Evaluating content validity for a culturally relevant wellness scale for women: the HER-WELL scale

Introduction: Wellness encompasses multiple dimensions that vary across populations, particularly among Saudi women, whose experiences are shaped by cultural, social, and religious factors. These factors shape the way wellness is perceived, pursued, and preserved. Despite growing attention to women's health, existing wellness scales often lack cultural relevance and gender sensitivity. In response, this study centers on assessing face and content validity as an initial validation step toward developing a culturally relevant wellness scale specifically for Saudi women, grounded in empirical evidence and rooted in their lived experiences. Methods: The wellness concepts and item pool were developed from a previous qualitative phase and a systematic review, which together identified eight core wellness dimensions. Face and content validity were assessed using a mixed-methods approach that combined qualitative and quantitative techniques. Results: A panel of multidisciplinary experts reviewed the initial pool of 71 items for clarity, relevance, and necessity. Based on their feedback, the scale was refined to 60 items covering the eight core wellness dimensions. These content-validity results provide the conceptual and cultural foundation for the instrument. Discussion: These content-validity results provide the conceptual and cultural foundation for the instrument and serve as a necessary starting point for future psychometric testing (e.g., CFA, PLS-SEM). Moreover, the mixed-methods validation approach used in this study provides a practical model for future researchers seeking to develop and validate measurement tools.