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This exploratory sequential mixed-methods study developed and psychometrically evaluated the Household Preparedness for Earthquake Hazards Questionnaire (HPE-Q). Item generation used semi-structured interviews and a systematic literature review, followed by quantitative item reduction and face, content, and construct validity testing. 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International Journal of Emergency Medicine (2026) 19:7  \n[https://doi.org/10.1186/s12245-025-01118-5](https://doi.org/10.1186/s12245-025-01118-5)  \nInternational Journal of Emergency Medicine  \nRESEARCH Open Access  \nDevelopment and psychometric assessment of the household earthquake preparedness questionnaire: an exploratory sequential mixed-methods study  \nFatemeh Rezabeigi Davarani 1, Hamid Sharif-Nia2, Mahmood Nekoei-Moghadam3, Abedin Iranpour4, Narges Khanjani5, Parya Jangipour Afshar6 and Hojjat Farahmandnia3*  \nAbstract  \nIntroduction Earthquakes may lead to fatalities and property loss often due to lack of preparedness among individuals. This study aimed to develop and assess the psychometric properies of a Household Preparedness for Earthquake Hazards Questionnaire (HPE-Q) .  \nMethods This study utilized a mixed-methods approach comprising of both qualitative and quantitative methods. The qualitative phase concentrated on item generation through semi-structured interviews conducted with Iranian households selected via purposive sampling, alongside a systematic literature review to develop a comprehensive item pool for evaluating household preparedness for earthquake hazards. The quantitative phase focused on item reduction and the assessment of the face, content, and construct validity. To evaluate the reliability of the questionnaire Cronbach’s alpha and intraclass correlation coefficients (ICC) were calculated.  \nResults The initial item pool comprised 88 potential items. Face validity, content validity, and item analysis evaluation was performed and the number of items was reduced to 61. Exploratory Factor Analysis (EFA) further pruned the instrument by eliminating 24 items and Confirmatory Factor Analysis (CFA) mandated the removal of 1 item resulting in a finalized 36-item HPE-Q anchored by 7 main factors: knowledge, self-efficacy, social support, social participation, collective efficacy, protective motivation and behavioral intention. Cronbach’s alpha was 0.92 and Interclass Correlation Coefficient (ICC) of the total score was 0.93.  \nConclusion Household preparedness for earthquakes is shaped by numerous factors that can either facilitate or impede preparedness and these factors may differ across communities and households. This questionnaire can help identify key aspects of households’ preparedness for earthquakes.  \nKeywords Household, Preparedness, Earthquake, Hazard, Questionnaire  \n*Correspondence:  \nHojjat Farahmandnia [Hojjat.farahmandnia@gmail.com](Hojjat.farahmandnia@gmail.com)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/licenses/by-nc-nd/4.0/](vecommons.org/licenses/by-nc-nd/4.0/.)[.](vecommons.org/licenses/by-nc-nd/4.0/.)  \nDavarani et al. International Journal of Emergency Medicine (2026) 19:7 Page 2 of 12  \nIntroduction  \nDisasters are sudden and surprising occurrences that cause human injury, life loss or environmental damage [1, 2","cbCaicPPDY7aSVVD","https://ap.wps.com/l/cbCaicPPDY7aSVVD","pdf",1468126,12,"English","# Introduction\n# Methods\n# Results\n# Conclusion\n# Keywords","[{\"question\":\"What was the purpose of developing the HPE-Q?\",\"answer\":\"The study aimed to develop and assess the psychometric properties of a Household Preparedness for Earthquake Hazards Questionnaire (HPE-Q).\"},{\"question\":\"How were questionnaire items generated and reduced?\",\"answer\":\"Items were generated through semi-structured interviews with Iranian households and supported by a systematic literature review. Quantitative analyses reduced the pool by testing validity and performing EFA and CFA to reach a finalized 36-item instrument.\"},{\"question\":\"What reliability and factor structure did the questionnaire achieve?\",\"answer\":\"The final HPE-Q was anchored by 7 main factors: knowledge, self-efficacy, social support, social participation, collective efficacy, protective motivation, and behavioral intention. Reliability showed Cronbach’s alpha of 0.92 and intraclass correlation coefficient (ICC) of 0.93 for the total score.\"}]","Development and psychometric assessment of the household earthquake preparedness questionnaire: an exploratory sequential mixed-methods study | PDF",1790750190]