# Wheel of Wellness — Evidence Base

Each mockup is grounded in one or more validated, peer-reviewed instruments published or
validated within the last 10-15 years. Instruments were selected for brevity
(5-30 items), accessibility at a 4th-grade reading level where possible, and
alignment with the six-dimension wellness framework (Physical, Emotional, Social,
Daily Life, Purpose, Growth).

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## 1. Generalized Audience

**Mockup:** `mockup-generalized.html`

| Instrument | Citation | Year | Items | Notes |
|-----------|----------|------|-------|-------|
| **WHO-5 Well-Being Index** | World Health Organization. (1998). *Well-being measures in primary health care: The DepCare project.* WHO Regional Office for Europe. Re-validated: Topp, C. W., Østergaard, S. D., Søndergaard, S., & Bech, P. (2015). The WHO-5 Well-Being Index: A systematic review of the literature. *Psychotherapy and Psychosomatics, 84*(3), 167-176. | 1998 / 2015 | 5 | Widely used, free, validated across 30+ languages. Measures subjective psychological well-being over 2 weeks. |
| **PROMIS Global Health-10** | Hays, R. D., Bjorner, J. B., Revicki, D. A., Spritzer, K. L., & Cella, D. (2009). Development of physical and mental health summary scores from the Patient-Reported Outcomes Measurement Information System (PROMIS) global items. *Quality of Life Research, 18*(7), 873-880. NIH-funded; public domain. | 2009 / 2018 | 10 | Free, public-domain. Covers physical, mental, and social health. Validated for general population. |

**Adaptation strategy:** WHO-5 items frame emotional/purpose dimensions; PROMIS global items contribute physical and social health language. Questions rewritten at ~4th-grade reading level.

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## 2. Parent / Caregiver

**Mockup:** `mockup-parent-caregiver.html`

| Instrument | Citation | Year | Items | Notes |
|-----------|----------|------|-------|-------|
| **Caregiver Well-Being Scale — Short Form (CWBS-SF)** | Tebb, S., & Berg-Weger, M. (2016). The Caregiver Well-Being Scale: Developing a short-form rapid assessment instrument. *Health & Social Work, 38*(4), 222-230. | 2016 | 16 | Abbreviated from the original 43-item CWBS. Measures basic needs and activities of daily living for caregivers. |
| **CAREPAL-8** | CAREPAL Consortium. (2024). The CAREPAL-8: A short screening tool for multidimensional family caregiver burden. *BMC Palliative Care, 23*, Article 80. | 2024 | 8 | Newest short-form caregiver burden screen. Covers emotional, physical, social, and financial domains. |
| **Preparedness for Caregiving Scale** | Archbold, P. G., Stewart, B. J., Greenlick, M. R., & Harvath, T. (1990). Mutuality and preparedness as predictors of caregiver role strain. *Research in Nursing & Health, 13*(6), 375-384. Updated validation: Pucciarelli, G., et al. (2014). *Journal of Advanced Nursing, 70*(10). | 1990 / 2014 | 8 | Measures perceived readiness across multiple caregiving domains. |

**Adaptation strategy:** Dual framing for single-parent and two-parent households. Combined CWBS-SF items for self-care neglect with CAREPAL-8 items for multidimensional burden. Added system navigation questions (IEP, insurance, benefits) specific to special-needs caregiving.

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## 3. Family Member / Household

**Mockup:** `mockup-family-member.html`

| Instrument | Citation | Year | Items | Notes |
|-----------|----------|------|-------|-------|
| **Beach Center Family Quality of Life Scale (FQOL)** | Hoffman, L., Marquis, J., Poston, D., Summers, J. A., & Turnbull, A. (2006). Assessing family outcomes: Psychometric evaluation of the Beach Center Family Quality of Life Scale. *Journal of Marriage and Family, 68*(4), 1069-1083. Updated: Chiu, C. Y., et al. (2020). *Journal of Intellectual Disability Research, 64*(1). | 2006 / 2020 | 25 | Five subscales: Family Interaction, Parenting, Emotional Well-Being, Physical/Material Well-Being, Disability-Related Support. |
| **Family Quality of Life Survey (FQoLS)** | Brown, I., et al. (2006). *Family Quality of Life Survey: Main caregivers of people with intellectual or developmental disabilities.* Toronto: Surrey Place Centre. | 2006 | 54 | Comprehensive family outcomes measure. Short-form adaptations available. |

**Adaptation strategy:** Mapped FQOL subscales to the 6-dimension wellness wheel. Family Interaction → Social, Emotional Well-Being → Emotional, Physical/Material → Physical, Disability-Related Support → Daily Life, Parenting → Purpose/Growth.

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## 4. Professionals (Therapists, Counselors, Coaches, Educators)

**Mockup:** `mockup-professional.html`

| Instrument | Citation | Year | Items | Notes |
|-----------|----------|------|-------|-------|
| **Professional Quality of Life Scale (ProQOL-5)** | Stamm, B. H. (2010). *The Concise ProQOL Manual* (2nd ed.). Pocatello, ID: ProQOL.org. | 2010 | 30 | Three subscales: Compassion Satisfaction (10 items), Burnout (10 items), Secondary Traumatic Stress (10 items). Gold standard for helping-profession wellness screening. |
| **Oldenburg Burnout Inventory (OLBI)** | Demerouti, E., Bakker, A. B., Vardakou, I., & Kantas, A. (2003). The convergent validity of two burnout instruments. *European Journal of Psychological Assessment, 19*(1), 12-23. Updated: Reis, D., et al. (2015). *BMC Public Health, 15*. | 2003 / 2015 | 16 | Measures exhaustion and disengagement. Validated across professions. |

**Adaptation strategy:** Blended ProQOL-5 items (compassion satisfaction, burnout, secondary trauma) with the 6-dimension personal wellness framework. Added work-life boundary and peer consultation items specific to clinical/coaching practice.

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## 5. Special Needs / Accessible Format

**Mockup:** `mockup-special-needs.html`

| Instrument | Citation | Year | Items | Notes |
|-----------|----------|------|-------|-------|
| **Personal Wellbeing Index — Intellectual Disability (PWI-ID)** | Cummins, R. A., & Lau, A. L. D. (2005). *Personal Wellbeing Index — Intellectual Disability* (3rd ed.). Melbourne: Australian Centre on Quality of Life, Deakin University. | 2005 | 8 | Uses simplified language and visual/concrete anchors. Validated with adults with mild to moderate ID. |
| **San Martin Scale** | Verdugo, M. A., et al. (2014). *Journal of Applied Research in Intellectual Disabilities, 27*(1). | 2014 | 95 | Comprehensive quality of life scale for people with significant disabilities. Short-form available. |

**Adaptation strategy:** Emoji-based 5-point response scale (😟→😄) replacing Likert-type text. Concrete, single-concept questions ("How do you feel about your health?"). Larger text, high-contrast colors, simplified vocabulary throughout. 12 items instead of 18. Support person may assist.

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## Cross-Cutting Frameworks

- **Six-Dimension Wellness Model:** Adapted from the National Wellness Institute (NWI) and Adams et al. (1997) with the "Occupational" dimension reframed as "Daily Life" (based on PWI-ID "safety/future security" domain and FQOL "disability-related support" domain).
- **4th-Grade Reading Level:** All question text reviewed against Flesch-Kincaid Grade Level targets (< 4.5). Simple sentence structure, no compound clauses, high-frequency vocabulary.
- **Trauma-Informed Design:** No mandatory identifiers, no account required, downloadable results under user control, clear "your answers are private" messaging.

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*Last updated: July 2026*
*All instruments cited are available for clinical and research use. Some require author permission for commercial use — verify licensing before deployment.*
