The investigation of accident risk in adolescents through a qualitative study and the development of an accident risk diagnosis scale for adolescents

INTRODUCTION AND AIM: The aim of this study is to identify risk factors leading to accidents and injuries based on adolescents' self-reports, and to develop a valid and reliable measurement tool for diagnosing accident risk among adolescents, guided by the qualitative data obtained. MATERIALS AND METHODS: This research was conducted using an exploratory sequential mixed-methods design and consists of two phases. The study population comprised adolescents enrolled in secondary education institutions affiliated with the Ministry of National Education within the boundaries of Serdivan district, Sakarya province. In the first phase, semi-structured individual interviews were conducted with 30 adolescent students within the scope of qualitative research. The data were analyzed using content analysis, and 10 themes and 76 codes were identified with the assistance of MAXQDA 2022 software. In the second phase, based on the qualitative findings, the "Adolescent Accident Risk Diagnosis Scale" was developed and administered to 505 adolescents, followed by a psychometric evaluation. Quantitative data were analyzed using SPSS 22 and AMOS 25 software. RESULTS: Themes identified in the first phase included participants' definitions of accidents and injuries, factors causing accidents, and perspectives on drowning, collisions, cuts, falls, burns, poisoning, traffic accidents, and prevention strategies for accidents and injuries. An initial item pool of 101 items was created based on these themes and reviewed by experts for content validity, resulting in a reduced pool of 42 items. After a pilot study and subsequent revisions, the final scale was administered to 505 adolescents. As a result of the exploratory factor analysis (EFA), the scale was finalized with 28 items grouped under four factors, explaining 55.87% of the total variance. The factors were titled as follows: "Risk-taking for Attention and Interest," "Unsafe Behaviors," "Risk-taking Due to Emotional States and Inattention," and "Risks Stemming from Rule Violation." Confirmatory factor analysis (CFA) results indicated good model fit (CFI = 0.989; RMSEA = 0.014). The overall internal consistency of the scale was high (α = 0.912), and Cronbach's alpha coefficients for the subscales ranged from 0.806 to 0.920. Item-total correlations were within acceptable ranges, and test-retest reliability was found to be very strong (ICC = 0.966–0.989, p <0.001). CONCLUSION: The Adolescent Accident Risk Diagnosis Scale developed in this study was determined to be a valid and reliable measurement tool.