Description

The ACHWM is a tablet-based survey designed to assess the health and well-being of Indigenous children and youth. Developed collaboratively with First Nation health leaders, children, and academic researchers, the ACHWM provides insights into wellness across four key domains: spiritual, emotional, physical, and mental health, reflecting the holistic perspective of the Medicine Wheel. Comprising 62 items (13 related to physical health, 24 to emotional health, 9 to mental health, and 16 to spiritual health) the ACHWM allows children to express their health experiences. Items are assessed on a 0-4 ordinal scale encompassing both frequency (0 = Never; 4 = Always) and importance (0 = Not Important; 4 = Extremely Important). Scores are averaged and converted to a range of 0 to 100, indicating well-being levels from poor to optimal.

Versions are available for First Nations, Métis, children in family services, and in both French and English. For more information about the instrument and related publications, visit www.ACHWM.ca.

AI/AN Communities where the measure has been used

Developed for Indigenous children, including First Nations, Inuit, and Métis communities in Canada.

Demographics of AI/AN participants where the scale has been used

Indigenous children aged 8-18 years.

Notes on adaptations or modifications

  • The ACHWM has been adapted to provide versions that reflect cultural differences and promote inclusivity. Available versions include those for First Nations, Métis, children in family services, as well as translations in French and English. Each version has been developed in collaboration with an advisory committee consisting of local Elders, community members, and children.
  • In the original research, the “A” in ACHWM stood for “Aboriginal.” However, under the guidance of the children, this has been changed to “Aaniish Naa Gegii,” which means “How are you?” in Anishnabemowin.

Modality and administration

Self-administered using a tablet-based application.

Scoring

  • The scoring for the Aboriginal Children’s Health and Well-Being Measure (ACHWM) consists of an overall wellness score derived from four quadrants: Emotional (24 items), Physical (13 items), Mental (9 items), and Spiritual (16 items). Each item is assessed using one of two 5-point categorical response options:
    • Frequency: Ranging from 0 (Never) to 4 (Always).
    • Importance: Ranging from 0 (Not Important) to 4 (Extremely Important).
  • Scores for each item are calculated on a 0–4 ordinal scale and then averaged across individual items for each quadrant. To obtain the overall wellness score and the scores for the four quadrants, the average is multiplied by 25. This results in a scoring range of 0 to 100, where 0 indicates poor well-being and 100 indicates optimal well-being.

Psychometric evidence

Young et al. (2016b) reported a Cronbach’s coefficient of 0.93 and a test-retest intra-class correlation coefficient of 0.94 for the ACHWM. Validity was established with a correlation of 0.52 (p < 0.0001) with the PedsQL (Young et al. 2015a).

Citation(s)

  • Barbic SP, Young NL, Usuba K, Stankiewicz E. Rasch Measurement Theory’s contribution to the psychometric properties of a co-created measure of health and wellness for Indigenous children and youth. J Clin Epidemiol. 2022 Nov;151:18-28. doi: 10.1016/j.jclinepi.2022.07.010. Epub 2022 Aug 2. PMID: 35926823.
  • Usuba, K., Russell, J., Ritchie, S. D., Mishibinijima, D., Wabano, M. J., Enosse, L., & Young, N. L. (2019). Evaluating the Outdoor Adventure Leadership Experience (OALE) program using the Aboriginal Children’s Health and Well-Being Measure (ACHWM©). Journal of Outdoor and Environmental Education, 22(3), 187-197.
  • Wabano, McGregor, L.E., Beaudin, McGregor, L. E.; Kristensen-Didur et. al. (2019). Health profiles of First Nations children living on-reserve in Northern Ontario: a pooled analysis of survey data
  • Young, N. L., Jacko, D.,Wabano, M. J., Hawthorne, L., Seabrook, S.,Wabanosse, S., & Usuba, K. (2016a). A screening mechanism to recognize and support aboriginal children at-risk: Based on a child-centric survey. Canadian Journal of Public Health, 107(4–5), e399–e403.2.
  • Young, N. L., Wabano, M. J., Blight, S., Baker-Anderson, K., Beaudin, R., McGregor, L. F., & Burke, T. A. (2017). Relevance of the aboriginal Children’s health and well-being measure beyond Wiikwemkoong. Rural and Remote Health, 17(2), 3941.
  • Young, N. L., Wabano, M. J., Burke, T. A., Ritchie, S. D., Mishibinijima, D., & Corbiere, R. G. (2013). A process for creating the Aboriginal children’s health and well-being measure (ACHWM). Canadian journal of public health = Revue canadienne de sante publique, 104(2), e136–e141. https://doi.org/10.1007/BF03405677
  • Young, N. L., Wabano, M. J., Usuba, K., Mishibinijima, D., Jacko, D., & Burke, T. A. (2016b). Reliability of the Aboriginal Children’s Health and Well-Being Measure (ACHWM). SpringerPlus, 5(1), Article 2082. https://doi.org/10.1186/s40064-016-3776-y
  • Young, N. L., Wabano, M. J., Usuba, K., Pangowish, B., Trottier, M., Jacko, D., & Corbiere, R. G. (2015a). Validity of the aboriginal children’s health and well-being measure: Aaniish Naa Gegii? Health and Quality of Life Outcomes, 13(1), 148. https://doi.org/10.1186/s12955-015-0351-0.
  • Young, Wabano, Ritchie, Burke, Pangowaish, et al. (2015b). Assessing children‚ interpretations of the Aboriginal Children Health and Well-Being Measure (ACHWM).

 Note: The included citations are not exhaustive but represent the examples we had access to. If you are an original author or have other work that could be included here, please contact us.