Development and validation of the HPV-WAK questionnaire for assessing women’s awareness and knowledge in Iran

BACKGROUND: Evidence indicates that knowledge about Human Papillomavirus remains limited in Iran. This study aimed to develop and psychometrically validate the Human Papillomavirus-related women's awareness and knowledge (HPV-WAK) questionnaire for Iranian women. METHODS: A mixed-methods study was conducted. First, an item pool was created through a rapid scoping review. Subsequently, the questionnaire's psychometric properties were assessed, including face validity, content validity (CVR/CVI), and hypothesis testing for construct validity (known groups comparison). Reliability was evaluated via internal consistency (KR-20) and inter-rater reliability (kappa). A cut-off score was determined using ROC analysis. RESULTS: From an initial 551 items, 122 were selected for the item pool. Following translation and cultural adaptation, a 50-item version underwent face validity assessment, leading to revisions of 5 items. The final 29-item questionnaire showed strong content validity (S-CVI/Ave = 0.97; S-CVI/UA = 0.83) after eliminating 21 items with low CVR (