The study comprised the design and psychometric evaluation of a questionnaire on society's perception of the risk of flash floods. The first phase involved a systematic review and qualitative studies to extract items of the initial tool. In the second phase, a quantitative approach was adopted for psychometric assessment.
3.1. First Phase: Item Generation
In the initial stage, a systematic review of available studies related to flash flood risk perception was conducted. Web of Science, Scopus, PubMed, and Google Scholar databases were searched to find studies using the keywords "risk perception," "flash flood," "sudden flood," and "dam break" until September 2023. Specific inclusion and exclusion criteria were established for selecting relevant articles on flash flood risk perception. Inclusion criteria encompassed research articles and theses in English focusing on this topic, while exclusion criteria included studies in languages other than English and Persian, those not directly addressing flash floods, letters to the editor, and conference abstracts. The screening process involved eliminating duplicates using EndNote software and independently reviewing titles, abstracts, and full texts by two authors to ensure alignment with the criteria. Data extraction utilized a standardized form to record essential details such as author information, publication year, research methods, sample demographics, and key findings. Quality evaluation of studies was conducted using the Joanna Briggs Institute (JBI) critical appraisal checklist, assessing elements like study objectives, sample size, participant characteristics, statistical analysis, and result congruence. Discrepancies were resolved through discussion and, if necessary, consultation with a third researcher. Studies meeting predefined criteria were included in the final review compilation. The selection process involved sequentially reading titles, abstracts, and full texts of studies, resulting in the identification of 25 relevant articles out of 1025 titles. Most of these articles utilized cross-sectional descriptive studies to assess residents' risk perception in the relevant areas.
To ensure comprehensive item coverage and to identify Iranian context-based items, a qualitative content analysis was conducted. Through content analysis, codes were extracted from interviews with the target group, meticulously examining interview content to identify patterns, important topics, and differing perspectives. In the qualitative study, 23 residents of Bakhtegan city, Fars province, Iran, were interviewed from December 2022 to February. People living in the city who had experienced flash floods and volunteered to participate in the study, and at the same time had information about flash floods, were included in the study using purposive sampling method. The main question included "Please describe your flash flood experience," and the interview was continued based on the participants' answers with probing questions. The duration of each interview varied from 30 to 55 minutes. Data collection employed the Graneheim and Lundman approach, and data categorization was carried out using MAXQDA 18 software. Trustworthiness was ensured through Guba and Lincoln criteria, including researcher rapport, data diversity, continuous comparison, and participant validation of findings (
15). Detailed documentation of analysis stages and participant feedback enhanced validity and reliability. Detailed contextual descriptions aimed to increase the transferability of findings.
The study extracted factors such as environmental variables (residential location, proximity to the river), economic and social variables (education level, income, marital status, family size), knowledge, trust in the media and aid organizations, and flood experience. Subsequently, the initial questionnaire was designed using items derived from both qualitative methods and systematic review. By scrutinizing and eliminating redundant items from the two extraction methods, a total of 36 items were confirmed for inclusion in the designed questionnaire, encompassing both objective and subjective factors influencing risk perception.
3.2. Second Phase: Psychometric Evaluation of the Questionnaire
The second phase of this study involved the psychometric evaluation of the risk perception questionnaire for flash floods, including testing its validity and reliability, encompassing face validity, content validity, and construct validity (
16).
Face validity assesses whether the questionnaire appears valid to subjects, patients, or observers, a criterion that can often be enhanced through appropriate wording alterations (
17). To ensure face validity in this study, 10 experts including Ph.D. students, researchers, and subjective experts were asked to comment on the questionnaire's ease of completion, grammar and spelling, writing clarity, and appropriateness. They rated each item on a 5-level scale, and items with an impact score of one and a half or higher were retained (
18).
Content validity was evaluated qualitatively and quantitatively. Thirteen experts were asked to provide detailed corrective feedback after studying the questionnaire, drawing from their expertise in disaster health, crisis management, and health education and promotion. Quantitative content validity entailed assessing the importance and appropriateness of the selected content. Content validity ratio (CVR) and Content Validity Index (CVI) were computed to ensure the selection of critical content and the appropriate design of measurement items. The numerical values of CVR were determined using a predefined table, and items scoring higher than 0.59 were considered significant and retained. For CVI, simplicity, relevance, and clarity were evaluated on a Likert Scale, and items with a resulting value exceeding 0.79 were deemed acceptable (
19).
Regarding reliability, internal consistency was assessed using Cronbach's alpha coefficient for the entire questionnaire (
20). At this stage, all residents of Bakhtegan city were eligible to participate in the study, regardless of whether they were directly exposed to flash floods or not.
Before conducting confirmatory factor analysis, assumptions of univariate normality, estimates of squared values, multivariate normal deviation, and outliers were evaluated using the Mahalanobis distance method. Missing data were handled using the maximum likelihood method. Subsequently, common dispersion between observed variables was examined to confirm linearity and address multicollinearity, enabling the use of parametric tests for confirmatory factor analysis.