Quality of Life Research

, Volume 28, Issue 2, pp 535–543 | Cite as

Test–retest reliability and validity of a single-item Self-reported Family Happiness Scale in Hong Kong Chinese: findings from Hong Kong Jockey Club FAMILY Project

  • Chen Shen
  • Man Ping WangEmail author
  • Henry C. Y. Ho
  • Alice Wan
  • Sunita M. Stewart
  • Kasisomayajula Viswanath
  • Sophia Siu Chee Chan
  • Tai Hing Lam



Family happiness is one major theme of family well-being in Chinese culture. We investigated the reliability and validity of the single-item Self-reported Family Happiness Scale (SFHS-1) with the score of 0–10, based on two studies in Hong Kong Chinese.


Study 1 was a territory-wide population-based telephone survey (n = 4038) conducted in 2016. Study 2 was a community-based family intervention program conducted during 2012–2013 (n = 1261) to enhance family communication and well-being. Test–retest reliability of the SFHS-1 was assessed over 1 month in Study 2. Family APGAR (Adaption, Partnership, Growth, Affection, Resolve) Scale, Family Communication Scale, Subjective Happiness Scale, 12-item Short Form Health Survey Version 2, and 2-item Patient Health Questionnaire were used to assess the convergent and discriminant validities of the SFHS-1 in both studies. Multiple regression analysis was used to assess the incremental validity by identifying the additional contribution of the SFHS-1 score in predicting subjective happiness.


The 1-month test–retest reliability assessed by intraclass correlation was 0.76. Family happiness was moderately to strongly correlated with family function, family communication, subjective happiness, mental health-related quality of life and depression, but weakly correlated with physical health-related quality of life. Furthermore, the score of the SFHS-1 added predictive power to mental health-related quality of life and depression in assessing subjective happiness.


Our results have shown the SFHS-1 as a reliable and valid measurement of family happiness in Hong Kong Chinese, suggesting SFHS-1 is highly practicable for future large epidemiological and community-based intervention studies.


Family happiness Single-item scale Reliability Validity Quality of life 



Adaption, Partnership, Growth, Affection, Resolve


Family Communication Scale


Family and Health Information Trends Survey


Health-related Quality of Life


Mental Component Subscale


Physical Component Subscale


2-Item Patient Health Questionnaire


12-Item Short Form Health Survey


Self-reported Family Happiness Scale


Subjective Happiness Scale



The project was funded by the Hong Kong Jockey Club Charities Trust. The authors wish to thank the participants who participated in the telephone surveys and the Public Opinion Programme (HKU) officials for conducting the surveys.

Compliance with ethical standards

Conflict of interest

None of the authors have any potential competing interests to declare.

Ethical approval

Ethical approval was granted by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster.

Informed consent

For Study 1, verbal informed consents were obtained from the respondents. For Study 2, written consent was obtained from each participant prior to participation in the programs. For children enrolled in the study, written consent was obtained from their next of kin, caretakers, or guardians on their behalf.

Supplementary material

11136_2018_2019_MOESM1_ESM.docx (20 kb)
Appendix Table (DOCX 19 KB)


  1. 1.
    McDowell, I. (2010). Measures of self-perceived well-being. Journal of Psychosomatic Research, 69(1), 69–79.Google Scholar
  2. 2.
    Subramanian, S. V., Kim, D., & Kawachi, I. (2005). Covariation in the socioeconomic determinants of self rated health and happiness: A multivariate multilevel analysis of individuals and communities in the USA. Journal of Epidemiology and Community Health, 59(8), 664–669. Scholar
  3. 3.
    Wang, F., Orpana, H. M., Morrison, H., de Groh, M., Dai, S., & Luo, W. (2012). Long-term association between leisure-time physical activity and changes in happiness: Analysis of the Prospective National Population Health Survey. American Journal of Epidemiology, 176(12), 1095–1100. Scholar
  4. 4.
    Shiue, I. (2015). Self and environmental exposures to drinking, smoking, gambling or video game addiction are associated with adult hypertension, heart and cerebrovascular diseases, allergy, self-rated health and happiness: Japanese General Social Survey, 2010. International Journal of Cardiology, 181, 403–412. Scholar
  5. 5.
    Ballas, D., & Dorling, D. (2007). Measuring the impact of major life events upon happiness. International Journal of Epidemiology, 36(6), 1244–1252. Scholar
  6. 6.
    McMahon, D. M. (2004). From the happiness of virtue to the virtue of happiness: 400 BC–AD 1780. Daedalus, 133(2), 5–17.Google Scholar
  7. 7.
    Lyubomirsky, S., & Lepper, H. S. (1999). A measure of subjective happiness: Preliminary reliability and construct validation. Social Indicators Research, 46(2), 137–155.Google Scholar
  8. 8.
    Nan, H., Ni, M. Y., Lee, P. H., Tam, W. W., Lam, T. H., Leung, G. M., et al. (2014). Psychometric evaluation of the Chinese version of the Subjective Happiness Scale: Evidence from the Hong Kong FAMILY Cohort. International Journal of Behavioral Medicine, 21(4), 646–652. Scholar
  9. 9.
    Wang, M. P., Wang, X., Lam, T. H., Viswanath, K., & Chan, S. S. (2014). Ex-smokers are happier than current smokers among Chinese adults in Hong Kong. Addiction, 109(7), 1165–1171. Scholar
  10. 10.
    Lu, L., Gilmour, R., & Kao, S.-F. (2001). Cultural values and happiness: An East-West dialogue. The Journal of Social Psychology, 141(4), 477–493.Google Scholar
  11. 11.
    Bond, M. H., & Hwang, K. (1986). The social psychology of Chinese people. Oxford: Oxford University Press.Google Scholar
  12. 12.
    Triandis, H. C. (1995). Individualism & collectivism. Boulder: Westview Press.Google Scholar
  13. 13.
    Lam, W. W., Fielding, R., McDowell, I., Johnston, J., Chan, S., Leung, G. M., et al. (2012). Perspectives on family health, happiness and harmony (3H) among Hong Kong Chinese people: A qualitative study. Health Education Research, 27(5), 767–779. Scholar
  14. 14.
    Chan, S. S., Viswanath, K., Au, D. W., Ma, C. M., Lam, W. W., Fielding, R., et al. (2011). Hong Kong Chinese community leaders’ perspectives on family health, happiness and harmony: A qualitative study. Health Education Research, 26(4), 664–674. Scholar
  15. 15.
    Odou, N., & Vella-Brodrick, D. A. (2013). The efficacy of positive psychology interventions to increase well-being and the role of mental imagery ability. Social Indicators Research, 110(1), 111–129.Google Scholar
  16. 16.
    Spoth, R., Redmond, C., Hockaday, C., & Shin, C. Y. (1996). Barriers to participation in family skills preventive interventions and their evaluations: A replication and extension. Family Relations, 45, 247–254.Google Scholar
  17. 17.
    Shek, D. T. (2002). Assessment of family functioning in Chinese adolescents: The Chinese family assessment instrument. International Perspectives on Child and Adolescent Mental Health, 2, 297–316.Google Scholar
  18. 18.
    Moos, R. H., & Moos, B. S. (1994). Family environment scale manual. Palo Alto: Consulting Psychologists Press.Google Scholar
  19. 19.
    Ho, H. C., Mui, M., Wan, A., Ng, Y. L., Stewart, S. M., Yew, C., et al. (2016). Happy Family Kitchen: A community-based research for enhancing family communication and well-being in Hong Kong. Journal of Family Psychology, 30(6), 752–762. Scholar
  20. 20.
    Ho, H. C., Mui, M., Wan, A., Ng, Y. L., Stewart, S. M., Yew, C., et al. (2016). Happy Family Kitchen II: A cluster randomized controlled trial of a community-based family intervention for enhancing family communication and well-being in Hong Kong. Frontiers in Psychology, 7, 638. Scholar
  21. 21.
    Shen, C., Wan, A., Kwok, L. T., Pang, S., Wang, X., Stewart, S. M., et al. (2017). A community-based intervention program to enhance family communication and family well-being: The Learning Families Project in Hong Kong. Frontiers in Public Health, 5, 257. Scholar
  22. 22.
    Kimberlin, C. L., & Winterstein, A. G. (2008). Validity and reliability of measurement instruments used in research. American Journal of Health-System Pharmacy, 65(23), 2276–2284. Scholar
  23. 23.
    Shen, C., Wang, M. P., Chu, J. T., Wan, A., Viswanath, K., Chan, S. S. C., et al. (2017). Health app possession among smartphone or tablet owners in Hong Kong: Population-based survey. JMIR MHealth UHealth, 5(6), e77. Scholar
  24. 24.
    Shen, C., Wang, M. P., Chu, J. T., Wan, A., Viswanath, K., Chan, S. S. C., et al. (2017). Sharing family life information through video calls and other information and communication technologies and the association with family well-being: Population-based survey. JMIR Mental Health, 4(4), e57. Scholar
  25. 25.
    Ziersch, A. M., & Baum, F. E. (2004). Involvement in civil society groups: Is it good for your health? Journal of Epidemiology and Community Health, 58(6), 493–500.Google Scholar
  26. 26.
    Courser, M., & Lavrakas, P. J. (2012). Item nonresponse and the 10-point response scale in telephone surveys. Survey Practice, 5(4), 1–5.Google Scholar
  27. 27.
    Cummins, R. A., & Gullone, E. (2000). Why we should not use 5-point Likert scales: The case for subjective quality of life measurement. Proceedings, Second International Conference on Quality of Life in Cities, (pp. 74–93).Google Scholar
  28. 28.
    Smilkstein, G. (1978). The Family APGAR: A proposal for family function test and its use by physicians. The Journal of Family Practice. 6, 1231–1239Google Scholar
  29. 29.
    Bland, J. M., & Altman, D. G. (1997). Cronbach’s alpha. BMJ, 314(7080), 572.Google Scholar
  30. 30.
    Olson, D. H., Gorall, D. M., & Tiesel, J. W. (2004). “Family communication”. Faces IV package. Minneapolis: Life Innovations.Google Scholar
  31. 31.
    Ware, J. Jr., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.Google Scholar
  32. 32.
    Lowe, B., Kroenke, K., & Grafe, K. (2005). Detecting and monitoring depression with a two-item questionnaire (PHQ-2). Journal of Psychosomatic Research, 58(2), 163–171. Scholar
  33. 33.
    Eisinga, R., Grotenhuis, M., & Pelzer, B. (2013). The reliability of a two-item scale: Pearson, Cronbach, or Spearman-Brown? International Journal of Public Health, 58(4), 637–642. Scholar
  34. 34.
    Chan, D., Ho, S., & Donnan, S. (1988). A survey of family APGAR in Shatin private ownership homes. Hong Kong Practitioner, 10, 3295–3299.Google Scholar
  35. 35.
    Lam, C. L., Tse, E. Y., & Gandek, B. (2005). Is the standard SF-12 health survey valid and equivalent for a Chinese population? Quality of Life Research, 14(2), 539–547.Google Scholar
  36. 36.
    Yu, X., Stewart, S. M., Wong, P. T., & Lam, T. H. (2011). Screening for depression with the Patient Health Questionnaire-2 (PHQ-2) among the general population in Hong Kong. Journal of Affective Disorders, 134(1–3), 444–447. Scholar
  37. 37.
    Ho, H. C., Mui, M., Wan, A., Ng, Y. L., Stewart, S. M., Yew, C., et al. (2016). Happy Family Kitchen II: A cluster randomized controlled trial of a community-based positive psychology family intervention for subjective happiness and health-related quality of life in Hong Kong. Trials, 17, 367. Scholar
  38. 38.
    Van Campen, C., & Iedema, J. (2007). Are persons with physical disabilities who participate in society healthier and happier? Structural equation modelling of objective participation and subjective well-being. Quality of Life Research, 16(4), 635–645. Scholar
  39. 39.
    Ip, P.-K. (2014). Harmony as happiness? Social harmony in two Chinese societies. Social Indicators Research, 117(3), 719–741.Google Scholar
  40. 40.
    Preston, C. C., & Colman, A. M. (2000). Optimal number of response categories in rating scales: Reliability, validity, discriminating power, and respondent preferences. Acta Psychologica, 104(1), 1–15.Google Scholar
  41. 41.
    Chen, G.-M. (2002). The impact of harmony on Chinese conflict management. In G.-M. Chen, & R. Ma (Eds.), Chinese conflict management and resolution (pp. 3–17). Westport: Ablex publishing.Google Scholar
  42. 42.
    Shen, C., Wan, A., Kwok, L. T., Pang, S., Wang, X., Stewart, S. M., et al. (2017). A community based intervention program to enhance neighborhood cohesion: The Learning Families Project in Hong Kong. PLoS ONE, 12(8), e0182722. Scholar
  43. 43.
    Ul-Haq, Z., Mackay, D. F., Martin, D., Smith, D. J., Gill, J. M., Nicholl, B. I., et al. (2014). Heaviness, health and happiness: A cross-sectional study of 163066 UK Biobank participants. Journal of Epidemiology and Community Health, 68(4), 340–348. Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Chen Shen
    • 1
    • 2
  • Man Ping Wang
    • 3
    Email author
  • Henry C. Y. Ho
    • 4
  • Alice Wan
    • 2
  • Sunita M. Stewart
    • 5
  • Kasisomayajula Viswanath
    • 6
    • 7
  • Sophia Siu Chee Chan
    • 3
  • Tai Hing Lam
    • 2
  1. 1.Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
  2. 2.School of Public HealthThe University of Hong KongHong KongChina
  3. 3.School of NursingThe University of Hong KongHong Kong SARChina
  4. 4.Department of PsychologyThe Education University of Hong KongHong KongChina
  5. 5.Department of PsychiatryThe University of Texas Southwestern Medical Center at DallasDallasUSA
  6. 6.Center for Community-Based ResearchDana-Farber Cancer InstituteBostonUSA
  7. 7.Department of Social and Behavioural SciencesHarvard TH Chan School of Public HealthCambridgeUSA

Personalised recommendations