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Objectives: The study aimed to assess the national attitudes toward individuals with mental health illnesses in Saudi Arabia, exploring the relationship between these attitudes and various sociodemographic factors. Methods: A cross-sectional design with computer-assisted telephone interviews was employed, covering all 13 administrative regions in Saudi Arabia. A total of 4,533 adults agreed to participate, and their attitudes toward people with mental illnesses (PWMI) were measured using an 11-item scale. The translation of the original English version of the PWMI to Arabic was validated and published previously. The scale used level of agreement on a 5-point Likert scale. The score varies from 11 to 55, where a higher score signifies higher stigma. The associations between total PWMI scores and sociodemographic variables were analyzed using linear regression. Results: The mean age of participants was 35.92 ± 12.84, with equal distribution across regions. The linear regression model showed significant associations between total PWMI scores and gender, education level, marital status, living with, or being friends with someone diagnosed with a mental illness, and working in healthcare. No significant associations were found with age, income level, and previous mental health diagnosis. The study suggests that negative stereotypes about mental illness may be more prevalent in Saudi Arabia, while Saudi participants had a more optimistic view regarding the recovery and outcomes of mental illnesses. Conclusions: The study highlights the importance of assessing mental health stigma and its associations with sociodemographic factors in Saudi Arabia. The significant associations found point to the need for targeted interventions and public health campaigns to address misconceptions and stereotypes surrounding mental health, ultimately improving the societal acceptance and well-being of individuals with mental health illnesses. [ABSTRACT FROM AUTHOR]

BackgroundSaudi Arabia implemented a plain tobacco packaging regulation, one of the World Health Organization’s recommended initiatives to help reduce smoking rates, in August 2019. A few weeks after implementation, a large number of smokers complained via various media channels, especially social media (eg, Twitter), that an extreme change in cigarette taste had occurred, frequency of coughing had increased, and for some, shortness of breath had led to hospitalization. ObjectiveThe main objective is to determine whether smokers blinded to cigarette branding report differences in taste between branded and unbranded cigarettes. The secondary objective is to observe the frequency of immediate cough or shortness of breath. MethodsThis study employed a within-person, randomized crossover design that recruited current smokers 18 years and older who were cleared upon physical assessment before the experiment. Participants received 6 sequences of different random exposures (3 puffs) to 3 plain-packaged cigarettes (2 from their favorite brand and 1 from another brand as a control) and 3 branded cigarettes (2 from the favorite brand and 1 from another brand as a control). Participants wore virtual reality goggles accompanied by special software to alter visual reality and gloves to alter the touch sensation. ResultsThis study recruited 18 participants, measured at 6 time points, to produce 108 experiments. Participants were not able to identify the correct type of cigarettes (plain or branded, estimate of fixed effect=−0.01, P=.79). Moreover, there were no differences in the ability of the participants to identify their favorite brand (t107=−0.63, mean 0.47, P=.53). In terms of immediate coughing, out of the 108 experiments, 1 episode of short coughing was observed, which was attributed to the branded cigarette, not the plain-packaged cigarette. ConclusionsAfter controlling the visual and touch sensations, participants were not able to differentiate between branded and plain-packaged cigarettes in terms of taste or inducing immediate shortness of breath or cough. Interestingly, participants were not able to identify their favorite brand.

BackgroundThe relationship between physical activity and mental health, especially the symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD), has received increasing attention in recent years. ObjectiveThe aim of this study was to explore the association between fulfilling the World Health Organization (WHO) global recommendations on physical activity and the risk and symptoms of MDD and GAD in the Saudi population. MethodsThis study was a secondary analysis of data from a large nationwide cross-sectional survey conducted via phone interviews in June and July 2020. In this study, a proportional quota sampling technique was used to obtain an equal distribution of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. The main mental health screening tool used for the risk of MDD was the Patient Health Questionnaire-9 (PHQ-9). Risk of GAD was measured using the Generalized Anxiety Disorder-7 (GAD-7) scale. Participants self-reported whether they fulfill the WHO global recommendations on (1) moderate-intensity aerobic physical activity (MIPA) and (2) vigorous-intensity aerobic physical activity (VIPA). The results were then analyzed based on the following two categories: fulfilling the WHO global recommendations or not. ResultsThe data analysis included 8333 participants recruited in the main study between June and July 2020. The response rate was 81.45% (8333/10,231). Of them, 50.3% (4192/8333) were female, and the mean age was 36.5 years, with a median age of 36 years and a range from 18 to 90 years. The average total PHQ-9 score was 5.61, and the average total GAD-7 score was 4.18. For men, the average total PHQ-9 and GAD-7 scores were associated with fulfilling recommendations for MIPA; however, there were no associations for VIPA in both sexes. Fulfilling the WHO’s recommendations for MIPA was associated with considerably fewer depressive symptoms in six of the nine items in the PHQ-9. Moreover, fulfilling recommendations for MIPA was associated with considerably fewer anxiety symptoms in six of the seven items in the GAD-7. However, fulfilling recommendations for VIPA was significantly associated with more depressive symptoms in one of the PHQ-9 items (“Thoughts that you would be better off dead or thoughts of hurting yourself in some way;” P

BackgroundWhile it is most often associated with its effects on physical health, obesity is also associated with serious self-stigmatization. The lack of a suitable, validated tool to measure weight-related self-stigma in Arabic countries may be partly responsible for the scarcity of literature about this problem. ObjectiveThis study investigated the reliability and validity of an Arabic version of the Weight Self-Stigma Questionnaire (WSSQ). MethodsData on the Arabic-translated version of the 12-item WSSQ were collected using two cross-sectional electronic questionnaires distributed among Saudi nationals through the Sharik Association for Health Research’s database in June 2020. Internal consistency, test-retest reliability, and exploratory factor analysis of the Arabic WSSQ were assessed and compared with the original English version and other translations. ResultsFor reliability analysis, 43 participants completed the Arabic WSSQ during two time periods. Internal consistency was α=.898 for the overall survey, α=.819 for the fear of enacted stigma subscale (factor 1), and α=.847 for the self-devaluation subscale (factor 2). The test-retest reliability of the intraclass correlation coefficient was α=.982. In the factor structure analysis, 295 participants completed the questionnaire. The Arabic WSSQ loading of the items was consistent with the original WSSQ, except for the loading of item 9, which was stronger in factor 2 than in factor 1. The two factors accounted for the observed variances of 47.7% and 10.6%. ConclusionsThe Arabic version of the WSSQ has good internal consistency and reliability, and the factorial structure is similar to that of the original WSSQ. The Arabic WSSQ is adaptable for clinicians seeking to assess weight-related self-stigma in Arabic-speaking people.

BackgroundThe COVID-19 outbreak can potentially be categorized as a traumatic event. Public health surveillance is one of the cornerstones of public health practice, and it empowers decision makers to lead and manage public health crises and programs more effectively by providing timely and useful evidence. ObjectiveThis paper presents the protocol for a study that aims to identify, track, and monitor trends in the population in Saudi Arabia at risk of major depressive disorders and anxiety during the COVID-19 pandemic. MethodsThis study utilizes continuous, cross-sectional, national-level mental health screening via computer-assisted phone interviews, conducted in four waves on a monthly basis (between May and August 2020). Arabic-speaking adults, aged ≥18 years, and living in Saudi Arabia were recruited via a random phone list. This surveillance system used the proportional quota sampling technique to achieve an equal distribution of participants, stratified by age and gender, and region, within and across the 13 administrative regions of Saudi Arabia. A sample size of 4056 participants per wave was calculated to achieve enough power to detect changes in mental health status. The questionnaire includes the Arabic version of the Patient Health Questionnaire-9 (PHQ-9) to measure depressive symptoms and the General Anxiety Disorder-7 (GAD-7) to measure anxiety. In addition, it will collect data on sociodemographic variables and potential risk factors. ResultsStudy recruitment began in May 2020. The data analysis was completed in October 2020, and the final report is expected to be published by the end of December 2020. ConclusionsMonitoring the population’s mental health status during the COVID-19 pandemic will inform decision makers of any potential deterioration in mental health on a national level and among subgroups, including across regions, age groups, and gender groups. It will allow decision makers to recognize issues and intervene sooner. It will also provide valuable scientific data to help understand the effects of epidemics and pandemics on mental health. As far as we know, this is the only study that attempts to monitor the mental health status of the general population on a monthly basis. International Registered Report Identifier (IRRID)DERR1-10.2196/23748

Background: Use of nutrition facts labels can be associated with healthier eating behaviors; however, consumers currently face difficulty understanding these labels or do not use them often. Thus, improving healthy grocery shopping behaviors among consumers might increase the overall health of the community. Aim: The study aims to explore consumers' behavior during grocery shopping and measure their basic knowledge regarding food product labels. Method: A national observational study (cross-sectional) was carried out on a convenience sample of Saudi Arabian residents aged 18 years and above. The data were obtained from all 13 administrative regions in Saudi Arabia at three different major supermarkets in each region. The data were analyzed using descriptive analysis, and binary logistic regression was used to investigate behavior variables. Results: A total of 12,675 participants were observed; of those, 52.2% did not interact with the product before putting it in their shopping cart. The study found that the production date (66.6%) and expiry date (51%) were the most frequently checked aspects of food labels; they were checked more frequently than nutrition facts (29%). Furthermore, there was a low level of dietary knowledge among consumers and a moderate level of believing food packages and media claims. Conclusions: Our results suggest that the Saudi community's understanding of food product information is limited and greater awareness and community education campaigns are required to improve the use of nutritional labels and increase nutritional knowledge. [ABSTRACT FROM AUTHOR]

Background: Public health surveillance systems should be evaluated periodically, and the evaluation should include recommendations for improving the system’s quality and efficiency. Each surveillance system may have a unique situation in which evaluating its quality depends on its methodology, aims, and other factors, such as the frequency of repeating the survey in the case of survey-based surveillance. Objective: As the consistency of the surveillance system to capture demographic data and its sensitivity to monitor the intended health-related event are important indicators of the quality of the surveillance system, the aim of this article is to evaluate the Saudi Arabia Mental Health Surveillance System (MHSS) in terms of consistency and sensitivity via the scientific hypothesis testing process. Methods: The quality of the MHSS was assessed by examining (1) the consistency of the main demographic variables and (2) the sensitivity to changes in score between the 2 mental health screening tools used in the MHSS and between the 3 waves collected in 3 consecutive months. The assessment uses all data collected via the MHSS between May 2020 and July 2020. The first null hypothesis predicted there were differences between the distributions of the demographic variables between the 3 waves. The second predicted there were no differences between the scores of the Patient Health Questionnaire 9 (PHQ-9) and the Generalized Anxiety Disorder 7-item scale (GAD-7) between the 3 waves. Results: In terms of sampling variables (age, gender, and region), there were no significant differences between the 3 waves in age, using one-way ANOVA, nor in gender and region, using the chi-square test. In addition, there were no significant differences between the 3 waves in all other demographic variables, except in the income variable. However, in terms of the PHQ-9 score, the one-way ANOVA (F2,12334=8.05; P<.001) showed significant differences between waves. Similarly, significant differences between waves were found in the GAD-7 score (F2,12334=7.09; P=.001). Conclusions: The MHSS showed a consistent distribution of the sample demographic variables, while being sensitive to the changes in mental health scores across waves. The MHSS can generate an acceptable level of consistency and sensitivity to monitor mental health trends. [ABSTRACT FROM AUTHOR]