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Design and validation of the Disaster Health Literacy Questionnaire for diabetes patients in Iran: a mixed-methods
Somayeh Panahi1, Zahra Heidari2, Maryam Heidarpour3
1Department of Health Information Technology, School of Allied Medical Sciences, Golestan University of Medical Sciences, Gorgan, Iran.
BMJ Open
|November 25, 2025
Summary
A new Disaster Health Literacy Questionnaire (DHLQ) was developed for diabetic patients in Iran. This validated tool assesses disaster perception, medication literacy, and self-help skills to improve emergency preparedness.
Area of Science:
- Health Literacy Research
- Psychometrics
- Disaster Medicine
Background:
- Diabetic patients face unique challenges during disasters, requiring tailored health literacy assessments.
- Existing tools may not adequately capture the specific needs of diabetic populations in disaster scenarios.
Purpose of the Study:
- To develop and psychometrically evaluate a multidimensional Disaster Health Literacy Questionnaire (DHLQ) for diabetic patients in Iran.
- To ensure the questionnaire is culturally relevant and linguistically appropriate in Persian (Farsi).
Main Methods:
- A sequential mixed-methods approach combining qualitative insights with quantitative psychometric validation.
- Utilized advanced multidimensional item response theory (MIRT) for construct validation.
- Evaluated content validity (CVR, CVI) and reliability (Cronbach's alpha, Kappa) in a sample of 570 diabetic patients.
Main Results:
- The 30-item DHLQ demonstrated excellent content validity and strong psychometric properties.
- MIRT confirmed a three-factor structure: Disaster Perception Risk, Medication-Nutritional Literacy, and Self-help and Emergency Literacy.
- The questionnaire showed good reliability and appropriate item difficulty and discrimination parameters.
Conclusions:
- The DHLQ is a rigorously validated instrument for assessing disaster health literacy in Iranian diabetic patients.
- Its multidimensional nature and psychometric soundness support its application in clinical practice and emergency planning.
- The DHLQ can identify specific literacy gaps to inform targeted interventions for improved disaster resilience.
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