment. [ABSTRACT FROM AUTHOR]

Suicide risk is elevated among college-aged students and individuals exposed to cumulative interpersonal trauma. This study used the interpersonal theory of suicide as a framework to test the relation between cumulative interpersonal trauma and suicide ideation through the indirect effects of cumulative interpersonal trauma via depression, thwarted belongingness (TB), and perceived burdensomeness (PB), in serial. Participants were 261 college students who endorsed prior trauma and completed cross-sectional study measures online. An atemporal serial mediation model indicated that cumulative interpersonal trauma significantly and indirectly related to suicide ideation through depressive symptoms, TB, and PB. The relation between cumulative interpersonal trauma and suicide ideation was explained by greater depressive symptoms, TB, and PB, in serial. Therefore, depressive symptoms, TB, and PB may be important modifiable clinical targets for college students with a history of cumulative interpersonal trauma. [ABSTRACT FROM AUTHOR]

Paediatricians and healthcare professionals working with children are well placed to observe parents and see a wide range of parenting from the exceptional to the abusive. Parenting has important short, medium and long term effects on child physical and mental health. Understanding these effects more fully helps paediatricians to comment on parenting, offer advice or refer to parenting programmes. This article outlines advances in neuroscience and attachment theory as well as contemporary issues that underpin the case for parenting intervention. It also discusses the rationale and evidence base for particular programmes, the UK policy context, and makes some suggestions on how paediatricians may wish to support better parenting. [ABSTRACT FROM AUTHOR]

Globally, promoting mental wellbeing among adolescents is of great public health and social significance. However, less is known about advances in measures of mental wellbeing, relevant for use in mental health interventions, which are age-appropriate and acceptable for use among adolescents. Comprehensive assessment includes multiple aspects of mental wellbeing, as well as positive indicators of feeling and functioning. This review used systematic review methods, guided by PRISMA, to identify and assess comprehensive instruments in terms of their content, conceptual relevance for youth, and responsiveness to change. Ryan and Deci's framework for mental wellbeing, grounded in hedonic and eudaimonic perspectives, was applied to assess the preponderance of feeling and functioning items for each instrument. The review identified 11 instruments that fit specified inclusion criteria. Only four of the scales were developed for adolescents. Though the scales varied in their preponderance of items, all scales encompassed at least one indicator of both feeling and functioning. Findings emphasize the importance of validating adult-developed instruments for youth and ensuring the instrument's cultural and conceptual relevance within groups of adolescents. As promoting mental wellbeing becomes critical to the field of practice, practitioners need access to relevant and acceptable measures. [ABSTRACT FROM AUTHOR]

Purpose: The Warwick-Edinburgh Mental Well-being Scale (WEMWBS), 14 positively worded statements, is a validated instrument to measure mental wellbeing on a population level. Less is known about the population distribution of the shorter seven-item version (SWEMWBS) or its performance as an instrument to measure wellbeing.Methods: Using the Health Survey for England 2010-2013 (n = 27,169 adults aged 16+, nationally representative of the population), age- and sex-specific norms were estimated using means and percentiles. Criterion validity was examined using: (1) Spearman correlations (ρ) for SWEMWBS with General Health Questionnaire (GHQ-12), happiness index, EQ-VAS (2) a multinomial logit model with SWEMWBS (low, medium and high wellbeing) as the outcome and demographic, social and health behaviours as explanatory variables. Relative validity was examined by comparing SWEMWBS with WEMWBS using: (1) Spearman correlations (continuous data), and (2) the weighted kappa statistic (categorical), within population subgroups.Results: Mean (median) SWEMWBS was 23.7 (23.2) for men and 23.2 (23.2) for women (p = 0.100). Spearman correlations were moderately sized for the happiness index (ρ = 0.53, P < 0.001), GHQ-12 (ρ = -0.52, p < 0.001) and EQ-VAS (ρ = 0.40, p < 0.001). Participants consuming <1 portion of fruit and vegetables a day versus ≥5 (odds ratio = 1.43 95% Confidence Interval = (1.22-1.66)) and current smokers versus non-smokers (1.28 (1.15-1.41)) were more likely to have low vs medium wellbeing. Participants who binge drank versus non-drinkers were less likely to have high versus medium wellbeing (0.81 (0.71-0.92)). Spearman correlations between SWEMWBS and WEMWBS were above 0.95; weighted kappa statistics showed almost perfect agreement (0.79-0.85).Conclusion: SWEMWBS distinguishes mental wellbeing between subgroups, similarly to WEMWBS, but is less sensitive to gender differences. [ABSTRACT FROM AUTHOR]

Although much research has been devoted to examining the relationship between negative mental health states (e.g., depression) and physical activity, the literature is scarce in terms of associations between positive mental health states (e.g., mental wellbeing) and physical activity. The objective of this study was to examine the association between mental wellbeing measured in 2019 and physical activity measured in 2020 (including bi-directionality). Data stem from a Danish nationally-representative panel of 5000 adults (aged 15+ years) conducted in 2019 and 2020, which was linked to register data. The SWEMWBS scale was used to assess mental wellbeing. The outcome was ≥150 min of physical activity per week (self-reported). Logistic regression models were performed, adjusting for covariates and physical activity at baseline. Each point increase in mental wellbeing in 2019 positively predicted ≥150 min of physical activity per week in 2020 (OR = 1.03, 95%CI 1.01–1.05). Compared to low mental wellbeing, moderate wellbeing was associated with higher odds (OR = 1.51, 95%CI 1.10–2.08) of engaging in ≥150 min of physical activity, while the odds among those with high mental wellbeing were even higher (OR = 1.93, 95%CI 1.37–2.72). The results reflected a dose-response pattern. Finally, the reverse pathway was noted as well, i.e., physical activity in 2019 positively predicted mental wellbeing in 2020. The results show that favorable mental health status – beyond the absence of mental illness – positively predicts adherence to recommended physical activity levels in the following year. Initiatives to promote mental wellbeing may be instrumental as a means to protect and enhance general health by positively influencing engagement in physical activity. Conversely, increasing physical activity levels may protect against mental illness and further enhance population mental wellbeing. • A study was conducted to investigate associations between mental wellbeing in 2019 and physical activity in 2020. • Compared to a low level of mental wellbeing, higher levels positively predicted physical activity. • The pattern in the results reflect a dose-response relationship, i.e., greatest benefit when mental wellbeing is maximized. • The reverse pathway was also noted, i.e., physical activity positively predicted mental wellbeing. • Promoting mental wellbeing may increase physical activity. Conversely, increasing physical activity may enhance mental health. [ABSTRACT FROM AUTHOR]