Using mobile health applications to enhance physical activity in Saudi Arabia: a cross-sectional study on users' perceptions.

BACKGROUND: This research aims to assess the users' perceptions of usability and quality of mobile health applications used for promoting physical activity in Saudi Arabia. METHODS: This was a quantitative cross-sectional study. A survey was developed based on the Technology Acceptance Model (TAM) and the Mobile Application Rating Scale (MARS) and distributed among the Saudi population through social media to assess the users' perceptions of using mobile applications to enhance physical activity. The survey questionnaire consisted of 27 questions in six sections, including demographics (nine items), perceived usefulness (three items), perceived ease of use (three items), attitudes (three items), user experience (six items) and subjective quality (three items). All the participants were in Saudi Arabia and >15 y of age. RESULTS: A total of 195 m-Health users participated in the survey. Of the total participants, 25.1% were overweight and 21.0% were obese. The workout frequency of most users was rarely (32.3%) and three to four times a week (29.2%). In addition, 55.9% of the users agreed that the application they use served all fitness levels and >80% either agreed or strongly agreed that it was easy for them to learn how to use the application. More than 70% of users agreed or strongly agreed that the application enhanced their knowledge of workouts and physical activity and >90% would recommend the application to others. There were no differences identified between the male and female participants and younger (<40 y) and older (>40 y) participants with respect to perceived usefulness and ease of use, attitudes, experiences and subjective quality. However, significant differences were observed between participants <40 y and >40 y of age in terms of perceived ease of use of mHealth applications. CONCLUSION: mHealth users across Saudi Arabia believe that the mHealth applications have good usability and quality factors. As a result, they can motivate people and help them achieve their goals in relation to physical activities.

Use of social media for the improvement of radiation safety knowledge among Saudi Arabian radiographers.

BACKGROUND: Radiographers have used social media networks for education, research, professional development and other purposes. However, in Saudi Arabia, there are no studies on the use of social media by radiographers. Therefore, the objective of this research was to evaluate the use of social media for the improvement of radiation safety knowledge among Saudi Arabian radiographers. METHODS: A questionnaire was designed to collect the data from Saudi Arabian radiographers. The questionnaire was created using Google Forms and was sent to 530 radiographers using WhatsApp. In total, 159 participants completed and returned the questionnaire through WhatsApp. The response rate was 30%. Basic descriptive statistics were employed to analyse the data. RESULTS: Most of the participants (79.9%) thought that social media could be used as a tool for the improvement of radiation safety knowledge. Also, almost half of participants (49.7%) employed social media when they needed to obtain information about radiation protection. Similarly, a majority of respondents (69.2%) used social media when they required information related to radiation safety. In addition, 81.7% of participants observed on video the existing information on radiation safety. Also, 71.7% of them were disposed to expand the use of social media to obtain information for radiation protection in their professional activities. CONCLUSION: The results indicate that social media can help to improve radiation safety knowledge among Saudi Arabian radiographers. Consequently, participants were willing to increase the use of these tools in their professional work.

Evaluation of the Mawid mobile healthcare application in delivering services during the COVID-19 pandemic in Saudi Arabia.

PURPOSE: The purpose of this study is to evaluate MAWID mobile application developed by the Ministry of Health, Saudi Arabia, which is used for primary care hospitals appointments management and for tracking and tracing COVID-19. PARTICIPANTS AND METHODS: An online questionnaire-based survey was used for collecting data related to three major factors including Ease of Use, Satisfaction, and Benefits of MAWID application among its users. Out of total 2542 participants, 345 participants completed only a part of the survey, and 204 participants did not use the application. After removing, 549 invalid responses, a final sample of 1993 was included for the data analysis. RESULTS: 82.1% of the participants referred MAWID as easy to use application, 79.8% were highly satisfied with the application, and majority of the participants reflected potential benefits of using the application. T-test results have revealed that significant differences existed between males and females, and young and older participants in relation to the Ease of Use and Satisfaction levels associated with MAWID application. CONCLUSION: Mobile applications can be very effective in delivering the healthcare services during pandemics. However, there is a need for regular evaluation and assessment to trach the change in users' needs and update the app according to the changing requirements.

Knowledge and attitude of Saudi Arabian citizens towards telemedicine during the COVID-19 pandemic.

BACKGROUND: The objective of this study was to investigate the knowledge and attitudes of Saudi Arabian citizens towards telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A cross-sectional survey was designed to carry out this study. The electronic survey, prepared using Google Forms, was distributed to 1500 randomly selected citizens of Saudi Arabia. A total of 330 participants completed and returned the questionnaire. Basic statistics were used to describe the data. RESULTS: The majority of the respondents (73.9%) were female. More than half of them (54.8%) were >35 y of age and had graduate or postgraduate degrees (65.5%). A total of 96.7% of the respondents were Saudis. Most of the participants (70.0%) were familiar with the term 'telemedicine' and thought that telemedicine (92.1%) could reduce transportation costs. Of the respondents, 58.8% had not seen a telemedicine system before and 67.0% indicated that they had not previously used telemedicine services. A total of 87.3% of the participants agreed or strongly agreed that telemedicine was a useful tool during the COVID-19 pandemic. Also, more than half of the participants agreed or strongly agreed that telemedicine facilitates the diagnosis of people (58.8%), increases communication (58.2%), reduces clinic visits (85.9%) and performs tasks quickly (70.3%). Also, 51.5% of the respondents disagreed or strongly disagreed that telemedicine affects patient privacy. CONCLUSIONS: The outcomes indicated that most of the participants had a positive attitude towards the use of telemedicine as a response to the COVID-19 pandemic in Saudi Arabia. They believed that telemedicine saves time, labour and costs and is an effective tool to treat coronavirus patients at a safe distance. However, the government should develop programs to raise awareness in the population about the use of telemedicine for the treatment of various diseases that afflict the Saudi Arabian people. Likewise, a legal framework must be implemented to protect the privacy of patients and healthcare providers.

Factors influencing the effectiveness of using flash glucose monitoring on glycemic control for type 1 diabetes in Saudi Arabia.

BACKGROUND: In 2017, 35000 Saudi children and adolescents were living with a type 1 diabetes (T1D) diagnosis. Diabetic complications are minimized upon strengthened glycemic regulation. The annual cost of treating diabetic patients with complications was four-fold higher than for patients without complications. The use of flash glucose monitoring (FGM) enables better diabetes treatment and thereby improves glycemic control. Understanding the factors that affect effectiveness of FGM will help enhance the device's use and management of hospital resources, resulting in improved outcomes. AIM: To investigate factors that affect effectiveness of the FGM system for glycated hemoglobin (HbA1c) levels/glycemic control among T1D patients. METHODS: A retrospective empirical analysis of T1D patient records from King Abdul-Aziz University Hospital and Prince Sultan Military Medical City was performed. T1D patients who began FGM between 2017 and 2019 were included. RESULTS: The data included 195 T1D patients (70 males and 125 females) with a mean age of 23.6 ± 8.1 years. Among them, 152 patients used multiple daily injection and 43 used an insulin pump. The difference in HbA1c level from baseline and after using FGM was -0.60 ± 2.10, with a maximum of 4.70 and a minimum of -6.30. There was a statistically significant negative correlation between the independent variables (age, duration of diabetes, level of engagement) and HbA1c. The group with the highest HbA1c mean (9.85) was 18-years-old, while the group with the lowest HbA1c mean (7.87) was 45-years-old. Patients with a low level of engagement (less than six scans per day) had the highest HbA1c mean (9.84), whereas those with a high level of engagement (more than eight scans per day) had the lowest HbA1c mean (8.33). CONCLUSION: With proper education, FGM can help people with uncontrolled T1D over the age of 18 years to control their glucose level.

The Impact of WhatsApp on the Blood Donation Process in Saudi Arabia.

BACKGROUND: WhatsApp was the most popular messenger app used in Saudi Arabia with 71% of the total population using it in 2020. WhatsApp is increasingly being used as a tool for mobile health (m-health) interventions; however, concerning blood donation, there is a lack of research studies on the topic. OBJECTIVE: This study aims to measure the general awareness levels of the blood donation process and assess blood donation history, the motivators and inhibitors to donating blood, and to assess the impact of WhatsApp on the blood donation process in Saudi Arabia. METHODS: In this research study, a descriptive quantitative cross-sectional analysis was adopted. A questionnaire survey was designed using Google Forms and distributed online through social media applications to collect data. All citizens aged above 18 years of age were eligible to participate in the survey. There were a total of 150 participants in the study. RESULTS: More than 90% of participants were aware of their blood group, blood donation requirements, and causes to be deferred from the donation. Furthermore, 27% of participants donated blood because their relatives or friends needed blood, 26% donated due to human solidarity, 18% did not donate blood because of their health condition and 14% did not because of the fear of needles. About 33% of participants relied on WhatsApp to search for blood donors, and all the requests were fulfilled with blood donors. In addition, 94% of participants strongly believed that the WhatsApp application had a significant role in bridging the gap for blood banks' need for blood donors. CONCLUSION: Social media applications such as WhatsApp can bridge the gap between blood banks, blood donors and the patients in need of blood in Saudi Arabia, where there is a shortage of blood donors.

Understanding the Impact of Digital Health Strategies During the COVID-19 Outbreak in Saudi Arabia.

BACKGROUND: The impact of COVID-19 has been analyzed from various aspects on the health care services management, accessibility and delivery of health care services. However, the COVID-19 pandemic has led to disruptions in health care services, which led to the increase in adoption of digital health technologies, mostly arising out of need and necessity. OBJECTIVE: Focusing on the prevailing situations (increasing reliance on digital health services), this study investigates the impact of digital health technologies from the perspectives of policymakers and citizens. METHODS: A mixed-methods approach was adopted. Twenty-seven semi-structured online interviews were conducted with experts and policymakers for assessing the impact from policymakers' perspectives. An online survey questionnaire instrument was used to collect the responses from 1698 Saudi Arabian citizens in relation to the various aspects of digital health applications. RESULTS: Health care expenditures increased during the COVID-19 outbreak, resulting in launch of various digital health applications. While policymakers defended their stand in improving health care services and accessibility; citizens reflected inability to book medicines/personal medical equipment online (Mean=2.4) and suffered a lack of personalized care (Mean=2.9) through digital health applications. Moreover, disparities exist between the population groups with respect to the accessibility, utilization, and perceptions of digital health technologies. CONCLUSION: Policymakers have to consider and address these differences in formulating digital health policies and implementing them.

Usage and Acceptability of the Wateen Application Among the Population of Saudi Arabia.

PURPOSE: The main objective of this research was to investigate the opinion of the population of Saudi Arabia on the use and acceptability of the Wateen application. METHODS: This research was a quantitative cross-sectional study in which an online questionnaire was distributed among the target population who were healthy people over 18 years of age that had used or known about the Wateen application. A total of 352 participants responded to the questionnaire. The data collection was carried out between November and December 2020. A basic descriptive statistical analysis was used to analyze the data. RESULTS: The participants had used the Wateen app to follow the donation record, as a reminder of donation dates, to find lists and blood bank locations, to request blood donation, and to find donation requests on social media. After receiving the blood donation request from the Wateen app, majority of the respondents felt encouraged, motivated, and educated to donate blood, and about blood donation, respectively. Participants also indicated that the application helped them to find donors. Besides, majority of the respondents stated that the Wateen app had reduced the gap between blood donors and the need for blood. However, few participants expressed that they had not received or observed a post about the Wateen application on social media networks. CONCLUSION: The results of this research indicated that there is a general acceptance of the use of the Wateen app among the participants of this study. However, the importance of the Wateen app needs to be further advertised so that it can be used in the blood donation process in all regions of Saudi Arabia. In this way, the people of Saudi Arabia will be more aware of the importance of the Wateen app in the blood donation process, and the goal of the Ministry of Health of bridging the gap between donation centers and blood donors could be achieved.

Sleep Quality Is Associated with Vitamin B12 Status in Female Arab Students.

Studies have explored how vitamin B12 status affects sleep among elders and children, but this remains to be investigated among young adults. We used the Pittsburgh Sleep Quality Index (PSQI) to assess the association between serum vitamin B12 and sleep among female college students in Saudi Arabia. In this cross-sectional study, we enrolled 355 participants (age (years), 20.7 ± 1.5; body mass index, 23.6 kg/m2 ± 5.2) at King Saud University, Riyadh, Saudi Arabia. Fasting blood samples were analyzed regarding the serum vitamin B12 and blood lipids. Anthropometric, socio-demographic, clinical history, stress, physical activity, and dietary data were collected. We assessed the sleep statuses of the participants using the PSQI. Around 72% of the participants were "poor" sleepers (PSQI > 5). Subgroup analysis within the tertiles showed that participants with higher vitamin B12 in the second and third tertiles reported better scores for sleep quality (B ± SE = -12.7 ± 5.6, p = 0.03; B ± SE = -32.7 ± 16.4, p = 0.05, respectively) and also reported a lower use of sleep medication (B ± SE = -21.2 ± 9.9, p = 0.03, in the second tertile only), after adjusting for the waist-hip ratio and stress. However, sleep was not found to be directly associated with either serum vitamin B12 or dietary vitamin B12. In conclusion, the serum vitamin B12 results show that the participants with higher vitamin B12 in the second and third tertiles reported better scores on the sleep quality scale and a lower use of sleep medication. However, no such associations were observed with the overall PSQI. More studies with larger sample sizes are needed to establish a direct relationship between sleep and vitamin B12.

A comparative study of strategies for containing the COVID-19 pandemic in Gulf Cooperation Council countries and the European Union.

BACKGROUND: The COVID-19 pandemic has impacted every aspect of human lives including health, businesses, and lifestyles. In spite of governments implementing various strategies across the globe, the pandemic is still expanding with increasing numbers of positive cases. In addition, countries are reopening and easing lockdown restrictions in order to get their economies back on track, and this has led to an increase in the transmission of novel coronavirus. Therefore, it is essential to regularly review the containment strategies employed in different regions in order to understand the characteristics of COVID-19 transmission and to formulate a future course of actions. OBJECTIVE: The objective of this study is to review the COVID-19 transmission statistics in Gulf Cooperation Council (GCC) and European Union (EU) countries, and to compare these data with the various containment strategies implemented for containing the spread of the virus. METHODS: A review method was adopted along with different statistical methods for comparing and analyzing COVID-19 data and containment strategies. Transmission types and the Case Fatality Rate (CFR) in the countries in both regions are used to present the current state of the pandemic. In addition, changes in the number of COVID-19 cases are compared with the mitigation and suppression strategies implemented in both regions and their impact is analyzed. RESULTS: Countries in the EU were slow in reacting to the pandemic, as delays are observed in the implementation of mitigation strategies. However, suppression strategies were implemented soon after mitigation strategies. GCC countries, on the other hand, were quick to react, and they implemented both mitigation and suppression strategies simultaneously, as soon as the pandemic emerged. The CFR was found to be low among GCC countries compared to EU countries. In addition, a second wave of transmission was observed in the EU, whereas in GCC countries there has been no second wave, although a gradual increase in the number of cases is observed. Community transmission was observed among the majority of countries in both GCC and EU countries. CONCLUSIONS: With the reopening of markets, the focus of governments should be on developing integrated user-centric preventive strategies, with a blend of awareness creation, motivation, and support.

Mobile Clinical Decision Support System for the Management of Diabetic Patients With Kidney Complications in UK Primary Care Settings: Mixed Methods Feasibility Study.

BACKGROUND: Attempts to utilize eHealth in diabetes mellitus (DM) management have shown promising outcomes, mostly targeted at patients; however, few solutions have been designed for health care providers. OBJECTIVE: The purpose of this study was to conduct a feasibility project developing and evaluating a mobile clinical decision support system (CDSS) tool exclusively for health care providers to manage chronic kidney disease (CKD) in patients with DM. METHODS: The design process was based on the 3 key stages of the user-centered design framework. First, an exploratory qualitative study collected the experiences and views of DM specialist nurses regarding the use of mobile apps in clinical practice. Second, a CDSS tool was developed for the management of patients with DM and CKD. Finally, a randomized controlled trial examined the acceptability and impact of the tool. RESULTS: We interviewed 15 DM specialist nurses. DM specialist nurses were not currently using eHealth solutions in their clinical practice, while most nurses were not even aware of existing medical apps. However, they appreciated the potential benefits that apps may bring to their clinical practice. Taking into consideration the needs and preferences of end users, a new mobile CDSS app, "Diabetes & CKD," was developed based on guidelines. We recruited 39 junior foundation year 1 doctors (44% male) to evaluate the app. Of them, 44% (17/39) were allocated to the intervention group, and 56% (22/39) were allocated to the control group. There was no significant difference in scores (maximum score=13) assessing the management decisions between the app and paper-based version of the app's algorithm (intervention group: mean 7.24 points, SD 2.46 points; control group: mean 7.39, SD 2.56; t37=-0.19, P=.85). However, 82% (14/17) of the participants were satisfied with using the app. CONCLUSIONS: The findings will guide the design of future CDSS apps for the management of DM, aiming to help health care providers with a personalized approach depending on patients' comorbidities, specifically CKD, in accordance with guidelines.