Effect of Digital-Based Self-Learned Educational Intervention about COVID-19 Using Protection Motivation Theory on Non-Health Students' Knowledge and Self-Protective Behaviors at Saudi Electronic University.

BACKGROUND: The COVID-19 pandemic has disastrous impacts that impose the cultivation of knowledge and motivation of self-protection to foster disease containment. AIM: Evaluate the effect of digital self-learned educational intervention about COVID-19 using the protection motivation theory (PMT) on non-health students' knowledge and self-protective behaviors at Saudi Electronic University (SEU). METHODS: A quasi-experimental study was accomplished at three randomly chosen branches of SEU (Riyadh, Dammam, Jeddah) using a multistage sampling technique to conveniently select 219 students. An electronic self-administered questionnaire was used, which included three scales for assessing the students' knowledge, self-protective behaviors, and the constructs of the PMT. The educational intervention was designed using four stages: need assessment, planning, implementation, and evaluation. A peer-reviewed digital educational content was developed after assessing the participants' educational needs using the pretest. Then, distributed through their university emails. A weekly synchronous Zoom cloud meeting and daily key health messages were shared with them. Finally, the post-test was conducted after two months. RESULTS: The mean participants' age (SD) among the experimental group was 28.94 (6.719), and the control group was 27.80 (7.256), with a high female percentage (63.4%, 73.8%) and a previous history of direct contact with verified COVID-19 patients (78.6%, 69.2%), respectively. A significant positive mean change (p = 0.000) was detected in the total COVID-19 knowledge of the experimental group post-intervention, either when it was adjusted for the covariates effect of the control group (F1 = 630.547) or the pretest (F1 = 8.585) with a large effect size (η2 = 0.745, η2 = 0.268, respectively). The same was proved by the ANCOVA test for the total self-protective behaviors either when it adjusted for the covariates effect of the control group (F1 = 66.671, p = 0.000) or the pretest (F1 = 5.873, p = 0.020) with a large effect size (η2 = 0.236, η2 = 0.164, respectively). The ANCOVA test proved that post-intervention, all the PMT constructs (perceived threats, reward appraisal, efficacy appraisal, response cost, and protection intention) and the total PMT score were significantly improved (p = 0.000) among the experimental group either when adjusted for the covariates effect of the control group (F1 = 83.835) or the pretest (F1 = 11.658) with a large effect size (η2 = 0.280, η2 = 0.561, respectively). CONCLUSIONS: The digital PMT-based self-learned educational intervention effectively boosts non-health university students' COVID-19 knowledge, protection motivation, and self-protective behaviors. Thus, PMT is highly praised as a basis for COVID-19-related educational intervention and, on similar occasions, future outbreaks.

COVID-19 cases and deaths after implementation of prevention strategies, Saudi Arabia.

Background: To prevent the spread of coronavirus disease 2019 (COVID-19), the Saudi Arabian Government introduced a number of measures in different phases (e.g. social distancing, curfew and lockdown). Aims: This study describes the incidence of COVID-19 in Saudi Arabia during different phases of prevention strategies and assesses their effects on controlling the spread of the disease. Methods: This cross-sectional study used COVID-19 data for 2 March-5 July 2020 from the Ministry of Health website. The period was divided into five phases based on prevention strategies implemented to control the infection. The incidence, point prevalence, case fatality, overall mortality rate and recovery rates for COVID-19 infection were assessed at the national, regional and city levels. Results: At the end of phase 5 on 5 July 2020, the nationwide incidence of COVID-19 was 11%, total recovery rate 70%, case fatality rate 0.9% and adjusted case fatality rate 1.4% (adjusted for time lag for mortality). The COVID-19 point prevalence increased from 2.1/100 000 population in phase 1 to 178.2/100 000 population in phase 5. A high recovery rate (68.7%) was observed in phase 4 accompanied with lower overall mortality and incidence in phase 5. The eastern region of Saudi Arabia had the highest point prevalence of COVID-19 infection (450.5 per 100 000 population), while Jeddah and Mecca had the highest overall mortality. Conclusions: The health system of Saudi Arabia efficiently used lockdown and curfew periods to prepare for management of confirmed cases of COVID-19, reflected by the decreased incidence and mortality rates in phase 5.

Parents' Willingness to Vaccinate Children against COVID-19 in Saudi Arabia: A Cross-Sectional Study.

OBJECTIVES: The present study aimed to investigate parents' willingness to vaccinate their children under the age of 18 with a COVID-19 vaccine. METHODS: This cross-sectional study was conducted in Saudi Arabia from January 2021 to March 2021. The univariate analysis using Mann-Whitney U-test, t-test, and chi-squared/Fisher's exact test was performed to identify sociodemographic factors associated with the acceptance of COVID-19 vaccine in children. Factors with statistical significance (p < 0.05) were analyzed using multivariate regression analysis to determine the variables affecting parents' decisions to vaccinate children. RESULTS: Overall, 44% (167) of parents reported that they would accept vaccinating their children with a COVID-19 vaccine. Young (86; 22.7%), married (135; 35.6%), and Saudi (114; 30%) parents seemed to be more concerned about their children being infected. Parents who intended to vaccinate themselves (OR: 0.599, 95% CI: 0.367-0.980) and who trust the healthcare system (OR: 0.527, 95% CI: 0.327-0.848) reported greater acceptance of children's vaccination. Among parents, the most frequent (40.9%) reason for vaccinating children was to prevent infection in other family members. What may underlie this result is that some parents understand that children can carry pathogens from persons in school to thoseat home. The most frequent (22.2%) reason for refusing vaccination was concerns about the side effects of the vaccine. CONCLUSIONS: Parents have differing opinions on frequencies and risks of coronavirus disease transmission and medical complications and of effectiveness and adverse effects of a vaccine. These results could be of use in designing public health information campaigns and health promotion programs based on perceived parental behavior and positive attitudes.

Socio-Demographics Correlate of COVID-19 Vaccine Hesitancy During the Second Wave of COVID-19 Pandemic: A Cross-Sectional Web-Based Survey in Saudi Arabia.

Background: The Coronavirus disease 2019 (COVID-19) pandemic is considered a major global public health threat affecting across the life course and socioeconomic aspects of life. Global acceptance to an effective vaccine is the most anticipated resolution. This study aims to evaluate intent to be vaccinated among public in Saudi Arabia during the second wave of the COVID-19 pandemic. Methods: A cross-sectional web-based study was designed in Saudi Arabia. Study participants (N = 658) were recruited through snowball sampling. The SurveyMonkey platform was used to record the response. Cross-tabulation was performed by participants' intention to vaccinate against COVID-19 virus with sociodemographic characteristics and respondents' risk perception toward COVID-19, trust in the healthcare system, and their history of vaccine hesitancy behavior. Multivariable logistic regression analysis was performed to compute the predictors of vaccination intention among the study participants. Results: Six hundred fifty-eight participants completed the survey (females = 47.4%). Of the 658 participants, 351 (53.3%) have shown intent to be vaccinated. Five hundred nineteen (78.8%) of the participants were reported to be at high risk of COVID-19, and 307 (46.6%) were reported to trust the healthcare system in the country. The multivariable analysis shows respondents with a high-risk perception (OR: 2.27, 95% CI: 1.49-3.48); higher trust in the healthcare system (OR: 3.24, 95% CI: 2.32-4.61) was found to be the significant factor affecting the decision in acceptance of the COVID-19 vaccine in Saudi Arabia. Conclusion: Participants reported high knowledge toward COVID-19 virus, and vaccine developments. About half (46.6%) of the study participants reported refusal/hesitancy toward the vaccine during the second wave of the pandemic in Saudi Arabia. The study highlighted that higher risk perception and higher trust in the healthcare system were found to be the main reasons for participants' intentions behind the vaccination.

Determinants of COVID-19 Vaccine Acceptance in Saudi Arabia: A Web-Based National Survey.

BACKGROUND: Vaccine hesitancy is a potential threat to global public health. Since there is an unprecedented global effort to develop a vaccine against the COVID-19 pandemic, much less is known about its acceptance in the community. Understanding key determinants that influence the preferences and demands of a future vaccine by the community may help to develop strategies for improving the global vaccination program. The aim of this study was to assess the prevalence of the acceptance of COVID-19 vaccine and their determinants among people in Saudi Arabia. METHODS: A web-based, cross-sectional study was conducted using snowball sampling strategy under a highly restricted environment. A bilingual, self-administered anonymous questionnaire was designed and sent to the study participants through social media plat-forms and email. Study participants were recruited across the country, including the four major cities (Riyadh, Dammam, Jeddah, and Abha) in Saudi Arabia. Key determinants that predict vaccine acceptance among respondents were modelled using logistic regression analysis. Of the 1000 survey invitees, 992 responded to the survey. RESULTS: Of the 992 respondents, 642 showed interest to accept the COVID-19 vaccine if it is available. Willingness to accept the future COVID-19 vaccine is relatively high among older age groups, being married participants with education level postgraduate degree or higher (68.8%), non-Saudi (69.1%), employed in government sector (68.9%). In multivariate model, respondents who were above 45 years (aOR: 2.15; 95% CI: 1.08-3.21) and married (aOR: 1.79; 95% CI: 1.28-2.50) were significantly associated with vaccine acceptance (p < 0.05). CONCLUSION: Addressing sociodemographic determinants relating to the COVID-19 vaccination may help to increase uptake of the global vaccination program to tackle future pandemics. Targeted health education interventions are needed to increase the uptake of the future COVID-19 vaccine.