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Development and evaluation of the cooperative experiences measure

Meza, B. P. L.; Dudovitz, R. N.; Hays, R. D.; Wong, M. D.

2026-05-24 public and global health
10.64898/2026.05.21.26353820 medRxiv
Show abstract

Given the growing crisis in youth mental health, there is a critical need to rebuild and sustain healthy social environments. Cooperative experiences (e.g., sports, clubs) may promote mental health but we lack rigorously tested measures to drive research and evaluation. This study sought to develop a measure of cooperative experiences and test associations with health. We developed and revised a measure of cooperative experiences based on interdisciplinary literature and 20 cognitive interviews. We recruited youth aged 13-25 years (N = 262) through youth-serving organizations and snowball sampling to complete an investigator-administered (n = 50) or self-administered (n = 212) survey assessing cooperative experiences (48 items), mental and physical health, and demographics. We assessed item characteristics, dimensionality, reliability, and construct validity. Multivariable linear regressions were used to estimate the association between the total score and self-reported health. Participants were 57% female, 69% Latino, 55% high school students, and 25% college students. The measure was reduced to 35 items (alpha = 0.90) with six subscales: sense of a unified group (7 items, alpha = 0.83), goal alignment (3 items, alpha = 0.80), inclusion and shared purpose (10 items, alpha = 0.88), social exclusion (2 items, alpha = 0.91), positive interdependence (7 items, alpha = 0.77), and negative interdependence (6 items, alpha = 0.87). A higher total score was associated with better self-reported mental health (beta = 0.25 standard deviation change in health score for each standard deviation change in cooperation scale, 95% CI [0.108, 0.394], p = 0.001) and self-reported general health (beta = 0.25, 95% CI [0.107, 0.395], p = 0.001). The study provides preliminary support for the reliability and validity of a new measure of exposure to cooperative experiences among youth. The measure holds promise as a tool to examine the relationship between social environments and health outcomes in real-world settings.

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