Development and validation of a questionnaire for assessment of happiness with reference to behavioral determinants of health. The Indian happiness rating scale III
Authors: Singh Ram B , Magomedova Aminat , Wilkzynska Agnieszka , Fedacko Jan , Niaz M Arif , Fatima Ghizal 
Published: January 2024

Background: Recent surveys indicate that the prevalence of happiness is more common in developed countries compared to developing countries, which is considered due to better availability of affordable medical care, more satisfaction in life and economic development. It is possible that chronic anxiety, aggression and depression may be associated with lack of happiness which may predispose poor social, and physical health, leading to unhappiness. This study aims to develop and validate questionnaire for assessment of happiness with greater accuracy, in the behavioral risk factors, so that the same can be used as a tool in the population studies. Subjects and methods: This cross-sectional survey was conducted at Halberg Hospital and Research Institute, Moradabad, India. All subjects; 980 urban (495 men and 485 women), 900 rural (510 men and 390 women) above 25 years of age were randomly selected and recruited from urban and rural populations. Clinical data as well as risk factors were recorded with the help of case record form using the validated questionnaires. Assessment of happiness was made by a new more detailed modified questionnaire involving happiness of mind by including questions related to social, emotional and psychological health behaviours with reference to behavioural risk factors. Results: The prevalence of happiness was 62.2% (n=612) among urban and 63.2% (n=569) among rural subjects. The prevalence of very happy and satisfied (20.2 vs 22.2 %), moderately happy and satisfied (23.7 vs 22.9 %) and the modestly happy and satisfied (18.4 vs 17.9 %) were not significantly different among urban and rural subjects. It seems that the accuracy of the Indian Happiness Rating Scale III is good enough to assess happiness in other populations. The prevalence of behavioral risk factors; alcoholism, alcohol intake in moderation, sedentary behavior, western type diet intake, sleep disorders, emotional stress disorders, breakfast missing, late night dinner, night shift work, were significantly greater among urban subjects compared with rural subjects. However, among subjects with happiness, the frequency of moderate alcohol intake was significantly greater compared to subjects with no happiness among urbans. There were no gender differences in happiness. Conclusions: It is possible that this modified questionnaire with 16 attributes, may accurately assess the status of happiness and successfully used for assessment of happiness rates in urban and rural populations. The questionnaire allowed us to identify approximately two third subjects with happiness, among both urban and rural populations. Similar prevalence of happiness among urban and rural subjects, despite more behavioral risk factors among urbans, indicate that economic development may not be necessary for happiness. Further studies are necessary to find out the role of happiness in relations to health and behavioral risk factors.