Validation of a questionnaire for assessing household vulnerability to climate change and health among small island communities.

Introduction: Small island communities in tropical regions are vulnerable to the impacts of climate change. However, there is a lack of a comprehensive tool to assess their health vulnerability, particularly at the household level. This study addresses this gap by developing and validating a questionnaire to evaluate household vulnerability to climate change and health in these communities. Materials and methods: The questionnaire was constructed in three phases: questionnaire development, validity assessment, and pilot testing. It was developed using a comprehensive framework that incorporated three key dimensions of vulnerability: exposure, sensitivity, and adaptive capacity. Results: Content validity, evaluated by a panel of experts, demonstrated excellent item-level and scale-level validity indices with S-CVI/UA and S-CVI/Ave of 0.89 and 0.98, respectively. Pilot testing conducted in Carey Island identified 13.5% of households as highly vulnerable. Key contributing factors include high exposure to drought and shoreline erosion, limited access to healthcare, insufficient financial resources, lack of elevated housing structures, and inadequate community engagement and adaptive behavior. Discussion: The validated tool provides a reliable and context-specific instrument for identifying vulnerable households, enabling policymakers and practitioners to design tailored interventions. This tool provides a structured and evidence-based approach for assessing vulnerability, supporting more effective planning and resilience-building in small island communities facing climate-related health risks.