Well-being Efficacy: Developing a Capability Framework for Sustainable Well-being through an International Modified e-Delphi Study (Preprint)

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BACKGROUND People may have knowledge about well-being, supportive resources, confidence, and opportunities to act, yet still struggle to sustain well-being as circumstances change. Existing constructs address many of these determinants individually, but a capability framework describing their mobilisation and coordination remains insufficiently defined. OBJECTIVE This study proposes Well-being Efficacy (WBE) as such a capability framework, in which WBE itself is conceptualised as an integrative meta-capacity that coordinates these resources into adaptive action for sustaining well-being across changing contexts. METHODS A two-round modified e-Delphi study was conducted with 20 multidisciplinary international experts. Following a prospectively published protocol, experts evaluated the proposed WBE definition and 18 dimensions. Consensus was defined a priori as ≥70% agreement. Qualitative feedback was incorporated between rounds to refine the framework. RESULTS The proposed WBE construct achieved 95% agreement in Round 1 (n=20), and all 18 dimensions reached consensus, with agreement ranging from 70% to 95%. Expert feedback led to refinements in wording and conceptual clarity without substantive alteration of the framework. Following revision, the overall construct and all dimensions achieved full consensus (100% agreement) in Round 2 (n=8). CONCLUSIONS The findings provide international multidisciplinary consensus for an integrative capability framework for WBE, within which WBE itself operates as a meta-capacity concerned with mobilising and coordinating personal and contextual resources to sustain well-being across changing circumstances. The resulting framework distinguishes WBE from established constructs focused primarily on knowledge, beliefs, resources, or opportunities and provides a conceptual basis for subsequent validation and measurement development. CLINICALTRIAL Not applicable. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1371/journal.pone.0321426

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