SACM - Australia

Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9648

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Analysing Existing Saudi Arabian University Admission Criteria for Accounting Programs
(Victoria University, 2025) Alboty, Yazeed; Farley, Alan; Yang, Helen
This research was motivated by the significant role played by effective admission criteria in predicting academic performance, particularly in Saudi Arabian accounting programs. The primary objective of this research is to investigate the appropriateness of Saudi Arabian university admission criteria for undergraduate and postgraduate accounting programs. First, for the bachelor accounting program, this research aims to explore how well existing admission criteria—which test different dimensions of prior knowledge—predict academic performance of accounting students based in Saudi Arabia. It evaluates the validity of the High School Grade Point Average (HSGPA) and College Entrance Exam (CEE)—that is, the General Aptitude Test (GAT) and Achievement Test (AT)—to predict student performance in the Preparatory Year Program (PYP), along with first-year core courses in the accounting program and First Year Grade Point Average (FYGPA) and overall Grade Point Average (GPA) of students at the end of the degree. It also examines how the business college PYP predicts performance in the first year, and overall student GPAs at the end of the degree. The role of gender as a moderator in these relationships is considered. This investigation is based on prior knowledge theory (PKT), which is characterised as a multidimensional, hierarchical entity comprised of various types of knowledge and skills. Tied to the above, for the Master of Accounting program, this research aims to evaluate how effectively one admission criterion predicts the relative academic performance of accounting students in Saudi Arabia. Specifically, it examines the impact of English language proficiency—as measured by International English Language Testing System (IELTS) scores—on the relative performance of Saudi Master of Accounting students in more versus less conceptually oriented accounting courses. This investigation is informed by cognitive load theory (CLT), which addresses the challenge of processing complex cognitive tasks with multiple interactive information elements. The findings demonstrated that when used as sole predictors, the explanatory variables (HSGPA, GA, and AT) all had statistically significant positive correlations with the dependent variables related to predicting academic performance. Multiple regression analyses indicated that HSGPA was the strongest incremental predictor of academic performance, whereas GAT was the weakest, showing no significant incremental predictive power in most cases. This study demonstrates that HSGPA is the strongest predictor of both short- and long-term college outcomes in particular accounting disciplines. Further, the results consistently imply that the individual courses and GPA of the PYP in the business college have predictive value for academic performance. Additionally, the results indicate that gender does moderate the relationship between admission criteria and PYP and academic performance, which is significant in many cases. Last, the results show that English language proficiency measured by the IELTS alone has no significant direct effect on the relative academic performance of Saudi accounting students. Several implications can be drawn from this research for stakeholders and policy makers. It raises questions about the continued use of GAT score as an entry criterion and strongly supports gender-based differential entry criteria. In addition, it provides insight into the efficacy of the PYP.
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A framework to adopt construction 4.0 in the Kingdom of Saudi Arabia: Impact of Institutional Pressures, Ambidexterity and Organizational Resources on Intention to Adopt
(University of Newcastle, 2025) Alyami, Abdullah; Thayaparan, Gajendran; Marcus, Jefferies; Tanvi, Newaz
Construction 4.0 is the construction industry’s response to Industry 4.0, a technological revolution to adopt innovative methodologies and modern technologies to boost productivity and efficiency in modern workplaces. Construction 4.0 is driven partly by an accelerated pace of urbanization, the resulting heightened demand within the construction industry, and the construction industry’s reputation for lack of modernization. It marks a paradigm shift characterised by the integration of digital technologies, automation, real-time data, and artificial intelligence across all stages of the construction lifecycle. The extant literature suggests that Construction 4.0 adoption is influenced by organizational resources (technology, people, process, and education), ambidexterity (exploration and exploitation), and institutional pressures (normative pressure, memetic pressure, and coercive pressure). The predominant discourse of existing studies on the implementation of Construction 4.0 have focused on its impact on work procedures, project completion times, quality, and safety measures, despite the significant influence of organizational resources, ambidexterity, and institutional pressures on the successful adoption of Construction 4.0. Less attention has been paid to how internal organisational factors and external institutional forces interact to shape the strategic intent to adopt Construction 4.0 technologies. This study addresses this gap by investigating the influence of three critical constructs: organisational resources (technology, people, processes, education and training), organisational ambidexterity (exploration and exploitation capabilities), and institutional pressures (coercive, normative, and mimetic) on the intention to adopt Construction 4.0 within the Saudi construction industry. Hence, this study investigates the influence of organizational resources, ambidexterity, and institutional pressures on the adoption of Construction 4.0 in the Kingdom of Saudi Arabia. Ultimately, the study has developed a framework for implementing Construction 4.0 in the Saudi construction industry. This research developed a theoretical model proposing eighteen (18) hypotheses, based on theories related to strategic resources (Resource-Based View), strategic flexibility (ambidexterity), and institutional pressures (institutional theory) to understand their impact on Construction 4.0 adoption. A comprehensive literature review was conducted, and a conceptual model was developed to measure the influencing factors. A quantitative research methodology was adopted, underpinned by a positivist paradigm. Data was collected through a questionnaire completed by 261 professionals in construction organizations in Saudi Arabia. Structural Equation Modelling (SEM) was adopted to test the hypotheses, examine the relationships between variables, and validate the conceptual model. The results of the SEM confirmed 13 of the 18 hypotheses, revealing that institutional pressures significantly influence exploration orientation. This orientation, in turn, positively impacts key organizational resources—particularly human capital, education and training, and processes—needed for the adoption of Construction 4.0. The intention to adopt C4.0 was found to be most strongly influenced by the development of these organizational resources. Moreover, the study identified five dominant adoption pathways that integrate external institutional forces and internal strategic capabilities. These pathways offer a nuanced understanding of how adoption dynamics unfold in practice, especially in contexts undergoing rapid socio-economic transformation. These findings offer theoretical and practical contributions. Theoretically, it advances the discourse on digital transformation in construction by integrating three organizational theories into a single explanatory model. The integration of organizational theories provides a deeper understanding of Construction 4.0 adoption dynamics. Empirically, it provides evidence-based insights specific to the Saudi Arabian context, an emerging market undergoing rapid reform aligned with Vision 2030. Practically, the study offers an empirically validated framework tailored to the Saudi construction context, which can inform decision-makers, policy developers, and construction professionals seeking to enhance productivity through digital transformation in alignment with national strategic ambitions.
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SHATTERED PERCEPTIONS: HOW NEGATIVE NEWS TRUMPS DESTINATION IMAGE IN CONFLICT-RIDDEN REGIONS
(Queensland University of Technology, 2024) Moathen, Wael; Wang, Di; Beatson, Amanda
This research investigates the causal effect of negative news media on destination image formation in conflict-ridden regions, addressing a critical gap in tourism literature. Destination image is pivotal in tourists’ decision-making processes and overall destination competitiveness. In conflict-ridden regions like the Middle East, negative news coverage can significantly impact these perceptions, potentially deterring visitors and affecting tourism economies. Despite the recognised importance of news media as an autonomous agent in image formation, limited empirical research has examined its causal effects, particularly in conflict- ridden areas. This study aims to comprehensively understand how negative news shapes destination image, the underlying mechanisms of this effect, and potential moderating factors. Study One establishes the main effect of negative news on destination image through a 2 (within-subjects: Time [before news story, after news story]) × 2 (between-subjects: News Frame [thematic, episodic]) × 4 (Countries [Turkey, Saudi Arabia, Dubai, Qatar]) experimental design. Analysis of variance (ANOVA) reveals that negative news significantly decreases destination image for the featured location and, to a lesser extent, other destinations in the region. The study demonstrates the robustness of this effect across different news frames, providing initial evidence for the pervasive impact of negative media coverage on regional perceptions. Study Two replicates and extends these findings using a 2 (Story type: negative v. ordinary) × 2 (Connotation: negative v. neutral) × Continuous prevention focus, between- participants experimental design. Through mediation analyses, it identifies perceived risk and negative emotions as significant mediators in the relationship between negative news and destination image. Additionally, moderation analysis reveals that prevention focus moderates the effect of negative news on perceived risk, with high prevention-focused individuals being more susceptible to negative news effects. Study Three further confirms these results and examines the impact across different travel arrangements using a 2 (Story type: negative v. ordinary) × 2 (Travelling arrangements: independent traveller v. all-inclusive packaged travellers) between-participants experimental design. The findings demonstrate that the negative effect of news persists for both independent iv Chapter 1: Introduction and package travellers, challenging assumptions about the risk-mitigating potential of all- inclusive packages in conflict-ridden destinations. Theoretically, this research makes several important contributions. It provides the first causal evidence of the negative effect of news media on destination image formation in conflict-ridden regions, addressing calls for more rigorous methodologies in this area. Identifying perceived risk and negative emotions as mediators advances understanding of the psychological mechanisms underlying this effect. Further, the research extends the application of regulatory focus theory in tourism contexts by demonstrating its relevance to news processing and destination perceptions. This research fills a significant geographical gap in tourism studies by examining an under-researched geographical region, thereby enhancing the global relevance of tourism scholarship and providing valuable insights for both academic discourse and practical tourism management. Practically, the findings offer valuable insights for destination marketing organisations in conflict-ridden regions. The research underscores the need for proactive media monitoring and rapid response strategies to counteract negative coverage. It highlights the importance of addressing both cognitive (perceived risk) and affective (negative emotions) components in image management efforts. The findings related to prevention focus suggest the need for tailored marketing approaches that consider individual differences in risk sensitivity. In conclusion, this research comprehensively examines how negative news media influences destination image formation in conflict-ridden regions. Establishing causal relationships, identifying underlying mechanisms and exploring moderating factors advances both theoretical understanding and practical strategies in destination marketing. As global tourism continues to navigate geopolitical challenges and media dynamics, these insights offer crucial guidance for managing destination perceptions in complex environments.
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Developing and Assessing the Effectiveness of a Web-based Breastfeeding Educational Resource on Exclusive Breastfeeding Rate among Saudi Women
(University of Wollongong, 2024-09) Alahmed, Salma; Frost, Steve; Meedya, Shahla; Fernanadez, Ritin; Win, Khin; Almutair, Abbas
Background Breastfeeding is not only a very cost-effective way of feeding a baby, but it is also associated with multiple health benefits for both mothers and infants. Henceforth, the World Health Organization highly recommends early initiation of breastfeeding within an hour after birth, followed by exclusive breastfeeding for up to six months. However, the rates of early initiation of breastfeeding and exclusive breastfeeding vary around the world, and in some countries, they are well below the WHO targets. Similarly, in Saudi Arabia, the rate of early initiation of breastfeeding ranges from 26.3% in the Northern region to 62.7% in the Southern region. Furthermore, the rate of exclusive breastfeeding at six months after birth varies from 19.2% to 28%. Despite national efforts to promote breastfeeding, a decline in breastfeeding practices has been recorded, coinciding with increased use of infant formula. Introducing formula milk during hospital stays in Saudi Arabia is common practice. Several misconceptions about body shape, the safety of colostrum, and breastmilk insufficiency, coupled with rapid economic growth, have contributed to this decline and early breastfeeding cessation, even though Saudi women are offered breastfeeding education during pregnancy. Therefore, there was a need to develop an online educational intervention to motivate Saudi women to breastfeed for a longer duration. Saudi Arabia has a deep-rooted cultural heritage based on the Islamic religion, and its main language is Arabic. Hence, the cultural and linguistic aspects of the educational intervention were considered important determinants of its successful implementation. Aim The aim of this program of Higher Degree Research (HDR) was to develop and assess the effectiveness of a Web-based Breastfeeding Educational Resource (WEBBER) on exclusive breastfeeding rate during the hospital stay until one month after birth. Method The multi-method study was carried out in three phases to address the research aim. In the first phase, a systematic review was conducted to collect evidence-based information. The content of the website was based on the knowledge gaps identified in the systematic review, the WHO recommendation and the Milky Way app. In the second phase, the content of the website was finalised through a consensus development conference involving local stakeholders from the participating hospital in Saudi Arabia and university researchers. Participants of the Consensus Development Conference were asked to give feedback before the meeting, and changes were made to the content accordingly. The meeting was conducted on Zoom, and polling was used to indicate whether consensus was reached about the content, images and layout. The Persuasive System Design model informed the framework of the website development phase. The third phase was divided into two stages. In the first stage, a quasi-experimental study with a before and after intervention design was used to assess the effectiveness of the Web-based breastfeeding educational resource in promoting breastfeeding practices. An online survey was conducted to collect information about the breastfeeding practices during a hospital stay and at one month after birth before (Standard Care group) and after (Intervention group) giving access to the website. In the second stage, a semi-structured interview was undertaken to explore women’s experiences using the website. The interview was digitally recorded and transcribed verbatim using the Otter application before translating into English. The quantitative data was analysed using R language for statistical computing. A log-binomial regression model was used to adjust for any confounding factors that were identified. The qualitative data was analysed using content and thematic analysis. Results A total of sixteen studies were included in the systematic review. Data from ten studies that reported on breastfeeding knowledge demonstrated that 42.3% to 82.3% of Saudi women had good knowledge. However, several gaps in knowledge were identified including managing breastfeeding challenges. A meta-analysis of seven studies that reported on attitudes showed that most Saudi women hold positive attitudes towards breastfeeding. However, around 40% of women believed that formula milk was as healthy as breastmilk, and 59.4% believed that formula feeding was more convenient. The literature review was crucial in developing the content of the website. After making changes to the content based on feedback received from the members of the Consensus Development Conference, 100% agreement about the content, layout and images was achieved during the meeting. This confirmed the cultural and linguistic appropriateness of the content of the website, which was successfully developed using the Persuasive Systems Design model. Findings from the quasi-experimental experimental demonstrated an almost three times increase in the rate of exclusive breastfeeding at one month after birth in the intervention group that was given access to the website. Several predictors of exclusive breastfeeding were identified, including intention to breastfeed for six months or more, baby not receiving pre-made infant formula, and unemployment status of the women. Thematic analysis of the data from the semi-structured interview revealed three themes, including “Satisfying,” “Helpful,” and “Motivational.” Participants found the website “satisfying” due to its “Accessibility,” “Visual attraction,” “User-friendliness,” “Informative content,” “Trustworthiness,” and “Uniqueness.” They qualified the website as being helpful because it was perceived as a “Problem solver,” “Supportive,” and “Confidence booster.” The four sub-themes associated with “Motivational” were “Motivation to continue breastfeeding,” “Preparedness for managing breastfeeding challenges,” “Facilitating the continuation of breastfeeding,” and “Enhancement of intention to Breastfeed for a longer period.” Overall, the women’s experience of using the website was very positive. Conclusion This program of Higher Degree Research (HDR) has demonstrated the effectiveness of the Web-based Breastfeeding Education Resource in improving the exclusive breastfeeding rate during the hospital stay until one month after birth in Saudi Arabia. The Consensus Development Conference facilitated the engagement with local stakeholders, who ensured the cultural and linguistic appropriateness of the evidence-based content derived from the systematic review, WHO and Milky Way App. The Persuasive Systems Design model was successfully employed in developing the website, which was confirmed by the positive feedback from breastfeeding women who felt more motivated to breastfeed. This study has demonstrated that a women-centred online breastfeeding educational intervention can improve breastfeeding practices in Saudi Arabia.
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Safe Return to Driving after Sustaining Road Traffic Injuries: Driver Assessment and Rehabilitation in Saudi Arabia
(Monash University, 2024) Alhashmi, Doha Hassan; Oxley, Jennie; Fossey, Ellie; Lalor, Aislinn
Background: In Saudi Arabia, motor vehicle crashes are a major cause of injury and disability. Rehabilitation is essential to reduce the severity and long-term disabilities resulting from road traffic injuries and to ensure successful reintegration of individuals into society. Occupational therapy plays a crucial role in this rehabilitation process. Since the occupational therapy profession is relatively new in Saudi Arabia, this thesis aimed to explore utilising occupational therapy services within post-crash rehabilitation and addressing safe return to driving. It also aimed to identify suitable interventions and policies that could enhance rehabilitation practices in the Saudi context. Methods: This research used a mixed methods approach involving quantitative and qualitative methods. Initially, a systematic review of methods to evaluate at-risk drivers was conducted. This was followed by two complementary studies: a quantitative observational retrospective cohort review and a descriptive qualitative study. The quantitative study used existing registry data from a Saudi major trauma centre. Data for 475 trauma registry patients was analysed using descriptive and regression analyses. Then qualitative semi-structured interviews with 13 occupational therapists explored their perspectives on post-crash rehabilitation practices and assessment of at-risk drivers. Data were analysed using reflexive thematic analysis. Results: The systematic review revealed the main approaches used internationally to assess at-risk drivers. Over two-thirds of the reviewed studies used on-road driving performance tests to ii determine driving competence independently or in combination with another method. The quantitative study data revealed that following RTIs, occupational therapy is utilised for several reasons and that the only significant predictor of occupational therapy referral (df=1, p=.049, CI=1.011- 75.27) was combined rehabilitation services use. The qualitative study identified themes highlighting the inaccessibility of post-crash rehabilitation due to multiple factors, including service centralisation and high demand. The rehabilitation pathway was described; there was also a lack of clarity on the occupational therapists’ role among other health professionals. Current limitations of rehabilitation services include insufficient experienced and specialised therapists, the predominance of the biomedical framework and the impairment focus in the current practice. The therapists in this study also reported their lack of knowledge and practical skills for driver assessment and rehabilitation practices, and their need for support and infrastructure to develop this practice area in Saudi Arabia. They also recommended the need for more research and engagement with stakeholders to establish this specialised practice area. Conclusions: This thesis highlighted the current practice challenges for rehabilitation following road traffic injuries in Saudi Arabia and emphasised the importance of a multidisciplinary approach in post-crash care. The thesis advocates a collaborative, participative approach to developing a driver assessment and rehabilitation policy by involving stakeholders, including at-risk drivers, healthcare professionals, and licensing authorities, so as to create a tailored and effective policy for Saudi Arabia. This is a crucial first step toward establishing a safe and sustainable practice framework that can enable therapists to 1) provide needed service to at risk drivers, 2) support at-risk drivers to resume driving safely and have meaningful and fulfilled lives, 3) protect all road users from preventable car crashes, and 4) alleviate the country’s burden from further road traffic injuries.
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Unveiling the Digital Divide: Public and Private Spaces on Social Media in the Saudi Context
(La Trobe University, 2024-05) Bahabri, Alaa Sultan; Bahfen, Nasya; McCarthy, Brigid
The emergence of social media has significantly altered the traditional boundaries between public and private, creating blurred spaces. As users around the world navigate these novel spaces, considerable research shows that they utilise various strategies to manage public and private. In the Saudi context, previous studies have shown that Saudis – influenced by Islamic privacy norms– tend to strictly segregate public and private spaces on social media using several strategies. Nonetheless, much of this research has primarily focused on users, with little attention paid to the influence of digital elements. This study investigates a common strategy of navigating public and private in the Saudi context, which is the segregation of public and private spaces across platforms. The study takes into account the influence of the platform’s interface and affordances. The study was conducted through three phases of data collection and analysis. The first phase involved analysing social media platforms using a digital ethnography approach; the walkthrough methodology to demonstrate the platform’s interface and affordances of public and private space. The second phase focused on investigating users’ perspectives and behaviours related to public and private spaces across platforms using a questionnaire and interviews. Lastly, the third phase delved deeper into specific public and private spaces identified during the earlier phases through in-depth interviews and further analysis the online social norms of public and private space. This study argues that, as social media platforms blur the boundaries between public and private, the proliferation of social media has led Saudi users to heavily rely on segregating public and private spaces across these platforms, taking into account each platform's interface and affordances. This segregation reflects the Islamic notion of privacy, and it allowed users to reflect and facilitate their culture and social norms in the online space. The findings revealed that Saudis preferred platforms with default public or default private design, while they negotiate semi-public platforms. Twitter was favoured as a public space due to its default public interface design, while Snapchat’s was favoured as a private space. Conversely, Facebook’s semi-public nature was rejected due to perceived openness, leading to its designation as a niche network among Saudis. Instagram’s semi-public space was also negotiated and was used as a functional platform. Finally, TikTok was rejected due to the perception that it is not culturally appropriate. 5 Further analysis examined the social norms on Twitter and Snapchat, highlighting the differences in public and private interactions. The study found Twitter users exhibited cautious behaviour due to its public interface design, and presented a collective self, with either a serious or professional personas. In contrast, Snapchat provided a unique dynamic, particularly as older users were present on the platform, leading young users to create a more closed private space that differed from offline private circles. Overall, this research underscores the intricate interplay of culture, technology, and user behaviour in shaping Saudi Arabia’s digital landscape, emphasising the importance of considering both the cultural values and digital environments in understanding these dynamics for effective platform design and policymaking.
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Reducing Type 1 Childhood Diabetes in Saudi Arabia by Identifying and Modelling Its Key Performance Indicators
(Royal Melbourne Institute of Technology, 2024-06) Alazwari, Ahood; Johnstone, Alice; Abdollahain, Mali; Tafakori, Laleh
The increasing incidence of type 1 diabetes (T1D) in children is a growing global health concern. Reducing the incidence of diabetes generally is one of the goals in the World Health Organisation’s (WHO) 2030 Agenda for Sustainable Development Goals. With an incidence rate of 31.4 cases per 100,000 children and an estimated 3,800 new cases per year, Saudi Arabia is ranked 8th in the world for number of T1D cases and 5th for incidence rate. Despite the remarkable increase in the incidence of childhood T1D in Saudi Arabia, there is a lack of meticulously carried out research on T1D in children when compared with developed countries. In addition, it is crucial to recognise the critical gaps in current understanding of diabetes in children, adolescents, and young adults, with recent research indicates significant global and sub-national variations in disease incidence. Better knowledge of the development of T1D in children and its associated factors would aid medical practitioners in developing intervention plans to prevent complications and address the incidence of T1D. This study employed statistical, machine learning and classification approaches to analyse and model different aspects of childhood T1D using local case and control data. In this study, secondary data from 1,142 individual medical records (359-377 cases and 765 controls) collected from three cities located in different regions of Saudi Arabia have been used in the analysis to represent the country’s diverse population. Case and control data matched by birth year, gender and location were used to control confounders and create a more robust and clinically relevant model. It is well documented that genetic and environmental factors contribute to childhood T1D so a wide range of potential key performance indicators (KPIs) from the literature were included in this study. The collected data included information on socioeconomic status, potential genetic and environmental factors, and demographic data such as city of residence, gender and birth year. Several techniques, such as cross-validation, hyperparameter tuning and bootstrapping, were used in this study to develop models. Common statistical metrics (coefficient of determination, R-squared, root mean squared error, mean absolute error) were used to evaluate performance for the regression models while for the classification models accuracy, sensitivity, precision, F score and area under the curve were utilised as performance measures. Multiple linear regression (MLR), artificial neural network (ANN) and random forest (RF) models were developed to predict the age at onset of T1D for all children 0-14 years old, as well as for the most common age group for onset, the 5-9 year olds. To improve the performance of the MLR models, interactions between variables were considered. Additionally, risk factors associated with the age at onset of T1D were identified. The results showed that MLR and RF outperformed ANN. The logarithm of age at onset was the most suitable dependent variable. RF outperformed the others for the 5-9 years age group. Birth weight, current weight and current height influenced the age at onset in both age groups. However, preterm birth was significant only in the 0-14 years cohort, while consanguineous parents and gender were significant in the 5-9 age group. Logistic regression (LR), random forest (RF), support vector machine (SVM), Naive Bayes (NB) and artificial neural network (ANN) models were utilised with case and control data to model the development of childhood T1D and to identify its key performance indicators. Full and reduced models were developed to determine the best model. The reduced models were built using the significant factors identified by the individual full model. The study found that full LR had the highest accuracy. Full RF and SVM with a linear kernel also performed well. Significant risk factors identified as being associated with developing childhood T1D include early exposure to cow’s milk, high birth weight, positive family history of T1D and maternal age over 25 years. Poisson regression (PR), RF, SVM and K-nearest neighbor (KNN) were then used to model the incidence of childhood T1D, taking in the identified significant risk factors. The interactions between variables were also considered to enhance the performance of the models. Both full and reduced models were created and compared to find the best models with the minimum number of variables. The full Poisson regression and machine learning models outperformed all other models, but reduced models with a combination of only two out of three independent variables (early exposure to cow’s milk, high birth weight and maternal age over 25 years) also performed relatively well. This study also deployed optimisation procedures with the reduced incidence models to develop upper and lower yearly profile limits for childhood T1D incidence to achieve the United Nations (UN) and Saudi recommended levels of 264 and 339 cases by 2030. The profile limits for childhood T1D then allowed us to model optimal yearly values for the number of children weighing more than 3.5kg at birth, the number of deliveries by older mothers and the number of children introduced early to cow’s milk. The results presented in this thesis will guide healthcare providers to collect data to monitor the most influential KPIs. This would enable the initiation of suitable intervention strategies to reduce the disease burden and potentially slow the incidence rate of childhood T1D in Saudi Arabia. The research outcomes lead to recommendations to establish early intervention strategies, such as educational campaigns and healthy lifestyle programs for mothers along with child health mentoring during and after pregnancy to reduce the incidence of childhood T1D. This thesis has contributed to new knowledge on childhood T1D in Saudi Arabia by: * developing a predictive model for age at onset of childhood T1D using statistical and machine learning models. * predicting the development of T1D in children using matched case-control data and identifying its KPIs using statistical and machine learning approaches. * modeling the incidence of childhood T1D using its associated significant KPIs. * developing three optimal profile limits for monitoring the yearly incidence of childhood T1D and its associated significant KPIs. * providing a list of recommendations to establish early intervention strategies to reduce the incidence of childhood T1D.
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Exploring Language Learning Strategies and Learners’ Identities Using WhatsApp Chats to Enhance the Learning of Arabic Grammar in Cooperative Learning Settings Online
(The University of Queensland, 2024) Almutairi, Azizah; Smala, Simone
This study investigates the innovative use of WhatsApp for teaching Arabic to international female students at Princess Nourah University in Saudi Arabia. Focusing on cooperative learning, it explores how WhatsApp interactions shape learner identities and support Arabic grammar learning. Guided by Norton’s theory of second-language learner identities and Johnson and Johnson’s cooperative learning model, the research examines identity shifts, cooperative strategies, and the negotiation of meaning in WhatsApp chats. Through chat analysis and interviews, the study offered insights into WhatsApp’s role in Arabic language acquisition and shed light on the broader role of social media platforms in the learning experiences of international higher education cohorts
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Motivating and Supporting Medication Adherence Behaviour for Chronic Conditions: Persuasive design of a mHealth app.
(University of Wollongong, 2024-03) Altuwayrib, Saleh Abdulqader; Win, Khin Than; Freeman, Mark
Arthritis requires long-term treatment and lifestyle management to manage symptoms and prevent disease progression. Medication adherence behaviour is essential for managing arthritis. However, the adherence rates for arthritis patients are often low due to factors like lack of motivation, forgetfulness, and limited knowledge about the condition. Mobile health applications (mHealth apps) emerged as a promising solution to support patient adherence by providing users with personalised, accessible, and interactive features that promoted medication management. Educational features that enable users to access health information can improve user awareness about the condition, reminder features can assist users from forgetting to take medication and motivational features like rewards and social support can be tailored to motivate and engage users. This thesis focuses on the motivational design of mHealth apps to support medication adherence behaviour for chronic arthritis conditions. The thesis addresses the gaps in existing mHealth apps for arthritis and medication adherence, which often fail to involve patients in the design process or address the specific barriers to adherence they encounter. The research question of this study is: What are the key design features of a motivational mobile health app that can promote medication adherence among chronic arthritis patients in Saudi Arabia? The thesis has several objectives to answer this research question, which include exploring the arthritis patients' needs, designing a mHealth app prototype, and evaluating the usability of the mHealth app among Saudi arthritis patients. This research adopts qualitative research methods, starting with a scoping review of medication adherence apps for different chronic health conditions, interviews with health care providers (HCPs), and online focus group discussions with chronic arthritis patients across Saudi Arabia. Interpretivism is used to understand adherence behaviour barriers, facilitators, and user needs and preferences to ensure the user-centric design process. Additionally, the research embraces pragmatism in the design and evaluation process through 3 design cycles that follow the six-design science research methodology (DSRM) steps. The selection of user requirements considers the theoretical framework adopted combining three components of the IMB model: information, motivation, and behavioural skills. Motivation aspects consider the intrinsic motivation that can be satisfied according to Self Determination Theory. The principles of persuasive design are considered to ensure that the app motivates users and supports health behaviour change. The user research, design, and evaluation resulted in an interactive mHealth app prototype tailored to the needs and preferences of Saudi arthritis patients. The evaluation steps in each cycle identified usability problems, and areas for improvements, confirmed user acceptance, and validated the features and content with HCPs. Therefore, user-evaluation in the final cycle showed high user satisfaction among arthritis patients in Saudi Arabia. The research highlights the potential of mHealth apps to engage users and support adherence behaviour by satisfying their needs, simplifying medication management, empowering users to monitor their arthritis, engaging users with the local arthritis community, and enabling users to access credible content and supportive services that aim to support patient adherence. Future work will focus on the app’s development, evaluate the app’s effectiveness, and explore scalability options to make the app accessible to a broader population of Arabic arthritis patients.
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An evaluation of the Rashaka Initiative: a school-based obesity intervention in Makkah City, Saudi Arabia
(University of Technology Sydney, 2024-03) Banany, Mohammed; Sibbritt, David; Gebel, Klaus
Background: Childhood overweight and obesity are public health issues worldwide. In Saudi Arabia, in 2016/2017 the Rashaka Initiative, a national school-based, multicomponent, weight-related intervention, was launched to decrease the prevalence of obesity among students by 5% within five years. Neither the development stage of the initiative nor its implementation has been evaluated to explore its processes and outcomes. Aim: This study was aimed at evaluating the implementation of the Rashaka Initiative in intermediate and secondary schools in Makkah City, Saudi Arabia, covering both process and outcome. To this end, the following objectives were pursued: (1) to develop an evaluation framework that can be used to assess the processes and outcomes of the initiative, (2) to determine whether there was a change in students’ body mass indices (BMIs) during the implementation period, and (3) to explore the knowledge and attitudes of the Rashaka stakeholders regarding the perceived barriers and facilitators of implementation in their schools. Methods: This retrospective study, conducted after the implementation of the Rashaka Initiative, was completed in three phases. In phase I, a conceptual framework called the school-based weight-related intervention evaluation framework (SWIEF) was developed by integrating some elements of the program evaluation framework used by the US Centers for Disease Control and Prevention (CDC) with the components of a logic model. In phase II, secondary data from the Rashaka Initiative were analysed. Phase III was a cross-sectional exploration of the Rashaka stakeholders’ knowledge and attitudes as well as what they perceive as facilitators and barriers to implementing the intervention at their schools. Results: The comprehensive literature review yielded a published systematic review (Banany et al. 2024, Systematic Reviews). This systematic review found 11 school-based weight-related intervention studies in the six Gulf Cooperation Council countries (GCC). Despite the methodological limitations of some of these studies, there is preliminary evidence of the possible benefits of school-based interventions on students' weight and associated lifestyle factors in these countries. A review of the literature also facilitated the development of the SWIEF. The analysis of the secondary data revealed a significant reduction in BMI (p<0.001) across schools that participated in the Rashaka Initiative over two school years (2016/17 and 2018/19). However, this reduction was not associated with the school environmental factors attributed to the initiative. The study findings found that students’ BMIs decreased more considerably in girls’ and intermediate schools than in boys’ and secondary schools (p<0.001 and p=0.031, respectively). The cross-sectional study indicated that significantly better knowledge of risk factors and interventions for childhood obesity was exhibited by female Rashaka stakeholders (vs their male counterparts), stakeholders who completed tertiary education (vs those with lower education levels) and stakeholders engaged in the initiative for more than two years (vs participants who joined more recently) (p<0.001, p<0.007 and p<0.033, respectively). School health counsellors had more positive attitudes towards children’s health and weight than principals (p<0.008). Significantly more favourable attitudes towards the Rashaka intervention were also found among female stakeholders (p<0.011) and those with better knowledge of the initiative’s objectives, components, activities, and outcomes (p<0.049). Among the stakeholders, 73% perceived collaboration with different government and private sector institutions as the most common facilitator of the Rashaka implementation at their schools, while 69% perceived a lack of time as the main barrier. Conclusions: Addressing childhood obesity is a public health priority that requires substantial efforts from all relevant key stakeholders in Saudi Arabia. The evidence derived in this thesis revealed that the Rashaka Initiative has yet to satisfy its objectives. Future studies should be more rigorous, theory-based, and holistic to tackle obesity among school students. Evaluations of school-based obesity interventions should use control groups, validated and reliable measures and rigorous data analysis. Long-term monitoring of the implemented interventions is highly recommended for their improvement and sustainability.
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