Promoting positive child and youth health and development requires clear definitions and comprehensive measures of child and youth thriving. The study’s objectives were to identify the scope, range, and gaps in definitions and measures of thriving for children or youth (birth through young adult).
Systematic searches of Pubmed, PsycInfo, Health and Psychosocial Instruments, Education Resources Information Center, and Scopus were conducted for articles that included definitions, conceptual frameworks, or measures of child and youth thriving. Inclusion criteria were that the articles: (1) provided a new definition or measure of child thriving, flourishing, or well-being; (2) focused on normally developing children 0 to 24 years old; and (3) were published between 2009 and 2022 in an English language peer-reviewed journal. Studies were categorized by child age, study type, population, and community-identified domains of thriving.
Of the 14 920 articles identified, 113 met inclusion criteria: 34 unique definitions or frameworks, 66 validated measures, and 12 articles presenting both a framework and measure. One-third of the articles focused on early childhood (0–5 years old); 47% on middle childhood (6–11 years old); 72% on adolescence (12–17 years old), and 22% on young adults (18–24 years old).
Current child thriving definitions, frameworks, and measures could be expanded in their coverage of age and key domains, such as racial equity and safety. Additional frameworks and measures focused on early childhood (0–5 years) and assessing thriving over time are needed.
Advancing the science of child well-being requires a common framework and measures for assessing optimal pediatric health and functioning. Brief measures of child well-being and positive health1,2 have been proposed for pediatric use, yet we lack standard definitions and measures of thriving among diverse children and adolescents.3–5 Overlapping constructs of thriving, flourishing, resilience, and well-being have emerged across multiple fields, including pediatrics, developmental systems theory, positive psychology, youth development, education, and sociology.6–9 Given this burgeoning and disparate literature, this scoping review summarizes recent child and youth thriving definitions, frameworks, and measures based on a community-informed model of thriving10 that provides an equity-focused and strength-based approach and integrates the multiple contexts that bidirectionally influence child well-being to identify current gaps and directions for future research.
Child thriving is multidimensional and involves the complex interaction between individual characteristics and family, community, and environmental factors. However, few measures comprehensively assess all domains of thriving, as Pollard’s (2003) systematic review of child well-being found that only 2% of measures assessed child well-being in more than 3 domains, and most (80%) assessed only 1 domain.5 Lippman and Moore (2011) expanded these domains to include individual, relationships, and contextual factors to represent a more comprehensive conceptualization of child thriving.4 Recent targeted reviews of adolescent flourishing (11 studies),11 emotional well-being (17 studies),12 and mental well-being measures (10 studies)13 have identified the need for increased empirical research on this topic. A more expansive review of child well-being summarized how studies measure child well-being, noting gaps in early childhood measures and longitudinal research.14 However, a review of child and youth thriving has not been conducted to date, particularly one spanning developmental periods from infancy to early adulthood and incorporating biomedical and community research on child optimal health.
Defining thriving requires distinguishing it from related constructs, such as well-being, flourishing, and resilience. Subjective well-being has been conceptualized as having frequent positive emotions, infrequent negative emotions, and an overall positive evaluation of life,15 and psychological well-being has been defined to included 6 dimensions leading to positive functioning: self-acceptance, environmental mastery, positive relationships, autonomy, purpose in life, and personal growth.16 Flourishing has been defined as having positive feelings, functioning in life, and being mentally healthy.17 Thriving differs from both psychological or subjective well-being and flourishing by including physical and social health in addition to mental health.18,19 For this review, we included flourishing and well-being as search terms, but excluded resilience since it is typically defined as having better than expected outcomes after hardship has been experienced and overcome,20,21 rather than optimal functioning.
Another challenge to assessing pediatric and youth thriving is incorporating the importance of equity, diversity, and the influence of culture on defining optimal functioning, as well as the dependence on context and interactions with the environment, as theorized by Bronfenbrenner’s ecological model of human development7,22 and Mark and Garcia Coll’s (2014) ecological model of the development of ethnically diverse children.23 A comprehensive measure of thriving is critical given that health equity has been defined as having the opportunity for optimal health and to achieve health potential,24 and since well-being and equity are inextricably linked.25 Community-based participatory research increases the potential to improve health and eliminate health disparities by bridging gaps between research and practice, addressing social justice, and building on family and community strengths to manage their health.26,27 For this reason, we applied our community-informed conceptual framework based on discussions with diverse community members and leaders, health and social service providers, researchers, caregivers and parents, and local policymakers to assess current definitions and measures of thriving, increasing the relevance to local communities and the external validity of the study results.
This scoping review updates and expands previous summaries of child well-being to include recent (up to 2022) definitions, frameworks, and measures of child thriving focused on a community-informed model that includes novel domains (safety; racial justice, equity, and inclusion) identified by community members as critical to thriving. Given the multidimensional aspects of child thriving and multiple disciplines informing previous definitions and assessments, a scoping review is appropriate to understanding the breadth of existing measures and current gaps as a necessary first step to developing a comprehensive measure of child and youth thriving. Specifically, this study aimed to (1) examine the scope and range of definitions, frameworks, and measures of thriving from birth through early adulthood (0–24 years of age); (2) identify gaps in definitions, frameworks, and measures of thriving; and (3) provide recommendations for furthering the measurement of child thriving.
Methods
We conducted a scoping review of recent (published between 2009–2022) child thriving definitions, frameworks, and measures to provide a comprehensive assessment of the literature to understand the extent and scope of knowledge on thriving.28 We followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) Extension for Scoping Reviews (PRISMA-ScR)29 and standard processes for conducting scoping reviews,28–31 including the following 6 steps: (1) research question identification; (2) literature search; (3) study selection; (4) data charting; (5) data analysis; and (6) stakeholder consultation.
Research Question Identification and Conceptual Framework
Our research question was to identify definitions, conceptualizations, and measures of thriving from birth through early adulthood and gaps in these definitions and measures. We used a conceptual framework of thriving based on our community-partnered mixed-method study which used concept mapping to identify 8 domains essential to child and youth thriving: (1) strong minds and bodies (physical and mental health), (2) positive identity and self-worth, (3) caring families and relationships, (4) safety, (5) fun and happiness, (6) racial justice, equity, and inclusion, (7) healthy environments, and (8) vibrant communities (neighborhood and community resources).10,32 These domains guided our evaluation of existing frameworks and measures, and we documented if additional domains outside of our framework were included in other conceptualizations and assessments of child thriving.
Literature Search
We developed a protocol to guide our scoping review and provide a standardized literature search (see Supplemental Information; scoping review protocols are not usually registered in Prospero, the international prospective register of systematic reviews). Our literature search combined 4 concepts: (1) thriving (including synonyms such as flourishing, well-being, positive health, strengths and assets); (2) definitions, conceptual frameworks, and models; (3) measurement or assessments; and (4) age groups from birth through young adult (ages 0–24 years based on the World Health Organization definition of youth).33 Through an iterative process between study investigators (L.R., S.R., A.E.) and a medical librarian (R.A.), search strategies using controlled vocabulary and keywords were appropriately adapted for each of these 5 online databases: PubMed; OVID PsycINFO; Health and Psychosocial Instruments; Education Resources Information Center; and SCOPUS (See Appendix 1 for a sample search strategy and full list of terms). Searches were completed between June 2019 and April 2022, limited to journal articles, human studies, English language, and publications between 2009 and 2022 to update previous literature reviews on child well-being conducted in 20105 and 2011.4 Additional articles were identified through hand searches of references of key articles. All types of empirical studies were considered for this scoping review, including qualitative studies, review articles, meta-analyses, quantitative studies, measurement development and validation studies, as well as studies conducted in international settings.
Study Selection
Titles and abstracts were screened by 2 researchers independently to determine if the study met the inclusion criteria of providing a unique model or measure of thriving focused on normally developing children 0 to 24 years old. Any discrepancies were resolved through discussion with the research lead (A.E.) who reviewed the final list of titles for inclusion. Only original articles were included in this review, so adaptations and translations of measures into other languages or for other populations were not included unless they substantively changed the definition or measure.
Data Charting
Once the list of titles was finalized, researchers reviewed the full publication to ensure that the article met the inclusion criteria and extracted study data into a database that cataloged and summarized the study type, population, ages, domains, and psychometric properties. We conducted duplicate reviews (approximately 10%) throughout the data charting process to ensure that researchers were consistently extracting data.
Data Analysis
We analyzed descriptive statistics (means, frequencies, percentages) of the types of studies, domains, and ages covered in articles included in the review. We also conducted thematic and content analyses of the author(s)’s domains related to our conceptual framework of child thriving.
Stakeholder Consultation
We presented findings to key stakeholders, researchers, health care and social service providers, and community members and leaders to incorporate their feedback into our results. Stakeholder comments informed the types of data collected during our review, the comparisons across measures that were examined, such as ease of administration and participant burden (length of survey, type of respondent), and the presentation of the results.
Results
Of the 14 920 articles identified, 113 met inclusion criteria (Fig 1), with 34 unique definitions or conceptualizations of thriving, 67 measures assessing child thriving, flourishing, or well-being, and 12 studies presenting both a framework and measure. Table 1 provides a summary of study characteristics and included domains of the reviewed definitions and measures.
This figure shows the number of articles identified, screened, and included in the scoping review conducted in 2022 following the PRISMA-ScR framework. Articles were excluded if they were duplicates or did not meet the inclusion criteria based on the abstract or full-text review.
This figure shows the number of articles identified, screened, and included in the scoping review conducted in 2022 following the PRISMA-ScR framework. Articles were excluded if they were duplicates or did not meet the inclusion criteria based on the abstract or full-text review.
Characteristics of Included Studies
| Study Characteristics | Frameworks, N (%) | Measuresa, N (%) | Total Studies, N (%) |
|---|---|---|---|
| Study classification | 34 (30) | 79 (70) | 113 |
| Type of study | |||
| Cross-sectional or measure development | 2 (6) | 67 (85) | 69 (61) |
| Longitudinal | 1 (3) | 6 (8) | 7 (6) |
| Qualitative or mixed method | 12 (35) | 2 (3) | 14 (12) |
| Review, theoretical, or conceptual | 19 (56) | 4 (5) | 23 (20) |
| Age groupsb | |||
| Early childhood (0–5 y) | 12 (35) | 24 (30) | 36 (32) |
| School-age (6–11 y) | 11 (32) | 43 (54) | 53 (47) |
| Adolescence (12–17 y) | 23 (68) | 60 (76) | 82 (73) |
| Young adult (18–24 y) | 8 (24) | 17 (22) | 25 (22) |
| Populations | |||
| United States | 20 (59) | 46 (58) | 66 (58) |
| International or both | 14 (41) | 33 (42) | 47 (42) |
| Domains Includedb | |||
| Strong minds and bodies | 28 (82) | 49 (62) | 77 (68) |
| Positive identity and self-worth | 31 (91) | 75 (95) | 106 (94) |
| Caring families and relationships | 31 (91) | 69 (87) | 100 (89) |
| Vibrant communities | 26 (76) | 33 (42) | 59 (52) |
| Healthy environments | 13 (38) | 14 (18) | 27 (24) |
| Safety | 11 (32) | 10 (13) | 21 (19) |
| Fun and happiness | 18 (53) | 30 (38) | 48 (43) |
| Racial justice, equity, and inclusion | 8 (24) | 6 (8) | 14 (12) |
| Average | 4.0 | 4.0 | 4 domains |
| Study Characteristics | Frameworks, N (%) | Measuresa, N (%) | Total Studies, N (%) |
|---|---|---|---|
| Study classification | 34 (30) | 79 (70) | 113 |
| Type of study | |||
| Cross-sectional or measure development | 2 (6) | 67 (85) | 69 (61) |
| Longitudinal | 1 (3) | 6 (8) | 7 (6) |
| Qualitative or mixed method | 12 (35) | 2 (3) | 14 (12) |
| Review, theoretical, or conceptual | 19 (56) | 4 (5) | 23 (20) |
| Age groupsb | |||
| Early childhood (0–5 y) | 12 (35) | 24 (30) | 36 (32) |
| School-age (6–11 y) | 11 (32) | 43 (54) | 53 (47) |
| Adolescence (12–17 y) | 23 (68) | 60 (76) | 82 (73) |
| Young adult (18–24 y) | 8 (24) | 17 (22) | 25 (22) |
| Populations | |||
| United States | 20 (59) | 46 (58) | 66 (58) |
| International or both | 14 (41) | 33 (42) | 47 (42) |
| Domains Includedb | |||
| Strong minds and bodies | 28 (82) | 49 (62) | 77 (68) |
| Positive identity and self-worth | 31 (91) | 75 (95) | 106 (94) |
| Caring families and relationships | 31 (91) | 69 (87) | 100 (89) |
| Vibrant communities | 26 (76) | 33 (42) | 59 (52) |
| Healthy environments | 13 (38) | 14 (18) | 27 (24) |
| Safety | 11 (32) | 10 (13) | 21 (19) |
| Fun and happiness | 18 (53) | 30 (38) | 48 (43) |
| Racial justice, equity, and inclusion | 8 (24) | 6 (8) | 14 (12) |
| Average | 4.0 | 4.0 | 4 domains |
Measures includes articles that were both a conceptualization and an assessment of thriving.
Studies can include more than 1 category (eg, age group, domain), so the total is greater than 100%.
Study Characteristics
Most of the articles (61%) were cross-sectional or scale development or validation studies. Less than a quarter (20%) of the articles were theoretical or review studies, corresponding to conceptual framework and definition articles. Fewer studies (6%) used a longitudinal design or longitudinal data and 12% used qualitative data. Most (58%) studies were United States-based and 42% were based in international settings, including Australia, New Zealand, China, and European countries (Table 1).
Sample sizes of the studies reporting testing measures ranged from 68 to 25 906 participants. The age of participants in the studies ranged from birth to 24 years old. Approximately one third (32%) of articles focused on early childhood (0–5 years old); 47% on middle childhood (6–11 years old); 73% on adolescence (12–17 years old), and 22% on young adults (18–24 years old). Some frameworks and measures included multiple age groups or did not specify ages, so these percentages do not add up to 100%.
Domains of Child Thriving
The definitions and measures of child thriving mapped onto our community-informed definition of child thriving, although only 1 framework included all 8 domains,34 with an average of 4 domains across measures and definitions. Most measures and definitions included positive identity and self-worth (94%), followed by caring families and relationships (89%). Fewer definitions and measures included safety (19%) and racial justice, equity, and inclusion (12%).
Three articles included 7 of our domains,35–37 and 10 frameworks or measures included 6 domains,38–47 representing comprehensive assessments of child and youth thriving. Two of these focused on children in the welfare system, including assessments of safety in relationships and environments absent from other measures of thriving in the general pediatric population.36,38 The Child and Youth Well-Being Index,47 Child Well-Being Scales for Child Welfare-Referred Children,38 the Personal Well-being Index,41,46,48 included all of our domains except for racial justice, equity, and inclusion. The Personal Well-being Index measures standard of living, health, achieving in life, relationships, safety, community connectedness, and future security for older children (over 12).41,46 The Developmental Assets Profile45 assesses support, empowerment, boundaries and expectations, constructive use of time, commitment to learning, positive values, social competencies, and positive identity. The 5 C’s model includes competence, confidence, connection, character, and caring measured by 76 items.39 The model was extended to include the sixth C, contribution, as an outcome shaped by the other 5 Cs,49 recognizing the importance of youth social conscience, altruism, generosity, and volunteering or civic engagement.4,39,50
Although most frameworks and measures emphasized psychological well-being, fewer included assessments of physical health and well-being integral to child thriving. These measures include the Cincinnati Thrive at Five measure uses data available in electronic health records to assess physical well-being, defined as up-to-date immunizations, healthy body mass index, no dental pain, normal or corrected vision and hearing, and meeting language development and socioemotional well-being milestones.1 Moore’s Index of Positive Child Well-being includes items on physical health, psychological health, social health, educational achievement, and cognitive development. The KIDSCREEN-10 is a health-related quality of life assessment including physical well-being, psychological well-being, autonomy, parent relations, peers and social support, and school environment.51 The Early Development Instrument52 for kindergarten children and the Middle Years Developmental Instruments53 for fourth–eighth graders assess 5 developmental areas, including physical health and well-being.
Additional Domains
Some frameworks assessed aspects of child well-being and thriving not initially included in our definition. Spiritual well-being was a core domain in several frameworks,40,41,47,54 whereas our community partners listed religious institutions as part of our vibrant communities domain. Benson and Scales (2009) framework of adolescen thriving focuses on adolescents having a spark or passion that leads them to engagement and absorption in activities.55 In a qualitative study of adolescents and young adults, personal strengths in response to personal challenges (such as the courage and perseverance to overcome fears and being open to personal growth) was critical to flourishing and thriving.56 Finally, romantic relationships and having a positive love life was emphasized in some frameworks of thriving, particularly those focused on youth and adolescents.40,41
Diverse Populations
The review included 5 child thriving definitions and measures developed for minority and indigenous populations in the United States and internationally, including immigrant23 and Aboriginal populations.57–59 These measures contained our community-informed concept mapping domains such as strong minds and bodies, with additional focus on traditional healing practices and cultural identity and ethnic pride that relate to our domain of racial justice, equity, and inclusion. Our domains of vibrant communities and healthy environments is consistent with the more holistic models of well-being of indigenous cultures, which are inclusive of extended family, tribal or village, and environmental well-being, as well as ancestral and spiritual connection.58,60,61 Spiritual development and religiosity are also important factors for overall well-being for many different cultures, including indigenous populations and African-American or Black communities.54
One article adapted an existing framework for transgender youth,62 describing how the 5C’s model of positive youth development could address challenges faced by gender expansive youth. Other articles have examined how child and youth well-being may be protective against negative health outcomes for transgender youth.63,64 This review suggests the need for additional frameworks and assessments adapted for all gender identities.
Measure Description
Of the 79 identified measures of child thriving, most (n = 60; 76%) were child or youth self-report only, 5 were parent report only, 9 included measures for both parent and child or youth report, 6 used secondary data (such as electronic medical record or indicators), and 3 included teacher or case manager report in addition to parent and youth report. The average number of items per measure was 38 (range of 3–167 items). A summary of the measures covered in this review, including domains, number of items, and psychometric properties, are described in Table 2.
Child and Youth Thriving Measures
| Measure Name, Citation | Brief Description of Measure Domains | Number of Items | Mode | Cronbach’s α (Range) | Sample (N, Ages or Grade, Location)a |
|---|---|---|---|---|---|
| Adapted Children’s Worlds Survey78 | Subjective well-being (life satisfaction, mental health, self-image), home and family life, life and neighborhood context, school relationships and quality, peer relationships | 65 | Youth self-report | 0.58–0.90 | 149, seventh grade students, Midwest US |
| Adolescence School Subjective Well-Being Scale (ASSWBS)79 | 7 dimensions of students’ subjective well-being: identification with school; learning and personal development; safety; relationship with colleagues; relationship with teachers; emotional wellbeing; relationship with family | 32 | Youth self-report | Overall: 0.88 (0.71–0.86) | 2252k, 13–19 y, Romania |
| Adolescent Thriving80 | Sparks, relationships, and empowerment | 58 | Youth self-report | 0.73–0.89 | 1817, 15 y, US |
| Australian Child Wellbeing Project (ACWP) Questionnaire81 | Family, friends, school, community or neighborhood, health, and money and material wellbeing | 18 | Youth self-report | NR | 5400+, 8–14 y, Australia |
| Behavioral and Emotional Engagement82 | Academic wellbeing (behavioral engagement, emotional engagement, behavioral disaffection, and emotional disaffection) | 20 | Youth self-report, teacher report | 0.61–0.85 | 1018, third–6th grade students, US; 53 teachers |
| Brief Adolescents’ Subjective Well-Being in School Scale (BASWBSS)83 | Satisfaction with school achievement, school management, teacher–student relationships, peer relationships, teaching, and academic learning; positive affect in school and negative affect in school | 8 | Youth self-report | 0.82 | 1228, seventh–8th and 10th–11th grade students, China |
| Brief Inventory of Thriving84 | Life satisfaction, positive emotions, support, belonging, meaning, engagement, self-worth, self-efficacy, accomplishment, optimism | 10 | Youth self-report | 0.75 | 490, college students 16–24 y, US |
| Brief Scale of Psychological Well-Being85 | Autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance | 24 | Youth self-report | 0.77–0.88 | 1433, 10–16 y, Hong Kong |
| Brief Scale of Psychological Well-Being for Adolescents (BSPWB-A)86 | Psychological wellbeing: self-acceptance, positive interpersonal relationships, autonomy, life development, total well-being | 20 | Youth self-report | Overall: 0.7, 0.79–0.95 | 1590, 13–19 y, Spain |
| Center for the Study of Social Policy Youth Thrive Survey87,88 | Assesses 5 factors: youth resilience; social connections; knowledge of adolescent development; concrete support in times of need; cognitive and social-emotional competence | 66 | Youth self-report | Overall: 0.96, 0.84–0.91 | 245, 12–26 |
| Character Strengths Inventory for Children (CSI-C)50 | 24 character strengths: interpersonal (eg, teamwork, leadership, kindness), transcendence (spirituality, gratitude, hope), intellectual (eg, curiosity, love of learning, creativity), and temperance (eg, forgiveness, modesty, self-regulation) strengths | 96 | Youth self-report | 0.73–0.87 | 2061, 7–12 y, Israel |
| Character Strengths89 | Future orientation, optimism, perseverance, responsibility, thrift, leadership, teamwork, gratitude, and respect | 27 | Youth self-report | NR | 2467, 9–19 y, US |
| Child and Youth Well-Being Index (CWI)47 | 7 domains: family economic well-being, health, safety or behavioral concerns, educational attainment, community connectedness, social relationships, emotional or spiritual well-being | 28 indicators | National data indicators; parent report | NA | 0–18 y, US |
| Child Flourishing Index (CFI)2 | Curiosity in learning new things, persistence in completing tasks, capacity to regulate emotions | 3 | Parent report | 0.67 | 51 156, 6–17 y, US |
| Child Well-Being Scales (CWBS) for Child Welfare-Referred Children38 | 3 factor model of physical well-being (physical health care, nutrition or diet, personal hygiene); academic well-being (adequacy of education, academic performance, school attendance); and socio-emotional well-being (children’s family relations, children’s misconduct and coping behavior) | 15 | Parent and case manager report | 0.72–0.79 | 249 parents and 46 case managers of 1–18 y, Portugal and Spain |
| Child Well-being90 | Material well-being, relationships, health and behavioral wellbeing, and educational, environmental enrichment in at-risk families | 64 | Parent report | NR | 4689, 0–9 y, US |
| Cincinnati Kids Thrive at 51 | Physical well-being, (immunizations up-to-date, healthy body mass index, free of dental pain, normal or corrected vision, normal or corrected hearing), language development (literacy and communication) and social and emotional well-being milestones | 8 indicators | EMR data | NA | 9544, 5 y, US |
| College Student Subjective Wellbeing Questionnaire (CSSWQ)91 | Covitality measured by 4 subscales: academic efficacy, college gratitude, school connectedness, and academic satisfaction | 15 | Youth self-report | 0.80–0.92 | 971 college students, US |
| Comprehensive Inventory of Thriving for Children (CIT-CHILD)92 | Supportive or enriching relationships, interest or engagement in daily activities, sense of mastery or accomplishment, optimism, subjective well-being (high life satisfaction & positive feelings) | 45 (12 subscales) | Youth self-report | Overall: 0.86, 0.61–0.83 | 626, 8–11 y, Italy |
| Developmental Assets Profile (DAP)45 | Support, empowerment, boundaries and expectations, constructive use of time, commitment to learning, positive values, social competencies, and positive identity | 58 | Youth self-report | 0.92–0.94 | 15 000+, 11–19 y, Albania, Bangladesh, Japan, Lebanon, and the Philippines |
| Dual Factor Measure of Mental Well-being93 | Self- report indicators of subjective well- being (life satisfaction, positive and negative affect), and psychopathology (psychological symptoms and overt risk- taking behavior) | 15 | Youth self-report | 0.75–0.87 | 21 993, grade 6–10 students, Canada |
| Dual Factor Model of Mental Health94 | Subjective well-being (life satisfaction and positive and negative affect), psychopathology, engagement (behavioral, emotional, cognitive), environmental context, academic achievement | 167 (multiple measures) | Youth self-report | 0.72–0.91 | 764, seventh and eighth grade students, US |
| Early Development Instrument (EDI)95 | 5 child development areas: physical health and wellbeing; social competence; emotional maturity; language, cognitive development, and communication skills; and general knowledge | 103 | Teacher report | 0.84–0.96 | 16 074 kindergarten students, Canada |
| Engaged Living in Youth Scale96 | Social integration (social connections, a desire to help others, purpose), absorption (desire to be active and when doing so being absorbed) | 15 | Youth self-report | 0.82–0.89 | 2198, 12–19 y, US |
| EPOCH Measure of Adolescent Well-being97 | 5 positive psychological characteristics: engagement, perseverance, optimism, connectedness, and happiness | 20 | Youth self-report | 0.63–0.95 | 4480, 10–18 y, US and Australia |
| Five C’s model of Positive Youth Development39 | Competence, confidence, connection, character, caring measured by combining scales | 76 | Youth self-report | 0.59–0.97 | 920, eighth–10th grade students, US |
| Flourishing at school (well-being and creativity)98 | Well-being: 4 factors: positive and negative emotional experience of well-being; feelings of competence; and engagement; creativity: interest in new things and intrinsic motivations | 12 indicators | Youth report | NR | 855, 7–12 y, France |
| Flourishing Children Project99 | 19 constructs of positive development across 6 domains: relationship skills, flourishing in relationships, flourishing in school and work, helping others to flourish, environmental stewardship, personal flourishing | Teen: 147, parent: 125 | Youth and parent report | 0.56–0.93 | 68, 12–17 y and 23 parents, US |
| Flourishing Scale100 | Positive relationships, feelings of competence, having meaning and purpose in life | 8 | Youth self-report | Flourishing scale: 0.87 | 689, college students, US and Singapore |
| Health Asset Profiles101 | Health assets: family financial, psychological, family social (family routines, communication, parental monitoring), friends social (student support, communication), school social (teacher support, competence, autonomy, participation), and human (learning difficulties, educational aspirations, health literacy) | 101 | Youth self-report | Used to develop health asset profiles (6 categories) | 3833, 13–15 y, Finland |
| Health-related quality of Life (HRQoL) in children and in adolescents102 | Physical, psychosocial, and social health, health behavior, and quality of life | 130 (multiple measures) | Youth self-report | 0.59–0.86 | 3195, fifth–seventh grade students, Portugal |
| Healthy and Ready to Learn measure71 | Early learning skills, social-emotional, self-regulation, and physical health | 18 | Parent report | NR | 7565, 3–5 y, US |
| Healthy Pathways Child-Report Scales103 | Comfort, energy, resilience, risk avoidance, subjective well-being, achievement | 88 (17 dimensions) | Youth self-report | 0.56–0.86 | 2095, fourth–6th grade students, US |
| How I feel About My School (HIFAMS) Questionnaire104 | Perceived well-being in the educational setting, including satisfaction with teachers, peers, classrooms, playgrounds, the transition to school, work and school | 7 | Youth self-report | 0.62 | 2345, 4–8 y, England |
| Index of Positive Child Well-being105 | Physical health, psychological health, social health, educational achievement and cognitive development | 30 (6–11 y), 32 (12–17 y) | Parent report | Index | 6–17 y, US |
| KIDSCREEN-1051 | Health-related quality of life including physical well-being, psychological well-being, autonomy and parent relations, peers and social support, and school environment | 10 | Youth and parent report | Youth: 0.82, parent: 0.78 | 22 830, 8–18 y and 16 237 parents, Europe |
| Life Satisfaction scale73 | Life satisfaction with work, school, home, social life, standard of living, career prospects, independence, and life as a whole | 12 | Youth self-report | NR | 7653 older adolescents, Australia |
| Mental health Continuum-Short Form (MHC-SF)106 | 3 dimensions of positive mental health: emotional, social, and psychological well-being | 14 | Youth self-report | >0.80 | 1234, 12 18 y, US |
| Middle Years Development Instrument (MDI)53 | Social and emotional development, connectedness to peers and adults at school, home, and in the neighborhood, school experiences, physical health and well-being, and constructive use of time after school | 71 | Youth self-report | 0.65–0.87 | 3026 children, fourth grade, Canada |
| Model of Subjective Well-being107 | Competence, autonomy, relatedness, satisfaction of family relationships, satisfaction of relationships with important others, positive affect, life satisfaction, determining of achievement goals, determining of relationship goals, determining of body goals | 45 | Youth self-report | 0.75–0.87 | 326, 14–17 y, Turkey |
| Modified Student Life Satisfaction Scale (SLSS) from the International Survey of Children’s Well-Being (ISCWeB)108 | Overall life satisfaction | 5 | Youth self-report | 0.69–0.71 | 1978, 10 and 12 y, Nepal |
| Multidimensional Adolescent Functioning Scale (MAFS)109 | 3 distinct subscales: general functioning, family-related functioning, and peer-related functioning | 23 | Youth self-report | 0.75–0.91 | 842 students in grade 10–12, Australia |
| PERMA Model of Flourishing110,111 | Psychological well-being with 5 domains: positive emotions (P), engagement (E), relationships (R), meaning (M), and accomplishment (A) | 118 | Youth self-report | 0.68–0.92, | 516, 13–18 y, Australia |
| Personal Wellbeing Index (PWI)-9112 | Added 2 new items to PWI: satisfaction with my time use, satisfaction with myself | 9 | Youth self-report | PWI-7: 0.80, PWI-9: 0.83 | 5331, 12–16 y, Brazil, Spain & Chile |
| Personal Well-being Index for Adults (PWI-A)46 | Standard of living, health, achieving in life, relationships, safety, community-connectedness, and future security | 7 | Youth self-report | 0.81 | 533 gifted college students, US |
| Personal Well-being Index for School Children (PWI-SC) | Health, quality of life, accomplishments, feeling safe, community, security for the future, and interpersonal relationships | 7 | Youth self-report | NA | NA |
| Positive Development and Resilience in Kindergarten113 | (1) Making contact or social performance, (2) self-control or thoughtfulness, (3) self-assertiveness, (4) emotional stability or coping with stress, (5) task orientation, (6) pleasure in exploring | 36 | Teacher observation | 0.81–0.88 | 351, preschool children, Germany |
| Positive Schema Questionnaire (PSQ)114 | 5 positive self-schema themes: optimism, trust, self-efficacy, success, and worthiness | 20 | Youth report | 0.85–0.94 | 172, 9–14 y, Canada |
| PROMIS Pediatric Life Satisfaction115 | Life satisfaction (feeling happy and positive about different aspects of life and life overall) | 4 and 8 item short forms | Youth and parent report | NR | 1992, 8–17 y and 964, parents of 5–17 y, US |
| PROMIS Pediatric Meaning and Purpose Item Banks116 | Eudaimonic well-being (children’s hopefulness, optimism, goal-directedness, and feelings that life is worth living). | 4 and 8 item short forms | Youth and parent report | >0.90 | 1895, 8–17 y and 927, parents of 5–17 y, US |
| PROMIS PGH-7 (Global Health)117 | Child’s global health: overall well-being, physical health, mental health, fun, and relationship with parent | 7 | Youth and parent report | Child: 0.88, parent:0.84 | 3635, 8–17 y children and 1807 parents of 5–17 y children, US |
| Psychological Wellbeing and Distress Screener (PWDS)91 | Psychological well-being (PWS) and distress (PDS) | 10 | Youth self-report | PWS: 0.75–0.77, PDS: 0.77-0.79 | 1264, fifth–10th grade students, US |
| Questionnaire on School Wellbeing (QBS)118 | Psychological, cognitive and social well-being: gratification, relationship with teachers, peer relationship, emotional attitude toward school, and self-efficacy | Student: 27, adult: 36 | Youth, parent and teacher report | Overall: 0.82, 0.54–0.81 | 1038, third–8th grade students, Italy |
| Relationships and opportunities index80 | Availability of school and community resources; participation in neighborhood programs; supportive adults; community values youth; connectedness | 47 | Youth self-report | Index | Nationally representative sample of 1817, 15 y, US |
| Resiliency Scales for Children and Adolescents (RSCA-A)119 | Adaptability, sense of relatedness, emotional reactivity, mastery, relatedness, emotional reactivity | 136 | Youth self-report | >0.70 | 1025 college students, Canada |
| Revised Developmental Assets framework120 | Internal assets: academic engagement, positive identity, positive values, social competencies; external assets: support, mattering and belonging, boundaries, and extracurricular activity participation | 64 | Youth self-report | NA | 121 157 sixth–12th graders, US |
| Salutogenic Wellness Promotion Scale for Adolescents (SWPS-Adol)121 | Health-promoting factors in 5 dimensions: physical, social, emotional, spiritual, and vocational health based on Holistic Ecological Assessment of Lifestyle for Total Health (H.E.A.L.T.H.) Model | 21 | Youth self-report | Overall: 0.84, subscales: 0.70 | 406, 14–16 y, US |
| Satisfaction with Life Scale (SWLS)122 | Combined with SLSS to assess overall life satisfaction | 5 | Youth self-report | NR | 2180, 10–14 y, Spain (sample size varied over 5 y) |
| Scale of Positive and Negative Experience (SPANE)100 | Positive experiences (6 items) and negative experiences (6 items) | 12 | Youth self-report | 0.81–0.89 | 689 college students, US and Singapore |
| School well-being123 | School wellbeing (including academic problems, disturbed work, bothered in class, loneliness, victimization, school work enjoyment, necessary academic help, school work satisfaction, friends, supportive peers, and supportive teacher) | 17 | Youth self-report | NR | 419, 1–10 grade students, Norway |
| Self-Description Questionnaire II124 | Social, moral, ethical aspects of self-concept: 7 nonacademic subscales (opposite-sex relations, same-sex relations, parent relations, honesty trustworthiness, emotional stability, physical ability, physical appearance); 3 academic subscales (verbal, mathematics, general school self-concept) and general self-concept | 102 | Youth self-report | 0.77–0.88 | 689, 11–16 y, Australia |
| Shortened Positive and Negative Affect Schedule for Children (PANAS-C)125 | 5-item positive affect scale (joyful, cheerful, happy, lively, proud) and a 5-item negative affect scale (miserable, mad, afraid, scared, sad) | 10 | Youth and parent report | 0.82–0.93 | 799, 6–18 y and 553 parents, US |
| Social and Emotional Health Survey (SEHS)126 | Belief in self, belief in others, emotional competence, engaged living primary, secondary, and higher education versions | 51 | Youth self-report | NR | 4189, eighth, 10th, and 12th grade students, US |
| Stirling Children’s Well-being Scale (SCWBS)127 | Well-being, emotional development, positive psychology | 15 | Youth self-report | 0.85 | 1849, 8–15 y, UK |
| Strengths Assessment Inventory (SAI)128 | Strengths: at home, school, during free time, with friends, from knowing myself, from keeping clean and healthy, from being involved, from your faith and culture, and from your goals and dreams | 105 items (youth) | Youth and parent report | 0.80–0.97 | 572, 10–18 y, Canada |
| Strong Souls57 | Social and emotional wellbeing: anxiety, resilience (includes relationships, interests, happiness), depression, and suicide risk | 25 | Youth self-report | Overall: 0.70 | 361 Indigenous adolescents, 13–19 y, Australia |
| Student Perception of Wellbeing Questionnaire (SPWQ)129 | Exercise, explanatory style, and conflict resolution | 24 | Youth self-report | 0.80–0.84 | 235, 6–8 y students and 251, 7–9 y students, Australia |
| Student Subjective Wellbeing Questionnaire (SSWQ)130 | Subjective wellbeing in school with 4 subscales: school connectedness, academic efficacy, joy of learning, and educational purpose | 16 | Youth self-report | >0.70 | 1002, sixth–8th grade students, US |
| Subjective Well-being41,40 | Health, standard of living, achievements in life, personal safety, own body, classmates, preparation for future, love life, family, time use, enjoy self, spirituality, place you live, religion (Personal Well-Being Index and Brief Multidimensional Students’ Life Satisfaction Scale items) | 14 | Youth self-report | 0.74–0.80 | 5316, 12–16 y, Brazil, Spain, and Chile |
| Survey of Subjective Well-being in Schools131 | Subjective well-being (SWB) in elementary school including satisfaction with school, affect toward school, well-being related to communication with peers, and subjective physical well-being | 19 | Youth self-report | NR | 1704, 8–10 y, Russia |
| Survey of Well-being of Young Children (SWYC)132 | Multiple domains of children’s well-being: cognitive, language, and motor development; behavioral and emotional adjustment; autism risk; and family stress | 10 | Parent report | 0.70–0.92 | 0–5.5 y, US |
| The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)133 | Mental well-being including positive affect (feelings of optimism, cheerfulness, relaxation), satisfying interpersonal relationships and positive functioning (energy, clear thinking, self-acceptance, personal development, competence, and autonomy | 14 | Youth self-report | 0.87 | 1650, 13–16 y, UK |
| Three-dimensional inventory of character strengths (TICS)134 | Character strengths: caring, inquisitiveness, and self-control | 15 | Youth self-report | 0.82–0.87 | 1074, 18–25 y, China, US, Italy, France, Canada, Switzerland, and the UK |
| Thriving Orientation Survey (TOS)55 | Spark identification, positive emotionality, stability or growth of spark, motivation, purpose, hopeful future, prosocial orientation, spiritual development, opportunities, supports, positive pressure, actions to develop and pursue sparks, frequency of specific adult actions, adult role models of sparks | 139 | Youth self-report | 0.48–0.96 | 2500+, middle and high school students, US |
| Thriving Outcomes80 | Academic (grade point average, mastery, school engagement, attendance); Psychological (purpose, ethnic identity, worries); Social (prosocial values, civic engagement, volunteering, racial respect); and Behavioral (leadership, anti-social behavior) outcomes | 38 (multiple measures) | Youth self-report | 0.73–0.89 | Nationally representative sample of 1817, 15 y, US |
| UNICEF Innocenti Report Card: Child Wellbeing35 | Material well-being, health and safety, education, behaviors and risks, housing and environment; compared with 1-item youth self-reported life satisfaction | 26 indicators | National data indicators | Not Applicable (NA) | 0–19 y, high-income countries |
| Updated Thriving Orientation Scale54 | Spark identification and motivation, positive emotionality, openness to challenge and discovery, hopeful purpose, moral and prosocial orientation, and spiritual development | 39 | Youth self-report | 0.47–0.92 | 152, African American 11–19 y, US |
| Very Short Well-Being Questionnaire for Children (VSWQ-C)135 | Health-related quality-of-life that covers key areas of children’s lives: home life, school life, friends, and health | 4 | Child self-report | 0.63–0.66 | 1520, 6–7 and 9–10 y, England |
| WHO-5 Well-being Index136 | Subjective psychological well-being | 5 | Child self-report | Adequate | Adapted to children 9 y and older |
| Measure Name, Citation | Brief Description of Measure Domains | Number of Items | Mode | Cronbach’s α (Range) | Sample (N, Ages or Grade, Location)a |
|---|---|---|---|---|---|
| Adapted Children’s Worlds Survey78 | Subjective well-being (life satisfaction, mental health, self-image), home and family life, life and neighborhood context, school relationships and quality, peer relationships | 65 | Youth self-report | 0.58–0.90 | 149, seventh grade students, Midwest US |
| Adolescence School Subjective Well-Being Scale (ASSWBS)79 | 7 dimensions of students’ subjective well-being: identification with school; learning and personal development; safety; relationship with colleagues; relationship with teachers; emotional wellbeing; relationship with family | 32 | Youth self-report | Overall: 0.88 (0.71–0.86) | 2252k, 13–19 y, Romania |
| Adolescent Thriving80 | Sparks, relationships, and empowerment | 58 | Youth self-report | 0.73–0.89 | 1817, 15 y, US |
| Australian Child Wellbeing Project (ACWP) Questionnaire81 | Family, friends, school, community or neighborhood, health, and money and material wellbeing | 18 | Youth self-report | NR | 5400+, 8–14 y, Australia |
| Behavioral and Emotional Engagement82 | Academic wellbeing (behavioral engagement, emotional engagement, behavioral disaffection, and emotional disaffection) | 20 | Youth self-report, teacher report | 0.61–0.85 | 1018, third–6th grade students, US; 53 teachers |
| Brief Adolescents’ Subjective Well-Being in School Scale (BASWBSS)83 | Satisfaction with school achievement, school management, teacher–student relationships, peer relationships, teaching, and academic learning; positive affect in school and negative affect in school | 8 | Youth self-report | 0.82 | 1228, seventh–8th and 10th–11th grade students, China |
| Brief Inventory of Thriving84 | Life satisfaction, positive emotions, support, belonging, meaning, engagement, self-worth, self-efficacy, accomplishment, optimism | 10 | Youth self-report | 0.75 | 490, college students 16–24 y, US |
| Brief Scale of Psychological Well-Being85 | Autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance | 24 | Youth self-report | 0.77–0.88 | 1433, 10–16 y, Hong Kong |
| Brief Scale of Psychological Well-Being for Adolescents (BSPWB-A)86 | Psychological wellbeing: self-acceptance, positive interpersonal relationships, autonomy, life development, total well-being | 20 | Youth self-report | Overall: 0.7, 0.79–0.95 | 1590, 13–19 y, Spain |
| Center for the Study of Social Policy Youth Thrive Survey87,88 | Assesses 5 factors: youth resilience; social connections; knowledge of adolescent development; concrete support in times of need; cognitive and social-emotional competence | 66 | Youth self-report | Overall: 0.96, 0.84–0.91 | 245, 12–26 |
| Character Strengths Inventory for Children (CSI-C)50 | 24 character strengths: interpersonal (eg, teamwork, leadership, kindness), transcendence (spirituality, gratitude, hope), intellectual (eg, curiosity, love of learning, creativity), and temperance (eg, forgiveness, modesty, self-regulation) strengths | 96 | Youth self-report | 0.73–0.87 | 2061, 7–12 y, Israel |
| Character Strengths89 | Future orientation, optimism, perseverance, responsibility, thrift, leadership, teamwork, gratitude, and respect | 27 | Youth self-report | NR | 2467, 9–19 y, US |
| Child and Youth Well-Being Index (CWI)47 | 7 domains: family economic well-being, health, safety or behavioral concerns, educational attainment, community connectedness, social relationships, emotional or spiritual well-being | 28 indicators | National data indicators; parent report | NA | 0–18 y, US |
| Child Flourishing Index (CFI)2 | Curiosity in learning new things, persistence in completing tasks, capacity to regulate emotions | 3 | Parent report | 0.67 | 51 156, 6–17 y, US |
| Child Well-Being Scales (CWBS) for Child Welfare-Referred Children38 | 3 factor model of physical well-being (physical health care, nutrition or diet, personal hygiene); academic well-being (adequacy of education, academic performance, school attendance); and socio-emotional well-being (children’s family relations, children’s misconduct and coping behavior) | 15 | Parent and case manager report | 0.72–0.79 | 249 parents and 46 case managers of 1–18 y, Portugal and Spain |
| Child Well-being90 | Material well-being, relationships, health and behavioral wellbeing, and educational, environmental enrichment in at-risk families | 64 | Parent report | NR | 4689, 0–9 y, US |
| Cincinnati Kids Thrive at 51 | Physical well-being, (immunizations up-to-date, healthy body mass index, free of dental pain, normal or corrected vision, normal or corrected hearing), language development (literacy and communication) and social and emotional well-being milestones | 8 indicators | EMR data | NA | 9544, 5 y, US |
| College Student Subjective Wellbeing Questionnaire (CSSWQ)91 | Covitality measured by 4 subscales: academic efficacy, college gratitude, school connectedness, and academic satisfaction | 15 | Youth self-report | 0.80–0.92 | 971 college students, US |
| Comprehensive Inventory of Thriving for Children (CIT-CHILD)92 | Supportive or enriching relationships, interest or engagement in daily activities, sense of mastery or accomplishment, optimism, subjective well-being (high life satisfaction & positive feelings) | 45 (12 subscales) | Youth self-report | Overall: 0.86, 0.61–0.83 | 626, 8–11 y, Italy |
| Developmental Assets Profile (DAP)45 | Support, empowerment, boundaries and expectations, constructive use of time, commitment to learning, positive values, social competencies, and positive identity | 58 | Youth self-report | 0.92–0.94 | 15 000+, 11–19 y, Albania, Bangladesh, Japan, Lebanon, and the Philippines |
| Dual Factor Measure of Mental Well-being93 | Self- report indicators of subjective well- being (life satisfaction, positive and negative affect), and psychopathology (psychological symptoms and overt risk- taking behavior) | 15 | Youth self-report | 0.75–0.87 | 21 993, grade 6–10 students, Canada |
| Dual Factor Model of Mental Health94 | Subjective well-being (life satisfaction and positive and negative affect), psychopathology, engagement (behavioral, emotional, cognitive), environmental context, academic achievement | 167 (multiple measures) | Youth self-report | 0.72–0.91 | 764, seventh and eighth grade students, US |
| Early Development Instrument (EDI)95 | 5 child development areas: physical health and wellbeing; social competence; emotional maturity; language, cognitive development, and communication skills; and general knowledge | 103 | Teacher report | 0.84–0.96 | 16 074 kindergarten students, Canada |
| Engaged Living in Youth Scale96 | Social integration (social connections, a desire to help others, purpose), absorption (desire to be active and when doing so being absorbed) | 15 | Youth self-report | 0.82–0.89 | 2198, 12–19 y, US |
| EPOCH Measure of Adolescent Well-being97 | 5 positive psychological characteristics: engagement, perseverance, optimism, connectedness, and happiness | 20 | Youth self-report | 0.63–0.95 | 4480, 10–18 y, US and Australia |
| Five C’s model of Positive Youth Development39 | Competence, confidence, connection, character, caring measured by combining scales | 76 | Youth self-report | 0.59–0.97 | 920, eighth–10th grade students, US |
| Flourishing at school (well-being and creativity)98 | Well-being: 4 factors: positive and negative emotional experience of well-being; feelings of competence; and engagement; creativity: interest in new things and intrinsic motivations | 12 indicators | Youth report | NR | 855, 7–12 y, France |
| Flourishing Children Project99 | 19 constructs of positive development across 6 domains: relationship skills, flourishing in relationships, flourishing in school and work, helping others to flourish, environmental stewardship, personal flourishing | Teen: 147, parent: 125 | Youth and parent report | 0.56–0.93 | 68, 12–17 y and 23 parents, US |
| Flourishing Scale100 | Positive relationships, feelings of competence, having meaning and purpose in life | 8 | Youth self-report | Flourishing scale: 0.87 | 689, college students, US and Singapore |
| Health Asset Profiles101 | Health assets: family financial, psychological, family social (family routines, communication, parental monitoring), friends social (student support, communication), school social (teacher support, competence, autonomy, participation), and human (learning difficulties, educational aspirations, health literacy) | 101 | Youth self-report | Used to develop health asset profiles (6 categories) | 3833, 13–15 y, Finland |
| Health-related quality of Life (HRQoL) in children and in adolescents102 | Physical, psychosocial, and social health, health behavior, and quality of life | 130 (multiple measures) | Youth self-report | 0.59–0.86 | 3195, fifth–seventh grade students, Portugal |
| Healthy and Ready to Learn measure71 | Early learning skills, social-emotional, self-regulation, and physical health | 18 | Parent report | NR | 7565, 3–5 y, US |
| Healthy Pathways Child-Report Scales103 | Comfort, energy, resilience, risk avoidance, subjective well-being, achievement | 88 (17 dimensions) | Youth self-report | 0.56–0.86 | 2095, fourth–6th grade students, US |
| How I feel About My School (HIFAMS) Questionnaire104 | Perceived well-being in the educational setting, including satisfaction with teachers, peers, classrooms, playgrounds, the transition to school, work and school | 7 | Youth self-report | 0.62 | 2345, 4–8 y, England |
| Index of Positive Child Well-being105 | Physical health, psychological health, social health, educational achievement and cognitive development | 30 (6–11 y), 32 (12–17 y) | Parent report | Index | 6–17 y, US |
| KIDSCREEN-1051 | Health-related quality of life including physical well-being, psychological well-being, autonomy and parent relations, peers and social support, and school environment | 10 | Youth and parent report | Youth: 0.82, parent: 0.78 | 22 830, 8–18 y and 16 237 parents, Europe |
| Life Satisfaction scale73 | Life satisfaction with work, school, home, social life, standard of living, career prospects, independence, and life as a whole | 12 | Youth self-report | NR | 7653 older adolescents, Australia |
| Mental health Continuum-Short Form (MHC-SF)106 | 3 dimensions of positive mental health: emotional, social, and psychological well-being | 14 | Youth self-report | >0.80 | 1234, 12 18 y, US |
| Middle Years Development Instrument (MDI)53 | Social and emotional development, connectedness to peers and adults at school, home, and in the neighborhood, school experiences, physical health and well-being, and constructive use of time after school | 71 | Youth self-report | 0.65–0.87 | 3026 children, fourth grade, Canada |
| Model of Subjective Well-being107 | Competence, autonomy, relatedness, satisfaction of family relationships, satisfaction of relationships with important others, positive affect, life satisfaction, determining of achievement goals, determining of relationship goals, determining of body goals | 45 | Youth self-report | 0.75–0.87 | 326, 14–17 y, Turkey |
| Modified Student Life Satisfaction Scale (SLSS) from the International Survey of Children’s Well-Being (ISCWeB)108 | Overall life satisfaction | 5 | Youth self-report | 0.69–0.71 | 1978, 10 and 12 y, Nepal |
| Multidimensional Adolescent Functioning Scale (MAFS)109 | 3 distinct subscales: general functioning, family-related functioning, and peer-related functioning | 23 | Youth self-report | 0.75–0.91 | 842 students in grade 10–12, Australia |
| PERMA Model of Flourishing110,111 | Psychological well-being with 5 domains: positive emotions (P), engagement (E), relationships (R), meaning (M), and accomplishment (A) | 118 | Youth self-report | 0.68–0.92, | 516, 13–18 y, Australia |
| Personal Wellbeing Index (PWI)-9112 | Added 2 new items to PWI: satisfaction with my time use, satisfaction with myself | 9 | Youth self-report | PWI-7: 0.80, PWI-9: 0.83 | 5331, 12–16 y, Brazil, Spain & Chile |
| Personal Well-being Index for Adults (PWI-A)46 | Standard of living, health, achieving in life, relationships, safety, community-connectedness, and future security | 7 | Youth self-report | 0.81 | 533 gifted college students, US |
| Personal Well-being Index for School Children (PWI-SC) | Health, quality of life, accomplishments, feeling safe, community, security for the future, and interpersonal relationships | 7 | Youth self-report | NA | NA |
| Positive Development and Resilience in Kindergarten113 | (1) Making contact or social performance, (2) self-control or thoughtfulness, (3) self-assertiveness, (4) emotional stability or coping with stress, (5) task orientation, (6) pleasure in exploring | 36 | Teacher observation | 0.81–0.88 | 351, preschool children, Germany |
| Positive Schema Questionnaire (PSQ)114 | 5 positive self-schema themes: optimism, trust, self-efficacy, success, and worthiness | 20 | Youth report | 0.85–0.94 | 172, 9–14 y, Canada |
| PROMIS Pediatric Life Satisfaction115 | Life satisfaction (feeling happy and positive about different aspects of life and life overall) | 4 and 8 item short forms | Youth and parent report | NR | 1992, 8–17 y and 964, parents of 5–17 y, US |
| PROMIS Pediatric Meaning and Purpose Item Banks116 | Eudaimonic well-being (children’s hopefulness, optimism, goal-directedness, and feelings that life is worth living). | 4 and 8 item short forms | Youth and parent report | >0.90 | 1895, 8–17 y and 927, parents of 5–17 y, US |
| PROMIS PGH-7 (Global Health)117 | Child’s global health: overall well-being, physical health, mental health, fun, and relationship with parent | 7 | Youth and parent report | Child: 0.88, parent:0.84 | 3635, 8–17 y children and 1807 parents of 5–17 y children, US |
| Psychological Wellbeing and Distress Screener (PWDS)91 | Psychological well-being (PWS) and distress (PDS) | 10 | Youth self-report | PWS: 0.75–0.77, PDS: 0.77-0.79 | 1264, fifth–10th grade students, US |
| Questionnaire on School Wellbeing (QBS)118 | Psychological, cognitive and social well-being: gratification, relationship with teachers, peer relationship, emotional attitude toward school, and self-efficacy | Student: 27, adult: 36 | Youth, parent and teacher report | Overall: 0.82, 0.54–0.81 | 1038, third–8th grade students, Italy |
| Relationships and opportunities index80 | Availability of school and community resources; participation in neighborhood programs; supportive adults; community values youth; connectedness | 47 | Youth self-report | Index | Nationally representative sample of 1817, 15 y, US |
| Resiliency Scales for Children and Adolescents (RSCA-A)119 | Adaptability, sense of relatedness, emotional reactivity, mastery, relatedness, emotional reactivity | 136 | Youth self-report | >0.70 | 1025 college students, Canada |
| Revised Developmental Assets framework120 | Internal assets: academic engagement, positive identity, positive values, social competencies; external assets: support, mattering and belonging, boundaries, and extracurricular activity participation | 64 | Youth self-report | NA | 121 157 sixth–12th graders, US |
| Salutogenic Wellness Promotion Scale for Adolescents (SWPS-Adol)121 | Health-promoting factors in 5 dimensions: physical, social, emotional, spiritual, and vocational health based on Holistic Ecological Assessment of Lifestyle for Total Health (H.E.A.L.T.H.) Model | 21 | Youth self-report | Overall: 0.84, subscales: 0.70 | 406, 14–16 y, US |
| Satisfaction with Life Scale (SWLS)122 | Combined with SLSS to assess overall life satisfaction | 5 | Youth self-report | NR | 2180, 10–14 y, Spain (sample size varied over 5 y) |
| Scale of Positive and Negative Experience (SPANE)100 | Positive experiences (6 items) and negative experiences (6 items) | 12 | Youth self-report | 0.81–0.89 | 689 college students, US and Singapore |
| School well-being123 | School wellbeing (including academic problems, disturbed work, bothered in class, loneliness, victimization, school work enjoyment, necessary academic help, school work satisfaction, friends, supportive peers, and supportive teacher) | 17 | Youth self-report | NR | 419, 1–10 grade students, Norway |
| Self-Description Questionnaire II124 | Social, moral, ethical aspects of self-concept: 7 nonacademic subscales (opposite-sex relations, same-sex relations, parent relations, honesty trustworthiness, emotional stability, physical ability, physical appearance); 3 academic subscales (verbal, mathematics, general school self-concept) and general self-concept | 102 | Youth self-report | 0.77–0.88 | 689, 11–16 y, Australia |
| Shortened Positive and Negative Affect Schedule for Children (PANAS-C)125 | 5-item positive affect scale (joyful, cheerful, happy, lively, proud) and a 5-item negative affect scale (miserable, mad, afraid, scared, sad) | 10 | Youth and parent report | 0.82–0.93 | 799, 6–18 y and 553 parents, US |
| Social and Emotional Health Survey (SEHS)126 | Belief in self, belief in others, emotional competence, engaged living primary, secondary, and higher education versions | 51 | Youth self-report | NR | 4189, eighth, 10th, and 12th grade students, US |
| Stirling Children’s Well-being Scale (SCWBS)127 | Well-being, emotional development, positive psychology | 15 | Youth self-report | 0.85 | 1849, 8–15 y, UK |
| Strengths Assessment Inventory (SAI)128 | Strengths: at home, school, during free time, with friends, from knowing myself, from keeping clean and healthy, from being involved, from your faith and culture, and from your goals and dreams | 105 items (youth) | Youth and parent report | 0.80–0.97 | 572, 10–18 y, Canada |
| Strong Souls57 | Social and emotional wellbeing: anxiety, resilience (includes relationships, interests, happiness), depression, and suicide risk | 25 | Youth self-report | Overall: 0.70 | 361 Indigenous adolescents, 13–19 y, Australia |
| Student Perception of Wellbeing Questionnaire (SPWQ)129 | Exercise, explanatory style, and conflict resolution | 24 | Youth self-report | 0.80–0.84 | 235, 6–8 y students and 251, 7–9 y students, Australia |
| Student Subjective Wellbeing Questionnaire (SSWQ)130 | Subjective wellbeing in school with 4 subscales: school connectedness, academic efficacy, joy of learning, and educational purpose | 16 | Youth self-report | >0.70 | 1002, sixth–8th grade students, US |
| Subjective Well-being41,40 | Health, standard of living, achievements in life, personal safety, own body, classmates, preparation for future, love life, family, time use, enjoy self, spirituality, place you live, religion (Personal Well-Being Index and Brief Multidimensional Students’ Life Satisfaction Scale items) | 14 | Youth self-report | 0.74–0.80 | 5316, 12–16 y, Brazil, Spain, and Chile |
| Survey of Subjective Well-being in Schools131 | Subjective well-being (SWB) in elementary school including satisfaction with school, affect toward school, well-being related to communication with peers, and subjective physical well-being | 19 | Youth self-report | NR | 1704, 8–10 y, Russia |
| Survey of Well-being of Young Children (SWYC)132 | Multiple domains of children’s well-being: cognitive, language, and motor development; behavioral and emotional adjustment; autism risk; and family stress | 10 | Parent report | 0.70–0.92 | 0–5.5 y, US |
| The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)133 | Mental well-being including positive affect (feelings of optimism, cheerfulness, relaxation), satisfying interpersonal relationships and positive functioning (energy, clear thinking, self-acceptance, personal development, competence, and autonomy | 14 | Youth self-report | 0.87 | 1650, 13–16 y, UK |
| Three-dimensional inventory of character strengths (TICS)134 | Character strengths: caring, inquisitiveness, and self-control | 15 | Youth self-report | 0.82–0.87 | 1074, 18–25 y, China, US, Italy, France, Canada, Switzerland, and the UK |
| Thriving Orientation Survey (TOS)55 | Spark identification, positive emotionality, stability or growth of spark, motivation, purpose, hopeful future, prosocial orientation, spiritual development, opportunities, supports, positive pressure, actions to develop and pursue sparks, frequency of specific adult actions, adult role models of sparks | 139 | Youth self-report | 0.48–0.96 | 2500+, middle and high school students, US |
| Thriving Outcomes80 | Academic (grade point average, mastery, school engagement, attendance); Psychological (purpose, ethnic identity, worries); Social (prosocial values, civic engagement, volunteering, racial respect); and Behavioral (leadership, anti-social behavior) outcomes | 38 (multiple measures) | Youth self-report | 0.73–0.89 | Nationally representative sample of 1817, 15 y, US |
| UNICEF Innocenti Report Card: Child Wellbeing35 | Material well-being, health and safety, education, behaviors and risks, housing and environment; compared with 1-item youth self-reported life satisfaction | 26 indicators | National data indicators | Not Applicable (NA) | 0–19 y, high-income countries |
| Updated Thriving Orientation Scale54 | Spark identification and motivation, positive emotionality, openness to challenge and discovery, hopeful purpose, moral and prosocial orientation, and spiritual development | 39 | Youth self-report | 0.47–0.92 | 152, African American 11–19 y, US |
| Very Short Well-Being Questionnaire for Children (VSWQ-C)135 | Health-related quality-of-life that covers key areas of children’s lives: home life, school life, friends, and health | 4 | Child self-report | 0.63–0.66 | 1520, 6–7 and 9–10 y, England |
| WHO-5 Well-being Index136 | Subjective psychological well-being | 5 | Child self-report | Adequate | Adapted to children 9 y and older |
NA, not applicable; NR, not reported.
Many instruments have been validated in among populations in different countries or different languages; only the original scale testing or validation psychometric properties and sample are reported in this table.
Discussion
This review provides a comprehensive summary of recent child and youth thriving definitions, frameworks, and measures to provide recommendations for future research and measure development to further the assessment of positive health. In this study, we characterized the existing child and youth thriving frameworks and measures using a community-informed conceptualization of thriving. Overall, current measures primarily focus on psychological aspects of thriving and well-being, with fewer focused on community-based aspects of thriving, particularly equity, inclusion, and safety, which were considered essential to thriving based on community member and health researcher and provider perspectives.10 This suggests that existing frameworks and measures developed without community member input could benefit from incorporating community member review on important cultural and contextual considerations in measuring thriving.
We centered racial justice, equity, and inclusion in our conceptual framework of child thriving. However, there is a large gap in the integration of racial equity in existing frameworks and measures, as 12% explicitly included an aspect of cultural diversity and inclusion in their model or assessment or were developed to address considerations for a specific cultural group or race or ethnicity. Additional studies may conceptualize addressing diversity and inequities as an outcome of supporting thriving. We posit that considerations of racial equity must be integrated into current assessments of thriving given the critical importance of racism and health disparities in pediatric health outcomes.65,66 Other identity intersectionalities, including gender identity, income, religion, and ability, should also be incorporated to provide meaningful and relevant assessments of thriving across diverse children and youth.67
Safety in relationships and environments was also not included in most of the measures of child thriving and flourishing. Although some (21) of the frameworks and measures included items related to safety, such as the Developmental Assets Profile45 and the Personal Well-being Index,41,46,48 assessments focused on children in the welfare system36,38 and international settings35,68 were more likely to include physical and emotional safety. Safety was found to be a key component of well-being,69 which is particularly relevant given the trends in violence experienced by youth in the United States and internationally. However, all children may experience unsafe situations and environments, requiring the inclusion of questions about safety in assessments of thriving for all children and youth.
Incorporating aspects of physical health in the assessment of thriving and flourishing was another gap in current assessments. Measures important to our community partners’ conceptualization of child thriving include amount and quality of physical activity, healthy weight and growth, sleeping and eating patterns, and fully met health needs (eg, dental and vision care and immunizations). Subjective reports of health could be enhanced with the inclusion of these aspects of positive physical health in a pediatric measure of thriving. However, positive physical health has been conceptualized as an outcome of thriving rather than a domain of thriving itself in some models.
We identified several comprehensive measures of youth and young adult thriving spanning multiple dimensions, including the Personal Well-being Index,41,46,48 the Developmental Assets Profile, which includes 40 protective factors and assets,45 and the 5/6C’s model of positive youth development.39 Several of the measures included in this review were developed as group-level instruments to test the effectiveness of interventions in classes, schools, or programs, and may need adaptations for use at the individual-level by pediatric practitioners. Measures developed primarily for research could be supplemented by longer tools or interviews that could be used for individual treatment. Additionally, the identification of the individual characteristics that contribute to thriving can provide the basis for health programs to increase children’s ability to thrive.70
Results from our scoping review highlighted that additional measures and instruments should be developed for infants and young children (ages 0–5 years), as this age group had fewer measures. Assessing thriving among infants and toddlers is not as well developed as the positive youth development literature for adolescents and young adults. For example, the National Survey of Children’s Health provides a brief measure of flourishing for young children that is 3 items focused on aspects of executive functioning (curiosity, staying calm, and persisting with tasks),2 and a Healthy and Ready to Learn measure for 3–5 year olds with 18 items in the domains of early learning skills, social-emotional, self-regulation, and physical health.71 The National Institutes of Health Patient-reported Outcomes Measurement Initiative System is also expanding current positive health measures developed for children 5–18 years old for children younger than 5,72 including measures of positive affect, physical activity, caregiver relationships, persistence, adaptability, and curiosity. However, no single composite measure of thriving encompassing multiple dimensions is currently available for younger children.
This review primarily identified theoretical or cross-sectional assessments of child and youth thriving with fewer studies that examined longitudinal trends or validated measures over time.39,47,73 These few studies suggest that child well-being may decline over time as children enter adolescence,74 and that well-being is lower for girls than boys.75 This gap has been noted in other reviews,14 and is important to address to understand how child thriving changes over time and influences later health and developmental outcomes. The review also identified measures assessing children in different contexts (home, school, and community), and integrating measures across these settings would provide a more comprehensive assessment of a child’s well-being.
Our study identified some measures and definitions of thriving relevant to child and youth in diverse populations, including immigrant and indigenous populations.23,57 Rountree and Smith (2016) provide an overview of how well-being is defined for indigenous communities (in the United States and internationally) that both dovetails and expands on the definitions of child thriving.60 Particularly relevant for indigenous communities is a connection to one’s ancestry, spiritual practice, and ceremony. However, an in-depth review of diverse populations is beyond the scope of the present literature review and additional work should identify how particular cultural practices influence thriving among diverse racial and ethnic groups.
Research Recommendations
Study Type and Population
This review points to the importance of additional studies of thriving in diverse populations based on characteristics such as race and ethnicity, gender identity, and geographic location. Longitudinal studies assessing how measures of thriving change over time and how they influence other health and developmental outcomes (such as academic performance and future success) are needed to inform future intervention and programming.
Developmental Stage
Early childhood was identified as a gap in valid thriving measures, based potentially on differences in what thriving means in early childhood and reliance on parent-report. The National Institutes of Health PROMIS Patient-reported Outcomes Measurement Initiative System pediatric positive health measures currently being expanded for children 0 to 5 years old are a potential source of measures related to thriving.72
Child Thriving Domains
Inclusion of safety, equity, and inclusion as part of understanding thriving in communities is needed. Persistent child health disparities in key indicators of child well-being, including academic, health, and socioemotional outcomes emphasize the critical importance of equity in child thriving definitions and measures.
Methodological Considerations
Multi-informant Measures
Most assessments for elementary-aged children and youth were based on self-report, highlighting the importance of centering youth voices in assessing their well-being. However, multi-informant measures including youth and parent or teacher reported measures and secondary data may help provide a more comprehensive picture of youth thriving across contexts. This is particularly important for younger children who may not be able to respond adequately to survey measures.
Limitations
Although over 14 000 articles were identified, this review may have missed child thriving definitions or frameworks that were published in other languages, not published in peer-reviewed journals, or that did not include our key terms related to well-being, flourishing, thriving, and positive health. We did not include frameworks or measures that were developed for specific subpopulations of children, including those with special needs or chronic health conditions. However, several included frameworks, such as the Developmental Assets Framework, have been applied to assess the experiences of youth with chronic conditions and depression.76 Evidence suggests that children and youth with special health needs and chronic physical and mental health conditions can have the similar positive health outcomes as peers without disabilities.77 Additional research aimed at understanding models of thriving and optimal functioning for children and youth with special health needs is needed. We focused on pediatric definitions and measures, so adult measures that could be relevant to pediatric populations were not included. Although we did not exclude models based on culture or country of development, this review does not provide an in-depth analysis of measures for adapted or developed for diverse populations, cultures, or languages. Additionally, we included articles describing the original development of a framework or measure, not translations or adaptations of measures unless these led to significant changes and an updated version of the framework or measure. Our review assessed frameworks and measures based on our community-informed conceptual framework of child and youth thriving, so may have underrepresented other domains important to child thriving. We only included frameworks and assessments with multiple domains of thriving, and articles assessing unidimensional concepts (such as self-esteem or engagement) that may be an important component to positive health and thriving were excluded. Our review was limited to studies focused on new conceptualizations and measures of thriving, rather than predictors or outcomes of thriving. We did not include studies of relationships between measures of thriving and other health or psychosocial outcomes.
Conclusions
Developing a clear definition and measure of child thriving is essential to furthering our understanding of the contexts and interventions that contribute to pediatric well-being in addition to preventing ill health. This scoping review of the breadth of available frameworks and assessments has identified gaps including few infant and early childhood measures and limited longitudinal assessments. Additional thriving measures for early childhood incorporating diverse community perspectives and considerations of racial and gender equity are needed.
Acknowledgments
We would like to acknowledge the research group at the Center for Adolescent and Young Adult Health at the University of Pittsburgh for their contribution to the scoping review data extraction. Thank you to the Pittsburgh Study Team for their stakeholder feedback.
Drs. Ettinger and Miller and Ms. Chavis conceptualized and designed the scoping review and reviewed the manuscript; Dr. Ettinger and Ms. Risser coordinated and supervised article review and abstraction, drafted the initial manuscript, and revised the manuscript; Ms. Risser, Mr. Rigas, Mr. Rahman, and Dr. Stokes reviewed the articles, conducted the initial analyses, and reviewed and revised the manuscript; Ms. Abromitis conducted the literature searches across all of the databases; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
FUNDING: All phases of this study were supported by the Children’s Hospital of Pittsburgh, the University of Pittsburgh, and the Shear Family Foundation. The funders had no role in the development of the scoping review.
CONFLICT OF INTEREST DISCLOSURES: The authors have no conflicts of interest relevant to this article to disclose.
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