Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 1, 2025
Date Accepted: Nov 10, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development and Validation of the WONE Index: A Multidimensional Stress Resilience Assessment for Digital Mental Health Applications
ABSTRACT
Background:
Stress resilience is a dynamic process involving the interaction between current psychological demands and modifiable adaptive resources. Existing measures assess stress and resilience as static and separate constructs, limiting their utility for digital mental health platforms and applied workplace interventions. There is a critical need for an integrated tool that can assess both perceived stress and resilience capacities within a single framework.
Objective:
This study aimed to develop and validate the WONE Index, a multidimensional stress resilience assessment tool designed to measure both current stress burden and protective resources among working adults. The Index is optimized for use in digital mental health contexts to support targeted intervention and personalized resilience-building.
Methods:
A two-study validation strategy was employed. Study 1 (N=1,005; US and UK employees) involved exploratory and confirmatory factor analyses, scale refinement, and convergent, discriminant, and criterion-related validity testing. Study 2 (N=306; US-based) expanded the item pool, employed domain-specific exploratory and confirmatory factor models, tested a hybrid scoring system combining empirical prediction and theoretical importance, and evaluated test-retest and incremental validity. External validation measures included the PSS-4, CD-RISC, BRS, PROMIS-SF-8, GAD-7, WHO-5, PHQ-8, and BFI-10.
Results:
Exploratory and confirmatory factor analyses supported a robust 10-factor structure encompassing stress (Work Stress, Personal Stress, Burnout) and resilience resource domains (Emotion Regulation & Coping, Social Connectedness, Purpose & Prosociality, Sleep, Physical Activity, Dietary Intake, and Perseverative Thinking). Second-order models demonstrated excellent fit (e.g., CFI=0.95, RMSEA=0.049), with strong internal consistency (CRs≥0.74) and convergent validity (e.g., Resilience subscale r=0.73 with CD-RISC; Stress subscale r=0.66 with PSS-4). HTMT ratios and personality-based correlations provided evidence of discriminant validity. Test-retest reliability was strong (ICCs=0.77–0.90). Incremental validity analyses showed the WONE Index predicted unique variance in depression, anxiety, and well-being above and beyond existing gold-standard measures.
Conclusions:
The WONE Index offers a scientifically grounded, psychometrically robust tool for assessing stress resilience capacity in working adults. Its dual-domain structure captures the interdependent relationship between stress exposure and resilience resources and supports real-time risk identification and personalized intervention delivery. The measure fills a critical gap in applied stress resilience science, with strong utility for digital health platforms and organizational wellbeing programs. Clinical Trial: Not registered.
Citation
