Exploring research-related knowledge and attitudes: a study among university students in Lebanon

BackgroundSleep is a vital component for cognitive function, emotional well-being, and overall health, yet it is frequently disrupted by external stressors, such as war and conflict. University students, particularly those in conflict zones, face increased risks of poor sleep quality due to academic pressure, psychological stress, and trauma exposure.ObjectivesThis study aims to assess the prevalence of poor sleep quality, sleep latency, and sleep efficiency among university students in Lebanon during the 2023–2024 war conflicts, and the direct and indirect effects of war exposure.Materials and methodsA cross-sectional study was conducted on 631 university students in Lebanon using the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Sociodemographic characteristics and the type of war exposure (direct or indirect) were also assessed. Inferential statistical tests were performed to identify correlations between sleep quality and sociodemographic factors, as well as sleep quality and war exposure. The Prevalence Rate Ratio (PRR) was calculated to identify risk and protective factors for poor sleep quality in each socio demographic group. A binary regression model was applied to predict the most significant risk factors for compromised sleep quality.Results73.5% of Lebanese university students had poor sleep quality (PSQI > 5), with a mean Global PSQI score of 8.20 (± 3.95). Students with direct war exposure had the highest mean score of 10.57 (p < 0.001), compared to 8.04 for those with indirect exposure. The average sleep latency PSQI score was 1.46 ± 1.04, and the average sleep efficiency PSQI score was 1.00 ± 1.00. Compared to no exposure, indirect exposure resulted in a 22% higher prevalence (PRR = 1.22) of poor sleep, while direct exposure showed a 60% higher prevalence (PRR = 1.60). The binary exposure showed that female gender increased the odds of poor sleep by 2.71 (p = 0.035), and direct war exposure increased the odds by 19.76 times (p = 0.001).ConclusionThis study highlights the profound impact of war exposure on sleep quality among Lebanese university students, with direct exposure having the greatest risk. Poor sleep quality in war-affected zones can lead to severe disruptions in academic performance, cognitive function, and overall mental and physical health. The findings underscore the need for targeted interventions, including mental health support and stress management programs, to limit sleep disturbances in conflict-affected populations. Further research is warranted to explore effective coping mechanisms and long-term sleep health in similar contexts.

A cross-sectional study was conducted investigating the association between exposure to financial, political, academic and social stressors, and symptoms of depression, anxiety and burnout among university students in Lebanon. Lebanon is a developing country experiencing a financial crisis and sociopolitical turmoil with poorly characterized impacts on the mental health of residents. To assess burnout and symptoms of depression, anxiety, a condensed version of the Malach-Pines Burnout Measure and the Patient Health Questionnaire-4 (PHQ-4) were used, respectively. Out of 240 respondents, 52.3% experienced burnout, 29.3% experienced high/very high burnout, and 54.2% reported symptoms of depression, anxiety. Women had poorer mental health outcomes. The strongest associations were between little sleep and burnout (aOR = 6.78, p < 0.001) and symptoms of depression, anxiety (aOR = 2.84, p < 0.001). Exposure to high financial and COVID-19 pandemic stressors were associated with high levels of burnout and symptoms of depression and anxiety. The results highlight the gravity of the psychological state of university students in Lebanon, as they navigate through the struggles of an uncertain future.

This study aims to assess the level of mental health literacy (MHL) and identify its associated factors among undergraduate university students in Lebanon. A secondary objective is to evaluate the Global Barriers to Counselling scores, their associated factors, and to examine their relationship with MHL. Cross-sectional study using an online self-administered questionnaire. University-level educational settings in Lebanon, including students from both public and private institutions across multiple regions. This study enrolled undergraduate students of all academic disciplines using a convenience sampling technique. Inclusion criteria included being 18 years and above, currently enrolled at university, able to comprehend the English language and consenting to participate. Primary outcomes: MHL scores, using the Mental Health Literacy Scale (MHLS); and Global Barriers to Counselling score, using the Revised Fit, Stigma and Value Scale (RFSV). Secondary analysis examined factors associated with MHLS score and Global Barriers to Counselling scores using multivariable linear regression. A total of 572 participants (65.0% female; mean age 21.1±3.7 years) were included. Most were Lebanese (87.4%). The median MHLS score was 86 (IQR 77-95), indicating generally good MHL. Factors associated with lower MHLS were male gender (β=-4.17, 95% CI -7.18 to -1.16, p=0.007) and being of non-Lebanese nationality (β=-6.26, 95% CI -11.06 to -1.46, p=0.011). Presence of a previous mental health diagnosis was associated with a higher MHLS score (β=5.32, 95% CI 1.43 to 9.22, p=0.008). The Global Barriers to Counselling score had a median of 28.7 (IQR 23.21-36.21). Male gender was significantly associated with a higher barrier score (β=3.44, 95% CI 4.85 to 5.04, p<0.001). Factors associated with lower barrier score were attending a mental health seminar in the past (β=-2.00, 95% CI -3.91 to -0.09, p=0.04), and having a higher MHLS score (β=-0.14, 95% CI -0.21 to -0.07). This study highlights good overall MHL among undergraduate university students in Lebanon, with variations based on gender, nationality and prior mental health exposure. Higher mental health literacy was associated with fewer perceived barriers to seeking counselling. These findings emphasise the need for tailored mental health initiatives in Lebanese universities that promote literacy, reduce stigma and enhance help-seeking behaviour across diverse student populations.

Eating disorders (EDs) have an important impact on both physical and mental wellbeing, especially in a young population. There is a lack in research about EDs in the Middle East, and especially in Lebanon, where the co-occurring obesity is a widespread health problem. Our study aims to assess the relation between night eating syndrome (NES) with binge eating disease (BED) and obesity (BMI) on one hand, and between NES and general health on the other hand, in university students. An observational cross-sectional study was conducted on 460 university students in Lebanon. Data collection was carried out using an online questionnaire. Socio-demographic and general health characteristics, BMI, Arabic validated General Health Questionnaire (GHQ-12), Arabic validated Binge Eating Scale (BES) and the Night Eating Diagnostic Questionnaire (NEDQ). Statistical analysis was accomplished on SPSS. Participants having highest income showed highest NEDQ score. Females and participants with a history of eating disorders were more likely to have BED. A significant correlation was also found between having an ED history and negative impact on general health. BMI was correlated with both NEDQ and BES. Having NES was associated with also having BED. Furthermore, those with NES showed higher scores regarding GHQ-12. Relatively high prevalence of NES and BED was noted in university students in Lebanon. This was correlated to a household income, general health, and BMI. The repercussion on both physical and mental morbidities highlights the importance for stepping up of the Lebanese organizational system to perform periodic screening.

Risky behaviours among young people are relatively frequent, with several motives and attitudes lying behind. Our objective was to evaluate the role of risk perception, attractiveness and motives for risk behaviour taking among university students in Lebanon. A cross-sectional study was carried out using a proportionate cluster sample of Lebanese students in public and private universities. Items of risk intake and perception scale, attractiveness of risky behaviours, and motives for risky behaviours were assessed, in addition to cigarette and waterpipe smoking and dependence, alcohol problematic consumption and mental distress scale. After verifying the validity of scales and reliability in the university students' population, we found that risk perception was associated with lower risk intake, while risk attractiveness was a driver for it. Moreover, motives differed in their driving of risky behaviour, a particular point was that women indicated more goal achievement objectives, the latter concept was associated with lower risk taking. University students in Lebanon, women in particular, demonstrated wiser behaviour and may benefit from heath education programme to increase their awareness about risky behaviours. Identifying other personal, environmental, social and psychological predictors may also be important to improve effectiveness of these programmes.

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a rapidly growing global health problem. Despite its growing incidence and potential for significant repercussions, MAFLD is still widely misunderstood and underdiagnosed. The purpose of this study was to investigate MAFLD-related knowledge, attitudes, and risk profiles among university students aged 17 to 26. A cross-sectional study with 406 university students in Lebanon, equally distributed among males and females, was conducted using a questionnaire that includes demographics, medical information, dietary habits, physical activity, and MAFLD-related knowledge and attitudes. The findings demonstrated a significant lack of knowledge regarding MAFLD, with more than half of participants (54.7%) having no prior knowledge of the illness. Students exhibited unhealthy lifestyle behaviors such as smoking (68%), insufficient physical exercise (44.1%), and poor food habits (52.5%). Having a family history of heart disease, personal history of diabetes mellitus, a balanced diet and prior knowledge of the disease were associated with a higher knowledge score (p<0.05). A higher attitude score existed among those who have a personal or family history of chronic diseases and those who have a prior negative impression about the disease, prior knowledge of the disease, and those who are physically active (p<0.05). Despite knowledge gaps, university students in Lebanon have, in general, an appropriate and positive attitude towards MAFLD. We recommend the introduction of focused educational interventions to address the necessity of lifestyle changes among university students and the community as a whole. Developing comprehensive MAFLD prevention methods requires future studies in different age groups and demographics.

Alcohol consumption is frequent among university students in Lebanon as elsewhere in the world. A cross-sectional study was conducted in Lebanon's public and private universities between October 2009 and September 2010 using a standardized questionnaire to assess personal beliefs about alcohol consumption, peers' behaviours and opinions and history of and current drinking practices. Of 1235 students, 199 (16.1%) had an AUDIT score>or=8. Older age, male sex, Christian religion, attending a private university, studying a non-health specialty and residing in Beirut or Mount Lebanon were associated with a higher risk of harmful drinking. Beliefs concerning alcohol consumption and peers' opinions and behaviours were factors significantly associated with harmful drinking, especially: ignoring the dangers of alcohol consumption; higher frequency of consumption with friends; and a higher proportion of friends who drank regularly. University students' alcohol drinking behaviour was mostly influenced by peers' behaviour, and a peer education programme is recommended to decrease the risk of harmful drinking.

The health crisis caused by COVID-19 pandemic has quickly evolved into an economic, cultural, and social crisis. Being an active entity in their communities, an evaluation of how much university students can contribute in raising awareness about the pandemic and in volunteering in their communities is deemed necessary. This study aims to assess the knowledge, attitudes, and practices toward COVID-19 pandemic among university students in Lebanon. An anonymous online self-reported questionnaire was conducted in March 2020 and a total of 193 university students participated. Scores were used to evaluate the knowledge, attitudes, and practices. Our results showed that the majority of the Lebanese University students have a good knowledge and practice score (0.82 and 0.64 respectively). However, the attitude score was relatively low and reflects a high cue to action score and a low Ministry Of Public Health (MOPH) satisfaction score. In addition, the KAP scores significantly differed between students majoring in health-related fields vs students majoring in non-health-related fields. The source of knowledge was associated with its score (p-value = .002). Finally, the statistical analysis proved that the study matches the KAP model which demonstrates that knowledge influences the attitudinal statements while attitude influences practice toward COVID-19. This assessment of the students’ understanding and awareness of the pandemic can help in the development of effective national strategies as well as envisage medium and long-term scenarios of preparedness.

The contemporary developments of Information and Communication Technologies usage have fueled a popular concern. The young people are experiencing technology addiction behavior due to excessive media and technology usage. A valid instrument is required to detect individuals at high risk of social media and technology addiction. Objective: The objectives of this study are to assess prevalence of the technology addiction using the Media and Technology Usage and Attitudes Scale (MTUAS) and to investigate the impacts of online social networking on health and academic performance of young university students in Lebanon. Methods: During the academic year 2017-2018, a cross-sectional study which enrolled 705 young university students was conducted. Data was collected using MTUAS questionnaire. The translation and cultural adaptation of the MTUAS followed a standardized protocol. The psychometric properties were then evaluated. We used multivariate regression analyses to determine which characteristics were associated with the technology addiction among students. Results: 705 filled out the questionnaire aged 17 to 35 years (mean = 20.42; SD = 2.41), 74% of whom were females. The internal consistency was high for all subscales and ranged from 0.54 - 0.87. The MTUAS yielded statistically significant scores for subgroups (known group validity). Males’ students had a higher risk of addiction to social media and technology than females. The use of media was viewed common among the smokers (OR = 1.76; 95% CI = 1.10 - 2.82, p = 0.02) and drinkers of alcohol (OR = 1.80; 95% CI = 1.04 - 3.11, p = 0.04). Students that used e-mailing, smartphone, and TV viewing had a high academic performance level. Females and public university students had negative attitudes toward technology. In conclusion: The technology becomes a big problem on the universities students’ users that has an impact on their life and affects their academic performance. The MTUAS Arabic version has been evaluated as a valid and reliable instrument.

BackgroundEngaging in unsafe sexual practices remains a major public health concern among young adults worldwide. Despite extensive global research, there is limited evidence from the Middle East, where sexuality is often a taboo subject and sexual education is minimal. This study aimed to examine the prevalence of risky sexual behaviors among university students in Lebanon and to identify factors associated with these behaviors, including substance use and engagement with social and digital media.MethodsA cross-sectional online survey was conducted among undergraduate and graduate students at the Lebanese American University between May and November 2022. Participants completed an anonymous, self-administered questionnaire assessing sociodemographic characteristics, sexual history, and multimedia use. Data were analyzed using IBM SPSS Statistics version 29. For the count outcome, poisson regression was applied to identify factors associated with a higher number of risky sexual behaviors, defined as unprotected sex, multiple simultaneous partners, sexual activity under the influence of substances, or transactional sex.ResultsAmong 588 participants, 233 (39.6%) were sexually active, of whom 225 (96.6%) reported at least one risky sexual behavior, with a mean of 2.24 risky behaviors per participant. Unprotected oral sex was the most common unsafe practice. Students who reported drug use were significantly more likely to engage in a higher number of risky sexual behaviors (rate ratio = 1.73), as were those who reported sexual activity with someone they had just met (rate ratio = 1.39). Social media and dating application use were not significantly associated after adjustment.ConclusionRisky sexual behaviors are highly prevalent among university students in Lebanon. These findings highlight the urgent need for culturally adapted educational interventions addressing substance use and promoting safer sexual behaviors among young adults in the Middle East.

Introduction: Unhealthy dietary habits are major risk factors for chronic diseases, particularly if adopted during early years of adulthood. Limited studies have explored the food consumption patterns among young adults in Lebanon. Our study aimed to examine common dietary patterns and their correlates among a large sample of university student population in Lebanon, focusing on correlation with gender and body mass index (BMI).Methods: A cross-sectional study was carried out on 3384 students, using a proportionate cluster sample of Lebanese students from both public and private universities. A self-administered food frequency questionnaire was used to assess dietary intake of university students. Factor analysis of food items and groups, cluster analysis of dietary patterns, and multivariate regressions were carried out.Results: Three dietary patterns were identified among university youth namely a vegetarian/low calorie dietary pattern (characterized mainly by consumption of plant-based food while avoiding “western” food, composite dishes, and bread); a mixed dietary pattern (characterized by high consumption of plant-based food, followed by composite dishes, bread, and a low consumption of western type food); and finally, a westernized dietary pattern (characterized by high consumption of white bread and western food, and a strong avoidance of plant food and composite dishes). We observed significant differences between males and females in terms of their reported food intake and dietary patterns. Females were particularly more prone to adopt the vegetarian/low calorie diet than males (ORa = 1.69; p < 0.001), while males were more likely to adopt a westernized diet (ORa = 1.51; p < 0.001), seemingly in private universities (p = 0.053). Students with high income and obese students (BMI ≥ 30 kg/m2) were more likely to consume vegetarian/low calorie diets (p < 0.05).Conclusion: Male university students reported a higher consumption of the westernized dietary pattern as compared to female university students in Lebanon, while the latter reported a higher adoption of a vegetarian diet. Health promotion programs are needed to address the dietary intakes and lifestyle behaviors of young adults in Lebanon to help prevent obesity and other associated comorbidities.

BackgroundThe transition from high school to university is a critical life stage associated with heightened vulnerability to mental health challenges. Despite global recognition, there is limited research on the psychosocial risks faced by first-year university students in Lebanon, a region further burdened by socio-economic and political instability.ObjectiveTo assess the mental health status of first-year university students in Lebanon, focusing on the prevalence and intensity of mental health challenges such as anxiety, depression, and stress during the transitional period.MethodsThis cross-sectional study involved 1,024 students from multiple Lebanese universities during the 2023-2024 academic year. Data were collected via a self-reported questionnaire and the General Health Questionnaire-28 (GHQ-28), that assesses mental health across four key dimensions: somatic symptoms, anxiety and insomnia, social dysfunction, and severe depression. Descriptive statistics, chi-square tests and P-values were used to analyze demographic, behavioral, and mental health data.ResultsA significant gender difference in employment (χ2 = 18.81, p = 0.00086) was found. The GHQ-28 survey results indicate that 64.3% of university students experience psychological distress, with higher prevalence among females (67.3%) than males (60.8%) (χ2 = 4.42, p = 0.035). 31.7% reported sleep disturbances, 27.9% felt overwhelmed, and 33.2% experienced hopelessness. 18.8% had thoughts of self-harm, and 3.1% considered ending their life. The GHQ-28 scores indicate a high prevalence of mental health challenges, taking a score of 24 as a cut off score.ConclusionsThe study highlights the urgent need for targeted mental health interventions for Lebanese university students, addressing both universal and region-specific challenges. The findings emphasize the importance of early intervention, increased access to mental health resources, and promoting systemic changes to improve overall student well-being.

ABSTRACTIntroduction: Smoking habits among university students in Lebanon are not clearly identified, and studies correlating these habits to asthma and allergic diseases are lacking. The primary objective of this study is to assess asthma and allergic diseases' predictors, particularly cigarette and/or waterpipe smoking and other environmental exposures, among university students. A second objective is to evaluate the potential role of these predictors as correlates of health-related self-assessment. Methods: A cross-sectional study, using a proportionate cluster sample of 3000 Lebanese students in both public and private universities, was conducted between January 2015 and December 2015. Results: The number of smokers at home, living close to an electricity generator and exposure to sand and dust significantly increased the odds of having asthma or allergic diseases (p = 0.015; OR = 1.183; p = 0.01; OR = 2.062; p = 0.001; OR = 3.558 respectively). Having tried cigarette smoking and having an air conditioner inside the means of transportation would decrease the odds of having asthma or allergic diseases by around 68% and 56.1% respectively (p = 0.009; ORa = 0.320; p = 0.01; ORa = 0.439 respectively). Conclusion: Although students with asthma or allergic diseases tended to avoid all identifiable atopic risk factors, lesser known environmental factors such as living close to an electricity generator, exposure to sand and dust, and exposure to car exhaust fumes were associated with a higher risk of asthma and a decrease in health related self-assessment. Students with asthma and allergic diseases smoked cigarettes and waterpipe at similar percentages, but cigarette smokers had a lower health related self-assessment.

Insufficient sleep is a significant public health issue with adverse medical consequences. Sleep disturbances are common among university students and have an effect on this group's overall health and functioning. The aim of this study was to investigate sleep habits and disorders in a population of university students across Lebanon. This was a cross-sectional study carried out in 2012 among 735 students aged 18-25 yrs. old, enrolled at six universities across Lebanon. The Pittsburg Sleep Quality Index (PSQI) was used to assess sleep quality and habits. Less than half of the total study population (47.3%) were good sleepers (PSQI<5). Upon bivariate analysis, males experienced more sleep difficulties than females (57.8% vs. 40.8%). The majority (60%) of males vs. 40% of females had trouble performing daily activities more than once per week (P=0.02). Results of the multivariate analysis revealed that reporting poor sleep quality was strongly associated with daytime dysfunction and sleep- enhancing medication use especially more than once per week. This is the first study to describe the nature of sleep problems among university students in Lebanon. This study suggests that sleep problems among Lebanese college students were common and such problems may interfere with daily performance. Findings from this study have important implications for programs intended to improve academic performance by targeting sleep habits of students.

There are insufficient data concerning health risk behaviours of university students in the Middle East, particularly Lebanon. Our objective was to identify health risk factors among university students in Lebanon, focusing on preventable behaviours. A cross-sectional study was carried out, using a proportionate cluster sample of Lebanese students in public and private universities. A standardised questionnaire was distributed across university campuses. Data concerning socio-demographic characteristics, toxic substances consumption (including tobacco, alcohol and illicit drugs), nutrition and sedentarity behaviours, in addition to sexual behaviours, were collected. Among 3384 participants, 20% were current cigarette smokers, while 23% were current waterpipe smokers and 33.5% declared consuming alcohol. Higher rates were found for smoking and alcohol consumption in private versus public universities (p < 0.001). Participants also reported a very low consumption of fruits and vegetables. Moreover, 31% of boys and 8.6% of girls declared having regular sexual activity; among them, 41% of boys and 26% of girls declared using a condom regularly. Substantial proportions of university students in Lebanon adopt risky behaviours for health, particularly in private universities. Health-promotion activities should be established to decrease the occurrence of these behaviours and prevent their future adverse health outcomes.