Validity of an abbreviated Individual Water Insecurity Experiences (IWISE-4) Scale for measuring the prevalence of water insecurity in low- and middle-income countries. (7th September 2022)

• Record Type: Journal Article
• Authors: Bethancourt, Hilary J.; Frongillo, Edward A.; Young, Sera L.
• Is Part Of: Journal of water, sanitation, and hygiene for development. Volume 12:Number 9(2022)
• Page Start: 647
• Page End: 658
• Publication Date: 2022-09-07
• Subjects: indicator -- measurement -- prevalence -- scale -- validation -- water security; Drinking water -- Sanitation -- Periodicals; Water-supply -- Periodicals; Drinking Water; Hygiene; Health Planning; Water-supply; Health planning; Hygiene; Drinking water -- Quality; Sanitation; Electronic journals; Periodicals; Periodicals; 363.6105
• DOI: 10.2166/washdev.2022.094
• Languages: English
• ISSNs: 2043-9083

Abstract

Abstract: The 12-item Water Insecurity Experiences Scales provide high resolution, cross-context equivalent data on household and individual water insecurity. A 4-item, 1-minute version of the Household Water Insecurity Experiences (HWISE-4) Scale has proven useful for understanding the prevalence of household water insecurity experiences when limited resources preclude the use of the HWISE-12 Scale. Herein, we tested the validity of an analogous four-item version of the Individual Water Insecurity Experiences Scale (IWISE-4) for measuring the prevalence of individual water insecurity when limited resources prevent implementation of the IWISE-12 Scale. We used data from adults in 31 low- and middle-income countries ( n =43, 970) to assess internal consistency, cross-country equivalence, predictive accuracy, and construct validity of the IWISE-4. Receiver operating characteristic curves showed that the IWISE-4 (range 0–12) predicted individual water insecurity with ≥95% accuracy in every country. An IWISE-4 cut-point of ≥4 provided the closest approximation of water insecurity prevalence as predicted by the IWISE-12 scale (cut-point ≥12), correctly classifying 87.1–98.5% of adults across countries, and was similarly associated with water quality dissatisfaction, a measure of construct validity. Although the IWISE-4 Scale cannot measure the severity of water insecurity, the IWISE-4 provides suitable and cross-country equivalent estimates of the prevalence of individual water insecurity. HIGHLIGHTS: We evaluated a 4-item version of the 12-item Individual Water Insecurity Experiences (IWISE) Scale for estimating water insecurity prevalence. The IWISE-4 Scale had good predictive accuracy, high sensitivity and specificity, and correctly classified the water insecurity status of >87% of adults in 31 countries. The IWISE-4 Scale is a suitable, cross-country equivalent instrument for estimating prevalence of water insecurity. Graphical Abstract