Development and validation of a self-report social determinants of health questionnaire in Australia

Candice Oster, Bill Gransbury, Deb Anderson, Vicki Martin, Pawel Skuza, Richard Leibbrandt

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Social determinants of health have a significant effect on health and wellbeing. There is increasing recognition of the need for health professionals to measure and address the social determinants affecting the health and wellbeing of their clients, yet efforts to do so are hampered by the lack of a validated, brief self-report measure that covers a range of determinants in a single measure. This study aimed to develop and conduct initial validation of a measure of social determinants of health, the Steps to Better Health Questionnaire (STBH-Q). Construct validity was assessed via factorial validity using exploratory factor analysis and second order confirmatory factor analysis (CFA), followed by convergent validity against the EQ-5D-5L quality of life measure. Reliability was assessed by exploring internal consistency. A convenience sampling approach was used, and 330 Australian adults aged 18 and over completed the survey. This initial validation suggests an underlying structure of STBH-Q consisting of Access; Employment, Finances & Education; Safety; Physical & Mental Health; and Family & Childhood, confirmed by second-order CFA. Results of convergent validity testing with the EQ-5D-5L demonstrated significant correlations of modest to moderate strength with the instrument as a whole and with the sub-scales in the expected direction. Cronbach’s alpha for the five scales ranged from 0.561 to 0.827. Further development and validation of the STBH-Q is needed to explore alternative questions regarding social connection and habits/addictions and add additional items to factors with only two items.
Original languageEnglish
Article numberdaac029
Number of pages11
JournalHealth Promotion International
Issue number3
Early online date21 Mar 2022
Publication statusPublished - Jun 2023


  • social determinants of health
  • validation
  • questionnaire


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