Developing a climate change health literacy scale: A methodological study in Turkish adults.

Introduction: This study aimed to develop a valid and reliable measurement tool assessing attitudes and behaviors of individuals aged 18 and above regarding the health impacts of climate change, supporting existing literature, field studies, and climate change mitigation efforts. Methods: In this methodological study, the "Climate Change Health Literacy Scale (CCHLS)" item pool was created, followed by content validity testing and validity and reliability analyses of the 31-item scale based on expert opinions. The scale was administered to 318 adults, revealing a four-factor structure with 24 items and explaining 67.03 % of the total variance through exploratory and confirmatory factor analyses. Results: Confirmatory factor analysis indicated acceptable goodness-of-fit values (χ²/sd=2.31, RMSEA=0.06, CFI=0.94, SRMR=0.04). The Cronbach's alpha coefficient was 0.94 for the entire scale, and sub-dimensions ranged from 0.75 to 0.93, indicating high reliability. Differentiation assessment between groups with the highest and lowest 27 % scores confirmed the discriminative and valid nature of all scale items, with no observed floor or ceiling effects. Conclusions: CCHLS, which was developed in Turkish and analyzed in Turkiye to assess adults' attitudes and behaviors towards climate change, is a valid and reliable tool, and its translation into other languages and dissemination will support individuals in society in assessing their knowledge and increasing their awareness about the effects of climate change on health.