Evaluation of dietary patterns and their impact on eye health among Saudi adults-A multi-regional cross-sectional analysis in Makkah, Riyadh, and Qassim.

Background and aim: Nutrition plays a vital role in maintaining and improving vision health. However, little is known about dietary intake habits and their correlation with vision health among adults in the Kingdom of Saudi Arabia (KSA). The present survey was aimed to assess dietary patterns and vision health among Saudi adults and to determine the association between dietary patterns and vision health. Methods: The present analytical study was carried out among 1,234 Saudi adults in the Makkah, Riyadh, and Qassim regions of KSA. We used the Arabic version of the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) and the diet quality screener (DQS). We applied Mann-Whitney U and Kruskal-Wallis tests to determine the association between vision function score and demographic characteristics. Furthermore, the Spearman correlation test was used to determine the relationship between the DQS and the NEI VFQ-25. Results: Of the studied population, the highest score obtained through the NEI VFQ-25 was in the social function domain (mean ± SD = 76.64 ± 18.63), followed by the general vision domain (mean ± SD = 75.21 ± 15.16) and was negatively correlated with age. Regarding dietary patterns, the intake of lean protein sources per week was the highest, with a mean intake of 4.17 days per week, followed by that of whole grains and milk or dairy products, with a mean intake of around four days per week. There was a significant correlation between various dietary intakes and visual function scores. Conclusion: The present survey underscores the significance of understanding regional dietary patterns and their implications for vision health. Furthermore, our study's findings indicate a need for targeted nutritional intervention measures to improve the vision health of this population.

Assessment of knowledge, attitude, and practice toward first aid management of choking hazards among Eastern Province Saudi adults: an observational study.

Background and aim: Childhood choking is a global health concern that mainly affects children under the age of 5 years. The parent's and caretaker's responsibility is critical in the children's lives and can potentially influence the result of at-home injuries such as choking. We aimed to assess the knowledge, attitude, practice, and associated factors of first aid management toward choking hazards among Saudi adults from the Eastern Province. Methods: The present analytical study was carried out among 390 Saudi adults attending different primary health centers in the Eastern Province of Saudi Arabia. We used a standard and validated data research topic tool to assess knowledge, attitude, and practice. Spearman's correlation was applied to determine the correlation between each section, while binomial logistic regression analysis was applied to identify the associated factors. Results: We observed knowledge, attitude, and practice scores in 43.3, 38.9, and 36.4% of the participants, respectively. Furthermore, positive correlations between knowledge and attitude (rho = 0.42, p = 0.001), between knowledge and practice (rho = 0.57, p = 0.001), and between attitude and practice (rho = 0.41, p = 0.001) were revealed in our survey. The knowledge of the participants was significantly higher with the age group of 30-40 years [adjusted odds ratio (AOR) = 3.67 (1.94-4.65), p = 0.001] and participants who received training in first aid management [AOR = 1.64 (1.12-2.49), p = 0.037]. This study found that males [AOR = 0.36 (0.21-0.63), p = 0.001] and those working in the private sector [AOR = 0.61 (0.31-0.87), p = 0.018] had significantly lower attitudes. Conclusion: Our results underscore the importance of continuous health education initiatives and training courses at primary health care centers regarding first aid management of choking hazards to improve awareness and practices. Furthermore, we recommend prospective multicenter studies to address region-specific knowledge gaps.

Prevalence and Determinants of Obesity and Overweight Among Children and Adolescents in the Middle East and North African Countries: An Updated Systematic Review.

In recent years, the countries of the Middle East and North Africa (MENA) region have experienced alarming increases in the prevalence of childhood overweight and obesity. This updated systematic review sought to measure the prevalence and determinants of obesity and overweight among children and adolescents in MENA countries. A literature search for relevant observational studies published in English was conducted using PubMed, Web of Science, Google Scholar, and Saudi Digital Library. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Twenty-one published articles during the past five years were included in the systematic review. Varied approaches were used to diagnose childhood overweight and obesity, including the International Obesity Taskforce (IOTF), Centre for Disease Control (CDC), World Health Organization (WHO), and Saudi Growth Pattern Curves. We found that the combined prevalence of childhood overweight and obesity in the Middle East is up to 49.4%, depending on the methods applied in their studies. Risk factors identified were age, male gender, lack of sufficient physical activity, consumption of fried food, perceived stress level, number of family members, family size, mother's occupation, education level, family history of obesity, high energy consumption from carbohydrates, ≥2 hours spent on watching television on weekend days with overweight, and always eating breakfast while watching television with obesity. The results of this review indicate that the issue of childhood and adolescent overweight and obesity in the Middle East is substantial and concerning. Most of the risk factors identified are modifiable and, if given appropriate attention, could significantly reduce the burden of associated chronic complications.

Evaluation of Age and Gender-Related Patterns in Clinical Features and Hematological Findings Among Hypothyroidism Patients in the Al-Jouf Region of Saudi Arabia: A Hospital-Based Study.

BACKGROUND: The prevalence of hypothyroidism is high in Saudi Arabia and the contributing factors are iodine deficiency and lack of balanced nutrition. This study aims to correlate the gender, age, and presence of co-morbidities with the laboratory findings and clinical presentation. METHODOLOGY: A cross-sectional study was done in the hospitals of the Al-Jouf region. The files of the patients diagnosed with hypothyroidism from the last two years were retrieved by non-probability consecutive sampling technique. IBM SPSS Statistics for Windows, Version 23, (Released 2015; IBM Corp., Armonk, New York, United States) was used for data entry and analysis. Descriptive statistics were presented as frequencies and proportions (for qualitative variables) and mean and standard deviation (SD) (for continuous data). Associated factors were identified through a chi-square test. A p-value less than 0.05 was considered statistically significant. RESULTS: Most of the patients were females within the age group of 36 to 50 years. Significant differences were observed between male and female patients with respect to the FT4 levels, hemoglobin (Hb) levels, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) values, and RBC counts (p-values of <0.001, <0.001, <0.001, <0.001, <0.001 and <0.001, respectively). However, no significant differences were observed between male and female patients in the TSH levels and hematocrit values. Most of the patients were euthyroid (77.24%). The pattern of thyroid function status did not show significant differences with respect to the gender of participants and the different age groups (p-values of 0.447 and 0.775, respectively). The most common co-morbidities observed were diabetes and hypertension. No significant association between the co-morbidities and the pattern of thyroid function status was observed. The most common symptoms were epigastric pain, fatigue, constipation, drowsiness, altered bowel habits, and weight gain. CONCLUSION: This hospital-based study provides valuable insights into some epidemiological characteristics, clinical features, and hematological findings in hypothyroidism patients of the Al-Jouf region. Significant differences were observed between male and female patients with respect to the FT4 levels, Hb levels, MCV, MCH, MCHC values, and RBC counts. The findings strengthen the existing knowledge base and emphasize the importance of timely detection and management of hypothyroidism in this population. Implementation of salt iodination programs and a timely evaluation of the hematological parameters is recommended. Further research is warranted to delve into the hidden mechanisms and long-term ramifications of hematological changes associated with hypothyroidism.

Prevalence, Patterns, and Associated Factors for Musculoskeletal Disorders Among the Healthcare Workers of Northern Saudi Arabia: A Multicenter Cross-Sectional Study.

Background: Musculoskeletal disorders (MSDs) have emerged as a pressing concern among healthcare workers (HCWs), gaining significant attention, particularly in the aftermath of the COVID-19 pandemic. This study evaluated the prevalence, pattern, and associated factors for MSDs among HCWs in northern Saudi Arabia. Participants and Methods: Employing a cross-sectional study design, the standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to collect data from participants. Systematic sampling method was employed to select 384 HCWs from diverse healthcare settings. Multivariate logistic regression analysis was conducted to identify factors associated with MSDs. Results: Among the participants, 72.4% reported one or more NMQ-listed MSDs. The most commonly affected body regions were the neck, shoulder, and lower back. MSDs showed significant associations with physical activity (adjusted odds ratio [AOR]= 0.72, 95% confidence interval [CI] = 0.53-0.93, p = 0.024), obesity status (AOR = 3.08, 95% CI = 1.56-4.71, p = 0.003), and ergonomic training (AOR = 0.38, 95% CI = 0.23-0.55, p < 0.001). Conclusion: Implementing preplacement and periodic ergonomic training for HCWs is recommended. This proactive measure holds the potential to alleviate MSD-related discomfort, reduce sickness absenteeism, and enhance overall productivity. Future longitudinal studies across different regions of Saudi Arabia are essential to establish causal links between risk factors and MSDs.

Maternal Perception, Hesitancy, and Satisfaction Toward Childhood Immunization in Primary Health Centers, Hafr Al-Batin: A Multicenter Cross-Sectional Study from Eastern Saudi Arabia.

Background: Consumer perception of and satisfaction with vaccination services is a critical and commonly used indicator for evaluating the quality of services provided by concerned authorities. The present survey assessed maternal perceptions, hesitancy, satisfaction, and factors associated with childhood immunization services provided at the primary health centers (PHCs) of eastern Saudi Arabia. Methods: The current analytical cross-sectional study included mothers of childhood vaccine beneficiaries attending PHCs in Hafr Al-Batin. We collected data related to mothers' perceptions, hesitancy, and satisfaction using a validated Arabic version of the data collection tool. Factors associated with low and high satisfaction with the immunization services were evaluated using logistic regression analysis. We performed Spearman correlation test to identify the correlation between the perception and satisfaction scores. Results: Of the 675 participants, 87.4% were satisfied with the immunization services provided at the PHCs. The participants' satisfaction was significantly associated with the immunized child's age group (adjusted odds ratio [AOR] = 1.89, 95% CI = 1.39-2.89, p = 0.037) and occupation status (AOR = 1.42, 95% CI = 1.17-1.74, p = 0.024). Vaccine hesitancy was significantly associated with the mother's age group (AOR = 1.89, 95% CI of AR = 1.35-3.39, P = 0.003) and number of children (AOR = 1.42, 95% CI of AR = 1.17-1.74, P = 0.024), Additionally, we found a significant positive correlation (Spearman's rho = 0.207, p < 0.001) between perception and satisfaction scores. Conclusion: We recommend targeted health education programs for mothers to improve their perceptions and the importance of all recommended childhood vaccines. Additionally, we suggest continuing maternal satisfaction assessments to enhance and maintain the quality of vaccination services.

Assessment of Psychosocial Correlates and Associated Factors of Colorectal Cancer Screening among Southwestern Saudi Population: A Cross-Sectional Study.

Psychosocial correlates are one of the crucial determinants for the uptake of colorectal cancer (CRC) screening by the pre-eligible population. The present study aimed to identify the psychosocial correlates of colorectal cancer screening and determine their associated factors among the Saudi population in the Najran region, Saudi Arabia. Using a validated questionnaire, we assessed five constructs of psychosocial correlates of CRC screening among 790 participants aged 45 years and above. The five constructs were salience and coherence, cancer worries, perceived susceptibility, response efficacy, and social influence. Of the studied population, less than 50% agreed with most of the five constructs' statements, and 27.5% preferred to follow their family members' advice. Significantly higher mean scores (±SD) were identified for the male gender (7.38 ± 2.15, p = 0.027) and participants working in government sectors (7.60 ± 2.03, p = 0.027) in the cancer worries construct, while the mean (±SD) scores of perceived susceptibility were significantly higher among married participants (14.38 ± 4.10, p = 0.023) and smokers (14.95 ± 3.92, p = 0.041). Our survey results could help policymakers to implement focused health education programs for the pre-eligible population on the importance of the uptake of CRC screening. Furthermore, it is recommended to carry out exploratory mixed-method surveys in other regions of Saudi Arabia to understand the region's specific psychosocial correlates towards CRC screening.

Assessment of health promotion behavior and associated factors among the northern Saudi adolescent population: a cross-sectional study.

Background and Aim: Health promotions among the adolescent population have a significant role in achieving the 2030 sustainable development goals of the World Health Organization. The COVID-19 pandemic has led to several devastating impacts on the health, economic, social, and healthcare systems, and adolescents' health promotions are no exception. We assessed health promotion behaviors and associated factors among the adolescent population of northern Saudi Arabia (KSA). Methods: We used the Arabic version of the adolescent health promotion scale (AHPS-40) among the 400-adolescent population. The AHPS-40 assessed six domains of adolescent health behavior: nutrition, social support, health responsibility, life appreciation, exercise, and stress management. We applied the Chi-square test to identify the associated factors of adolescent health promotion activities and the logistic regression test to find the predictors for overall health promotion categories. Results: Of the studied participants, the mean ± SD of the total AHPS-40 was 103.31 ± 18.78. The nutrition domain of the AHPS-40 was significantly associated with the age group (p = 0.002), and the social support domain was significantly related to fathers' (p = 0.022) and mothers' education (p = 0.006). The exercise domain of AHPS-40 was significantly associated with age group (p = 0.018) and school level (p = 0.026). Gender was significantly associated with most of the six domains. Furthermore, more than half (52.7%) of them had a low health promotion behavior, which was significantly associated with gender (adjusted odds ratio = 1.59, 95% CI of AOR = 1.04 -2.45, p = 0.032). Conclusion: Our study results suggest improving health promotion behaviors by instituting awareness-raising and health promotion intervention programs for adolescent groups. Furthermore, we recommend a focused, exploratory, mixed-method survey among the adolescents of other regions of KSA to identify the region-specific adolescent's health promotion behaviors.

A Cross-Sectional Evaluation of Parents' Awareness Towards Testicular Torsion and Their Response to a Potential Torsion: A Northern Saudi Study.

Background: Assessment of parents' awareness of testicular torsion (TT) is essential to plan for necessary awareness-raising campaigns by policymakers. Hence, the preventable loss of testis due to inadequate awareness can be avoided. We aimed to evaluate the awareness of TT amongst parents from the Aljouf region, KSA, and to assess their response to a potential torsion. Methods: We conducted a cross-sectional study among parents from the Aljouf region. The sample population was obtained using a consecutive sampling method. The present study used a pretested Arabic questionnaire. We used a statistical package for social science software for data analysis. Results: There were 320 parents who participated in different public places for the present study. Of the respondents, 10.6% of their children had sudden pain in the scrotum. More than half (52.2%) had never heard of testicular torsion, and 72.5% of parents agreed that they would seek immediate medical attention for severe testicular pain, but a low (42.5%) proportion of parents responded that they would seek help immediately. Nearly one-fourth of them responded that less than 6 hours is the critical time for repair. Parents who were knowledgeable at the critical time had more odds of presenting to a healthcare facility immediately for both mild (OR = 2.77, CI = 1.55-4.03, p = 0.001) and severe (OR = 1.92, CI = 1.03-3.63, p = 0.032). Conclusion: We found a lack of awareness of TT among Saudi parents. It is suggested to improve the knowledge among them through awareness-raising campaigns by the concerned health authorities through feasible methods. Furthermore, we recommend conducting a futuristic multicenter and exploratory study to find province-specific awareness.

A Cross-Sectional Evaluation of Knowledge About Breast Cancer and Perceived Barriers to the Uptake of Mammogram Screening Among Northern Saudi Women: A Population-Based Study.

Background: Mammogram screening (MS) is the gold-standard method for early detection of breast cancer (BC), and its use has been proven to minimize BC-related deaths and reduce treatment costs. However, recent epidemiological surveys have reported that rates of mammogram uptake by the Saudi female population are low. Here, we assessed the knowledge of BC and perceived barriers to MS uptake among pre-eligible northern Saudi women. Participants and Methods: We administered a standard and validated Arabic questionnaire to 400 women aged 40-69 years. SPSS version 21.0 (IBM Corporation, Armonk, NY, USA) was used for data analysis. We applied logistic regression analysis to find the factors associated with participants' knowledge of BC and MS. Spearman correlation test was applied to find the correlation between knowledge and barrier scores. Results: The study participants reported that smoking habits (61.3%) and unhealthy food habits (57.8%) were the most common risk factors for BC. Of the studied participants, 56.3% had low or medium degrees of knowledge about BC risk factors and MS. The degree of knowledge was significantly associated with education level (adjusted odds ratio [aOR], 2.35; 95% confidence interval [CI]. = 1.61-3.13; P = 0.008) and a family history of BC (aOR, 3.66; 95% CI, 1.94-5.49; P < 0.001). Fear of a BC diagnosis (50.8%) and concerns regarding test procedures were the most common barriers to MS uptake. We also found a negative correlation between participants' knowledge and perceived barriers to MS (rho = -0.389, P < 0.001). Conclusion: We recommend that concerned authorities offer women multiple health education sessions covering BC risk factors and the necessity for pre-eligible women to undergo MS spaced at regular intervals at different facilities. Furthermore, a multicentric mixed-methods survey is warranted to find the qualitative aspects of barriers to MS.

Medication Adherence and Its Associated Factors among Patients with Type 2 Diabetes Mellitus Attending Primary Health Centers of Eastern Province, Saudi Arabia.

Medication adherence by patients with diabetes is critical, as it plays a crucial role in individuals' long-term health and well-being. We evaluated the medication adherence, illness perception, diabetes knowledge, and associated factors among patients with type 2 diabetes mellitus (T2DM) attending primary health centers (PHCs) in the eastern province of the Kingdom of Saudi Arabia (KSA) using a validated Arabic version of a data collection form. In order to identify the variables that are associated with medication adherence, we applied a logistic regression analysis. Furthermore, we performed the Spearman test to find the correlation between medication adherence, illness perception, and diabetes knowledge. Of the 390 studied patients, 21.5% had low medication adherence, and it was significantly associated with gender (adjusted OR (AOR) = 1.89, 95% CI = 1.27-2.73, p = 0.003) and duration of diabetes (AOR = 0.83, 95% CI = 0.67-0.95, p = 0.017). Furthermore, we found a significant positive correlation between medication adherence and illness perception (rho = 0.217, p = 0.007) and knowledge of diabetes and medication adherence (rho = 0.425, p < 0.001). We recommend improving T2DM patients' knowledge about the importance of adherence to their medication regimen in several health education sessions at the PHCs. In addition, we recommend mixed-method medication adherence assessment surveys in different parts of the KSA.

Evaluation of oral health-related quality of life and its association with mental health status of patients with type 2 diabetes mellitus in the post-COVID-19 pandemic era: A study from Central Saudi Arabia.

Background and objectives: The association between oral and mental health is reciprocal, in which poor oral health may lead to several mental health issues, especially among patients with diabetes. The present study evaluated oral health-related quality of life (OHRQOL) and its association with mental health conditions among patients with type 2 diabetes mellitus (T2DM) in central Saudi Arabia. Methods: The Arabic version of the Oral Health Impact Profile-14 (OHIP-14) questionnaire and the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) were used to assess the OHRQOL and mental health status of patients with diabetes. We utilized logistic regression analysis to identify the predictors of poor OHRQOL, and Spearman's correlation test to identify any correlations between OHIP-14 and overall DASS-21 scores, as well as each subscale. Results: Of the 677 patients included in the present study, 52.7% had a poor OHRQOL, which was significantly higher (positive association) among patients with a longer duration of diabetes (adjusted odds ratio [AOR] = 3.31; 95% confidence interval [CI] = 1.96-4.17) and those who did not periodically monitor their oral health (AOR = 2.85; 95% CI = 1.76-3.89). Some forms (mild, moderate, severe, or extremely severe) of depression, anxiety, and stress were observed in 59.7, 71.1, and 67.1% of the participants, respectively. Furthermore, we found that the total OHRQOL scores had a significant positive association with depression (AOR = 2.32, 95% CI = 1.34-3.71, p = 0.001), anxiety (AOR = 1.81, 95% CI = 1.22-2.79, p = 0.003), and stress (AOR = 1.43, 95% CI = 1.14-2.19, p = 0.026). Conclusion: The results of the present study suggest the importance of appropriate and targeted health education programs for T2DM patients to ensure periodic dental examinations and oral health. Additionally, we recommend counseling sessions for all T2DM patients with trained healthcare providers to improve their mental health status during follow-up visits at outpatient diabetes care centers.

Knowledge and Attitude towards Clinical Trials among General Population of Northern Saudi Arabia during COVID-19 Era: A Cross-Sectional Study.

Recruiting and retaining sufficient participants is one of the biggest challenges researchers face while conducting clinical trials (CTs). This is due to the fact of misconceptions and insufficient knowledge concerning CTs among the public. The present cross-sectional study was conducted from April 2021 to May 2022. We evaluated knowledge and attitude among 480 participants using a pretested Arabic questionnaire. The correlation between knowledge and attitude score was tested through Spearman's correlation test, and the logistic regression test evaluated the associated factors for knowledge and attitude. Of the studied participants, 63.5% were male and belonged to the age group less than 30 years (39.6%). Nearly two-thirds (64.6%) of them had never heard of CT. More than half of the participants had poor knowledge (57.1%) and attitude (73.5%) towards CTs. Participants' knowledge scores were significantly associated with education level (p = 0.031) and previous participation in health-related research (p = 0.007). Attitude scores were significantly related to marital status (p = 0.035) and the presence of chronic diseases (p = 0.008). Furthermore, we found a significant positive correlation between knowledge and attitude scores (p < 0.001, Spearman's rho = 0.329). The present study revealed that most of the study population had poor knowledge and moderate attitudes towards CT. Targeted health education programs at different public places are recommended to improve the public's knowledge of the importance of CT participation. In addition, exploratory and mixed-methods surveys in other regions of KSA is required to recognize the region-specific health education needs.

Evaluation of Self-Management Behaviors and Its Correlation with the Metabolic Syndrome among the Type 2 Diabetes Mellitus Patients of Northern Saudi Arabia.

Self-management behavior among diabetes patients is essential to monitor blood sugar levels, make necessary lifestyle changes, and help patients reduce their risk of complications from diabetes. We assessed the prevalence of metabolic syndrome (MS) and its association with self-management behavior and sociodemographic characteristics among 310 patients with type 2 diabetes mellitus (T2DM) attending different diabetes care centers in northern Saudi Arabia. We evaluated the self-management behaviors of patients with T2DM using a validated Arabic version of the Summary of Diabetes Self-Care Activities Scale. Regarding MS, we applied the National Cholesterol Education Program (NCEP) Adult Treatment Plan-3 (ATP-3) guidelines. A logistic regression analysis was used to identify the predictors of MS. We found that more than one-third (36.5%) of patients had MS according to the NCEP ATP-3 criteria. The prevalence of MS was significantly associated with unsatisfactory self-management behaviors. Regarding sociodemographic predictors for MS, we found a significant association between gender (ref: female: Adjusted OR (AOR) = 1.89, 95%CI = 1.17-2.95, p = 0.007) and body mass index (ref.: normal range: AOR = 2.98, 95%CI = 1.31-5.07, p = 0.003). Our findings suggest a tailor-made multifaceted intervention to improve the self-management behaviors of T2DM patients, which, in turn, can reduce MS.

Knowledge and Attitude towards Obstructive Sleep Apnea among Primary Care Physicians in Northern Regions of Saudi Arabia: A Multicenter Study.

Obstructive sleep apnea (OSA) is a serious and often underreported condition, despite its highly prevalent distribution. Primary care physicians (PCPs) play an integral role in screening and managing patients with a high risk of developing OSA. This northern Saudi Arabian cross-sectional survey assessed the knowledge and attitude towards OSA among 264 randomly selected PCPs using the OSA Knowledge and Attitude (OSAKA) questionnaire. Among the participating PCPs, 43.9% and 45.1% had low scores in the knowledge and attitude categories, respectively. More than three-fourths (78%) of them recognized that an overnight sleep study is the gold standard for diagnosing OSA. Regarding referral, 39.4% of the OSA patients encountered by the PCPs were referred to ENT specialists, while 21% were referred to sleep clinics, and 18.2% were referred to pulmonologists. Nearly half (50.8%) of the participants recognized OSA as an important clinical disease, and 56.8% were confident in caring for OSA patients. Spearman's correlation of the current study identified a positive correlation between knowledge scores and attitude scores (rho-0.151, p = 0.017). It is important to improve PCPs' knowledge regarding OSA and the necessity for referral through different training methods. Furthermore, the study findings emphasize the need to include appropriate OSA programs and continuing medical education for PCPs.

Primary Care Physicians' Knowledge, Attitude, and Potential Referral Barriers towards Bariatric Surgery: A Northern Saudi Study.

Introduction: Bariatric surgery is the most effective procedure for sustained weight loss and control of obesity-associated comorbidities among morbidly obese patients. Successful bariatric surgery depends on a multidisciplinary approach involving all healthcare workers, including the primary care physicians, from the referral of patients to long-term follow-up. The present study assessed the knowledge, attitude, and potential referral barriers of primary care physicians to bariatric surgery and associated sociodemographic factors. Materials and methods: The present analytical cross-sectional study was conducted among 280 randomly selected primary care physicians using a standard and validated data collection tool. We performed an independent t-test and one-way ANOVA to find the association between sociodemographic characteristics and knowledge, attitude, and referral barrier scores. Furthermore, multilinear regression analysis was executed to determine the association among knowledge, attitude, and barriers. Results: The current study found that 52.9%, 19.3%, and 59.3% had a low score in the knowledge, attitude, and barriers categories. The attitude scores were significantly associated with the education status (p = 0.005) and current position at primary health centers (p = 0.012), and the referral barriers score was significantly associated with the work experience duration (p = 0.004). We found a positive relationship between knowledge and attitude (regression coefficient (ß) [95% CI]:0.389 [0.154 to 0.585], p = 0.001) and a negative relationship between knowledge and referral barriers (ß [95% CI]: -0.291 [-0.127 to -0.058], p = 0.007). Conclusions: Our survey findings suggest that a lack of knowledge regarding bariatric surgery led to several concerns and referral barriers among the physicians. Therefore, the recommendation is to improve the primary care physicians' knowledge through continuing medical education, symposium, and other suitable training methods with a special focus on obesity care in the curriculum. Furthermore, a mixed-method survey involving other provinces of the KSA is warranted to formulate the region-specific training needs.

Knowledge, Attitude, and Practice towards Evidence-Based Medicine among Northern Saudi Primary Care Physicians: A Cross-Sectional Study.

The evidence-based practice of primary care physicians is essential because they are the first line of contact with the local community, and they cater to most of their communities' health needs. In the current study, in which we used a cross-sectional survey in northern Saudi Arabia, we assessed primary care physicians' knowledge, attitude, practice, and barriers regarding evidence-based medicine (EBM). Of the 300 physicians who participated, less than half had high knowledge (43.7%) and attitude (47.7%) toward EBM. The chi-square test revealed that the knowledge categories were significantly associated with the age group (p = 0.002) and EBM training received in the past five years (p < 0.001), and the attitude categories were significantly associated with nationality (p = 0.008). Of the respondents, 155 (51.7%) used EBM in their daily clinical practice. Through logistic regression analysis, we found that the identified predictors of including EBM in clinical practice were the 31−45-year-old age group (adjusted odds ratio (AOR) = 2.11, 95% confidence interval (CI) = 1.65−2.73) and EBM training received during last 5 years (AOR = 2.12, 95% CI = 1.35−2.94). We recommend enhancing primary care physicians' knowledge of EBM and its importance in clinical practice through appropriate training programs. A multi-centric mixed-method survey is warranted in other provinces of the KSA to recognize region-specific training demand.

Medication Adherence Among Hypertensive Patients Attending Different Primary Health Centers in Abha, Saudi Arabia: A Cross-Sectional Study.

Background and Objectives: Optimal blood pressure control is achieved by medication adherence. This will reduce the risk of associated morbidities and mortalities. The present study aimed to determine medication adherence and its associated factors among hypertensive patients attending different primary health centers (PHC) in Abha, Saudi Arabia (KSA). Methods: A cross-sectional study was conducted among ten different PHCs in Abha, KSA. Simple random sampling procedure was utilized to choose 400 participants. A structured anonymous questionnaire was used in the present study. Analysis of the data was done using the SPSS program, version 23. A logistic regression statistical test was applied to identify the independent associated factors of medication adherence. Furthermore, we have applied Spearman's test to find the correlation between overall B-IPQ score and medication adherence score. Results: A total of 400 hypertensive patients responded in the present survey. More than one-third of the participants (36.3%) were in the high adherence category group, while the remaining participants (63.7%) were either low or medium adherence category. The binary logistic regression analysis revealed that low and medium adherence category is significantly associated with age (adjusted odds ratio [AOR] = 0.96, 95% CI =0.93-0.99, p = 0.021), married participants (AOR = 0.42, 95% CI =0.33-0.58, p = 0.001), residing at village (AOR = 1.49, 95% CI =1.14-1.73, p = 0.038), and participants with monthly family income of 5000 to 7000 SAR (AOR = 3.06, 95% CI =1.62-5.79, p = 0.001). A negligible positive correlation was revealed between illness perception and medication adherence. Conclusion: The present study revealed that hypertensive patients poorly adhere to their antihypertensive medications. This low adherence is significantly associated with the age, monthly income, people living in rural areas, and married participants. The present study results recommend sustained efforts to implement health education programs and awareness-raising interventions targeted at hypertensive patients.

Knowledge, attitude and practice towards bio-medical waste management among healthcare workers: a northern Saudi study.

Background: Health care workers (HCWs) involved in day-to-day care and other healthcare activities play a significant role in biomedical waste (BMW) management. The World Health Organization stated some of the causes for the failure of BMW management, namely, lack of awareness of the health hazards related to BMW and inadequate trained HCWs in BMW management. The present study assessed knowledge, attitude, and practice (KAP) towards BMW management among the HCWs in northern Saudi Arabia. Methodology: The present study assessed KAP through a self-administered and validated questionnaire. Using a multistage probability sampling method, 384 HCWs from different healthcare facilities participated in this survey. We performed binomial logistic regression analysis to find association between KAP subscales and sociodemographic characteristics. Spearman's correlation test was performed to find the strength and direction of correlation (rho) between KAP scores. Results: Of the population studied, high knowledge, attitude, and practice scores were found in 47.1%, 65.1%, and 49.5% of the HCWs, respectively. The present study found that knowledge score was significantly higher among the age group from 30 to 39 years (ref: age less than 30 years: AOR = 2.25, 95% CI [1.05-4.85], p = 0.04) and non- Saudi nationals (ref: Saudi: AOR = 2.84, 95% CI [1.63-4.94], p < 0.001) The attitude score towards BMW management was significantly lower among the HCWs working in tertiary care settings (ref: PHC: AOR = 0.38, 95% CI [0.12-0.69], p = 0.01). Regarding the practice score, the male categories had a significantly higher score (ref: female: AOR = 1.82, 95% CI [1.19 -2.99], p = 0.02), while pharmacist (ref: physicians: AOR = 0.39, 95% CI [0.18-0.58], p = 0.02) and lab technicians (ref: physicians: AOR = 0.31, 95% CI [0.11-0.53], p = 0.02) had a significant lower practice score. The test results revealed a weak positive correlation of knowledge with the attitude scores (rho = 0.249, p = 0.001), and a moderately strong positive correlation was found between attitude and practice scores (rho = 0.432, p = 0.001). Conclusion: This study suggests that a regular training program for the HCWs on BMW management is necessary through symposiums, role play, interactive lectures, and other feasible training methods. Furthermore, a multicentric prospective exploratory study is to be conducted in other regions of the KSA to understand the region-specific training needs of HCWs.

Female Healthcare Workers' Knowledge, Attitude towards Breast Cancer, and Perceived Barriers towards Mammogram Screening: A Multicenter Study in North Saudi Arabia.

Breast cancer is the most commonly diagnosed cancer among women in the Kingdom of Saudi Arabia and other Middle East countries. This analytical cross-sectional study assessed knowledge, attitude towards breast cancer, and barriers to mammogram screening among 414 randomly selected female healthcare workers from multiple healthcare facilities in northern Saudi Arabia. Of the studied population, 48.6% had low knowledge, and 16.1% had a low attitude towards breast cancer risk factors and symptoms. The common barriers to mammogram screening were fear to discover cancer (57.2%) and apprehension regarding radiation exposure (57%). Logistic regression analysis found that lack of awareness regarding mammogram was significantly associated with age (p = 0.030) and healthcare workers category (ref: physicians: p = 0.016). In addition, we found a significant negative correlation between knowledge and barrier scores (Spearman's rho: −0.315, p < 0.001). It is recommended to develop target-oriented educational programs for the healthcare workers, which would empower them to educate the community regarding the risk factors and the importance of mammogram screening. Furthermore, a prospective study is warranted in other regions of the Kingdom of Saudi Arabia to understand the region-specific training needs for the healthcare workers.