Development and validation of the earthquake early warning information stimulation-emergency awareness-emergency behavior questionnaire for community-dwelling older adults

The compound impacts of population aging and persistent seismic risks underscore the pivotal role of earthquake early warning (EEW) in mitigating losses from primary and secondary seismic hazards. The effectiveness of EEW systems depend on rational responses, and cognitive biases may trigger panic and increase secondary risks. This study aims to development and validation of the EEW Information Stimulation-Emergency Awareness-Emergency Behavior Questionnaire for Community-Dwelling Older Adults to assist disaster nurses in conducting assessments and implementing targeted EEW education and behavioral guidance. The preliminary questionnaire was developed through literature review, in‑depth interviews, content analysis of educational videos, expert meetings, and two rounds of expert consultation. A cross-sectional survey was conducted among 520 community-dwelling older adults in Sichuan Province, China, in October 2025. Psychometric properties were evaluated using item analysis, reliability, and validity testing. The final questionnaire consists of 22 items covering three dimensions: EEW information stimulation (6 items), emergency awareness (8 items), and emergency behavior (8 items).The questionnaire demonstrated excellent reliability, with a Cronbach’s α coefficient of 0.922, a split‑half reliability of 0.806, and a test–retest reliability of 0.913. The self-developed questionnaire in this study presents robust reliability and valid construct validity. It can be adopted as a reliable measurement tool to comprehensively evaluate the exposure characteristics of EEW information stimulation, emergency awareness, and emergency behavior among community-dwelling older adults. This study establishes a standardized protocol for developing and validating the Community Older Adults’ Earthquake Early Warning (EEW) Information Stimulation-Emergency Awareness-Emergency Behavior Questionnaire based on the Stimulus-Organism-Response (SOR) theory. The research adopts a rigorous mixed-methods design, including literature analysis, in-depth interviews, Delphi expert consultation, and multi-dimensional psychometric testing, to ensure high content validity, construct validity, and reliability. The questionnaire provides a theory-driven, culturally adapted, and practical tool to systematically assess older adults’ perception, awareness, and behavioral responses to EEW, supporting targeted disaster education, emergency training, and risk-reduction interventions in community settings.