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Research in western countries concludes that children and adolescents are exposed to multiple forms of online risks and harms. However, in the context of Saudi Arabia, research in online safety education is lagging. Currently, online safety education is generic and not research informed. Hence, this exploratory study seeks to generate a qualitative understanding of online risks and harms experienced by Saudi children, adolescents, and parents as well as online safety strategies. Using a semi-structured interview, this study explores the views of 15 children (12–15 years) and 10 parents. Interpretative Phenomenological Analysis (IPA) yielded four key themes: Negotiating the Promise and Peril of the internet, Living with the Shadows of the Online World, Psychological, and Physical Health Consequences, and Navigating Safety in a Digital Landscape of Uncertainty. While the benefits are clear (e.g., education and socialisation), children and parents have shared worries about cyberbullying, aggression, and exploitation. Internet addiction and isolation are notable consequences along with vision impairment and obesity. Children’s online safety practices are reactive, e.g., blocking and deleting risky content/behaviour, while parents share their struggles in monitoring children online. Online safety education, or the lack of it, is to blame. Children’s and parents’ limited awareness of online risks and poor online safety practices need to improve in Saudi Schools and households; there is an urgent need for further research and adequate implementation of systematic online safety education.

Background/Aim: To provide the most recent estimate of childhood obesity and determine the trend in childhood obesity in Riyadh city over the past two decades, by comparing our results with previous studies that published data comparable to our study in terms of geography, sample age (6-16 years), and use of World Health Organization (WHO) cut-offs to define obesity. Patients and Methods: A cross-sectional study was conducted in 2015 among school children in Riyadh city. A sample of 7930 children (67% girls) aged 6-16 years were randomly selected. Body mass index for age and gender above +1 and below +2 standard deviation scores (SDS) defined overweight (SDS, z-scores) and >+2 SD scores defined obesity. Results: The overall prevalence of overweight and obesity was 13.4% (14.2% for girls and 12% for boys; P= 0.02) and 18.2% (18% for girls and 18.4% for boys; P = 0.73), respectively. When compared with the WHO-based national prevalence rate of obesity reported in 2004 (≈9.3%), the obesity rate has doubled over a 10-year period. There was a significantly higher prevalence of obesity in adolescents (>11 years) than in children (20.2% vs 15.7%; P < 0.01). Overweight and obesity increased significantly with higher levels of socioeconomic status. Obese children were at 1.5 and 2 times risk of developing gas bloating and vomiting than non-obese children. Conclusion: The prevalence of overweight and obesity has risen alarmingly among Saudi children and adolescents over the past decade and should make a strong case to initiate and monitor effective implementation of obesity prevention measures.

Background Identifying the leading risk factors and major determinants of morbidity and mortality in school-age children and adolescents is pivotal for health and maintenance of well-being. This review provides an overview of health conditions/risk factors driving morbidity and mortality and identifies gaps in existing data to improve health and development needs in school-age children and adolescents. Methods PubMed, Embase, Web of Science, and official websites of global databases and national surveys were searched from January 2012 until April 2022 for relevant publications reporting the prevalence of health conditions/risk factors that contribute to morbidity and mortality in children/adolescents (5–19 years of age) in the Kingdom of Saudi Arabia (KSA). Results A total of 21 publications were included in the review. Overall, data on children aged 5–9 and 10–19 years old are very scarce except for health conditions assessed in the national school-based screening programs, and only one nationally representative study in 2011 for 10–19 year olds. Data for those ≥ 15 are more prevalent considering they are included in most nationally representative data (e.g., 2013 Saudi Health Interview, the 2018 Household Health, and the 2019 Sports) surveys. However, gaps remain. Overweight and obesity estimates for children and adolescents varied significantly across different datasets and data collection years, ranging from 37% to 18%, respectively, to 6% and 4% for overweight and obesity across different age groups. Mental health disorders were the leading cause of morbidity among children and adolescents aged 5–14-year-old accounting for 19% of the total burden. Road traffic injuries were the leading cause of death among children and adolescents aged 5–14-year-old at 25%. Conclusions This review provides a snapshot of the health status of school-age children and adolescents in KSA and highlights the major data gaps especially for those < 10 year old where no nationally representative datasets exist. Many of the data sources for other age groups are not nationally representative or are too old to be useful for recommendations today. There is an urgent need to collect updated and robust data for school aged-children and adolescents in KSA to inform evidence-based policies and priorities. This study was not pre-registered in a publicly accessible registry.

Hypertension (HTN) is a primary global health concern. Moreover, according to the 2010 Global Burden of Disease, hypertension accounted for roughly a quarter of cardiovascular disease fatalities and 1.9 percent of all deaths in Saudi Arabia in 2010. Also, hypertension is a significant risk factor for cardiovascular disease, morbidity, and mortality. However, assessing blood pressure (BP) and preventing hypertension among children and adolescents has become a global priority. This study aims to determine the prevalence of hypertension among children in the Jazan region of Saudi Arabia. Also, to determine the common risk factors associated with pediatric hypertension. We conducted this cross-sectional study among boys and girls aged 6–14 years visiting Al-Rashid Mall, one of the two main malls in Jazan city, the capital of Jazan region, Saudi Arabia, between November 2021 and January 2022. We included children willing to participate in the study after obtaining their parents’ consent and children’s assent. We used a standardized questionnaire to interview the parents to collect the children’s data. We also measured the children’s resting BP. Then we classified the measurements according to the updated International Pediatric Hypertension Association (IPHA) chart. We also measured the height and weight of the children and calculated their BMI. We used SPSS version 25 for the data entry and analysis. Our results showed that the prevalence of hypertension and prehypertension was insignificantly higher in females (11.84% and 12.65%) compared to males (11.52% and 11.52%), respectively. Our participants’ main associated factors with prehypertension and hypertension were overweight, obesity, and family income. Pediatric hypertension and prehypertension were highly prevalent in Jazan region. Therefore, being overweight and obese should be considered risk factors for pediatric hypertension. Our study emphasizes the need for early intervention to prevent pediatric HTN, particularly among overweight and obese children.

Background Few lifestyle factors have been simultaneously studied and reported for Saudi adolescents. Therefore, the purpose of the present study was to report on the prevalence of physical activity, sedentary behaviors and dietary habits among Saudi adolescents and to examine the interrelationships among these factors using representative samples drawn from three major cities in Saudi Arabia. Methods This school-based cross-sectional study was conducted during the years 2009-2010 in three cities: Al-Khobar, Jeddah and Riyadh. The participants were 2908 secondary-school males (1401) and females (1507) aged 14-19 years, randomly selected using a multistage stratified sampling technique. Measurements included weight, height, sedentary behaviors (TV viewing, playing video games and computer use), physical activity using a validated questionnaire and dietary habits. Results A very high proportion (84% for males and 91.2% for females) of Saudi adolescents spent more than 2 hours on screen time daily and almost half of the males and three-quarters of the females did not meet daily physical activity guidelines. The majority of adolescents did not have a daily intake of breakfast, fruit, vegetables and milk. Females were significantly ( p < 0.05) more sedentary, much less physically active, especially with vigorous physical activity, and there were fewer days per week when they consumed breakfast, fruit, milk and diary products, sugar-sweetened drinks, fast foods and energy drinks than did males. However, the females' intake of French fries and potato chips, cakes and donuts, and candy and chocolate was significantly ( p < 0.05) higher than the males'. Screen time was significantly ( p < 0.05) correlated inversely with the intake of breakfast, vegetables and fruit. Physical activity had a significant ( p < 0.05) positive relationship with fruit and vegetable intake but not with sedentary behaviors. Conclusions The high prevalence of sedentary behaviors, physical inactivity and unhealthy dietary habits among Saudi adolescents is a major public health concern. There is an urgent need for national policy promoting active living and healthy eating and reducing sedentary behaviors among children and adolescents in Saudi Arabia.

Background In Saudi Arabia, stay-at-home orders to address the coronavirus disease 2019 (COVID-19) pandemic between March 15 and 23, 2020 and eased on May 28, 2020. We conducted a scoping review to systematically describe physical activity and sedentary behavior in Saudi Arabia associated with the timing of the lockdown. Methods We searched six databases on December 13, 2021 for articles published in English or Arabic from 2018 to the search date. Studies must have reported data from Saudi Arabia for any age and measured physical activity or sedentary behavior. Results Overall, 286 records were found; after excluding duplicates, 209 records were screened, and 19 studies were included in the review. Overall, 15 studies were cross-sectional, and 4 studies were prospective cohorts. Three studies included children and adolescents (age: 2–18 years), and 16 studies included adults (age: 15–99 years). Data collection periods were <  = 5 months, with 17 studies collecting data in 2020 only, one study in 2020–2021, and one study in 2021. The median analytic sample size was 363 (interquartile range 262–640). Three studies of children/adolescents collected behaviors online at one time using parental reporting, with one also allowing self-reporting. All three studies found that physical activity was lower during and/or following the lockdown than before the lockdown. Two studies found screen time, television watching, and playing video games were higher during or following the lockdown than before the lockdown. Sixteen adult studies assessed physical activity, with 15 utilizing self-reporting and one using accelerometry. Physical activity, exercise, walking, and park visits were all lower during or following the lockdown than before the lockdown. Six adult studies assessed sedentary behavior using self-report. Sitting time (4 studies) and screen time (2 studies) were higher during or following the lockdown than before the lockdown. Conclusions Among children, adolescents, and adults, studies consistently indicated that in the short-term, physical activity decreased and sedentary behavior increased in conjunction with the movement restrictions. Given the widespread impact of the pandemic on other health behaviors, it would be important to continue tracking behaviors post-lockdown and identify subpopulations that may not have returned to their physical activity and sedentary behavior to pre-pandemic levels to focus on intervention efforts.

Background Cyberbullying is becoming common in inflicting harm on others, especially among adolescents. This study aims to assess the prevalence of cyberbullying, determine the risk factors, and assess the association between cyberbullying and the psychological status of adolescents facing this problem in the Jazan region, Saudi Arabia. Methods A cross-sectional study was conducted on 355 students, aged between 12–18 years, through a validated online questionnaire to investigate the prevalence and risk factors of cyberbullying and assess psychological effects based on cyberbullying questionnaire and Mental Health Inventory-5 (MHI-5) questions. Results The participants in this study numbered 355; 68% of participants were females compared to 32% were males. Approximately 20% of the participants spend more than 12 h daily on the Internet, and the estimated overall prevalence of cyberbullying was 42.8%, with the male prevalence slightly higher than females. In addition, 26.3% of the participants were significantly affected in their academic Performance due to cyberbullying. Approximately 20% of all participants considered leaving their schools, 19.7% considered ceasing their Internet use, and 21.1% considered harming themselves due to the consequences of cyberbullying. There are essential links between the frequency of harassment, the effect on academic Performance, and being a cyber victim. Conclusions Cyberbullying showed a high prevalence among adolescents in the Jazan region with significant associated psychological effects. There is an urgency for collaboration between the authorities and the community to protect adolescents from this harmful occurrence.

Background Traumatic spine injuries (TSIs) in paediatric and adolescent populations are uncommon but often result in serious morbidity and healthcare burden. In Saudi Arabia, limited population-based data exist to describe the epidemiology and outcomes of TSIs in this group. Methods This retrospective cohort study included patients aged 1–18 years with TSIs admitted to King Saud Medical City in Riyadh between August 1, 2017, and December 31, 2022. Data were extracted from the Saudi TraumA Registry (STAR). Patients were categorised into three groups: pre-school (1–6 years), school-age (7–12 years), and adolescents (13–18 years). Demographic, injury, and outcome variables were analysed using descriptive and comparative statistics. Results A total of 353 patients were included, with males comprising 84.7%. Motor vehicle crashes (MVCs) were the leading cause of injury (69.3%). Overall, thoracic spine injuries were most common (43.8%), while high cervical injuries predominated in pre-school children (40.8%). Polytrauma occurred in 72.5% of cases, and a third of the patients required ICU admission. Among those admitted to ICU or who died, head injuries were the most frequent associated injury. Common procedures included spinal internal fixation (25%), craniotomy/craniectomy (20%), and lower-limb fixation (19.5%). Mechanical ventilation was required in 23.8% of patients, and in-hospital mortality was 3.4%. Mortality was associated with higher Injury Severity Scores, lower Glasgow Coma Scale, and increased need for trauma team activation, blood transfusion, and respiratory support. Conclusion This study highlights the burden of TSIs among children and adolescents in Saudi Arabia, particularly those caused by MVCs and frequently associated with polytrauma. The findings highlight the pressing need for targeted prevention strategies, improved trauma system infrastructure, and multidisciplinary management. Future research should investigate long-term outcomes and evaluate the effectiveness of preventive initiatives.

Depression and anxiety are prevalent mental illnesses among young people. Crisis like the Coronavirus Disease 2019 (COVID-19) pandemic may increase the current prevalence of these illnesses. A cross-sectional, descriptive design was used to (1) explore the prevalence of depression, anxiety, and stress among youth and (2) identify to what extent certain variables related to COVID-19 could predict depression, anxiety, and stress (DAS) among young people in six different countries. Participants were requested to complete an online survey including demographics and the DAS scale. A total of 1,057 participants from Oman (n=155), Saudi Arabia (n=121), Jordan (n=332), Iraq (n=117), United Arab Emirates (n=147), and Egypt (n=182) completed the study. The total prevalence of depression, anxiety, and stress was 57%, 40.5%, and 38.1%, respectively, with no significant differences between countries. Significant predictors of stress, anxiety, and depression were being female, being in contact with a friend and/or a family member with mental illness, being quarantined for 14 days, and using the internet. In conclusion, COVID-19 is an epidemiological crisis that is casting a shadow on youths’ DAS. The restrictions and prolonged lockdowns imposed by COVID-19 are negatively impacting their level of DAS. Healthcare organisations, in collaboration with various sectors, are recommended to apply psychological first aid and design appropriate educational programmes to improve the mental health of youth.

There is an increasing number of studies in the literature on the prevalence of attention-deficit/hyperactivity disorder (ADHD), indicating its high prevalence. This study sought to investigate the reliability of the ADHD Rating Scale-5 (ADHD-RS-5) for adolescents in Saudi Arabia as a valid screening tool for this age group. Furthermore, it aimed to calculate the cutoff score for screening for ADHD in the Saudi environment to provide a reliable tool that helps specialists assessing for ADHD among adolescents.This study applied a descriptive approach to verify the reliability of the ADHD-RS-5 in the Saudi environment. The sample consisted of 477 parents and 1284 teachers of Saudi and non-Saudi adolescents (aged 13 to below 20 years) residing in Riyadh, Makkah, and the Eastern Province. Both forms of the ADHD-RS-5 (home and school) were applied to the sample under supervision of the Saudi ADHD Society. Data were analyzed using IBM SPSS Statistics (version 26), JASP (version 0.18.3.0), and MedCalc statistical software (version 22.030).Confirmatory factor analysis results revealed acceptable goodness-of-fit indicators for the home and school forms of the ADHD-RS-5. Pearson’s correlation coefficients for both forms were found to be positive and statistically significant ( p  > 0.001); the coefficient values ranged between 0.669 and 0.921 for the home form and between 0.795 and 0.954 for the school form. In addition, Cronbach’s α coefficient values ​​for inattention, hyperactivity, impairment, and the scale’s total score for the home form were 0.919, 0.913, 0.952, and 0.952, respectively, while for the school form were 0.955, 0.944, 0.969, and 0.981, respectively. Cronbach’s α coefficient values ​​were close to the values ​​of the McDonald’s ω for the home form (0.920, 0.914, 0.953, and 0.965, respectively) and for the school form (0.955, 0.939, 0.968, and 0.977, respectively). These results indicate that the ADHD-RS-5, both home and school forms, and its subscales have good Cronbach’s α and McDonald’s ω coefficients. The findings also showed that the prevalence of ADHD among adolescents in Saudi Arabia was 5.03% based on the home form and 5.92% based on the school form. The cutoff value to screen for ADHD in adolescents in the Saudi environment for the home form was > 30, with a sensitivity of 91.67% (95% confidence level [CL] = 73–99), a specificity of 86.98% (95% CL = 83.5–89.9), and 81.29% accuracy. However, the cutoff score in the school form was > 28, with a sensitivity of 94.74% (CL = 81.1–98.5), a specificity of 89.65% (CL = 87.8–91.3), and 86.46% accuracy.The current findings suggest that the Arabic version of the ADHD-RS-5-AR has strong psychometric properties, with good indicators of internal consistency and reliability. This study provides valuable information for the national ADHD survey planned to be carried out in 2024–2025. It will also support the preventive efforts in Saudi Arabia and Saudi Vision 2030 in achieving its goals related to the quality of life and well-being of community members of all ages as well as the goals of sustainable development.