Article Text

Download PDFPDF

Preparedness of community-based organisations in biohazard: reliability and validity of an assessment tool
  1. Fatemeh Rezaei1,
  2. Mohammad R Maracy2,
  3. Mohammad H Yarmohammadian3,
  4. Ali Ardalan4 and
  5. Mahmood Keyvanara5
  1. 1 Department of health in emergencies and disasters, Isfahan University of Meical science, Isfahan, Iran (the Islamic Republic of)
  2. 2 School of Public Health, Department of Epidemiology & Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
  3. 3 Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
  4. 4 Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
  5. 5 Faculty of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
  1. Correspondence to Dr Mahmood Keyvanara; keyvanara{at}


The purpose of this study was to develop a tool for community-based health organisations (CBHOs) to evaluate the preparedness in biohazards concerning epidemics or bioterrorism. We searched concepts on partnerships of CBHOs with health systems in guidelines of the Centers for Disease Control and Prevention and literature. Then, we validated the researcher-made tool by face validity, content validity, exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and criterion validity. Data were collected by sending the tool to 620 CBHOs serving under supervision of Iran’s ministry of health. Opinions of health professionals and stakeholders in CBHOs were used to assess face and content validity. Factor loads in EFA were based on three-factor structure that verified by CFA. We used SPSS V.18 and Mplus7 software for statistical analysis. About 105 health-based CBHOs participated. After conducting face validity and calculating content validity ratio and content validity index, we reached 54 items in the field of planning, training and infrastructure. We conducted construct validity using 105 CBHOs. Three items exchanged between the fields according to factor loads in EFA, and CFA verified the model fit as Comparative Fit Index, Tucker-Lewis index and root mean square error of approximation were 0.921, 0918 and 0.052, respectively. The Cronbach’s of the whole tool was 0.944. Spearman correlation coefficient confirmed criterion validity as coefficient was 0.736. Planning, training and infrastructure fields are the most important aspects of preparedness in health-based CBHOs. Applying the new assessment tool in future studies will show the weaknesses and capabilities of health-based CBHOs in biohazard and clear necessary intervention actions for health authorities.

  • community health services
  • community health planning
  • community health centers
  • public health
  • primary health care

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors FR and MK contributed to the conception and design of the work; FR and MRM participated in data acquisition, analysis and interpretation. MHY and AA revised the work critically for important intellectual content.

  • Funding The author(s) received no financial support for the research, authorship and/or publication of this article.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.