Association between body weight perception and actual body mass index among adult women in Erbil city, Iraq.

BACKGROUND: The misperception of body weight can significantly affect individuals' health behaviors, such as physical activity, diet, and weight management. This study aimed to examine the association between body weight perception and actual body mass index (BMI) among adult women and explore the factors influencing this relationship. METHODS: Five hundred forty female individuals aged 18-65 participated in this cross-sectional study. The validated Global Physical Activity Questionnaire was used for data collection. The BMI of the participants was calculated from measured body weight and height. Body weight perception was assessed using a single questionnaire item. The association of BMI and body weight perception was assessed, and the result was categorized as underestimation, consistency, and overestimation. The Chi-square test was used to assess the association between the consistency of BMI and body weight perception by different sociodemographic factors. The kappa test was used to analyze the consistency of BMI and body weight perception. RESULTS: Of the 540 participants, 13.3% underestimated their body weight status, 79.1% accurately perceived their body weight status, and 7.6% overestimated their body weight status. Unmarried women (11.7%) were more likely than ever married (4.3%) to overestimate their body weight (p = 0.005). On multiple logistic regression, being unmarried (OR = 1.68 (95%CI 1.01-2.80)) was significantly associated with body weight misperception. Body weight perception and BMI categories showed a significantly good consistency (kappa = 0.612, p < 0.001). Correct perception of body weight was highest among the overweight, followed by normal weight and underweight individuals (82.1%, 75.8%, and 72.2%, respectively). CONCLUSION: Body weight perception was well associated with actual body weight status. Unmarried women are more likely to misperceive body weight, particularly overestimating it. Underestimation of body weight was relatively high and much higher than the overestimation, which might keep obese individuals from weight loss activities. Preventing obesity should include awareness about body weight misperceptions.

A cross-sectional study on the perceived barriers to physical exercise among women in Iraqi Kurdistan Region.

BACKGROUND: Limited research has investigated the barriers to physical exercise among women in Iraqi Kurdistan Region and other similar Muslim and Middle Eastern societies. This study aimed to determine the prevalence of perceived barriers to physical exercise among women and examine the associations of these barriers with the participants' sociodemographic characteristics. METHODS: A cross-sectional study was carried out in Erbil, Iraqi Kurdistan Region, from December 2022 to January 2023. A self-administered online survey was designed using Google Forms. A convenience sample of 500 women and girls aged 18-65 years was selected for the study. A questionnaire was designed for data collection, including a list of 21 potential barriers to physical exercise developed based on literature review and experts' opinions. The barriers were divided into three categories: interpersonal (8 barriers), social environment (8 barriers), and built environment factors (5 barriers). The participants were asked to indicate for each potential barrier whether it was "not really a barrier, somewhat a barrier, or a very important barrier." The statistical package for social sciences was used to estimate the prevalence of different barriers and assess their association with sociodemographic characteristics using the Chi-square test. RESULTS: The prevalence of physical inactivity among the study participants was 68.2%. The most prevalent interpersonal barriers to physical exercise included lack of time (47.4%), followed by fatigue (24%), and cost (22.4%). Regarding social environment factors, work (30.6%), harassment outside (22.2%), not having a friend or family member accompanying (19%), and not being allowed by family (15.4%) were the most prevalent barriers to physical exercise. Lack of footpaths, cycle lanes, or parks (34.4%), limited accessibility of gyms or other exercise facilities (25.8%), and environmental pollution (21%) were the most prevalent built environment factors as barriers to physical exercise. CONCLUSION: Women in Iraqi Kurdistan Region experience many barriers to physical exercise. Women require family and social support and awareness about exercise benefits to overcome interpersonal and social environment barriers to physical exercise. Built environment factors are very important barriers and can be reduced by taking appropriate action and adopting necessary policies to provide the required infrastructure and facilities for physical exercise.

A survey of perceived risk and protective behaviours towards COVID-19 in 2020 in Iraqi Kurdistan.

INTRODUCTION: Human perceptions and behavioural responses to the risk of epidemics have always been crucial factors in studying and containing disease spread. This study aims to assess and understand the risk perception and the behavioural response of a sample of the population in the Kurdistan Region toward COVID-19. METHODOLOGY: A self-administered online survey (designed on Google Forms) was designed to get a rapid appraisal of the risk perception and behavioural response of people living in the Iraqi Kurdistan Region about COVID-19 from 17-25 November 2020. RESULTS: A total of 390 individuals responded to the survey. Many respondents (65.6%) recognized COVID-19 as a high or very high threat level. The most frequently applied protective behaviours included avoiding spitting on the ground (76.2%), avoiding contacting ill persons (75.9%) and wearing face masks (75.6%). The main source of information about COVID-19 was Internet news (46.2%), followed by social media (44.9%). Significantly higher perceptions of the threat of COVID-19 were found among females (p = 0.004) and those having family members with chronic diseases (p < 0.001). CONCLUSIONS: Understanding the general public's risk perception toward the COVID-19 infection is essential for determining effective protective measures and can be used to guide proper preventive behaviour.

Hawler Medical University students' perceptions of e-learning during the COVID-19 pandemic.

BACKGROUND: Protective measures like social distancing and staying home when possible were imposed by the public health authorities to combat the COVID-19 pandemic. Educational institutions which had previously experienced only face-to-face traditional methods of service delivery suffered from huge difficulties in maintaining an effective teaching process. This cross-sectional study investigates the experiences of students of Hawler Medical University (Erbil, Iraqi Kurdistan), exploring their e-learning experience and satisfaction when conventional classroom learning was suspended due to lockdown. METHODS: A self-administered online questionnaire designed on Google Forms was administered from 14 to 31 March 2020. The main section of the questionnaire asked participants to rate their agreement with statements concerning e-learning satisfaction using a five-point Likert scale, with answers ranging from strongly disagree to strongly agree. RESULTS: From an initial 1550 participants, 808 ultimately completed the processual stage. The majority of respondents were female, from the College of Medicine, of urban residence, and of an average economic situation. Three-quarters of the respondents had not participated in any online course before, 27.7% did not have the required electronic devices, 43.3% did not have the sufficient computer skills for the e-learning, and 38% thought that the University did not support the use of the e-learning system. During the processual stage, only 24.4% thought that the internet connection was good and helpful, 14.6% easily attended the online sessions, 35.6% thought that teachers have enough time to answer students' questions and concerns, and 18% that the teaching materials contributed to the course objectives and overall learning outcome. CONCLUSIONS: Hawler Medical students were not well prepared to engage in the e-learning process. The majority experienced internet access and other technical problems in accessing the online sessions. They did not feel that the e-learning process has contributed to the achievement of course objectives and overall learning outcomes.

Knowledge, attitudes, and positions of religious leaders towards female genital cutting: A cross-sectional study from the Kurdistan Region of Iraq.

BACKGROUND: Understanding the perspectives of the key players in the community regarding female genital cutting (FGC) is very important for directing preventive programs. Religious leaders help shape community behaviors, which is highly pertinent in the case of FGC as it is frequently perceived to be a religious requirement. This study assesses religious leaders' knowledge, attitudes, and positions towards FGC in the Kurdistan Region of Iraq. METHODS: This cross-sectional study was conducted in the Kurdistan Region of Iraq. It included a purposive sample of 147 local religious leaders (khateebs) representing the three governorates of Erbil, Sulaimaniyah, and Duhok. A self-administered questionnaire was used to collect data about the religious leaders' knowledge, attitude, and position towards FGC. RESULTS: The participants identified reduction of the sexual desire of women as the main benefit (37%) and risk (24%) of FGC. Cultural tradition and religious requirements were the main reported reasons for practicing FGC. About 59% of the religious leaders stated that people ask for their advice on FGC. Around 14% of the participants supported performing FGC, compared to 39.1% who opposed it. Religious (73.9%) and cultural (26.1%) rationales were the main reasons given for supporting FGC. Being a cultural practice with harmful effects (53.5%) and lack of clear religious evidence (46.6%) were the main reasons for being against FGC. Around 52% of the participants recommended banning FGC by law, while 43.5% did not support banning it. A statistically significant association (P = 0.015) was found between religious leaders' residence and their position on performing FGC. More than 46% of those residing in Duhok were against performing FGC, compared to lower proportions in Erbil (38.8%) and Sulaimaniyah (30%). CONCLUSION: Religious leaders believed that cultural tradition was the main reason behind practicing FGC and they believed that FGC is not common in KRI, and even that it is decreasing. The religious leaders in our study reported that they could have an influential role in the FGC issue due to their position in the community. There was no statistically significant association between religious leaders' age, education level, or work experience and their position on performing FGC. However, a statistically significant association was found between religious leaders' residence and their position on performing FGC. A conclusive decision concerning the prohibition of FGC needs to be made by religious authorities. Health awareness activities incorporating FGC risks should be carried out to inform religious leaders at different levels of religious positions. Further research exploring perspectives of religious authorities concerning religious leaders' inconclusive judgment about FGC is deemed necessary.

The Impact of COVID-19 Related Lockdown on the Prevalence of Spousal Violence Against Women in Kurdistan Region of Iraq.

There is increasing concern about the impact of the COVID-19 pandemic and the lockdown's social and economic consequences on gender-based violence. This study aimed to assess the impact of the COVID-19 pandemic on gender-based violence by comparing the prevalence of spousal violence against women before and during the COVID-19 related lockdown periods. This study was conducted in the Kurdistan Region of Iraq using a self-administered online questionnaire survey after the COVID-19 lockdown period in June 2020. Data were collected from a sample of 346 married women about the occurrence, frequency, and forms of spousal violence before and during the lockdown period. Significant increases in violence were observed from the pre-lockdown period to the lockdown period for any violence (32.1% to 38.7%, p = .001), emotional abuse (29.5% to 35.0%, p = .005), and physical violence (12.7% to 17.6%, p = .002). Regarding emotional abuse, humiliation (24.6% to 28.3%, p = .041) and scaring or intimidation (14.2% to 21.4%, p < .001) significantly increased during the lockdown. For physical violence, twisting the arm or pulling hair (9.0% to 13.0%, p = .004) and hitting (5.2% to 9.2%, p = .003) significantly increased during the lockdown. Forcing to have sexual intercourse also significantly increased during lockdown (6.6% to 9.5%., p = .021). The concerned authorities and women's rights organizations should collaborate to enhance the prevention of violence against women. An effective prevention strategy should emphasize recognizing and acknowledging the extent of the problem, raising awareness about the problem and the available resources to address it, and ensuring social and economic stability. Lessons learned about the increased prevalence of spousal violence against women during the COVID-19 pandemic and the need to adopt appropriate strategies to prevent and address it will be valuable for similar future crises.

Risk Perception and Behavioral Response to COVID-19: A Survey of University Students and Staff in the Iraqi Kurdistan Region.

This study explores the risk perceptions and behavioral responses of university academics and students toward the COVID-19 pandemic. All universities in Iraqi Kurdistan were invited to take part in a self-administered online survey; 976 individuals ultimately completed it. The survey included eight main questions about personal risk perception and behavioral response to COVID-19 based on a five- or nine-point ordinal scale. A high percentage of the respondents perceived it as highly unlikely they were at risk of getting infection (26.9%), serious illness (29.7%), and death (41.7%). The percentage of the respondents who applied protective measures frequently or always was high for most protective behavior types, except for wearing masks, wearing gloves, and avoiding touching the face. There was a significant (P < .001) weak positive correlation between risk perception and protective behaviors. The respondents followed protective behavior measures reasonably, but the frequency of undertaking some important protective behaviors was relatively low.

A qualitative assessment of women's perspectives and experience of female genital mutilation in Iraqi Kurdistan Region.

BACKGROUND: Female genital mutilation (FGM) is prevalent in Iraqi Kurdistan Region, but there is a lack of adequate knowledge about how the practice is perceived by the women population who are the direct victims of the practice. This study aimed to assess the knowledge, beliefs, and attitude of a sample of Kurdish women of FGM and identify the main enabling factors for performing this practice and the barriers to ending it. METHODS: This qualitative study was based on six focus groups involving a sample of 51 women. We used a topic guide to lead discussions, which included questions on women's perspectives of different aspects of FGM such as the reasons for practicing it, the positive and negative consequences, the continuation of the practice and tackling this problem in the community. Content analysis was used for the qualitative analysis of the data. RESULTS: The women had poor knowledge about different aspects of FGM particularly concerning the procedure and the consequences. The mutilated participants revealed the devastating experience of the pain and the psychological effects they have experienced. Reducing sexual desire, having halal (permissible by Allah) hands, and religious requirement were the main reasons for practicing FGM. Reduction in women's sexual desire and the related social problems with the husband were the main problems identified to be associated with FGM. Most women did not support the continuation of FGM practice, but some women still think that FGM should be left to the people's preference. The participants identified raising people's awareness, active involvement of religious leaders in prevention efforts and the issuance and enforcement of legislation against FGM as the primary measures to reduce FGM practice. CONCLUSION: Passing through FGM at childhood is an overwhelming experience with long-term effects for women. There is still a significant segment among the women population that do not oppose the continuations of FGM and need religious and scientific evidence against FGM. Some reasons for practicing FGM are deeply embedded in the culture and traditions, and there is a need for extensive efforts to raise the awareness of the population and change their thoughts and behavior about FGM.