Development and validation of the lifetime sense of safety scale in Kenyan adults

Background Safety supports psychological wellbeing and potentially shapes brain aging yet existing scales overlook cumulative lifespan safety experiences. Methods To address this gap, we developed and validated the Lifetime Sense of Safety (LSS) scale in Kenyan adults. The LSS uses visual analog scaling with a red-to-green color gradient to retrospectively rate felt safety across life stages and settings. We evaluated scale psychometrics and associations with social determinants of health and indicators of brain health. Results The LSS shows adequate internal consistency and test-retest reliability, with two distinct but correlated factors representing childhood and adulthood safety. Women and individuals experiencing poverty report lower lifetime safety. Total LSS scores correlate negatively with stress and anxiety and positively with resilience and memory. Conclusions The LSS is a psychometrically valid tool for evaluating cumulative lifespan safety in Kenyan adults. Longitudinal studies combining the LSS with neuroendocrine, inflammatory, and neuroimaging measures could identify mechanisms linking safety to brain health.