Children's rates of COVID-19 vaccination as reported by parents, vaccine hesitancy, and determinants of COVID-19 vaccine uptake among children: a multi-country study from the Eastern Mediterranean Region.

BACKGROUND: Huge efforts are being made to control the spread and impacts of the coronavirus pandemic using vaccines. However, willingness to be vaccinated depends on factors beyond the availability of vaccines. The aim of this study was three-folded: to assess children's rates of COVID-19 Vaccination as reported by parents, to explore parents' attitudes towards children's COVID-19 vaccination, and to examine the factors associated with parents' hesitancy towards children's vaccination in several countries in the Eastern Mediterranean Region (EMR). METHODS: This study utilized a cross-sectional descriptive design. A sample of 3744 parents from eight countries, namely, Iraq, Jordan, Kuwait, Lebanon, Palestine, Qatar, Saudi Arabia (KSA), and the United Arab Emirates (UAE), was conveniently approached and surveyed using Google forms from November to December 2021. The participants have responded to a 42-item questionnaire pertaining to socio-demographics, children vaccination status, knowledge about COVID-19 vaccines, and attitudes towards vaccinating children and the vaccine itself. The Statistical Package for Social Sciences (SPSS- IBM, Chicago, IL, USA) was used to analyze the data. A cross-tabulation analysis using the chi-square test was employed to assess significant differences between categorical variables and a backward Wald stepwise binary logistic regression analysis was performed to assess the independent effect of each factor after controlling for potential confounders. RESULTS: The prevalence of vaccinated children against COVID-19 was 32% as reported by the parents. Concerning parents' attitudes towards vaccines safety, about one third of participants (32.5%) believe that all vaccines are not safe. In the regression analysis, children's vaccination was significantly correlated with parents' age, education, occupation, parents' previous COVID-19 infection, and their vaccination status. Participants aged ≥50 years and those aged 40-50 years had an odds ratio of 17.9 (OR = 17.9, CI: 11.16-28.97) and 13.2 (OR = 13.2, CI: 8.42-20.88); respectively, for vaccinating their children compared to those aged 18-29 years. Parents who had COVID-19 vaccine were about five folds more likely to vaccinate their children compared with parents who did not receive the vaccine (OR = 4.9, CI: 3.12-7.70). The prevalence of children's vaccination in the participating Arab countries is still not promising. CONCLUSION: To encourage parents, vaccinate their children against COVID-19, Arab governments should strategize accordingly. Reassurance of the efficacy and effectiveness of the vaccine should target the general population using educational campaigns, social media, and official TV and radio channels.

Jordanian views regarding sharing of medical data for research: A cross-sectional study during COVID-19 pandemic.

PURPOSE: In the current study, the views of Jordanian regarding sharing medical reports for research purposes were investigated during the COVID-19 pandemic. In addition, motivators and barriers regarding sharing of medical records were examined. METHODS: This observational survey-based cross-sectional study was conducted using an electronic questionnaire during the COVID-19 pandemic (second half of 2020). The questionnaire link was disseminated through two social media platforms (WhatsApp and Facebook), targeting Jordanian adults (age >18 years). RESULTS: In this study, 1,194 participants agreed to complete the study survey. Results showed that 58.3% of them (n = 696) reported to be willing to share their medical data. while 17.6% of the participants (n = 210) showed hesitancy to share their medical information. The most important motivators as perceived by the study participants were helping other patients who have similar health conditions (n = 995, 83.3%). Moreover, fearing from stigma (n = 753, 63.1%), and the lack of confidence in data security and privacy (n = 728, 61.0%) were among the main barriers preventing participants from sharing their information. Finally, results showed that participants with higher educational level (bachelor or higher) (OR = 0.299, P<0.001), or those living in center of Jordan (OR = 0.270, P<0.001) showed a lower tendency to share their medical data. While participants those who have shared data before showed a higher tendency to share their medical data (OR = 2.524, P<0.001). CONCLUSION: In this study, many of the participants had a positive attitude towards sharing biomedical data for scientific research during the COVID-19 pandemic, many had doubts in the control over their data. Thus, policymakers and data users should address the concerns and values of patients and understand their preferences in favor of an ethically scrupulous use of data in research.

Beliefs Toward Smoking and COVID-19, and the Pandemic Impact on Smoking Behavior and Quit Intention: Findings from a Community-Based Cross-Sectional Study in Jordan.

BACKGROUND: The relationship between smoking and coronavirus disease-2019 (COVID-19) is still topical with mixed epidemiological evidence. However, the pandemic may affect people's beliefs toward smoking as well as their smoking behavior and quit intentions. Considering high smoking rates in Jordan, our current study aimed to assess the following domains in a community-based sample from Jordan: (i) the beliefs that surround smoking/vaping and COVID-19 and (ii) the pandemic impact on smoking behavior and quit intention. METHODS: A cross-sectional study was conducted in Jordan from March 9 to March 16, 2021, utilizing a web-based structured questionnaire. The questionnaire comprised 13 items on sociodemographic, health, and smoking profiles, 14 items to assess beliefs surrounding COVID-19 and the use of combustible cigarettes (CCs), waterpipe (WP), and electronic cigarettes (ECs), and 12 items to assess the pandemic impact on smoking behavior and quit intention. RESULTS: Of 2424 survey respondents who participated in our study, there were 1163 never-smokers, 1044 current smokers, and 217 ex-smokers. The mean age of participants was 35.2 years (SD: 11.06). Most participants have reported anti-smoking beliefs with around 72.9% believed that WP smoking is related to the risk of contracting COVID-19. Also, 71.7% believed that smoking CC may worsen the COVID-19 clinical course, while 74.1% of respondents believed that smoking has no protective effect against COVID-19. During the pandemic, about 28.1% and 19.3% of current smokers reported increased or reduced smoking, respectively. Besides, 459 current smokers have expressed their plans/intention to quit smoking during the pandemic, of whom 27.5% (n = 126) confirmed that the driving force for their decision is a COVID-19-related reason, such as self-protection (n = 123) and protection of family members (n = 121) which were the most cited reasons. Also, around 63 participants have successfully ceased smoking during the pandemic. However, only 22 of them reported that the main driving motivation of their successful quit attempt was the COVID-19 pandemic. CONCLUSION: Most participants' beliefs and attitudes were against smoking during the pandemic. Nevertheless, the double-edged effect of the pandemic on smoking habits should be carefully considered, and reliable anti-smoking measures should be strengthened and sustained in the country.

Attitudes and Commitment Toward Precautionary Measures Against COVID-19 Amongst the Jordanian Population: A Large-Scale Cross-Sectional Survey.

Aims: This study aimed to (1) assess the non-pharmaceutical intervention (NPI) measures that were used by the Jordanian population against COVID-19, and (2) determine the sociodemographic and behavioral predictors of contracting COVID-19 with a focus on the utilization of personal precautionary measures. Methods: A descriptive questionnaire-based cross-sectional survey was used in this study. A structured web-based questionnaire was disseminated to the Jordanian community through social media platforms. Participants were asked a series of questions about socio-demographic characteristics, in addition to the knowledge, attitudes, and commitment toward using various personal precautionary measures (e.g., face mask, hand washing, social distancing) against the COVID-19. Data were analyzed using descriptive statistics, cross-tabulation, and binary logistic regression through SPSS®. Results: Responses from 7,746 participants were included in our final analyses. Descriptive statistics showed that most participants (82.6%) believed that face mask protects against COVID-19. Around 69.5% of the participants were completely committed to wearing a face mask, while 65% of the participants were completely committed to hand washing. The results of the regression analysis revealed that female gender (AOR = 1.2; 95% CI: 1.07-1.35; p = 0.002), having a family member infected with COVID-19 (AOR = 8.5; 95% Cl: 7.51-9.70; p = 0.001), having a health-related work or study (AOR = 1.2; 95% Cl: 1.09-1.38; p = 0.001), believing that face masks do not protect against COVID-19 (AOR = 1.3; 95% Cl: 1.12-1.47; p = 0.001), and partial commitment to handwashing (AOR = 1.2; 95% Cl: 1.11-1.75; p = 0.006) were all associated with an increased odds of contracting COVID-19 among the participants. Conclusion: Overall, commitment to non-pharmaceutical intervention (NPI) measures, such as wearing a face mask, hand washing, and physical distancing, was not optimal among Jordanians. This might explain the dramatic increase in the infectivity rate of the COVID-19 virus in the past few months in the country. More sustainable efforts regarding health promotion and strict policies are required to prevent a third wave of hitting the country and to prevent similar infectious threats in the future.

The Experiences of Nurses and Physicians Caring for COVID-19 Patients: Findings from an Exploratory Phenomenological Study in a High Case-Load Country.

Various changes have affected health services delivery in response to the repercussions of the COVID-19 pandemic, and this may exhibit unprecedented effects on healthcare workers (HCWs). This study aimed to explore the lived experience of physicians and nurses caring for patients with COVID-19 in Jordan. An interpretative phenomenology approach was used, and sampling was purposively performed. Data were collected through semi-structured interviews using an online meeting platform (Zoom®). Interviews were audio-recorded, transcribed verbatim, and analyzed. The data were obtained from 26 physicians and nurses caring for patients with COVID-19. The mean age of the participants was 29.41 years (SD = 2.72). Six main themes and 17 subthemes were identified: (i) emotional reactions; (ii) preparation; (iii) source of support; (iv) extreme workload; (v) occupational challenges, and (vi) work-related concerns. The results showed that nurses and physicians caring for COVID-19 patients in Jordan were experiencing mental and emotional distress and were practicing under inadequate work conditions. This distress could be multifactorial with personal, organizational, or cultural origins. Our findings may guide policymakers to consider the potential factors that significantly affect working environment in healthcare settings, the physical and mental wellbeing of HCWs, and the required professional training that can help in enhancing resilience and coping strategies amidst crises.

Psychological Impact of COVID-19 Pandemic Among the General Population in Jordan.

Objective: Pandemics are claimed to result in certain stressors. However, the potential psychological impact of a pandemic is often overlooked. The current study aimed to assess the psychological impact of the COVID-19 pandemic on Jordanians and to evaluate the influence of the socio-demographic variables on this impact. Method: The current study employed a descriptive cross-sectional design using the Impact of Event Scale-Revised (IES-R) via a web-based questionnaire. The researchers utilized convenience sampling which led to a total of 2,854 participants from the 12 governorates of Jordan. Results: The average score of the participants' responses on the IES-R questionnaire turned out to be 22.5 ± 11.7. Females were found to have more than double the odds of having an increased IES-R score [odds ratio (OR) = 2.2, confidence interval (CI) = 1.76-2.67] and participants who were older than 65 years had triple the odds of having the same risk compared to young adults aged 18-25 years (OR = 3.1, CI = 1.3-7.4). Significantly, having a family member diagnosed with COVID-19 placed individuals at a 7-fold higher risk of having an increased IRS-R score compared to their counterparts who did not have a family member diagnosed with COVID-19 (OR = 7, CI = 3.7-13.3). Conclusion: COVID-19 pandemic has imposed significant level of psychological burden on Jordanians, especially among females. Governments should collaborate with psychiatrists, mental health professionals and local institutions to offer high-quality, timely crisis-oriented psychological services to the affected individuals for the duration of the COVID-19 pandemic.