P357 A new measure of sexual wellbeing for community surveys: Development and Validation of the The Natsal-SW

Background Sexual wellbeing is intrinsic to public health but long-standing conflation of sexual health and sexual wellbeing has limited our ability to address everyday sexual issues. This study proposed a seven-domain model, and developed and validated a brief measure for community surveys. Method Domains of sexual wellbeing were determined through critical engagement with wide-ranging literature and 40 semi-structured interviews to explore resonance with lived experiences. Measure development involved 7 cognitive interviews and two web-based surveys of general population samples (n=590, n=814), to assess performance of individual items, conduct exploratory and confirmatory factor analysis, and examine whether the resultant measure was associated with external variables as hypothesised. A sub-sample (n=113) completed the survey again after two weeks to test re-test reliability. Results We proposed seven domains of sexual wellbeing: security and safety; respect; self-esteem; resilience; forgiveness of past sexual experiences; self-determination and comfort. Semi-structured interviews confirmed the relevance of these domains to lived experiences of sex and sexuality. Drawing on the semi-structured and cognitive interviews we drafted a 25-item measure to capture these domains. Based on individual item assessment and exploratory and confirmatory factor analyses, we trimmed the measure to 13-items. The confirmatory factor analysis indicated that a ‘general specific model’ had best fit (RMSEA: 0.064; CFI: 0.975, TLI: 0.962), and functioned equivalently across age groups, genders, sexual orientation and relationship status. The final measure was associated with external variables in the directions hypothesised (all p Conclusion Our conceptual model and 13-item measure distinguishes sexual wellbeing from sexual health and enables sexual wellbeing to be quantified and understood within and across populations.