Development and validation of a family-oriented questionnaire to support the prevention of Iron deficiency anemia in first-grade schoolgirls

Background Iron Deficiency Anemia (IDA) affects approximately 40% of school-age children worldwide, with first-grade girls representing a priority population for early prevention and intervention. Objective To establish the psychometric properties of the Family-Centered Questionnaire based on Intervention Mapping to Encourage Iron Deficiency Anemia Prevention in First-Grade Schoolgirls (FCIDAS). Methods In this psychometric validation study conducted in Torbat Heydariyeh, Iran, 296 mothers were selected by multistage stratified sampling (98.7% response rate). Content validity was verified by 15 experts (I-CVI = 0.78, S-CVI = 0.92). Psychometric evaluation included exploratory factor analysis (principal axis factoring with Promax rotation), convergent validity (AVE ≥ 0.50), discriminant validity (Fornell-Larcker criterion), test-retest reliability (14-day interval, n = 54, ICC[2,1]), and measurement error (Bland-Altman analysis, SEM, SDC). Model fit was assessed using the following indices: χ 2 /df < 3, CFI > 0.95, TLI > 0.95, RMSEA < 0.06, and SRMR < 0.08. Results Exploratory factor analysis supported a seven-factor model (45 items) explaining 62.28% of the variance, demonstrating acceptable preliminary psychometric properties: CFI = 0.960, TLI = 0.957, RMSEA = 0.048, and SRMR = 0.065. Factor loadings ranged from 0.52 to 0.93 (p < 0.001). Internal consistency (McDonald's ω) ranged from 0.687 to 0.938 (total ω = 0.872). Average variance extracted exceeded 0.50 for all constructs (range: 0.51–0.78). Test-retest reliability at a 14-day interval (n = 54) gave an ICC of 0.89. Measurement errors were acceptable (SEM = 8.20 points; SDC = 22.71 points), and floor and ceiling effects were negligible (<1% and <5%). Of the 12 pre-specified construct validity hypotheses, 10 were confirmed (83.3%). Conclusion The FCIDAS demonstrated sound psychometric properties in an Iranian sample and provides a reliable measure of maternal prevention behaviors regarding iron deficiency anemia in first-grade schoolgirls. As the first validated instrument for maternal IDA prevention in Iran, the FCIDAS incorporates an Intervention Mapping framework, reflects culturally specific features, and captures a theoretically grounded factor structure. Trial registration number IRCT20160824029512N2. This trial was registered on April 5, 2022, under the identifier 59972.