Cross-cultural adaptation, validation, and measurement invariance of the First Aid Willingness Questionnaire (FAWQ) among Turkish adolescents

BACKGROUND: This study translated, culturally adapted, and evaluated the First Aid Willingness Questionnaire for Schoolchildren to assess adolescents' self-reported readiness to help and potential barriers to first-aid provision. METHODS: This cross-sectional psychometric study included 470 high school students in Aksaray, Türkiye. The questionnaire underwent forward-backward translation, review by 12 experts, and pilot testing with 35 students. Exploratory factor analysis derived the structure, which was subsequently evaluated via ordinal confirmatory factor analysis in the same sample. Content and construct validity, internal consistency, and measurement invariance across gender, grade level, and perceived family income were assessed. RESULTS: All item-level content validity ratios exceeded 0.83; the scale-level content validity index was 0.90. Removing two items yielded a 16-item, three-factor structure: First Aid Willingness, Negative Emotions, and Perceived Knowledge. The model showed acceptable fit: scaled χ²(101) = 288.09, p < 0.001; comparative fit index = 0.95; Tucker-Lewis index = 0.94; root mean square error of approximation = 0.06, 90% confidence interval [0.05, 0.07]; standardized root mean square residual = 0.06. Composite reliability ranged from 0.79 to 0.90. Average variance extracted ranged from 0.49 to 0.59, with borderline convergent validity for Negative Emotions. Discriminant validity was supported. Cronbach's alpha ranged from 0.72 to 0.87, and McDonald's omega from 0.74 to 0.87. Configural, threshold, metric, and scalar invariance were supported across all grouping variables. Strict invariance was supported across grade level and perceived family income, but not gender. CONCLUSION: The results provide preliminary evidence for the Turkish questionnaire's psychometric properties and support subscale interpretation and latent mean comparisons within the study sample. Independent replication and evaluation of temporal stability, responsiveness, and external validity are needed.