NIOSH Worker Well-Being Questionnaire (WellBQ)

How to Use the Questionnaire

How long does it take to complete the NIOSH WellBQ?

The questionnaire will take about 15 minutes to complete.

How do I administer the NIOSH WellBQ?

The NIOSH WellBQ is designed to collect information across the five domains of worker well-being without posing a burden to respondents. Because the questionnaire is meant to comprehensively assess worker well-being, NIOSH recommends administering the NIOSH WellBQ as a whole. Users who are interested in only specific topics may wish to administer other instruments, such as those listed in the NIOSH WellBQ Item Source Table.

Complementing the worker well-being items are 15 optional ones pertaining to employment circumstances and worker demographics. These sample items were selected on the basis of their common use in population and occupational health questionnaires. Users may exclude, add, or edit these optional items, depending on the questionnaire application. We recommend that these items be placed at the end, following the NIOSH WellBQ.

What information should I provide to participants about data privacy?

Whether using the NIOSH WellBQ for research, surveillance, or practical applications within organizations, steps should be taken to protect the anonymity of participants throughout the data collection, analysis, and reporting processes. Participant names or other potentially identifying information such as their computer IP (internet protocol) address should not be collected together with their NIOSH WellBQ responses. Protecting worker privacy is an essential element of a Total Worker Health^® approach.

When using the NIOSH WellBQ for research or surveillance,

• Establish procedures to obtain informed consent from prospective participants.
• Consult with a relevant human subjects review body and obtain approval as needed to ensure the use of ethical procedures and the protection of participants’ privacy.

When an organization uses the instrument for more practical purposes, including the optional demographic or employment items and their variants can be a concern. Responses to these items, individually or in combination, could lead to participant identification and breach of privacy if they are linked at the individual level to responses to the NIOSH WellBQ items. This applies to the NIOSH WellBQ injury items (Q62 and Q63) as well. If the interest is simply an overall or global assessment of well-being, organizations may want to consider if it is necessary to collect demographic, employment, or injury information.

In some cases, organizations may wish to dig deeper and explore worker well-being in relation to various organizational or worker characteristics. This would necessitate linking responses to the demographic and employment items or the NIOSH WellBQ injury items with responses to other NIOSH WellBQ items at the individual level.

To help minimize risk to privacy under these circumstances:

• Use a third party operating under the guidance of a human subjects review body to administer and conduct subgroup analyses
• Ensure that the linked response data are inaccessible to the organization. Make sure that any participant subgroup under study is large enough to prevent the identification of a subgroup member and their responses to NIOSH WellBQ items.

Provide the following information to individuals when soliciting their participation in the NIOSH WellBQ:

• Purpose of administering the questionnaire
• Procedures involved
• Participation is voluntary
• Risks/benefits to completing the questionnaire
• Steps taken to protect the anonymity of respondents throughout the data collection, analysis, and reporting processes
• Compensation (if any)
• Right to withdraw
• A point of contact for questions or concerns

For information about research ethics, please see the CDC Office of Science website.

Are there restrictions on use of the NIOSH WellBQ?

This instrument may be freely reproduced, reprinted, or distributed. Many of the items have been adopted, with permission when necessary, from existing questionnaires. NIOSH obtained permission for using items for the purpose of this instrument. Permissions to adopt some items for this instrument do not allow fees to be charged for their use. The codebook provides specific use stipulations for each item when necessary. Please contact NIOSH Total Worker Health staff at twh@cdc.gov if you have questions.

Please see the NIOSH WellBQ Item Source Table for the full list of sources for questionnaire items.

Items that were drawn or adapted from the public domain or that were created by the research team are denoted as such in the codebook and the NIOSH WellBQ Item Source Table; no restrictions apply to the use of these items. Please note the suggested citation for the NIOSH WellBQ on the NIOSH website.

Questionnaire Development

How was the NIOSH WellBQ developed?

The NIOSH WellBQ was created by NIOSH and researchers at the RAND Corporation with funding from NIOSH. The design and content of the questionnaire were guided by a new conceptual framework that identifies the five domains of worker well-being. This framework was derived from an in-depth, multi-disciplinary literature review of well-being theories, research, and measurement tools by the RAND Corporation. Conditions of interest within each domain, which in turn defined the types of questions posed within each domain, were identified with assistance from a scientific panel with expertise in well-being and occupational safety and health.

The items in the questionnaire were strategically selected on the basis of their relevance to the five domains of worker well-being. Most of the items are adopted from existing instruments. After a draft questionnaire was created, cognitive testing was conducted on a convenience sample of employed individuals. Approval to field-test the questionnaire was then obtained from the Office of Management and Budget (OMB), on June 1, 2018 (OMB Control Number 0920-1234). The draft questionnaire was fielded on a probability-based sample by an internet-based survey administration service, following an initial pre-test of the questionnaire. Participants in the field test completed the draft questionnaire in approximately 20 minutes. Data from 975 respondents were analyzed to create multi-question scales, conduct factor analysis and other psychometric testing, conduct tests of concurrent validity, and eliminate less productive items. Some items were revised to improve clarity, and a few items were eliminated from the piloted tool. The final questionnaire can be completed in approximately 15 minutes.

Questionnaire Results

How can the data from the NIOSH WellBQ be interpreted?

The NIOSH WellBQ is a new instrument whose qualities are supported by extensive psychometric analyses based upon a large pilot study. As with all new instruments, the NIOSH WellBQ has limitations at this stage of development. The limitations will be addressed through accumulation of data and development of information in the future. For example, the available information is not sufficient to establish norms for measures across worker populations and industry and occupational sectors. Similarly, the available information is not sufficient to develop algorithms for creation of summary scores to characterize worker well-being. Applying the NIOSH WellBQ in a variety of workplace settings and among various worker populations will provide the information needed to address these limitations.

In the meantime, inferences regarding the status of worker well-being, intervention needs, intervention effects, etc., can be drawn from review of responses to questions and scale scores and from profiles of these values and scores across NIOSH WellBQ measures of interest. For immediate applications of the NIOSH WellBQ, please see the discussion on “How the NIOSH WellBQ Can Be Used” in the document.

In summary, users may apply the NIOSH WellBQ for the following purposes:

1. To set benchmarks internal to an organization or workforce
2. To examine changes over time or assess the impact of interventions
3. To compare results between groups within the same facility or workforce or across organizations or working populations.

It is important to note, however, that the design of the NIOSH WellBQ does not permit absolute or clinical judgements of worker well-being, nor are there firm thresholds for scores that would signal actions to affect worker well-being.

Once I have the results from the NIOSH WellBQ, how do I use the information to improve working conditions and worker health?

Please see the Resources for Action for resources that may be useful for improving​ worker well-being on the basis of applying the instrument. For guidance on development of actions or interventions after using the NIOSH WellBQ, please see Fundamentals of Total Worker Health Approaches. NIOSH will develop further guidance for scoring and interpretation as new analysis arises from further research.

Still have questions about the NIOSH WellBQ? Email us at twh@cdc.gov.