Journal article
Development and validation of a Safety Compliance scale for fire-based emergency medical services (EMS) personnel
Prehospital emergency care, pp 1-16
28 Oct 2025
PMID: 41147877
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Ensuring occupational safety in high-risk professions requires validated tools to assess and promote safety behavior tailored to specific organizational contexts. Safety compliance, a specific form of safety behavior, refers to workers' adherence to safety policies, procedures, and standards within an organization. Current safety instruments adapted for emergency medical services (EMS) do not specifically measure safety compliance and may not capture the unique challenges and risk faced by fire-based EMS personnel. We developed and validated an EMS Safety Compliance scale for fire-based EMS personnel to address their occupational safety risks.
Items were developed by the research team and three EMS personnel using iterative item development. The items were field-tested as a scale of 15 items on the Fire service Organizational Culture of Safety (FOCUS) survey. The FOCUS survey is a validated safety climate survey specific for the United States (U.S.) fire and rescue service and is administered in U.S. fire departments that opt in. Our analysis included survey respondents that self-reported holding an EMS role (n = 3,117). We conducted exploratory factor analysis (EFA) (n = 1,041) to identify the number of factors for the scale through factor reduction and then we conducted confirmatory factor analysis (CFA) (n = 2,076) to confirm the measurement structure of the scale. We also tested the discriminant validity between this new scale and a previously developed Fire Safety Compliance scale.
The EFA identified a 1-factor 10-item EMS Safety Compliance scale among respondents self-reporting holding an EMS role within U.S. fire departments. The CFA results indicated support for the 1-factor structure and the fit statistics were indicative of a good fit. Further, we found discriminant validity between this new measure and an established measure of safety compliance related to fire suppression contexts measured on FOCUS.
Our results suggest the EMS Safety Compliance scale is a reliable and valid measure. This scale can be used in future research to gauge safety compliance among EMS personnel in U.S. fire departments that participate in FOCUS or as a standalone measure.
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Details
- Title
- Development and validation of a Safety Compliance scale for fire-based emergency medical services (EMS) personnel
- Creators
- Ashley M Geczik - Drexel UniversityJin Lee - Kansas State UniversityDavid Gefen - Drexel UniversityChristian J Resick - Drexel UniversityJoseph A Allen - University of UtahD Alex Quistberg - Drexel UniversityPeter Burke - New York City Fire DepartmentDiane McKinsey - Philadelphia Fire DepartmentRobert Borse - Dallas CountyAndrea L Davis - Drexel UniversityJennifer A Taylor (Corresponding Author) - Drexel University
- Publication Details
- Prehospital emergency care, pp 1-16
- Publisher
- Taylor & Francis
- Number of pages
- 10
- Grant note
- Drexel University
The data used for this study were previously obtained with the support of a FEMA Assistance to Firefighters Grant (AFG) Program, Fire Prevention and Safety (FP&S) grant: FEMA AFG FP&S Grant #EMW-2022-FP-00636 (2023-2025). FEMA had no role in study design; in the collection, analysis, or interpretation of data; in the writing of the manuscript; or in the decision to submit the article for publication. The first author's doctoral research was supported by a Graduate Assistantship from the Department of Environmental and Occupational Health at Drexel University Dornsife School of Public Health.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Decision Sciences (and Management Information Systems); Urban Health Collaborative; Management; Environmental and Occupational Health
- Web of Science ID
- WOS:001614506400001
- Scopus ID
- 2-s2.0-105022020580
- Other Identifier
- 991022124263704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Emergency Medicine
- Public, Environmental & Occupational Health