Abduljaleel Abdullatif Zainel

Background: Social media use has become highly prevalent among adolescents and has been linked to both positive and negative health outcomes. However, evidence regarding its relationship with mental health and obesity remains inconsistent, and limited data are available from primary care settings in Qatar. This study aimed to describe patterns of social media use and adolescents’ perceptions regarding its effects and to examine associations between active social media engagement, mental health outcomes, and BMI-for-age among adolescents attending Primary Health Care Corporation (PHCC) health centers in Qatar. Methods: A cross-sectional study was conducted between 5th May 2024 to 30th June 2024 among adolescents aged 11–17 years attending six PHCC health centers across Qatar. Participants were recruited using systematic random sampling. Data were collected through structured face-to-face interviews using a questionnaire that assessed sociodemographic characteristics, social media use, frequency of active social media engagement, and participants’ perceptions regarding the effects of social media. Mental health outcomes, including depression, anxiety, and anger, were assessed using PROMIS Emotional Distress scales, while anthropometric measurements were used to calculate BMI-for-age z-scores. Descriptive statistics, bivariate analyses, and multivariable logistic regression models were performed. Results: A total of 429 adolescents participated in the study. Overall, 25.3% of participants were classified as overweight and 21.7% as obese. Moderate-to-severe anxiety, depression, and anger were reported by 16.2%, 11.4%, and 10.3% of participants, respectively. TikTok (56.9%), Snapchat (48.7%), and Instagram (47.3%) were the most frequently used social media platforms. While 58.2% of participants perceived social media as having positive effects on communication and relationships, many also perceived it to contribute to obesity (47.6%), mental health disorders (41.7%), and excessive screen time (58.3%). However, these findings represented participants’ perceptions rather than objectively measured effects. Statistical analyses demonstrated limited evidence of associations between the measured frequency of active social media engagement and BMI-for-age, depression, anxiety, or anger. In multivariable analyses, higher household income was associated with increased odds of moderate-to-severe anxiety; however, the overall regression model was not statistically significant, and the finding should therefore be interpreted cautiously. Conclusions: Adolescents attending primary care services in Qatar reported substantial social media use, notable levels of emotional distress, and a high prevalence of overweight and obesity. Although many participants perceived social media as having adverse effects on health and well-being, statistical analyses provided limited evidence of associations between the measured frequency of active social media engagement and mental health outcomes or BMI-for-age. These findings highlight the importance of distinguishing perceived effects from observed associations and highlight the need for longitudinal studies using more comprehensive measures of social media use to better understand potential relationships with adolescent health outcomes.

Background: Non-communicable diseases (NCDs) are a major contributor to morbidity and mortality worldwide, with Qatar experiencing a particularly high burden. Lifestyle-related risk factors, including physical inactivity and poor dietary habits, are central to NCD prevalence. Understanding the knowledge, attitudes, and practices (KAP) regarding healthy lifestyle behaviours is essential for designing effective public health interventions. Aim: To evaluate KAP related to two key components of healthy lifestyle—healthy diet and physical activity among adults using primary care services in Qatar. Methods: A cross-sectional survey was conducted among 940 adults registered with the Primary Health Care Corporation (PHCC). Participants were selected using multistage random sampling across PHCC. Data were collected using a culturally adapted, interview-based questionnaire assessing healthy diet and physical activity. KAP scores were standardised to a 0–100 scale. Results: Participants demonstrated high knowledge (healthy diet: mean 75.7; physical activity: mean 66.6) and positive attitudes (healthy diet: mean 74.1; physical activity: mean 76.9) towards healthy lifestyle behaviours. However, practice scores were substantially lower (healthy diet: mean 49.6; physical activity: mean 9.6). No significant associations were found between healthy diet practice and gender, BMI, or educational status, while age, nationality, marital status, and knowledge and attitude scores were significantly associated with healthy diet practice. Conclusion: Despite adequate knowledge and favourable attitudes, the adoption of healthy lifestyle practices remains limited among Qatar’s primary care population. These findings highlight the need for targeted interventions that address behavioural barriers and facilitate the translation of knowledge into practice. The insights gained are critical for informing public health policies and NCD prevention efforts in Qatar.

Objectives: To investigate and highlight the factors associated with smoking relapse and to demonstrate the withdrawal symptoms related to smoking cessation. Methods: This study is part of a larger historical cohort involved 490 participants who attended smoking cessation clinics in primary health care settings. A total of 143 relapsed after they initially quit smoking and included in this study. The participants were interviewed by phone using a structured questionnaire after obtaining informed consent. Frequency distribution tables and proportions were used to describe the study results. Results: More than half (55.9%) of participants who initially quit smoking by attending the smoking cessation clinics reported that relationships with smokers were the main reason for smoking relapse. Emotional or social problems led to relapse among 38.5% of the participants. Withdrawal symptoms were relatively low (14.7%). An increase in appetite was prevalent among 74.8% of smoking quitters as the main withdrawal symptom. This was followed by weight gain in 72%, craving for cigarettes/smoking in 71.3%, and feelings of anger in 53.1%. All the tested sociodemographic variables, namely: age, sex, nationality, income, education, and marital status, failed to show a statistically significant association with early timing of relapse (1–6 months). Conclusion: The study identified various factors linked to smoking relapse among individuals using smoking cessation services. Relationships with smokers and emotional or social problems were the most common reasons. Additional research is needed to investigate strategies and interventions specifically targeting early smoking relapse to attain the desired health outcomes from smoking cessation services.

Background: Type 2 diabetes mellitus (T2DM) has a high prevalence in Qatar, necessitating a thorough understanding of its risk factors. This study explored the associations between specific risk factors and T2DM among adults attending Primary Health Care Corporation (PHCC) centers in Qatar. Methods: Employing a cross-sectional study design, data were extracted from the electronic medical records of individuals aged 18 years and older who visited the PHCC health centers during the year 2017. Data analysis was performed using univariate and multiple regression models. Results: The study included 127,941 participants, 33% of whom were diagnosed with T2DM. Age was the most significant risk factor, with individuals aged 60 years and older having an adjusted odds ratio (aOR) of 7.53, and those aged 40–59 years having an aOR of 3.55. Sex was also found to influence T2DM risk, as males had an aOR of 1.47. Nationality also played a role, as individuals of southern Asian descent exhibited an increased risk of T2DM, with an aOR of 2.40, while Qataris had an aOR of 1.55. Having high blood pressure was associated with more than doubling the risk of developing T2DM. Conclusion: This study provides essential epidemiological insights that can inform decision-making related to T2DM in Qatar. Our findings highlight that males over the age of 40, particularly those of South Asian descent with high blood pressure are at increased risk of T2DM. Identifying the major risk factors is essential for the prevention and management of T2DM.

Background: Tobacco dependence is a chronic disease that often requires repeated interventions and multiple attempts to quit. Cigarette smoking is the leading preventable cause of mortality. Globally, an estimated 1.3 billion people smoke. In Qatar, Smoking cessation services (SCSs) are provided free of charge to citizens and at a minimal cost to non-citizens. This study aimed to measure the effectiveness of the smoking cessation program adopted by the Primary Health Care Corporation (PHCC) of Qatar. This was achieved through calculating the percentage of smoking cessation service users (survival probabilities) who maintained the non-smoking status after selected follow up periods. Moreover, the study highlighted the possible association of selected explanatory variables with smoking cessation survival probabilities. Methods: In this historical cohort study 490 participants were recruited by simple random sampling who attended the smoking cessation clinics (SCCs) in PHCC prior to 30/06/2021. The participants were contacted by phone and invited to participate in the study. The participants who agreed to participate in the study were interviewed utilizing a structured questionnaire. Results: Initially 311 (63.5%) of the participants quitted smoking after receiving SCSs. There were statistically significant differences between quitting smoking and the nationality and the educational level of participants (p ≤ 0.001 and 0.02 respectively). About one fourth (23.3%) of individuals who initially quitted smoking relapsed and resumed smoking as early as 6 months after completing their SCC visits. This relapse rate increased to 38.7, 47.2 and 51.1% after 12, 24 and 36 months respectively. Less than a half (45.8%) maintained the non-smoking status after 42 months from their initially quitting. Conclusion and recommendations: The findings of the study substantiate the effectiveness of SCSs designed within PHCC both in short- and long-term basis. Younger individuals, smokers with Arab ethnicity, smokers falling within high income and education groups were identified as high-risk groups and need highest focus. The accessibility to the service among the local population can be increased by upscaling the advertisement of the existing services.

Background: Covid-19 related studies report psychological impacts during home isolation and social distancing. Despite that, children and adolescents were able to adopt coping strategies that assisted in lowering severe levels of psychological disorders. This study aims to report on the psychosocial implications of social distancing and isolation on children of different nationalities who reside in Qatar, and to reveal their coping ways. Methods: This is a cross sectional study with qualitative component at its end. The study is a part of a larger study that reported the results of a national screening for psychological disorders experienced by children and adolescents in Qatar. A bilingual online questionnaire included close-ended and one open-ended question to screen for psychological changes and identify coping strategies practiced by children and adolescents (7–18 years) during home-isolation and social distancing. The quantitative questionnaire had five main sections as follows: the sociodemographic characteristics, Spence Children’s Anxiety Scale, Kutcher Adolescent Depression Scale, and Clinical Anger Scale). The last section screened for eight different coping strategies. The summative content analysis was used to analyze the open-ended question “What practices do you do at home that make you happy?”. First, open coding was used (for identification), followed by the axial coding (for comparison), and lasted by sorting of coping strategies inductively. Results: Six thousand six hundred and eight (6608) subjects participated between June 23 and July 18, 2020. The clinical outcomes of the study had varying prevalence and levels of severity, which ranged from mild to severe. Higher prevalence was noted for adjustment disorder 66.5% (n = 4396), and generalized anxiety 60% (n = 3858), in comparison to depression 40% (n = 2588). Additionally, participants reported using cognitive, spiritual, social, and physical coping strategies. Eight higher order themes were identified to reflect the coping strategies: playing with siblings or pets, gardening, cooking, practicing arts and crafts, and doing chores. Furthermore, Sociodemographic factors such as ethnicity, religion and family status played a considerable role in choosing the type of coping strategy. Conclusion: The uniqueness of the study is bringing the psychosocial implications of social distancing through the voices of children and adolescents, and coping strategies from their perspective. These results are of importance for educational and healthcare systems that are recommended to collaborate even in “normal” times to prepare these age categories for any future crises. The importance of daily lifestyle and family is highlighted as protectors, and crucial factors in emotional management.

Background: In December 2019, a novel coronavirus called SARS-CoV-2 was identified as the cause of a cluster of pneumonia cases in Wuhan, China. It rapidly spread due to human-to-human transmission, resulting in a global pandemic. Nearly every country, including Qatar, has established guidelines and regulations to limit the spread of the virus and to preserve public health. However, these procedures have been associated with negative effects on the psychological and intellectual well-being of individuals, including children and adolescents. Objective: The objective of this study was to determine the psychological influence of home isolation and social distancing on children and adolescents during the COVID-19 pandemic in Qatar, and the strategies used to cope with these measures. Methods: This cross-sectional study was undertaken using an online questionnaire administered through SMS text messaging. All home-isolated children and adolescents registered at the Primary Health Care Corporation aged 7-18 years were invited to participate in the study. Children and adolescents with intellectual disadvantages were excluded. A P value of .05 (two-tailed) was considered statistically significant. Results: Data were collected from 6608 participants from June 23 to July 18, 2020. Nearly all participants adhered to the official regulations during the period of home isolation and social distancing; however, 69.1% (n=4568) of parents believed their children were vulnerable to the virus compared to 25% (n=1652) who expressed they were not vulnerable at all. Higher levels of anger, depression, and general anxiety were prevalent among 1.3% (n=84), 3.9% (n=260), and 1.6% (n=104) of participants, respectively. The mean score for the emotional constructs anger and depression decreased with increased compliance with regulations (P=.04 and P=.11, respectively). The differences in mean score for all psychological and coping strategies used among participants across the 3 levels of vulnerability to SARS-CoV-2 were statistically significant. The mean score varied little with increasing reported vulnerability to the virus. This mild variation can make a difference when the sample size is large, as is the case in this study. Conclusions: Screening for psychological and social disruptions is important for the development of strategies by schools and health care providers to assess and monitor behavioral changes and negative psychological impact during post–COVID-19 reintegration. Participants experiencing higher levels of anxiety should be given more attention during reintegration and transitional phases in schools. Although electronic devices and social media platforms may have lowered anxiety levels in some cases, it is important to address how they are used and how content is tailored to children and adolescents. It is also important to maintain an active lifestyle for children and young persons, and encourage them not to neglect their physical health, as this promotes a better psychological state of mind.

BACKGROUND In December 2019, a novel coronavirus called SARS-CoV-2 was identified as the cause of a cluster of pneumonia cases in Wuhan, China. It rapidly spread due to human-to-human transmission, resulting in a global pandemic. Nearly every country, including Qatar, has established guidelines and regulations to limit the spread of the virus and to preserve public health. However, these procedures have been associated with negative effects on the psychological and intellectual well-being of individuals, including children and adolescents. OBJECTIVE The objective of this study was to determine the psychological influence of home isolation and social distancing on children and adolescents during the COVID-19 pandemic in Qatar, and the strategies used to cope with these measures. METHODS This cross-sectional study was undertaken using an online questionnaire administered through SMS text messaging. All home-isolated children and adolescents registered at the Primary Health Care Corporation aged 7-18 years were invited to participate in the study. Children and adolescents with intellectual disadvantages were excluded. A P value of .05 (two-tailed) was considered statistically significant. RESULTS Data were collected from 6608 participants from June 23 to July 18, 2020. Nearly all participants adhered to the official regulations during the period of home isolation and social distancing; however, 69.1% (n=4568) of parents believed their children were vulnerable to the virus compared to 25% (n=1652) who expressed they were not vulnerable at all. Higher levels of anger, depression, and general anxiety were prevalent among 1.3% (n=84), 3.9% (n=260), and 1.6% (n=104) of participants, respectively. The mean score for the emotional constructs anger and depression decreased with increased compliance with regulations (P=.04 and P=.11, respectively). The differences in mean score for all psychological and coping strategies used among participants across the 3 levels of vulnerability to SARS-CoV-2 were statistically significant. The mean score varied little with increasing reported vulnerability to the virus. This mild variation can make a difference when the sample size is large, as is the case in this study. CONCLUSIONS Screening for psychological and social disruptions is important for the development of strategies by schools and health care providers to assess and monitor behavioral changes and negative psychological impact during post–COVID-19 reintegration. Participants experiencing higher levels of anxiety should be given more attention during reintegration and transitional phases in schools. Although electronic devices and social media platforms may have lowered anxiety levels in some cases, it is important to address how they are used and how content is tailored to children and adolescents. It is also important to maintain an active lifestyle for children and young persons, and encourage them not to neglect their physical health, as this promotes a better psychological state of mind.

Objectives To investigate the prevalence of vitamin D deficiency among individuals attending primary healthcare facilities in Qatar and to assess the association between vitamin D deficiency and some medical conditions in persons aged 18–65 years old. Setting The study was undertaken in publicly funded primary healthcare services in the State of Qatar. Participants A total of 102 342 participants aged between 18 and 65 years old with a valid serum vitamin D test result during the year 2017. Outcome measures Serum level Results The prevalence rate of severe vitamin D deficiency was 14.1% among study participants with no history of vitamin D replacement therapy in the previous months. The prevalence rate of vitamin D deficiency was as high as 71.4% and that of vitamin D insufficiency was up to 92.7%. None of the five chronic conditions explored in the study (diabetes, hypertension, asthma, stroke and cardiovascular disease) had an obvious association with severe vitamin D deficiency status in a bivariate analysis. However, multivariate modelling showed that (adjusting for age, gender, body mass index and nationality and each of the included chronic conditions) hypertension, cardiovascular diseases and stroke placed an individual at a higher risk of having an associated severe vitamin D deficiency status. Conclusion Although not comprehensive and nationally representative, this study is suggestive of a higher prevalence of vitamin D deficiency among young adults, females, Qatari nationality and those with higher body mass index. Multivariate modelling showed that hypertension, cardiovascular diseases and stroke were associated with a higher risk of severe vitamin D deficiency status.

Type 2 diabetes mellitus (T2DM) and obesity are syndemic and will have a significant impact on affected individuals and healthcare services worldwide. Evidence shows that T2DM remission can be achieved with significant weight loss in those who are younger with early diabetes and requiring fewer medications for glycaemic control. DIADEM-I aims to examine the impact of an intensive lifestyle intervention (ILI) using a low-energy diet (LED) meal replacement approach combined with physical activity in younger individuals with early T2DM. The planned study is an ongoing, non-blinded, pragmatic, randomised controlled, parallel-group trial examining the impact of an LED-based ILI on body weight and diabetes remission in younger (18–50 years) T2DM individuals with early diabetes (≤ 3-year duration). The ILI will be compared to usual medical care (UMC). The primary outcome will be weight loss at 12 months. Other key outcomes of interest include diabetes remission, glycaemic control, diabetes complications, cardiovascular health, physical activity, mental health, and quality of life. It is planned for the study to include 138 subjects for assessment of the primary outcome. Safety will be assessed throughout. If DIADEM-I demonstrates a clinically significant effect for younger individuals with early T2DM, it will inform clinical guidelines and services of the future for management of T2DM. ISRCTN: ISRCTN20754766 (date assigned: 7 June 2017); ClinicalTrials.gov, ID: NCT03225339 Registered on 26 June 2017.