Background The concept of resilience is multi-dimensional and cross-disciplinary, which has resulted in different conceptualisations and ways of measuring it. The exposure to environmental and health risks is unequally distributed according to age, gender, education, income, amongst others. Risks and impacts are more extensive for individuals with low resilience, and resilient individuals are better able to deal with threats. The aim of this study was to develop a Mixed Methods Individual Resilience Measure (MMIRM) and explore the sources of resilience.

Methods A mixed methods approach was used to develop a new measure of resilience which includes both general and specified resilience. The MMIRM was established through a process of transforming the Sense Of Coherence scale (SOC-13) into a quantitative general resilience index (GRI) and into a qualitative data collection tool to assess specified resilience to environmental and health risks (i.e. extreme temperatures). Questionnaires and interviews were used to collect primary data at the individual level. Quantitative and qualitative data were analysed separately using SPSS and NVivo 9, respectively, and combined using triangulation. The quantitative scores of the SOC-13 scale and its dimensions were calculated and used to develop the GRI using a series of equations. The qualitative data on specified resilience were analysed using an iterative and systematic coding process. We then assessed the relationship between general and specified resilience, and the relationship between resilience and the wider determinants of health to understand the sources of resilience.

Results The GRI Cronbach’s alpha was 0.741 and the sample’s overall GRI had a value of 0.647, ranging from 0 (less resilient) to 1 (more resilient), indicating that overall participants had high general resilience. The indicator values for the three components of resilience, comprehensibility (0.740), manageability (0.602) and meaningfulness (0.647) also revealed high resilience of participants. Male, older and married participants, with higher education levels and income had higher general resilience. Specified resilience was mainly influenced by: (i) perceived ability to deal with the threat (comprehensibility); (ii) the availability of resources (e.g. money) (manageability), and; (iii) the perceived ability to act. Levels of resilience were varied and diverse within and between participants, with some individuals showing high general resilience but low specified resilience and vice-versa.

Conclusion The MMIRM captures the different dimensions of resilience and its connexions with the wider determinants of health and, health, social and gender inequalities. These findings highlight the need to develop and implement a person-centred approach with tailored actions for building individual general and specified resilience to environmental and health risks.