Prevalence, Parents’ Hesitancy, and Determinants of COVID-19 Vaccination Among Children: A Multi-Country Study From the Eastern Mediterranean Region (preprint)

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 the prevalence of children’s vaccination against COVID-19, to explore parents’ attitudes towards children’s vaccination, and to discover 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. 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. Results: The prevalence of vaccinated children against COVID-19 was 32% as indicated 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.

A Qualitative Exploration of University Students’ Perspectives on Distance Education in Jordan: An Application of Moore’s Theory of Transactional Distance (preprint)

The current study aimed at exploring university students’ perspectives on the emergency distance education strategy that was implemented during the COVID-19 crisis in Jordan, one of the countries in the Eastern Mediterranean Region. Utilizing a qualitative design supported by Moore’s theory of transactional distance, a total of 17 semi-structured interviews were conducted with university students of various study levels and disciplines. Data were inductively analyzed using thematic analysis as suggested by Braun and Clarke. Seven themes have emerged, including, (i) Students’ psychological response to the sudden transition in educational process, (ii) Students’ digital preparedness, equality, and digital communication, (iii) Students’ and teachers’ technical competencies and technostress, (iv) Student-student and student-teacher interpersonal communication, (v)  Quality and quantity of learning materials, (vi) Students’ assignments, examinations, and non-reliable evaluation methods, and (vii) Opportunities with positive impact of distance learning. The study findings provide evidence that the sudden transition from traditional on-campus to online distance education was significantly challenging in many aspects and was not a pleasant experience for many participants. Various factors under the jurisdiction of academic institutions and decision-makers are considered main contributing factors to the students’ educational experiences amid the pandemic crisis. Therefore, better planning and more sustainable utilization of educational resources have paramount importance in providing a high-quality education. Additionally, more dedicated efforts in terms of equitable, reliable, and credible evaluation systems should be considered in Jordan’s distance education strategy.

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 (preprint)

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 towards smoking as well as smoking behavior and quit intentions. Considering high smoking rates in Jordan, our current study aimed to assess the following points in a community-based sample from Jordan: (i) the beliefs that surround smoking and COVID-19, (ii) the pandemic impact on smoking behavior and quit intention. Methods: : A cross-sectional study was conducted in Jordan utilizing an online 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 (CC), waterpipe (WP), and electronic cigarettes (EC), 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 shown 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, and many smokers reported their willingness to quit smoking due to the pandemic. 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 (=121) which were the most reported ones. 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 reported anti-smoking beliefs and attitudes 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.

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 (preprint)

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 towards smoking as well as smoking behavior and quit intentions. Considering high smoking rates in Jordan, our current study aimed to assess (i) the beliefs that surround smoking and COVID-19, (ii) the pandemic impact on smoking behavior and quit intention.Methods A cross-sectional study was conducted in Jordan utilizing an online 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 (CC), waterpipe (WP), and electronic cigarettes (EC), 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 shown 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, and many smokers reported their willingness to quit smoking due to the pandemic.Conclusion Most participants reported anti-smoking beliefs and attitudes 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.