Development and psychometric validation of a first aid health literacy assessment questionnaire for older adults.

BACKGROUND: Despite the critical role of health literacy in emergency management, no specific questionnaire exists to measure first aid health literacy in the older population. To address this gap, the present study aimed to develop and psychometrically evaluate a first aid health literacy assessment questionnaire for older adults in 2024-2025. METHODS: This methodological study focused on questionnaire development and psychometric evaluation based on the framework proposed by Boateng et al. Initial questionnaire items were generated through an extensive literature review. Content validity and face validity were assessed using quantitative and qualitative methods. A multi-stage random sampling method was employed to recruit 400 eligible older adults who were covered by comprehensive health centers affiliated with Kashan University of Medical Sciences. All participants completed a background information questionnaire, the Persian version of the Abbreviated Mental Test (AMT), and the Health Literacy Instrument for Adults-Short Form (HELIA-SF). Construct validity was evaluated using Principal Component Analysis (PCA) and convergent validity. Internal consistency was assessed using the Kuder-Richardson Formula 21 (KR-21), test-retest reliability was measured via the intra-class correlation coefficient (ICC), and stability was determined using the standard error of measurement (SEM) and the minimal detectable change (MDC). Ceiling and floor effects were also examined. Data analysis was performed using JASP version 0.19.3. RESULTS: The content validity ratio (CVR) and content validity index (CVI) for all items exceeded 0.8 and 0.9, respectively, and the modified kappa coefficient was greater than 0.89. Item impacts were all above 4.5. PCA extracted three components, collectively accounting for 58.2% of the variance in the total score. Results revealed a significant positive correlation between the first aid health literacy assessment questionnaire for older adults and the HELIA-SF (p < 0.001). Reliability indices were as follows: KR-21 = 0.704, ICC = 0.955, SEM = 0.707, and MDC = 2.331. No ceiling or floor effects were observed. CONCLUSION: The first aid health literacy assessment questionnaire for older adults demonstrates good validity and reliability. This questionnaire can effectively measure first aid health literacy levels in the older population and can design targeted educational interventions to improve their health outcomes. CLINICAL TRIAL NUMBER: Not applicable.