Design and Validation of a Health System Preparedness Assessment Tool for Mass Gatherings
- 1Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 2Department of Health in Education & Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 3Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Background: Mass gatherings, such as the arbaeen pilgrims walking, pose unique public health challenges requiring comprehensive preparedness strategies. Despite the existence of several tools, there is no validated and context-specific instrument to assess health system preparedness in such events. This research aimed to design and psychometrically validate the health system preparedness assessment tool for mass gatherings (HPAT). Materials and Methods: This sequential mixed-methods study was conducted in three phases. First, a scoping review of international and national documents was performed using Arksey and O’Malley’s framework, resulting in the extraction of 324 unique preparedness-related items. In the second phase, qualitative expert consultations conducted through focus group discussions refined these items into four main domains and 11 subdomains. In the third phase, psychometric evaluation, including face, content, and construct validity, as well as reliability testing, was performed on data from 260 healthcare and emergency professionals. Results: The final HPAT consisted of 148 items across four domains: Health, medical care and treatment, management and logistics, and coordination and safety. Exploratory factor analysis (EFA) confirmed the four-domain structure (KMO=0.892; Bartlett’s test P<0.001). Content validity was excellent (mean CVI=0.98), and internal consistency was also high (Cronbach’s α=0.96). The tool demonstrated substantial inter-rater reliability (Kappa=0.76). Conclusion: The validated HPAT provides a reliable, comprehensive, and context-specific instrument for evaluating health system preparedness for mass gatherings. Its application can guide policy and practice by identifying gaps, strengthening intersectoral coordination, and enhancing public health readiness for large-scale events.
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BibTeX
@article{ahmadi2026design,
title = {{Design and Validation of a Health System Preparedness Assessment Tool for Mass Gatherings}},
author = {Fariba Ahmadi and Zohreh Ghomian and Sakinah Rakhshanderou and Azadeh Tahernejad},
journal = {Health in Emergencies \& Disasters Quarterly},
year = {2026},
month = sep,
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Design and Validation of a Health System Preparedness Assessment Tool for Mass Gatherings
AU - Fariba Ahmadi
AU - Zohreh Ghomian
AU - Sakinah Rakhshanderou
AU - Azadeh Tahernejad
PY - 2026
DA - 2026/09/01
JO - Health in Emergencies & Disasters Quarterly
AB - Background: Mass gatherings, such as the arbaeen pilgrims walking, pose unique public health challenges requiring comprehensive preparedness strategies. Despite the existence of several tools, there is no validated and context-specific instrument to assess health system preparedness in such events. This research aimed to design and psychometrically validate the health system preparedness assessment tool for mass gatherings (HPAT). Materials and Methods: This sequential mixed-methods study was conducted in three phases. First, a scoping review of international and national documents was performed using Arksey and O’Malley’s framework, resulting in the extraction of 324 unique preparedness-related items. In the second phase, qualitative expert consultations conducted through focus group discussions refined these items into four main domains and 11 subdomains. In the third phase, psychometric evaluation, including face, content, and construct validity, as well as reliability testing, was performed on data from 260 healthcare and emergency professionals. Results: The final HPAT consisted of 148 items across four domains: Health, medical care and treatment, management and logistics, and coordination and safety. Exploratory factor analysis (EFA) confirmed the four-domain structure (KMO=0.892; Bartlett’s test P<0.001). Content validity was excellent (mean CVI=0.98), and internal consistency was also high (Cronbach’s α=0.96). The tool demonstrated substantial inter-rater reliability (Kappa=0.76). Conclusion: The validated HPAT provides a reliable, comprehensive, and context-specific instrument for evaluating health system preparedness for mass gatherings. Its application can guide policy and practice by identifying gaps, strengthening intersectoral coordination, and enhancing public health readiness for large-scale events.
SN - 2345-4210
ER -