Instruments for measuring financial well-being among Veterans: A systematic review

Abstract: LAY SUMMARY: Financial health contributes to Veterans' well-being. The authors systematically searched the literature to identify tools that measure financial well-being, assessed their quality, and asked three Veteran partners to review their clarity and applicability. This search identified 13 instruments that measure financial well-being, among which the Well-Being Inventory (WBI), Economic Quality of Life Measure (Econ-QOL), Personal Financial Wellness Scale, and Living Standards Capabilities for Elders Scale demonstrated good properties; only the WBI and Econ-QOL have been tested with Veterans. These instruments may be helpful to gauge the financial well-being of Veterans and determine the impact of policies aimed at supporting financial well-being. Introduction: Financial health is one of seven aspects that have been identified to appraise the well-being of Veterans. The authors conducted a systematic review to identify instruments that measure financial well-being. Methods: The authors searched the MEDLINE, EMBASE, PsycINFO, AgeLine, PTSD Pubs, Sociological Abstracts, and Social Sciences Abstracts databases from inception to April 13, 2023, for development or validation studies reporting on financial well-being instruments. The consensus-based standards for the selection of health measurement instruments (COSMIN) were used to assess risk of bias and measurement properties of eligible studies. Three Canadian Veteran partners independently reviewed and assessed the clarity and applicability of all identified tools. Results: Thirteen instruments that assessed financial well-being were identified. Of these instruments, five (38%) demonstrated sufficient structural validity, 12 (92%) internal consistency, three (23%) cross-cultural validity, one (8%) test-retest reliability, and 10 (77%) construct validity. Veteran partners identified four instruments as very clear and very applicable to Veterans: Well-Being Inventory (WBI), Economic Quality of Life Measure (Econ-QOL), Personal Financial Wellness Scale (PFWS), and Living Standards Capabilities for Elders Scale (LSCAPE). The WBI was developed and validated with a Veteran sample. The Econ-QOL was developed with a general sample and validated among Veterans. Discussion: Among the four instruments reporting strong psychometric properties and endorsed by the study's Veteran partners, only the WBI was both developed and validated with a U.S. Veteran population, whereas the Econ-QOL was only validated with that population. The PFWS and LSCAPE appear promising but require validation among Veterans.