Development and validation of a firefighters' organizational health culture score

Firefighters rely on teamwork, but their organizational health culture (OHC) is understudied. We aimed to develop and validate a 34-item OHC measurement tool. Data were collected from 543 Taiwanese and 28 US firefighters between May 2023 and March 2024. Exploratory and confirmatory factor analyses (i.e., EFA and CFA) were conducted, and six factors of OHC-leadership support, leadership commitment, sleep and mental health policy, physical activity and nutrition policy, organizational approach, and sense of belonging-were identified. EFA was conducted using data from 271 Taiwanese firefighters, and CFA was performed on the rest, with the latter showing a good fit. We found that a better OHC was correlated with a healthier lifestyle and fewer posttraumatic stress disorder and depressive symptoms. We offer both English and traditional Chinese versions. The OHC's causal effects require further studies.