Development and validation of the organizational health behavior index: a mixed-methods instrument for measuring organizational health.

Background: Organizational health is crucial to promote employees' well-being, sustainable performances, and long-term survival; existing tools are, however, frequently unidimensional and have been developed without consideration for the organizational context. Purpose: The purpose of this study was to construct and validate the Organizational Health Behavior Index (OHBI), a composite measure that includes quantitative and qualitative domains. Methods: A sequential mixed-methods design was used to survey 7,548 workers in various Saudi industries. Subscale A (quantitative) comprised awareness, appreciation, relations, engagement, and communication satisfaction, which were validated through EFA, CFA, and reliability. Subscale B (qualitative) included organizational culture, employee persona, and voice, which were analyzed for theme, interrater reliability, and expert triangulation. Results: CFA revealed a good fit (CFI = 0.960, TLI = 0.950, RMSEA = 0.053) with factor loadings > 0.70 and reliability α ≥ 0.707. Criterion-related validity demonstrated strong correlations (r = 0.75-0.83) with an existing model. The second aim we accomplished was to enhance our results by measuring employee-induced cultural perceptions (Subscale B). Conclusion: The OHBI is a reliable multidimensional measure of organizational health, providing both theoretical and practical value. Future validation work in other contexts is suggested.