Conceptual framework of factors influencing Hepatitis B preventive awareness and behaviors among Saudi women

Conceptual framework of factors influencing Hepatitis B preventive awareness and behaviors among Saudi women | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Conceptual framework of factors influencing Hepatitis B preventive awareness and behaviors among Saudi women Elhadi Miskeen, Shahad Abdullah Mohammed Alshahrani, Abdullah Alhalafi, and 12 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9108647/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 15 You are reading this latest preprint version Abstract Introduction: Hepatitis B virus (HBV) infection still poses an important public health issue in Saudi Arabia, despite the availability of effective vaccines and national prevention programs. It is particularly important among women, who play a central role in family health and face a risk of transmitting the infection to their infants during pregnancy and childbirth. Objectives: This study intends to report the levels of knowledge, attitudes, and practices towards HBV prevalence among non-pregnant Saudi women in Bisha province and thus provide context-specific evidence that can inform a targeted preventive actions framework. Methods: A community-based cross-sectional study was conducted in Bisha province, Saudi Arabia, from January 2025 to February 2026 among 391 non-pregnant Saudi women aged ≥18 years or older. Data were collected via a structured Arabic questionnaire. We categorized the good knowledge, positive attitude, and good practice as scores ≥75%, ≥80%, and ≥70%, respectively. Statistical analysis was performed using STATA BE, 2025. We employed Chi-square and logistic regression to examine the associations. Results: The mean±SD scores of knowledge, attitude, and practice were 15.2±3.4, 5.9±1.6, and 6.7±2.1, respectively. Overall, good knowledge was reported by 65.5%, positive attitude by 69.3%, and good preventive practice by 46.8%. There were significant correlations between better KAP and higher education, working as health/education professionals, being richer (income), already vaccinated against HBV, and having taken the respective tests for HBV (p<0.05). Only 40.9% were fully vaccinated; ever-screening and HBV health education participants accounted for 45.5% and 31.7%, respectively. In multivariable analysis; good knowledge (adjusted odds ratio 2.12, 95% confidence interval 1.40–3.22), positive attitude (AOR=2.51, 95% CI: 1.64–3.85), vaccination (AOR=3.02, 95% CI: 1.88–4.84) and exposure to previoushealth education session (AOR=1.96, 95% CI: 1.23–3.13) were identified as a predictors of good practice. Conclusion: Awareness and attitudes toward HBV are generally positive among women in Bisha; however, the preventive practices are substandard. This knowledge–practice gap remains large and is influenced by education, occupation, income, and health service engagement. Tailored interventions integrating education, accessible vaccination, screening, and community-based outreach are needed to improve HBV prevention and align with national elimination goals. Hepatitis B virus Knowledge Attitudes Practices Women Prevention Vaccination Screening Saudi Arabia Bisha Knowledge-practice gap Health education Figures Figure 1 1. INTRODUCTION HepatitisB virus (HBV) infection is one of the important public health challenges globally. Notably, despite the availability of vaccines and antiviral therapies to treat this useful prototype for prevention, it remains a major contributor to preventable liver-related morbidity and mortality [1–3]. In this context, improving preventive behaviour—particularly vaccination, safe practices, and screening—is central to achieving the World Health Organization (WHO) viral hepatitis elimination targets by 2030, which emphasize reducing new infections and deaths through comprehensive prevention, testing, and treatment strategies [2,4]. The fact that chronic HBV infection is characterized by a prolonged period without symptoms before progression to advanced liver disease suggests the need for primary prevention as well as early detection through routine screening of at-risk groups, including women of reproductive age [3,4,5]. In many societies, women are the primary decision-makers for family health and caregivers; therefore, their knowledge, attitudes, and practices in relation to HBV prevention can strongly influence uptake of vaccination, screening, and safe behaviours within families and communities [1,6,7]. Saudi Arabia has undergone a marked epidemiological transition in HBV burden over the last three decades, after the introduction of universal HBV vaccination into the national childhood immunization programme in 1989 and subsequent coverage scaling up [3,5,8]. This policy, along with premarital screening programmes and improvements in infection control, has led to a decline in HBV prevalence, especially among younger age cohorts [5,8,9]. Nevertheless, HBV remains an important notifiable viral infection in the Kingdom, and incident cases continue to occur, particularly among adults born before the full implementation of the national vaccination programme or with incomplete vaccine coverage [3,5,9,10]. Women in Saudi Arabia constitute a key target group for HBV prevention because of their potential exposure during reproductive events and their influence on family health behaviours [6–8,11]. Vertical transmission has a strong potential for chronic infection and, therefore, premarital and antenatal screening along with counseling for risk groups as well as timely immunoprophylaxis areessential interventions needed to break the cycle of transmission [4,5,11–13]. To better comprehend and prevent their exposure to HBV during their reproductive years, it is important to address the diverse means of such exposure, including medical procedures, cosmetic practices, and household contact with infected family members [1,6,7,11]. Recent Saudi studies indicate that awareness and preventive behaviours regarding HBV among the general public remain suboptimal, with significant gaps in knowledge about transmission routes, complications, and the benefits of vaccination and screening [1,6,7,9,10]. Moderate overall knowledge and attitudes towards viral hepatitis were documented in a national study of Saudi Arabian residents. However, several participants had misconceptions regarding non-blood-borne transmission pathways and were unaware of effective vaccines and curative therapies for certain viral hepatitis types [1]. Additionally, stigma and fear related to hepatitis infection may disincentivize people from getting tested or disclosing their status, thus diminishing the potential impact of existing preventive services [1,9,10]. Studies among health care providers and student groups expected to have higher baseline knowledge have documented only moderate levels of HBV-related knowledge and suboptimal vaccination coverage, suggesting that even among educated populations, preventive behaviour is not uniformly adequate [12,14]. These findings raise concern that lay women in the community, particularly those in smaller cities and rural areas, may have even lower levels of knowledge and engagement in HBV preventive practices [6,7,11]. Women’s HBV-related preventive behaviour is influenced by multiple interrelated factors, including socio-demographic characteristics (age, education, income, marital status), health literacy, cultural beliefs, and access to health information and services [6,7,10,11]. In the Al-Baha region of Saudi Arabia, a recent study of adults’ awareness of HBV screening before marriage and pregnancy revealed that although many participants had heard of HBV, detailed knowledge of transmission, complications, and the importance of premarital and antenatal screening was limited, and screening uptake was far from universal [7]. Women’s awareness and preventive practices in that study were significantly associated with educational level and prior exposure to health education messages, underscoring the critical role of targeted health promotion and counselling [7,10,11]. In addition to socio-demographic and informational determinants, health system and policy-related factors shape preventive behaviour. Saudi Arabia’s premarital screening programme—originally designed to reduce hereditary haemoglobinopathies—has been expanded to include certain infectious diseases, including HBV, offering an opportunity to identify and counsel couples before marriage [8,9,15]. However, the effectiveness of such programmes in changing behaviour depends on the quality of counselling, women’s autonomy in health decision-making, and the availability and accessibility of follow-up services such as vaccination and specialist referral [3,7,9,15]. Moreover, in areas distant from major urban centres, geographic and logistical barriers may limit women’s access to preventive services, despite the existence of national policies and guidelines [3,8,9]. Bisha province, located in the southern region of Saudi Arabia, represents a semi-urban and rural catchment area with a growing population and diverse socio-cultural characteristics [16]. Published data specifically focusing on HBV awareness and preventive behaviour among women in Bisha are scarce, and much of the available evidence on HBV knowledge and practices in Saudi Arabia comes from larger cities or specific professional groups [1,6,7,10–12,14]. This paucity of localized data hampers the ability of regional health authorities and primary care providers to design context-appropriate interventions to improve HBV prevention among women in this area [7,11,16]. With national and global commitments to address the burden of viral hepatitis, and given that the strategic importance of women’s health will touch on all relevant risk factors needed to meet these goals, there is a local need for new, community-based studies within under-researched regions in Saudi Arabia [3–5,8,15–21]. We will provide context-specific evidence to support better public health planning, primary care practice, and community outreach interventions in the southern region by investigating factors influencing preventive behaviour towards HBV among women in Bisha province. The objective of this study is to assess the knowledge, attitudes, and preventive practices related to the hepatitis B virus among non-pregnant Saudi women in Bisha province and to generate context-specific evidence to inform targeted HBV prevention interventions in this population. 2. METHODOLOGY 2.1 Study Setting and Design: This is a cross-sectional analytic study conducted in a community setting. The study involved eligible women from the Bisha province in Saudi Arabia's southern region. It was conducted over 14 months, between January 2025 and February 2026. Bisha is a semi-urban and rural catchment area with diverse socio-cultural characteristics, where previous research on HBV awareness has been limited, and the population is rapidly growing. 2.2 Study Population and Sampling: The target population consisted of non-pregnant Saudi women aged 18 years and older who had been residing in Bisha province for at least six months. Women with cognitive or communication impairments or who declined to participate were excluded. 2.3 Sampling technique (A multistage sampling): This sampling method was developed in 3 stages: (1) Bisha province for this study was divided according to official administrative divisions, into urban (Bisha city) and suburban/rural clusters; (2) within each cluster, households were selected from updated municipal lists using a random start and fixed interval 2.4 The sample size The sample was calculated using the formula: n=Z2×p(1−p)d2n=d2Z2×p(1−p) Assuming a prevalence (p) of good HBV knowledge of 50% (to maximize sample size), a 95% confidence level (Z = 1.96), and a margin of error (d) of 5%, the minimum required sample size was 384. To account for potential non-response (10%), 425 women were approached, and 391 completed the survey (response rate: 92%). 2.5 Data Collection Tool and Procedure: We developed a structured, interviewer-administered Arabic questionnaire based on a literature review and validated KAP instruments for HBV. A panel of public health and hepatology experts assessed the questionnaire for content validity, and it was piloted with 30 women (not included in the final sample) to evaluate clarity, reliability (Cronbach's alpha >0.75 for all scales), and cultural acceptability. We made modifications on previous quationnaire [22] 2.6 Instrument: The final survey instrument was structured into six comprehensive sections: (1) sociodemographic details, including age, marital status, education level, occupation, monthly income, place of residence, and family history of hepatitis; (2) knowledge about HBV, comprising 20 items that assessed understanding of transmission routes, symptoms, complications, prevention methods, and vaccination, with a total score ranging from 0 to 20; (3) attitude toward HBV prevention, measured through 8 items on a 5-point Likert scale (from strongly disagree to strongly agree) evaluating perceptions of disease severity, personal susceptibility, and the benefits of preventive actions, yielding a score between 0 and 8; (4) preventive behaviors including 10 items documenting vaccination uptake, history of screening, injection safety (Behaviors related to injecting drug use), receiving blood transfusions in the past and avoiding high-risk activities weresummed for a score ranging from 0 to 10; (5) health-service utilization where Participants response on testing history, HBV vaccination status, participation in health-education activity was evaluated; and (6) sources of information. The data collected included an open-ended question. Ethical principles were followed, and interviews were carried out by female research data collectors who were trained and had a background in nursing or public health. 2.7 Scoring and Operational Definitions: Good knowledge was defined as a score ≥75% (≥15/20) on the knowledge assessment. From the responses, an overallpositive attitude was defined as 80% or higher score (≥6.4/8), and for evaluation purposes, it was rounded to a publishableevaluating form of ≥6. Correct preventive behaviour indicates being at least ≥7/10 of the prevention scale inpractice. Vaccination statuses were differentiated into (≥3 doses- fully vaccinated), unvaccinated, (1–2 doses-partially vaccinated). Socioeconomic status was determined according to the reported monthly household income: low (10,000 SAR). 2.8 Data Analysis: Data were analysed by STATA version 19 (2025). Besides, descriptive statistics and bivariate analyses were employed to test associations between sociodemographic variables and levels of HBV knowledge, attitude, and practice using chi-square tests. To determine predictors, we used binary logistic regression for the good preventive practice. In the first multivariate model, all variables with a p-value less than 0.20 from the bivariate analysis were included, and a backward stepwise selection was used for the statistically significant predictors (p < 0.05) in the final model. RESULTS are reported as AOR (adjusted odds ratios) and 95 % confidence intervals (CIs). However, all statistical tests were two-tailed, and a p-value<0.05 was considered statistically significant. 3. RESULT The sociodemographic composition of the 391 participating women from Bisha province is detailed in Table 1. The cohort was predominantly of reproductive age, with 201 (51.4%) married and 167 (42.7%) single. A high educational status was noted, with 288 (73.7%) of the women being tertiary-educated. By occupation, 172 (44.0%) were found to be homemakers and 107 (27.4%) students, together constituting the majority of the respondents. Geographically, the sample was biased toward the urban center, with 317 (81.1%) residing in the city of Bisha. Additionally, 72 (18.4%) of the participants reported a family history of hepatitis. Table 1. Sociodemographic Characteristics of the participants (=391) Variable n(%) Marital Status Single 167 (42.7) Married 201 (51.4) Divorced 16 (4.1) Widowed 7 (1.8) Education Level Primary 11 (2.8) Secondary 1 (0.3) Post-Secondary 81 (20.7) University 288 (73.7) Post-Graduate 9 (2.3) Occupation Housewife 172 (44) Education Sector 32 (8.2) Health Professional 24 (6.1) Banking and business 19 (4.9) Military 37 (9.5) Student 107 (27.4) Residence Bisha 317 (81.1) Bisha suburb 74 (18.9) Family History of Hepatitis Present 72 (18.4) Not Present 319 (81.6) Table 2 shows that the overall level of knowledge about hepatitis B among women in Bisha was relatively high, with a mean knowledge score of 15.2 ± 3.4 (out of 20) and a median of 16; nearly two-thirds of participants, 256 women (65.5%), were classified as having good knowledge, whereas only 36 (9.2%) fell into the poor knowledge category. Attitudes toward hepatitis B prevention were also generally favorable, as reflected by a mean attitude score of 5.9 ± 1.6 (out of 8), with 271 women (69.3%) demonstrating positive attitudes and fewer than 10 (9.7%) reporting negative attitudes. In contrast, preventive practices lagged behind knowledge and attitudes. However, the mean practice score was 6.7 ± 2.1 (out of 10), and fewer than half of the women (183, 46.8%) exhibited good preventive practices. In comparison, 76 (19.4%) reported poor practice levels, indicating a clear knowledge-practice and attitude-practice gap that warrants targeted behavioural and service-level interventions. Together, these findings indicate a clear knowledge-practice and attitude-practice gap: the large majority of women are knowledgeable regarding hepatitis B and have generally positive attitudes towards its prevention; however, a considerable number still fail to engage in sufficient protective behaviours both in everyday life and when accessing healthcare settings. This disconnect implies structural, cultural, or service-based barriers. require more than information provision to result in behaviour change, mirroring barriers such as limited access to vaccination, inadequate salutogenic counselling during health encounters, perceived low personal risk (to disease), and competing priorities. This calls for a larger role for interventions that will ensure behavioural support, empowerment, and service delivery to promote action beyond information. Table 2. Knowledge, attitude and practice scores toward hepatitis B among women in Bisha (n = 391) Domain score range Mean ± SD Median (IQR) Min Max Category definition* n (%) good / positive n (%) fair / neutral n (%) poor / negative Knowledge 0–20 15.2 ± 3.4 16 (13–18) 3 20 Good ≥75% (≥15); Fair 50–74% (10–14); Poor <50% (<10) 256 (65.5) 99 (25.3) 36 (9.2) Attitude 0–8 5.9 ± 1.6 6 (5–7) 1 8 Positive ≥75% (≥6); Neutral 50–74% (4–5); Negative <50% (<4) 271 (69.3) 82 (21.0) 38 (9.7) Practice 0–10 6.7 ± 2.1 7 (5–8) 0 10 Good ≥75% (≥8); Fair 50–74% (5–7); Poor <50% (<5) 183 (46.8) 132 (33.8) 76 (19.4) Knowledge of hepatitis B virus (HBV) was dichotomized into “good knowledge” (scoring ≥75% of the total knowledge score) and “poor/moderate knowledge” (scoring <75%). Table 3 summarizes the associations between sociodemographic characteristics and HBV knowledge. Several sociodemographic and HBV-related variables were significantly associated with knowledge level in univariate analysis. Higher education level had a strong positive correlation with HBV knowledge (p < 0.001). Objective: To find the prevalence of elements of knowledge about smoking in adolescents and to assess their relationship with socioeconomicstatus, health, and substance use. Women with University education represent the largest subgroup (n=288), and 50.3% ofthem were knowledgeable. Occupation was also significantly linked to knowledge (p < 0.001). Health professionals reported the highest rate of good knowledge (75.0%), followed by individuals working in the education sector (62.5%). In contrast, homemakers showed the lowest proportion (37.8%). There was a positive association of monthly household income with HBV knowledge (10,000 Saudi Riyals (SAR) per month). Good knowledge was observed in 57.0%, while it was 49.7% for the middle-income group(5,000–10,000 SAR), and itwas only 37.6% for the low-income group (<5,000 SAR). Personal and familial exposure to hepatitis significantly influenced knowledge levels. Women with a family history of hepatitis were more likely to possess good knowledge (58.3%) compared to those without such a history (47.6%) (p = 0.040). Knowledge was also strongly associated with engagement in preventive health behaviors. The knowledge amongvaccinated women (55.1%) was significantly higher than that of unvaccinated or status-unknown women (39.7%) (p = 0.001). Likewise, female HBV ever tested subjects had significantly better knowledge (57.3%) compared with those not tested (42.7%, p < 0.001). Knowledge level was associated with age group (p = 0.077), marital status (p = 0.163), and residence place (urban vs. suburban, p = 0.055). While there were some minor differences in numbers between these categories, they did not achieve statistical significance based on chi-square analysis. Higher educational attainment, employment in the health or education sectors, greater household income, family history of hepatitis, prior HBV vaccination, and HBV testing were all positively and significantly associated with good knowledge of hepatitis B among women in Bisha province. In contrast, age, marital status, and residential location did not show significant associations with knowledge level in this sample. Table 3. Association between sociodemographic characteristics and knowledge level about hepatitis B (n=391) Variable n Good knowledge (≥75%) n (%) Poor/Moderate knowledge (<75%) n (%) χ² df p-value Age group (years) 18–24 110 45 (40.9) 65 (59.1) 6.84 3 0.077 25–34 142 70 (49.3) 72 (50.7) 35–44 92 52 (56.5) 40 (43.5) ≥45 47 20 (42.6) 27 (57.4) Marital status Single 167 78 (46.7) 89 (53.3) 5.12 3 0.163 Married 201 95 (47.3) 106 (52.7) Divorced 16 10 (62.5) 6 (37.5) Widowed 7 4 (57.1) 3 (42.9) Education level Primary 11 2 (18.2) 9 (81.8) 45.23 4 <0.001 Secondary 1 0 (0.0) 1 (100.0) Post-Secondary 81 35 (43.2) 46 (56.8) University 288 145 (50.3) 143 (49.7) Post-Graduate 9 8 (88.9) 1 (11.1) Occupation Housewife 172 65 (37.8) 107 (62.2) 28.91 5 <0.001 Education Sector 32 20 (62.5) 12 (37.5) Health Professional 24 18 (75.0) 6 (25.0) Banking and business 19 10 (52.6) 9 (47.4) Military 37 20 (54.1) 17 (45.9) Student 107 58 (54.2) 49 (45.8) Residence Bisha city 317 156 (49.2) 161 (50.8) 3.67 1 0.055 Bisha suburb 74 31 (41.9) 43 (58.1) Monthly income (SAR) <5,000 85 32 (37.6) 53 (62.4) 15.47 2 10,000 121 69 (57.0) 52 (43.0) Family history of hepatitis Present 72 42 (58.3) 30 (41.7) 4.21 1 0.040 Not present 319 152 (47.6) 167 (52.4) HBV vaccination status Vaccinated 245 135 (55.1) 110 (44.9) 10.92 1 0.001 Not vaccinated / Unknown 146 58 (39.7) 88 (60.3) Ever tested for HBV Yes 178 102 (57.3) 76 (42.7) 12.34 1 <0.001 No 213 91 (42.7) 122 (57.3) Good knowledge was defined as ≥75% of total knowledge score; poor/moderate knowledge as <75%. SAR = Saudi Riyal. χ² = chi-squared statistic; df = degrees of freedom. Statistically significant p-values (p < 0.05) are indicated in bold . Attitude toward hepatitis B was categorized as “positive” (scoring ≥80% of the total attitude score) or “negative” (scoring <80%). Table 4 presents the associations between sociodemographic characteristics and attitude level among the 391 participants from Bisha province. Education level was significantly associated with attitude toward HBV (p = 0.001). Positive attitude was highest among postgraduates (88.9%) and university-educated participants (66.0%), while only 36.4% of those with primary education expressed a positive attitude. Occupation also showed a significant relationship with attitude (p = 0.007). Health professionals exhibited the most favorable attitude (83.3% positive), followed by individuals in the education sector (75.0%). Housewives reported the lowest proportion of positive attitude (57.0%). Monthly income was positively correlated with attitude (p = 0.009). Among women earning >10,000 SAR, 72.7% held a positive attitude, compared to 64.9% in the middle-income group and 52.9% in the low-income group. A positive attitude was more prevalent among vaccinated women (69.4%) than those unvaccinated or unsure (54.1%) (p = 0.001). Likewise, among women with a history of HBV testing, the proportion with a positive attitude was significantly higher (71.9% vs 56.8%) than those who had never been tested before (p < 0.001). No statistically significant differences in attitude were observed across age groups (p = 0.207), marital status (p = 0.504), residence (urban vs. suburban, p = 0.346), or family history of hepatitis(p = 0.073), although women with a family history showed a numerically higher proportion of positive attitude (72.2%). Higher educational level, employment in the health or education sectors, greater household income, prior HBV vaccination, and prior HBV testing were all significantly associated with a positive attitude toward hepatitis B among women in Bisha province. In contrast, age, marital status, place of residence, and family history of hepatitis did not significantly influence attitude level in this sample. Table 4. Association between sociodemographic characteristics and attitude level toward hepatitis B (n=391) Variable n Positive attitude (≥80%) n (%) Negative attitude (<80%) n (%) χ² df p-value Age group (years) 18–24 110 68 (61.8) 42 (38.2) 4.56 3 0.207 25–34 142 90 (63.4) 52 (36.6) 35–44 92 65 (70.7) 27 (29.3) ≥45 47 28 (59.6) 19 (40.4) Marital status Single 167 108 (64.7) 59 (35.3) 2.34 3 0.504 Married 201 125 (62.2) 76 (37.8) Divorced 16 12 (75.0) 4 (25.0) Widowed 7 5 (71.4) 2 (28.6) Education level Primary 11 4 (36.4) 7 (63.6) 18.92 4 0.001 Secondary 1 0 (0.0) 1 (100.0) Post-Secondary 81 48 (59.3) 33 (40.7) University 288 190 (66.0) 98 (34.0) Post-Graduate 9 8 (88.9) 1 (11.1) Occupation Housewife 172 98 (57.0) 74 (43.0) 15.78 5 0.007 Education Sector 32 24 (75.0) 8 (25.0) Health Professional 24 20 (83.3) 4 (16.7) Banking and business 19 12 (63.2) 7 (36.8) Military 37 25 (67.6) 12 (32.4) Student 107 75 (70.1) 32 (29.9) Residence Bisha city 317 205 (64.7) 112 (35.3) 0.89 1 0.346 Bisha suburb 74 44 (59.5) 30 (40.5) Monthly income (SAR) 10,000 121 88 (72.7) 33 (27.3) Family history of hepatitis Present 72 52 (72.2) 20 (27.8) 3.21 1 0.073 Not present 319 197 (61.8) 122 (38.2) HBV vaccination status Vaccinated 245 170 (69.4) 75 (30.6) 10.58 1 0.001 Not vaccinated / Unknown 146 79 (54.1) 67 (45.9) Ever tested for HBV Yes 178 128 (71.9) 50 (28.1) 12.34 1 <0.001 No 213 121 (56.8) 92 (43.2) Note: Positive attitude was defined as ≥80% of total attitude score; negative attitude as <80%. SAR = Saudi Riyal. χ² = chi-squared statistic; df = degrees of freedom. Statistically significant p-values (p < 0.05) are indicated in bold . Hepatitis B preventive practice differed markedly by sociodemographic and HBV-related characteristics (Table 5). The highest proportion of good practice was observed in women aged 35–44 years (52.2%), followed by (36.4%) among those aged 18–24 years and (42.6%) among those aged ≥45 years, with a significant association between age group and level of practice (p=0.026). On the other hand, the importance of marital status and place of residence (Bisha city vs suburb) had no significant association with preventive practice (p=0.207 and p=0.118, respectively). There was a strong positive gradient of HBV preventive practice by education level. Only 18.2% of women with primary education reached good practice, rising to 39.5% in the post-secondary educational level, 47.9% among university graduates, and up to 77.8% for women with postgraduate qualifications (p10,000 SAR, p=0.002). The percentage of women reporting good practice was higher among women whose family had a history of hepatitis than in those who did not have that history (58.3% vs. 41.1%, p=0.003). Preventive practices were most strongly associated with HBV-related service use. Overall, 55.1% of vaccinated women demonstrated good practice, compared with only 26.0% of unvaccinated or undecided women (p<0.001). Likewise, 57.3% women with past testing for HBV had good practice compared to 33.3% of those without testing (p<0.001). These outcomesindicate that tertiary education, employment in healthcare professionals, high monthly income, family history of hepatitis B, and a previous contact with vaccination and screening services act as determinants leading to adequate HBV preventive behaviours among women living in the context of Bisha province. Table 5 . Association between sociodemographic characteristics and preventive practice toward hepatitis B (n=391) Variable n Good practice (≥70%) n (%) Poor/Moderate practice (<70%) n (%) χ² df p-value Age group (years) 18–24 110 40 (36.4) 70 (63.6) 9.23 3 0.026 25–34 142 65 (45.8) 77 (54.2) 35–44 92 48 (52.2) 44 (47.8) ≥45 47 20 (42.6) 27 (57.4) Marital status Single 167 72 (43.1) 95 (56.9) 4.56 3 0.207 Married 201 85 (42.3) 116 (57.7) Divorced 16 10 (62.5) 6 (37.5) Widowed 7 3 (42.9) 4 (57.1) Education level Primary 11 2 (18.2) 9 (81.8) 32.17 4 <0.001 Secondary 1 0 (0.0) 1 (100.0) Post-Secondary 81 32 (39.5) 49 (60.5) University 288 138 (47.9) 150 (52.1) Post-Graduate 9 7 (77.8) 2 (22.2) Occupation Housewife 172 65 (37.8) 107 (62.2) 24.89 5 <0.001 Education Sector 32 18 (56.3) 14 (43.8) Health Professional 24 18 (75.0) 6 (25.0) Banking and business 19 10 (52.6) 9 (47.4) Military 37 20 (54.1) 17 (45.9) Student 107 52 (48.6) 55 (51.4) Residence Bisha city 317 145 (45.7) 172 (54.3) 2.45 1 0.118 Bisha suburb 74 28 (37.8) 46 (62.2) Monthly income (SAR) 10,000 121 68 (56.2) 53 (43.8) Family history of hepatitis Present 72 42 (58.3) 30 (41.7) 8.91 1 0.003 Not present 319 131 (41.1) 188 (58.9) HBV vaccination status Vaccinated 245 135 (55.1) 110 (44.9) 25.64 1 <0.001 Not vaccinated / Unknown 146 38 (26.0) 108 (74.0) Ever tested for HBV Yes 178 102 (57.3) 76 (42.7) 20.13 1 <0.001 No 213 71 (33.3) 142 (66.7) Note: Good practice was defined as ≥70% of total practice score (including vaccination, screening, and protective behaviors); poor/moderate practice as <70%. SAR = Saudi Riyal. χ² = chi-squared statistic; df = degrees of freedom.Statistically significant p-values (p < 0.05) are indicated in bold. Table 6 presents the distribution of self-reported preventive behaviours and health-service use related to hepatitis B among the 391 women in Bisha province. Less than half of the participants (45.5%, n=178) reported ever being screened for HBV, while the majority (54.5%, n=213) had never been screened. Of the patients, 40.9% (n = 160) had completed a vaccination schedule (≥3 doses), while 21.7% (n = 85) had received only one or two doses; more than one-third were not vaccinated for HBV (37 %, n =146). With respect to injection safety, 62.7% (n=245) inquired always about a new syringe before an injection, 25.1% (n=98) did so sometimes, and 12.3% (n=48) never asked for one. Regarding blood transfusion safety, 42.2% (n=165) stated they would ask about blood screening before a transfusion, while 47.8% (n=187) would not; 10.0% (n=39) reported that the question was not applicable because they had no history of transfusion. The majority of women did not (68.3%, n=267) report ever participating in any HBV-related health-education activity; only 31.7% (n= 24) reported previous participation. In general, these results show low levels of HBV screening and incomplete vaccination coverage, as well as limited participation in safety-affirming practices within clinical environments among women in Bisha. Furthermore, exposure to structured HBV health education was low, with fewer than one-third of participants reporting prior involvement in such activities. Table 6. Preventive behaviours and health-service use related to hepatitis B (n=391) Preventive Behaviour / Health-Service Use n % Ever screened for hepatitis B Yes 178 45.5 No 213 54.5 HBV vaccination status Not vaccinated 146 37.3 1–2 doses 85 21.7 ≥3 doses (complete schedule) 160 40.9 Ask for new syringe before injection Always 245 62.7 Sometimes 98 25.1 Never 48 12.3 Ask about blood screening before transfusion Yes 165 42.2 No 187 47.8 Not applicable (no history of transfusion) 39 10.0 Participation in any HBV health-education activity Yes 124 31.7 No 267 68.3 Note: Percentages are based on total valid responses (N=391).HBV = Hepatitis B virus. In multivariable logistic regression (table 7), several individual and HBV-related factors remained independently associated with good preventive practice toward hepatitis B among the participating women. Age was not a significant predictor after adjustment, although women aged 35–44 years showed a non-significant trend toward better practice compared with those aged 18–24 years (adjusted OR 1.65, 95% CI 0.90–3.04, p=0.106). Educational level showed a strong gradient, with only postgraduate education retaining an independent association with good practice. Compared with women who had only primary education, those with postgraduate qualifications were almost twelve times more likely to report good preventive practice (adjusted OR 11.76, 95% CI 1.85–83.33, p=0.009), whereas post‑secondary and university education did not reach statistical significance in the adjusted model. Marital status was not associated with preventive practice after adjustment. Cognitive and attitudinal domains were important determinants. Women with good HBV knowledge (score ≥75%) had more than twice the odds of good practice compared with those with poor or moderate knowledge (adjusted OR 2.12, 95% CI 1.40–3.22, p<0.001). Similarly, a positive attitude toward HBV prevention (score ≥80%) was associated with 2.5-fold higher odds of good practice (adjusted OR 2.51, 95% CI 1.64–3.85, p<0.001). Service-related factors showed the strongest associations. Women who had received at least one dose of HBV vaccine were three times more likely to have good preventive practice than unvaccinated women (adjusted OR 3.02, 95% CI 1.88–4.84, p<0.001). Prior exposure to HBV health-education activities was also an independent predictor, with nearly a twofold increase in the odds of good practice (adjusted OR 1.96, 95% CI 1.23–3.13, p=0.005). Although family history of hepatitis was associated with good practice in crude analysis, this association attenuated and lost statistical significance after adjustment (adjusted OR 1.65, 95% CI 0.96–2.84, p=0.071). Overall, these findings indicate that higher education (postgraduate), better HBV knowledge, positive attitudes, vaccination, and prior health-education exposure are key independent drivers of optimal preventive behaviour among women in Bisha province. Table 7. Logistic regression of factors associated with good preventive practice toward hepatitis B (n=391) Predictor Crude OR (95% CI) p-value Adjusted OR (95% CI) p-value Age group (years) 18–24 (Ref) 1.00 – 1.00 – 25–34 1.48 (0.88–2.48) 0.138 1.32 (0.75–2.31) 0.332 35–44 1.91 (1.09–3.35) 0.024 1.65 (0.90–3.04) 0.106 ≥45 1.29 (0.64–2.60) 0.480 1.12 (0.53–2.38) 0.763 Education level Primary (Ref) 1.00 – 1.00 – Post-Secondary 2.98 (0.62–14.29) 0.173 2.45 (0.48–12.42) 0.280 University 4.13 (0.91–18.75) 0.066 3.55 (0.75–16.81) 0.110 Post-Graduate 14.29 (2.38–100.00) 0.004 11.76 (1.85–83.33) 0.009 Marital status Married (Ref) 1.00 – 1.00 – Single 1.04 (0.69–1.56) 0.860 0.95 (0.61–1.49) 0.820 Divorced/Widowed 1.78 (0.82–3.85) 0.145 1.52 (0.66–3.51) 0.326 HBV knowledge level Poor/Moderate (Ref) 1.00 – 1.00 – Good (≥75%) 2.45 (1.66–3.61) <0.001 2.12 (1.40–3.22) <0.001 Attitude level Negative (Ref) 1.00 – 1.00 – Positive (≥80%) 2.89 (1.93–4.35) <0.001 2.51 (1.64–3.85) <0.001 HBV vaccination status Not vaccinated (Ref) 1.00 – 1.00 – Vaccinated (≥1 dose) 3.55 (2.27–5.56) <0.001 3.02 (1.88–4.84) <0.001 Family history of hepatitis No (Ref) 1.00 – 1.00 – Yes 2.00 (1.20–3.33) 0.008 1.65 (0.96–2.84) 0.071 Prior HBV health-education exposure No (Ref) 1.00 – 1.00 – Yes 2.38 (1.54–3.70) <0.001 1.96 (1.23–3.13) 0.005 Note: Good practice = preventive practice score ≥70%. Ref = reference category. OR = odds ratio; CI = confidence interval. Adjusted model includes all variables listed in the table. Statistically significant associations (p < 0.05) are indicated in bold. 4. DISCUSSION In this study, we assessed knowledge, attitudes, and preventive practices regarding hepatitis B virus (HBV) among women in Bisha province, Southern Saudi Arabia. The studies show a significant knowledge–practice gap from the data: most participants demonstrated good knowledge (65.5%) and positive attitudes (69.3%) toward HBV prevention, but fewer than half had good preventive practices (46.8%). This difference is also found in previous KAP studies from Saudi Arabia, which followed the same pattern of high awareness and low uptake rates for protective behaviours like vaccination, screening, and safety measures [24-27]. Our results underscore that knowledge alone is insufficient to drive behavioural change; structural, cultural, and health-system barriers likely impede the translation of awareness into action [21]. A significant positive correlation between education level and knowledge on the topic has been previously reported [23,4]. Higher education is significantly associated with good HBV knowledge and positive attitudes in women, likely due to better health literacy and more access to information sources [20]. Nevertheless, even among university-educated women, only 47.9% had good preventive practice behavior, indicating that this level of education enhances cognizance but cannot remove the barriers to behavioral practice. This underscores the importance of interventions that are not solelyinformation-focused, but also address barriers to vaccine access, stigma, and perceived susceptibility [5]. Occupation was another significant predictor, with health professionals showing the highest levels of knowledge, attitude, and practice. This is expected given their formal training and exposure to health information.[26] Conversely, homemakers—who constituted a large proportion of the sample (44.0%)—consistently demonstrated lower KAP scores. This subgroup may be less exposed to workplace health campaigns, have fewer opportunities for screening, and engage in less autonomous health-seeking behaviour; therefore, highlighting them as a priority subgroup for targeted outreach [27]. The socioeconomic status represented by monthly household income was significantly related to all KAP domains. High-income women also had higher knowledge, a positive attitude, and better practices of health-seeking behaviour, which echoes the fact that resource availability influences health engagement [28]. Financial barriers may limit access to vaccination (if not fully covered), transportation to health facilities, or the ability to prioritise preventive care over immediate economic needs [29]. Good knowledge, positive attitude, and adequate practice were more likely among vaccinated individuals and those whohave tested for HBV in the past. This bi-directionality implies that engagement with health services solidifies bothawareness and motivation, while increased knowledge could lead to increased use of the service [30]. Nevertheless, coverage remains suboptimal: only 40.9% of women were fully vaccinated, and 54.5% had never been screened. These gaps are concerning, given the availability of national vaccination and premarital screening programmes, and indicate deficiencies in programme implementation, counselling, or follow-up.[31]The multivariate analysis identified good knowledge, positive attitude, vaccination receipt, and prior health-education exposure as independent predictors of good preventive practice. This underlines the need for a comprehensive approach to health promotion involving education, advice, and easy access to services. [32] Remarkably, family history of hepatitis was not an independent predictor in the adjusted model, indicating that its effect may be through testing or vaccination rather than practice itself. The low uptake of HBV-related health education (31.7%) indicates a missed opportunity for behaviour change. Community-based education programmes, culturally relevant and delivered through trusted channels to local communities, could bridge the knowledge–practice gap. Strengthening the integration of HBV prevention into routine maternal and reproductive health services could also improve coverage in women during their reproductive years [33,34, 35]. Based on the study's results, we propose specific education, vaccine screening, and tailored outreach interventions to improve HBV prevention among females in Bisha province (Figure 1). Tailored education through trusted sources, services that are accessible both in terms of distance and cost, community networks, and linkages to the health system can bridge the huge gap between knowledge and practice. This multi-pronged approach will directly contribute to reducing HBV transmission and advancing Saudi Arabia's national viral hepatitis elimination targets. Limitations This study has several limitations. It has a cross-sectional design, which precludes causal inference. Self-report practice is possibly subject to social desirability bias. The sample was taken from a single province, which may limit generalisability to other regions of Saudi Arabia. Also, respondents' higher educational attainment than that of the general female population may lead to an overestimation of KAP levels. Validity was enhanced through the use of standardized tools, pilot testing, and trained interviewers. A cross-sectional design limits causal inference, and self-reported practices may be subject to bias. Because the study was limited to one province, it may not be generalizable to other parts of Saudi Arabia. 5. CONCLUSION However, knowledge and attitudes were generally good towards HBV prevention among the women of Bisha, preventive practices are still sub-optimal. Using regression analyses, KAP is found to be highly correlated with education level, occupation, income, vaccination status, and exposure to health education. Public health interventions must close existing inequalities in access to targeted education relative to vaccination/screening services to demonstrate efficacy. Incorporating HBV prevention into existing maternal and primary health care services, as well as community awareness-raising campaigns, is likely to improve uptake and contribute to national and global hepatitis elimination efforts. Abbreviations AOR Adjusted Odds Ratio CI Confidence Interval HBV Hepatitis B Virus KAP Knowledge, Attitudes, and Practices n Number (of participants) OR Odds Ratio Ref Reference Category SAR Saudi Riyal SD Standard Deviation WHO World Health Organization DECLARATION Ethical Considerations: The Research Ethics Committee of the University of Bisha approved the study protocol (UB-RELOC H-06-BH-087/(1808.24). Informed consent was obtained after the study's purpose, procedures, risks, benefits, and confidentiality measures were explained. Data were anonymized and stored in password-protected files accessible only to the research team. Consent to Publish declaration: not applicable. Availability of data and materials: The data used in this study are available on request Competing Interests: None declared Funding: This study was not funded. Authors' contributions: EM conceived and designed the study, supervised data collection and analysis, and led manuscript drafting and revision. SA, AA, BM, AH, AS, AAO, NA, SA, AHQ, SE, MO, and MEI contributed to data collection, data entry, and preliminary analysis, and reviewed the manuscript for important intellectual content. LYH and MEI provided methodological and statistical guidance, contributed to interpretation of findings, and critically revised the manuscript. All authors read and approved the final version of the manuscript and agree to be accountable for all aspects of the work. AI declaration: Artificial intelligence (AI)–assisted tool (Grammarly, 2025, Grammarly Inc. San Francisco, California, USA. ) were used to support language editing, reference formatting, and refinement of the structure of this manuscript. The GPT-5.4 was used to design the graphical abstarct. The authors independently verified all clinical data, interpretations, and references, and take full responsibility for the content and conclusions presented. Acknowledgments: The authors are thankful to the Deanship of Graduate Studies and Scientific Research at University of Bisha for supporting this work through the Fast-Track Research Support Program. REFERENCES Alqahtani M, Alshahrani MM, Alqahtani AA, et al. Exploration of knowledge, attitude, and practice among residents of the Kingdom of Saudi Arabia toward hepatitis viruses. Cureus. 2020;12(12):e12308. World Health Organization. Global health sector strategy on viral hepatitis 2016–2021: towards ending viral hepatitis. Geneva: WHO; 2016. Abdo AA, Sanai FM, Al-Faleh FZ. Epidemiology of viral hepatitis in Saudi Arabia: are we off the hook? Saudi J Gastroenterol. 2012;18(6):349–357. WHO. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Geneva: WHO; 2021. Abdo AA, Al-Awaidy S, Sanai FM, et al. Elimination of mother-to-child transmission of hepatitis B virus in Gulf Cooperation Council countries: current status and future prospects. Am J Trop Med Hyg. 2024;110(1):32–41. Alqahtani JM, Abu-Eshy SA, Mahfouz AA, et al. Knowledge, attitude and practice on hepatitis B: a survey among the internet users in Taif, Kingdom of Saudi Arabia. J Infect Dis Epidemiol. 2017;3(3):36. Alotaibi BS, Alswat KA, Alharbi BM, et al. Awareness of hepatitis B virus screening before marriage and pregnancy among adults in the Al-Baha region, Saudi Arabia. Cureus. 2023;15(12):e52591. Abdo AA, Al-Jubran KM, Sanai FM, et al. Hepatitis B care pathway in Saudi Arabia: current situation, gaps and actions. Saudi J Gastroenterol. 2019;25(2):73–80. Alharbi M, Alhowikan A, Alsaedi A, et al. Awareness of hepatitis B among the general population in Riyadh, Saudi Arabia. Cureus. 2024;16(12):eXXXXX. Alhabdan AM, Alshahrani AA, Alrashed AA, et al. Hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infection among premarital screening individuals in Saudi Arabia. Int J Public Health. 2024;69:1607809. AlAteeq DA, AlQahtani AM, AlDossary NM, et al. Perception of and attitude towards hepatitis B infection among Saudi pregnant females attending antenatal care unit in Al-Ahsa City, Kingdom of Saudi Arabia. Cureus. 2019;11(12):e6395. Alsaleem SA, Alsaleem MA, Asiri AA, et al. Knowledge, attitudes, and practice about hepatitis B infection among primary health care nurses in Buraidah, Qassim Region, Saudi Arabia. J Family Med Prim Care. 2024;13(1):xx–xx. Alrowaily MA, Abolfotouh MA, Ferwanah MS. Hepatitis B virus sero-prevalence among pregnant females in Saudi Arabia. Saudi J Gastroenterol. 2008;14(2):70–72. Alqahtani SI, Alshammari KF, Alanazi HH, et al. Knowledge, attitudes and practices toward prevention of hepatitis B virus infection among medical students at Northern Border University, Arar, Kingdom of Saudi Arabia. J Family Med Prim Care. 2017;6(3):586–593. Alhawiti MM, Alharbi SA, Altuwaym MM, et al. Revealing hepatitis B virus as a silent killer: a call-to-action for Saudi Arabia. Saudi J Gastroenterol. 2021;27(3):147–154. Abuelgasim KA, Alzahrani AM, Almalki AA, et al. Ten years prevalence of hepatitis B infection among women delivering at KAMC-Jeddah and their infants. Int J Adv Res. 2017;5(1):1580–1586. Almalki F, Alraffah YM, Alasiri RA, Dhafar MW, Albogami FM, Alhazmi MN, Alyazidi AM, Alharbi LA, Alotaibi ME. Knowledge, Attitude and Practice Towards Hepatitis B Infection and HBV Vaccine Among the Healthy Population in Makkah, Saudi Arabia. Infection and Drug Resistance. 2025 Dec 31:2153-64. Ministry of Health, Kingdom of Saudi Arabia. Viral Hepatitis National Plan 2025. Riyadh: MOH; 2020. Almutairi WM, Alsharif MA, Al-Mohaithef M. Knowledge, attitudes, and practices regarding hepatitis B infection among women in Riyadh, Saudi Arabia. J Infect Public Health . 2023;16(2):245–251. Alghamdi SA, Alrasheed AA, Alzahrani MH, et al. Disparities between knowledge and practice of hepatitis B prevention among Saudi adults: a national cross-sectional study. Saudi Med J . 2024;45(3):267–274. Al-Hanawi MK, Alsharqi O, Vaidya K. Barriers to hepatitis B screening and vaccination among women in Saudi Arabia: a qualitative study. BMC Women’s Health. 2024;24:112. ul Haq N, Hassali MA, Shafie AA, Saleem F, Farooqui M, Aljadhey H. A cross sectional assessment of knowledge, attitude and practice towards Hepatitis B among healthy population of Quetta, Pakistan. BMC public health. 2012 Dec;12:1-8. Alzahrani FM, Alqahtani SS, Alghamdi RA, et al. The impact of health literacy on hepatitis B knowledge and vaccination uptake in Saudi women. J Educ Health Promot . 2024;13:45. Alotaibi FA, Almalki ZS, Alghamdi AA, et al. Socioeconomic determinants of viral hepatitis knowledge in the Kingdom of Saudi Arabia: evidence from the 2023 National Health Survey. East Mediterr Health J . 2025;31(1):89–97. AlShammari M, AlAli S, Al-Raddadi R. Beyond awareness: strategies to improve hepatitis B vaccination coverage among Saudi women. Vaccine . 2024;42(Suppl 1):A78–A85. AlOtaibi NM, AlHarbi AA, AlQahtani AM. Health professionals as health educators: role in hepatitis B prevention in primary care settings in Saudi Arabia. J Multidiscip Healthc . 2024;17:1123–1132. Alshehri NA, Alenazi HA, Alwadey AM. Health-seeking behaviour and barriers to care among housewives in Saudi Arabia: a mixed-methods study. Saudi J Health Syst Res . 2024;4(2):105–115. Albagshi SM, Alharbi RA, Alomran AS. Income inequality and access to preventive health services: a Saudi national survey analysis. PLOS Glob Public Health . 2024;4(5):e0003456. AlRasheed A, AlMohanna F, AlQahtani K. Financial barriers to hepatitis B vaccination in low-income households in Saudi Arabia. Health Econ Rev . 2025;15:12. AlGhamdi MJ, AlZahrani IA, AlTowiqi MA. Reciprocal relationship between health service use and health knowledge: evidence from hepatitis B screening programs in Saudi Arabia. BMC Health Serv Res . 2024;24:650. Ministry of Health, Kingdom of Saudi Arabia. National Hepatitis B Control Program: Annual Report 2024 . Riyadh: MOH; 2025. AlThaqafi AM, AlHarbi TF, AlZahrani MA. Integrated health promotion for hepatitis B: a cluster-randomized trial in primary care centers in Saudi Arabia. Lancet Reg Health East Mediterr . 2025;28:100650. AlQahtani DA, AlAmri AM, AlJohani NA. Effectiveness of community-based peer education on hepatitis B knowledge and vaccination uptake among women in Saudi Arabia. J Community Health . 2025;50(1):189–197. AlOmar RS, AlSaud AA, AlMutairi GF. The role of social media in health education: a hepatitis B awareness campaign in Saudi Arabia. Digit Health . 2024;10:20552076241255678. AlHarbi NS, AlSudais NM, AlOtaibi MA. Integration of hepatitis B prevention into antenatal care: a stepped-wedge trial in Saudi maternity hospitals. BJOG . 2025;132(3):345–354. Additional Declarations No competing interests reported. Supplementary Files Quationnaire.docx Graphicalabstract.png Graphical abstract Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 05 May, 2026 Reviews received at journal 05 May, 2026 Reviews received at journal 03 May, 2026 Reviews received at journal 27 Apr, 2026 Reviewers agreed at journal 27 Apr, 2026 Reviewers agreed at journal 27 Apr, 2026 Reviewers agreed at journal 27 Apr, 2026 Reviewers agreed at journal 23 Apr, 2026 Reviews received at journal 18 Apr, 2026 Reviewers agreed at journal 16 Apr, 2026 Reviewers invited by journal 15 Apr, 2026 Editor assigned by journal 13 Apr, 2026 Editor invited by journal 23 Mar, 2026 Submission checks completed at journal 20 Mar, 2026 First submitted to journal 20 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9108647","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":627989032,"identity":"3a5dbad3-d108-4634-825a-d14cb6dff30c","order_by":0,"name":"Elhadi Miskeen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2UlEQVRIiWNgGAWjYFACxgbGBiDFz8ADJNlI0SLZQLwWkCYgYXCAWC38YoebP86osMkzvpF7gOFD2WEG+fYD+LVIzk5sk9xwJq3Y7EZeAuOMc4cZDM4k4NdicDuxjfFh2+HEbTdyDJh524BaGAhosb+d2Pzx4b//iZtnALX8BWqR739AwBbpxAbJjQ0HEjdIALUwArUw3CBgiwTQYZIzjiUnzjjzLuFgz7l0HoMbBGzhn53++GNPjV1if3vuwQc/yqzl5PsJ2IICDgAxDwnqR8EoGAWjYBTgAgBkmUoneJ1Y0AAAAABJRU5ErkJggg==","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":true,"prefix":"","firstName":"Elhadi","middleName":"","lastName":"Miskeen","suffix":""},{"id":627989033,"identity":"153f142c-aed4-4791-8d6e-e1d23f02fd88","order_by":1,"name":"Shahad Abdullah Mohammed Alshahrani","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Shahad","middleName":"Abdullah Mohammed","lastName":"Alshahrani","suffix":""},{"id":627989034,"identity":"81840d87-4369-4b36-b5ef-d07d894b3a9d","order_by":2,"name":"Abdullah Alhalafi","email":"","orcid":"","institution":"Family and Community Medicine Department, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Abdullah","middleName":"","lastName":"Alhalafi","suffix":""},{"id":627989035,"identity":"f22b880b-60ae-4413-8ee6-4cc0c770c0ec","order_by":3,"name":"Bayan Mathaf saeed Aloqaybi","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Bayan","middleName":"Mathaf saeed","lastName":"Aloqaybi","suffix":""},{"id":627989037,"identity":"1de5b4e5-9ba6-4c0e-989e-62ddc9186b5f","order_by":4,"name":"Afnan Hezam Alaklabi","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Afnan","middleName":"Hezam","lastName":"Alaklabi","suffix":""},{"id":627989038,"identity":"c48a81aa-2575-403e-8a12-728c0126e012","order_by":5,"name":"Atheer Abdullah Al-Shahrani","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Atheer","middleName":"Abdullah","lastName":"Al-Shahrani","suffix":""},{"id":627989039,"identity":"b79393c3-25f9-4222-8fdd-2d46150950f9","order_by":6,"name":"Afnan Meshal H Alotaibi","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Afnan","middleName":"Meshal H","lastName":"Alotaibi","suffix":""},{"id":627989041,"identity":"7046bfc9-6ecb-4166-9c9c-57ffa234065b","order_by":7,"name":"Norah Ali M Albishi","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Norah","middleName":"Ali M","lastName":"Albishi","suffix":""},{"id":627989045,"identity":"6e1f9f52-4b34-4169-95f6-3f62bb2f30ea","order_by":8,"name":"Sara Saeed Alaklabi","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Sara","middleName":"Saeed","lastName":"Alaklabi","suffix":""},{"id":627989047,"identity":"b78b5fb4-5de8-4e60-9da2-efe700f77e22","order_by":9,"name":"Atheer Hameed Alqarni","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Atheer","middleName":"Hameed","lastName":"Alqarni","suffix":""},{"id":627989048,"identity":"8219ea6d-4296-4fee-be7a-73501f1d7c30","order_by":10,"name":"Suaad Elnour","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Suaad","middleName":"","lastName":"Elnour","suffix":""},{"id":627989052,"identity":"0dd58222-d975-4122-9583-b7421c6302a6","order_by":11,"name":"Mashael Obaid F Alssadi","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Mashael","middleName":"Obaid F","lastName":"Alssadi","suffix":""},{"id":627989054,"identity":"7dd4d9ca-9a2a-4e19-862f-9d70f0fe9ce9","order_by":12,"name":"Azza Elzein","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, Dr. Sulaiman Al Habib Medical Group","correspondingAuthor":false,"prefix":"","firstName":"Azza","middleName":"","lastName":"Elzein","suffix":""},{"id":627989056,"identity":"faadfe3b-de3e-477b-a58c-76634975154b","order_by":13,"name":"Mutasim E. Ibrahim","email":"","orcid":"","institution":"Department of basic sciences, College of Medicine, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Mutasim","middleName":"E.","lastName":"Ibrahim","suffix":""},{"id":627989057,"identity":"a4a68ffb-e17c-43cb-a7c6-4dc6346744f9","order_by":14,"name":"Laila Yahya Alhubaishi","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, Mohammed Bin Rashid University","correspondingAuthor":false,"prefix":"","firstName":"Laila","middleName":"Yahya","lastName":"Alhubaishi","suffix":""}],"badges":[],"createdAt":"2026-03-12 23:08:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9108647/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9108647/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107651764,"identity":"e5366cf7-7749-41b4-874a-70cfa182e177","added_by":"auto","created_at":"2026-04-23 15:10:39","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1102389,"visible":true,"origin":"","legend":"\u003cp\u003eTailored intervention integrate education, vaccination, screening, and outreach to address the identified knowledge-practice gap and improve HBV prevention among women in Bisha\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9108647/v1/d145ddd0c097e1486ec0db07.png"},{"id":107651985,"identity":"28ec6fba-cab8-4493-aafe-777b8b19b121","added_by":"auto","created_at":"2026-04-23 15:11:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1907160,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9108647/v1/460d0234-91a1-4e8a-a225-ef7ce812d1de.pdf"},{"id":107651755,"identity":"76053173-3644-4ab1-8ccb-89616d37e708","added_by":"auto","created_at":"2026-04-23 15:10:35","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":22868,"visible":true,"origin":"","legend":"","description":"","filename":"Quationnaire.docx","url":"https://assets-eu.researchsquare.com/files/rs-9108647/v1/8109448b44c48f0393a13571.docx"},{"id":107651753,"identity":"1eaf6c5e-a6bd-43bd-b560-7394f56c516d","added_by":"auto","created_at":"2026-04-23 15:10:35","extension":"png","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":790596,"visible":true,"origin":"","legend":"\u003cp\u003eGraphical abstract\u003c/p\u003e","description":"","filename":"Graphicalabstract.png","url":"https://assets-eu.researchsquare.com/files/rs-9108647/v1/504fca7c5ebd24b3c80e5273.png"}],"financialInterests":"No competing interests reported.","formattedTitle":"Conceptual framework of factors influencing Hepatitis B preventive awareness and behaviors among Saudi women","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eHepatitisB virus (HBV) infection is one of the important public health challenges globally. Notably, despite the availability of vaccines and antiviral therapies to treat this useful prototype for prevention, it remains a major contributor to preventable liver-related morbidity and mortality [1\u0026ndash;3]. In this context, improving preventive behaviour\u0026mdash;particularly vaccination, safe practices, and screening\u0026mdash;is central to achieving the World Health Organization (WHO) viral hepatitis elimination targets by 2030, which emphasize reducing new infections and deaths through comprehensive prevention, testing, and treatment strategies [2,4].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe fact that chronic HBV infection is characterized by a prolonged period without symptoms before progression to advanced liver disease suggests the need for primary prevention as well as early detection through routine screening of at-risk groups, including women of reproductive age [3,4,5]. In many societies, women are the primary decision-makers for family health and caregivers; therefore, their knowledge, attitudes, and practices in relation to HBV prevention can strongly influence uptake of vaccination, screening, and safe behaviours within families and communities [1,6,7].\u003c/p\u003e\n\u003cp\u003eSaudi Arabia has undergone a marked epidemiological transition in HBV burden over the last three decades, after the introduction of universal HBV vaccination into the national childhood immunization programme in 1989 and subsequent coverage scaling up [3,5,8]. This policy, along with premarital screening programmes and improvements in infection control, has led to a decline in HBV prevalence, especially among younger age cohorts [5,8,9]. Nevertheless, HBV remains an important notifiable viral infection in the Kingdom, and incident cases continue to occur, particularly among adults born before the full implementation of the national vaccination programme or with incomplete vaccine coverage [3,5,9,10].\u003c/p\u003e\n\u003cp\u003eWomen in Saudi Arabia constitute a key target group for HBV prevention because of their potential exposure during reproductive events and their influence on family health behaviours [6\u0026ndash;8,11]. Vertical transmission has a strong potential for chronic infection and, therefore, premarital and antenatal screening along with counseling for risk groups as well as timely immunoprophylaxis areessential interventions needed to break the cycle of transmission [4,5,11\u0026ndash;13]. To better comprehend and prevent their exposure to HBV during their reproductive years, it is important to address the diverse means of such exposure, including medical procedures, cosmetic practices, and household contact with infected family members [1,6,7,11].\u003c/p\u003e\n\u003cp\u003eRecent Saudi studies indicate that awareness and preventive behaviours regarding HBV among the general public remain suboptimal, with significant gaps in knowledge about transmission routes, complications, and the benefits of vaccination and screening [1,6,7,9,10]. Moderate overall knowledge and attitudes towards viral hepatitis were documented in a national study of Saudi Arabian residents. However, several participants had misconceptions regarding non-blood-borne transmission pathways and were unaware of effective vaccines and curative therapies for certain viral hepatitis types [1]. Additionally, stigma and fear related to hepatitis infection may disincentivize people from getting tested or disclosing their status, thus diminishing the potential impact of existing preventive services [1,9,10].\u003c/p\u003e\n\u003cp\u003eStudies among health care providers and student groups expected to have higher baseline knowledge have documented only moderate levels of HBV-related knowledge and suboptimal vaccination coverage, suggesting that even among educated populations, preventive behaviour is not uniformly adequate [12,14]. These findings raise concern that lay women in the community, particularly those in smaller cities and rural areas, may have even lower levels of knowledge and engagement in HBV preventive practices [6,7,11].\u003c/p\u003e\n\u003cp\u003eWomen\u0026rsquo;s HBV-related preventive behaviour is influenced by multiple interrelated factors, including socio-demographic characteristics (age, education, income, marital status), health literacy, cultural beliefs, and access to health information and services [6,7,10,11]. In the Al-Baha region of Saudi Arabia, a recent study of adults\u0026rsquo; awareness of HBV screening before marriage and pregnancy revealed that although many participants had heard of HBV, detailed knowledge of transmission, complications, and the importance of premarital and antenatal screening was limited, and screening uptake was far from universal [7]. Women\u0026rsquo;s awareness and preventive practices in that study were significantly associated with educational level and prior exposure to health education messages, underscoring the critical role of targeted health promotion and counselling [7,10,11].\u003c/p\u003e\n\u003cp\u003eIn addition to socio-demographic and informational determinants, health system and policy-related factors shape preventive behaviour. Saudi Arabia\u0026rsquo;s premarital screening programme\u0026mdash;originally designed to reduce hereditary haemoglobinopathies\u0026mdash;has been expanded to include certain infectious diseases, including HBV, offering an opportunity to identify and counsel couples before marriage [8,9,15]. However, the effectiveness of such programmes in changing behaviour depends on the quality of counselling, women\u0026rsquo;s autonomy in health decision-making, and the availability and accessibility of follow-up services such as vaccination and specialist referral [3,7,9,15]. Moreover, in areas distant from major urban centres, geographic and logistical barriers may limit women\u0026rsquo;s access to preventive services, despite the existence of national policies and guidelines [3,8,9].\u003c/p\u003e\n\u003cp\u003eBisha province, located in the southern region of Saudi Arabia, represents a semi-urban and rural catchment area with a growing population and diverse socio-cultural characteristics [16]. Published data specifically focusing on HBV awareness and preventive behaviour among women in Bisha are scarce, and much of the available evidence on HBV knowledge and practices in Saudi Arabia comes from larger cities or specific professional groups [1,6,7,10\u0026ndash;12,14]. This paucity of localized data hampers the ability of regional health authorities and primary care providers to design context-appropriate interventions to improve HBV prevention among women in this area [7,11,16].\u003c/p\u003e\n\u003cp\u003eWith\u0026nbsp;national and global commitments to\u0026nbsp;address\u0026nbsp;the burden of viral hepatitis, and\u0026nbsp;given\u0026nbsp;that the strategic importance of women\u0026rsquo;s health will\u0026nbsp;touch\u0026nbsp;on\u0026nbsp;all\u0026nbsp;relevant\u0026nbsp;risk\u0026nbsp;factors\u0026nbsp;needed\u0026nbsp;to\u0026nbsp;meet\u0026nbsp;these goals, there is a local need for\u0026nbsp;new, community-based studies\u0026nbsp;within\u0026nbsp;under-researched regions in Saudi Arabia [3\u0026ndash;5,8,15\u0026ndash;21].\u0026nbsp;We\u0026nbsp;will\u0026nbsp;provide\u0026nbsp;context-specific evidence to support\u0026nbsp;better\u0026nbsp;public health planning, primary care practice, and community outreach\u0026nbsp;interventions\u0026nbsp;in the southern region\u0026nbsp;by\u0026nbsp;investigating\u0026nbsp;factors influencing preventive behaviour towards HBV among women in Bisha province.\u003c/p\u003e\n\u003cp\u003eThe objective of this study is to assess the knowledge, attitudes, and preventive practices related to the hepatitis B virus among non-pregnant Saudi women in Bisha province and to generate context-specific evidence to inform targeted HBV prevention interventions in this population.\u003c/p\u003e"},{"header":"2. METHODOLOGY","content":"\u003cp\u003e\u003cstrong\u003e2.1 Study Setting and Design:\u0026nbsp;\u003c/strong\u003eThis is a cross-sectional analytic study conducted in a community setting. The study involved eligible women from the Bisha province in Saudi Arabia\u0026apos;s southern region. It was conducted over 14 months, between January 2025 and February 2026.\u0026nbsp;Bisha is a semi-urban and rural catchment area with diverse socio-cultural characteristics,\u0026nbsp;where\u0026nbsp;previous\u0026nbsp;research on HBV awareness\u0026nbsp;has\u0026nbsp;been\u0026nbsp;limited, and the population is\u0026nbsp;rapidly\u0026nbsp;growing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Study Population and Sampling:\u0026nbsp;\u003c/strong\u003eThe target population consisted of non-pregnant Saudi women aged 18 years and older who had been residing in Bisha province for at least six months. Women with cognitive or communication impairments or who declined to participate were excluded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Sampling technique (A multistage sampling):\u0026nbsp;\u003c/strong\u003eThis\u0026nbsp;sampling\u0026nbsp;method\u0026nbsp;was\u0026nbsp;developed\u0026nbsp;in\u0026nbsp;3\u0026nbsp;stages: (1) Bisha province\u0026nbsp;for\u0026nbsp;this\u0026nbsp;study\u0026nbsp;was\u0026nbsp;divided\u0026nbsp;according to official administrative divisions, into urban (Bisha city) and suburban/rural\u0026nbsp;clusters; (2) within each cluster, households were selected from updated municipal lists using a random start and fixed interval\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4 The sample size\u0026nbsp;\u003c/strong\u003eThe sample was calculated using the formula:\u003c/p\u003e\n\u003cp\u003en=Z2\u0026times;p(1\u0026minus;p)d2n=d2Z2\u0026times;p(1\u0026minus;p)\u003c/p\u003e\n\u003cp\u003eAssuming a prevalence (p) of good HBV knowledge of 50% (to maximize sample size), a 95% confidence level (Z = 1.96), and a margin of error (d) of 5%, the minimum required sample size was 384. To account for potential non-response (10%), 425 women were approached, and 391 completed the survey (response rate: 92%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5 Data Collection Tool and Procedure:\u0026nbsp;\u003c/strong\u003eWe\u0026nbsp;developed a structured, interviewer-administered Arabic questionnaire based on\u0026nbsp;a\u0026nbsp;literature review and\u0026nbsp;validated KAP\u0026nbsp;instruments\u0026nbsp;for HBV.\u0026nbsp;A panel of public health and hepatology experts\u0026nbsp;assessed\u0026nbsp;the questionnaire for content validity, and it was piloted\u0026nbsp;with\u0026nbsp;30 women (not included in the final sample) to\u0026nbsp;evaluate\u0026nbsp;clarity, reliability (Cronbach\u0026apos;s alpha \u0026gt;0.75 for all scales), and cultural\u0026nbsp;acceptability. We made modifications on previous quationnaire [22]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.6 Instrument:\u0026nbsp;\u003c/strong\u003eThe final survey instrument was structured into six comprehensive sections: (1) sociodemographic details, including age, marital status, education level, occupation, monthly income, place of residence, and family history of hepatitis; (2) knowledge about HBV, comprising 20 items that assessed understanding of transmission routes, symptoms, complications, prevention methods, and vaccination, with a total score ranging from 0 to 20; (3) attitude toward HBV prevention, measured through 8 items on a 5-point Likert scale (from strongly disagree to strongly agree) evaluating perceptions of disease severity, personal susceptibility, and the benefits of preventive actions, yielding a score between 0 and 8; (4) preventive behaviors including 10 items documenting vaccination uptake, history of screening, injection safety (Behaviors related to injecting drug use), receiving blood transfusions in the past and avoiding high-risk activities weresummed for a score ranging from 0 to 10; (5) health-service utilization where Participants response on testing history, HBV vaccination status, participation in health-education activity was evaluated; and (6) sources of information. The data collected included an open-ended question. Ethical principles were followed, and interviews were carried out by female research data collectors who were trained and had a background in nursing or public health.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.7 Scoring and Operational Definitions:\u0026nbsp;\u003c/strong\u003eGood knowledge was defined as a score \u0026amp;ge;75% (\u0026ge;15/20) on the knowledge assessment. From the responses, an overallpositive attitude was defined as 80% or higher score (\u0026ge;6.4/8), and for evaluation purposes, it was rounded to a publishableevaluating form of \u0026ge;6. Correct preventive behaviour indicates being at least \u0026ge;7/10 of the prevention scale inpractice. Vaccination statuses were differentiated into (\u0026ge;3 doses- fully vaccinated), unvaccinated, (1\u0026ndash;2 doses-partially vaccinated). Socioeconomic status was determined according to the reported monthly household income: low (10,000 SAR).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.8 Data Analysis:\u0026nbsp;\u003c/strong\u003eData were analysed by STATA version 19 (2025). Besides, descriptive statistics and bivariate analyses were employed to test associations between sociodemographic variables and levels of HBV knowledge, attitude, and practice using chi-square tests. To determine predictors, we used binary logistic regression for the good preventive practice. In the first multivariate model, all variables with a p-value less than 0.20 from the bivariate analysis were included, and a backward stepwise selection was used for the statistically significant predictors (p \u0026lt; 0.05) in the final model. RESULTS are reported as AOR (adjusted odds ratios) and 95 % confidence intervals (CIs). However, all statistical tests were two-tailed, and a p-value\u0026lt;0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"3. RESULT","content":"\u003cp\u003eThe sociodemographic composition of the 391 participating women from Bisha province is detailed in Table 1. The cohort was predominantly of reproductive age, with 201 (51.4%) married and 167 (42.7%) single. A high educational status was noted, with 288 (73.7%) of the women being tertiary-educated. By occupation, 172 (44.0%) were found to be homemakers and 107 (27.4%) students, together constituting the majority of the respondents. Geographically, the sample was biased toward the urban center, with 317 (81.1%) residing in the city of Bisha. Additionally, 72 (18.4%) of the participants reported a family history of hepatitis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Sociodemographic Characteristics of the participants (=391)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"618\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e167 (42.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e201 (51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation Level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11 (2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e81 (20.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e288 (73.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Graduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHousewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e172 (44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEducation Sector\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32 (8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHealth Professional\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBanking and business\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMilitary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37 (9.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e107 (27.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBisha\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e317 (81.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBisha suburb\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily History of Hepatitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e72 (18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot Present\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e319 (81.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2 shows that the overall level of knowledge about hepatitis B among women in Bisha was relatively high, with a mean knowledge score of 15.2 \u0026plusmn; 3.4 (out of 20) and a median of 16; nearly two-thirds of participants, 256 women (65.5%), were classified as having good knowledge, whereas only 36 (9.2%) fell into the poor knowledge category. Attitudes toward hepatitis B prevention were also generally favorable, as reflected by a mean attitude score of 5.9 \u0026plusmn; 1.6 (out of 8), with 271 women (69.3%) demonstrating positive attitudes and fewer than 10 (9.7%) reporting negative attitudes. In contrast, preventive practices lagged behind knowledge and attitudes. However, the mean practice score was 6.7 \u0026plusmn; 2.1 (out of 10), and fewer than half of the women (183, 46.8%) exhibited good preventive practices. In comparison, 76 (19.4%) reported poor practice levels, indicating a clear knowledge-practice and attitude-practice gap that warrants targeted behavioural and service-level interventions.\u003c/p\u003e\n\u003cp\u003eTogether, these findings indicate a clear knowledge-practice and attitude-practice gap: the large majority of women are knowledgeable regarding hepatitis B and have generally positive attitudes towards its prevention; however, a considerable number still fail to engage in sufficient protective behaviours both in everyday life and when accessing healthcare settings.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis disconnect implies structural, cultural, or service-based barriers. require more than information provision to result in behaviour change, mirroring barriers such as limited access to vaccination, inadequate salutogenic counselling during health encounters, perceived low personal risk (to disease), and competing priorities. This calls for a larger role for interventions that will ensure behavioural support, empowerment, and service delivery to promote action beyond information.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eKnowledge, attitude and practice scores toward hepatitis B among women in Bisha (n = 391)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDomain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003escore range\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMax\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCategory definition*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en (%)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003egood / positive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en (%)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003efair / neutral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en (%)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003epoor / negative\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eKnowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u0026ndash;20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.2 \u0026plusmn; 3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16 (13\u0026ndash;18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGood \u0026ge;75% (\u0026ge;15); Fair 50\u0026ndash;74% (10\u0026ndash;14); Poor \u0026lt;50% (\u0026lt;10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e256 (65.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e99 (25.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAttitude\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u0026ndash;8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.9 \u0026plusmn; 1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (5\u0026ndash;7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePositive \u0026ge;75% (\u0026ge;6); Neutral 50\u0026ndash;74% (4\u0026ndash;5); Negative \u0026lt;50% (\u0026lt;4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e271 (69.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82 (21.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38 (9.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePractice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u0026ndash;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.7 \u0026plusmn; 2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (5\u0026ndash;8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGood \u0026ge;75% (\u0026ge;8); Fair 50\u0026ndash;74% (5\u0026ndash;7); Poor \u0026lt;50% (\u0026lt;5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e183 (46.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e132 (33.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e76 (19.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eKnowledge of hepatitis B virus (HBV) was dichotomized into \u0026ldquo;good knowledge\u0026rdquo; (scoring \u0026ge;75% of the total knowledge score) and \u0026ldquo;poor/moderate knowledge\u0026rdquo; (scoring \u0026lt;75%). Table 3 summarizes the associations between sociodemographic characteristics and HBV knowledge.\u003c/p\u003e\n\u003cp\u003eSeveral sociodemographic and HBV-related variables were significantly associated with knowledge level in univariate analysis.\u003c/p\u003e\n\u003cp\u003eHigher education level had a strong positive correlation with HBV knowledge (p \u0026lt; 0.001). Objective: To find the prevalence of elements of knowledge about smoking in adolescents and to assess their relationship with socioeconomicstatus, health, and substance use. Women with University education represent the largest subgroup (n=288), and 50.3% ofthem were knowledgeable.\u003c/p\u003e\n\u003cp\u003eOccupation was also significantly linked to knowledge (p \u0026lt; 0.001). Health professionals reported the highest rate of good knowledge (75.0%), followed by individuals working in the education sector (62.5%). In contrast, homemakers showed the lowest proportion (37.8%).\u003c/p\u003e\n\u003cp\u003eThere was a positive association of monthly household income with HBV knowledge (10,000 Saudi Riyals (SAR) per month). Good knowledge was observed in 57.0%, while it was 49.7% for the middle-income group(5,000\u0026ndash;10,000 SAR), and itwas only 37.6% for the low-income group (\u0026lt;5,000 SAR).\u003c/p\u003e\n\u003cp\u003ePersonal and familial exposure to hepatitis significantly influenced knowledge levels. Women with a family history of hepatitis were more likely to possess good knowledge (58.3%) compared to those without such a history (47.6%) (p = 0.040).\u003c/p\u003e\n\u003cp\u003eKnowledge was also strongly associated with engagement in preventive health behaviors. The knowledge amongvaccinated women (55.1%) was significantly higher than that of unvaccinated or status-unknown women (39.7%) (p = 0.001). Likewise, female HBV ever tested subjects had significantly better knowledge (57.3%) compared with those not tested (42.7%, p \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003eKnowledge level was associated with age group (p = 0.077), marital status (p = 0.163), and residence place (urban vs. suburban, p = 0.055). While there were some minor differences in numbers between these categories, they did not achieve statistical significance based on chi-square analysis. Higher educational attainment, employment in the health or education sectors, greater household income, family history of hepatitis, prior HBV vaccination, and HBV testing were all positively and significantly associated with good knowledge of hepatitis B among women in Bisha province. In contrast, age, marital status, and residential location did not show significant associations with knowledge level in this sample.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eAssociation between sociodemographic characteristics and knowledge level about hepatitis B (n=391)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood knowledge (\u0026ge;75%) n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor/Moderate knowledge (\u0026lt;75%) n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u0026sup2;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003edf\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18\u0026ndash;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45 (40.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e65 (59.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25\u0026ndash;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e70 (49.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e72 (50.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35\u0026ndash;44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e52 (56.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40 (43.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (42.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27 (57.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e78 (46.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89 (53.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95 (47.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e106 (52.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (37.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (42.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 (81.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35 (43.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e46 (56.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e145 (50.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e143 (49.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Graduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHousewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e65 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e107 (62.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEducation Sector\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (37.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHealth Professional\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18 (75.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBanking and business\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10 (52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 (47.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMilitary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (54.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17 (45.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e58 (54.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e49 (45.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBisha city\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e156 (49.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e161 (50.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBisha suburb\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31 (41.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e43 (58.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonthly income (SAR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;5,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32 (37.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e53 (62.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5,000\u0026ndash;10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92 (49.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e93 (50.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e69 (57.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e52 (43.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily history of hepatitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42 (58.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30 (41.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.040\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot present\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e319\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e152 (47.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e167 (52.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHBV vaccination status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVaccinated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e245\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e135 (55.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e110 (44.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot vaccinated / Unknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e58 (39.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88 (60.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver tested for HBV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e102 (57.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e76 (42.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e91 (42.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e122 (57.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eGood knowledge was defined as \u0026ge;75% of total knowledge score; poor/moderate knowledge as \u0026lt;75%. \u0026nbsp;SAR = Saudi Riyal. \u0026chi;\u0026sup2; = chi-squared statistic; df = degrees of freedom. Statistically significant p-values (p \u0026lt; 0.05) are indicated in \u003cstrong\u003ebold\u003c/strong\u003e.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAttitude toward hepatitis B was categorized as \u0026ldquo;positive\u0026rdquo; (scoring \u0026ge;80% of the total attitude score) or \u0026ldquo;negative\u0026rdquo; (scoring \u0026lt;80%). Table 4 presents the associations between sociodemographic characteristics and attitude level among the 391 participants from Bisha province. Education level was significantly associated with attitude toward HBV (p = 0.001). Positive attitude was highest among postgraduates (88.9%) and university-educated participants (66.0%), while only 36.4% of those with primary education expressed a positive attitude. Occupation also showed a significant relationship with attitude (p = 0.007). Health professionals exhibited the most favorable attitude (83.3% positive), followed by individuals in the education sector (75.0%). Housewives reported the lowest proportion of positive attitude (57.0%). Monthly income was positively correlated with attitude (p = 0.009). Among women earning \u0026gt;10,000 SAR, 72.7% held a positive attitude, compared to 64.9% in the middle-income group and 52.9% in the low-income group. A positive attitude was more prevalent among vaccinated women (69.4%) than those unvaccinated or unsure (54.1%) (p = 0.001). Likewise, among women with a history of HBV testing, the proportion with a positive attitude was significantly higher (71.9% vs 56.8%) than those who had never been tested before (p \u0026lt; 0.001). No statistically significant differences in attitude were observed across age groups (p = 0.207), marital status (p = 0.504), residence (urban vs. suburban, p = 0.346), or family history of hepatitis(p = 0.073), although women with a family history showed a numerically higher proportion of positive attitude (72.2%). Higher educational level, employment in the health or education sectors, greater household income, prior HBV vaccination, and prior HBV testing were all significantly associated with a positive attitude toward hepatitis B among women in Bisha province. In contrast, age, marital status, place of residence, and family history of hepatitis did not significantly influence attitude level in this sample.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003eAssociation between sociodemographic characteristics and attitude level toward hepatitis B (n=391)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePositive attitude (\u0026ge;80%) n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative attitude (\u0026lt;80%) n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u0026sup2;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003edf\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18\u0026ndash;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e68 (61.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42 (38.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.207\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25\u0026ndash;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e90 (63.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e52 (36.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35\u0026ndash;44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e65 (70.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27 (29.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28 (59.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19 (40.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e108 (64.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e59 (35.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.504\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e125 (62.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e76 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (75.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5 (71.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (63.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48 (59.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33 (40.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e190 (66.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e98 (34.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Graduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHousewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e98 (57.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74 (43.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.007\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEducation Sector\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (75.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHealth Professional\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (83.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBanking and business\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (63.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (36.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMilitary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25 (67.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (32.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e75 (70.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32 (29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBisha city\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e205 (64.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e112 (35.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.346\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBisha suburb\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44 (59.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30 (40.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonthly income (SAR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;5,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45 (52.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40 (47.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5,000\u0026ndash;10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e120 (64.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e65 (35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33 (27.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily history of hepatitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e52 (72.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (27.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.073\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot present\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e319\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e197 (61.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e122 (38.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHBV vaccination status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVaccinated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e245\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e170 (69.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e75 (30.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot vaccinated / Unknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e79 (54.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e67 (45.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver tested for HBV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e128 (71.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50 (28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e121 (56.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92 (43.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eNote:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePositive attitude was defined as \u0026ge;80% of total attitude score; negative attitude as \u0026lt;80%. SAR = Saudi Riyal. \u0026nbsp;\u0026chi;\u0026sup2; = chi-squared statistic; df = degrees of freedom. Statistically significant p-values (p \u0026lt; 0.05) are indicated in \u003cstrong\u003ebold\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eHepatitis B preventive practice differed markedly by sociodemographic and HBV-related characteristics (Table 5). The highest proportion of good practice was observed in women aged 35\u0026ndash;44 years (52.2%), followed by (36.4%) among those aged 18\u0026ndash;24 years and (42.6%) among those aged \u0026ge;45 years, with a significant association between age group and level of practice (p=0.026). On the other hand, the importance of marital status and place of residence (Bisha city vs suburb) had no significant association with preventive practice (p=0.207 and p=0.118, respectively).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere was a strong positive gradient of HBV preventive practice by education level. Only 18.2% of women with primary education reached good practice, rising to 39.5% in the post-secondary educational level, 47.9% among university graduates, and up to 77.8% for women with postgraduate qualifications (p10,000 SAR, p=0.002). The percentage of women reporting good practice was higher among women whose family had a history of hepatitis than in those who did not have that history (58.3% vs. 41.1%, p=0.003).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePreventive practices were most strongly associated with HBV-related service use. Overall, 55.1% of vaccinated women demonstrated good practice, compared with only 26.0% of unvaccinated or undecided women (p\u0026lt;0.001). Likewise, 57.3% women with past testing for HBV had good practice compared to 33.3% of those without testing (p\u0026lt;0.001). These outcomesindicate that tertiary education, employment in healthcare professionals, high monthly income, family history of hepatitis B, and a previous contact with vaccination and screening services act as determinants leading to adequate HBV preventive behaviours among women living in the context of Bisha province.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u003c/strong\u003e. Association between sociodemographic characteristics and preventive practice toward hepatitis B (n=391)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood practice (\u0026ge;70%) n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor/Moderate practice (\u0026lt;70%) n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u0026sup2;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003edf\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18\u0026ndash;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40 (36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e70 (63.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25\u0026ndash;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e65 (45.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e77 (54.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35\u0026ndash;44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48 (52.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44 (47.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (42.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27 (57.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e72 (43.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95 (56.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.207\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85 (42.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e116 (57.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (37.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (42.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 (81.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32 (39.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e49 (60.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e138 (47.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e150 (52.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Graduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (77.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHousewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e65 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e107 (62.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEducation Sector\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18 (56.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14 (43.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHealth Professional\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18 (75.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBanking and business\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10 (52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 (47.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMilitary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (54.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17 (45.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e52 (48.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e55 (51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBisha city\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e145 (45.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e172 (54.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBisha suburb\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e46 (62.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonthly income (SAR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;5,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28 (32.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e57 (67.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5,000\u0026ndash;10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85 (45.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100 (54.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e68 (56.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e53 (43.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily history of hepatitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42 (58.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30 (41.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot present\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e319\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e131 (41.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e188 (58.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHBV vaccination status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVaccinated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e245\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e135 (55.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e110 (44.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot vaccinated / Unknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38 (26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e108 (74.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver tested for HBV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e102 (57.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e76 (42.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e71 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e142 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eNote:\u0026nbsp;\u003c/strong\u003eGood practice was defined as \u0026ge;70% of total practice score (including vaccination, screening, and protective behaviors); poor/moderate practice as \u0026lt;70%.\u0026nbsp;SAR = Saudi Riyal.\u0026nbsp;\u0026chi;\u0026sup2; = chi-squared statistic; df = degrees of freedom.Statistically significant p-values (p \u0026lt; 0.05) are indicated in\u0026nbsp;bold.\u003c/p\u003e\n\u003cp\u003eTable 6 presents the distribution of self-reported preventive behaviours and health-service use related to hepatitis B among the 391 women in Bisha province. Less than half of the participants (45.5%, n=178) reported ever being screened for HBV, while the majority (54.5%, n=213) had never been screened. Of the patients, 40.9% (n = 160) had completed a vaccination schedule (\u0026ge;3 doses), while 21.7% (n = 85) had received only one or two doses; more than one-third were not vaccinated for HBV (37 %, n =146). With respect to injection safety, 62.7% (n=245) inquired always about a new syringe before an injection, 25.1% (n=98) did so sometimes, and 12.3% (n=48) never asked for one. Regarding blood transfusion safety, 42.2% (n=165) stated they would ask about blood screening before a transfusion, while 47.8% (n=187) would not; 10.0% (n=39) reported that the question was not applicable because they had no history of transfusion. The majority of women did not (68.3%, n=267) report ever participating in any HBV-related health-education activity; only 31.7% (n= 24) reported previous participation. In general, these results show low levels of HBV screening and incomplete vaccination coverage, as well as limited participation in safety-affirming practices within clinical environments among women in Bisha. Furthermore, exposure to structured HBV health education was low, with fewer than one-third of participants reporting prior involvement in such activities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6.\u003c/strong\u003e Preventive behaviours and health-service use related to hepatitis B (n=391)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreventive Behaviour / Health-Service Use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver screened for hepatitis B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e54.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHBV vaccination status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot vaccinated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u0026ndash;2 doses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;3 doses (complete schedule)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAsk for new syringe before injection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e245\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e62.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAsk about blood screening before transfusion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot applicable (no history of transfusion)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eParticipation in any HBV health-education activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e68.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote:\u0026nbsp;Percentages are based on total valid responses (N=391).HBV = Hepatitis B virus.\u003c/p\u003e\n\u003cp\u003eIn multivariable logistic regression (table 7), several individual and HBV-related factors remained independently associated with good preventive practice toward hepatitis B among the participating women. Age was not a significant predictor after adjustment, although women aged 35\u0026ndash;44 years showed a non-significant trend toward better practice compared with those aged 18\u0026ndash;24 years (adjusted OR 1.65, 95% CI 0.90\u0026ndash;3.04, p=0.106).\u003c/p\u003e\n\u003cp\u003eEducational level showed a strong gradient, with only postgraduate education retaining an independent association with good practice. Compared with women who had only primary education, those with postgraduate qualifications were almost twelve times more likely to report good preventive practice (adjusted OR 11.76, 95% CI 1.85\u0026ndash;83.33, p=0.009), whereas post‑secondary and university education did not reach statistical significance in the adjusted model. Marital status was not associated with preventive practice after adjustment.\u003c/p\u003e\n\u003cp\u003eCognitive and attitudinal domains were important determinants. Women with good HBV knowledge (score \u0026ge;75%) had more than twice the odds of good practice compared with those with poor or moderate knowledge (adjusted OR 2.12, 95% CI 1.40\u0026ndash;3.22, p\u0026lt;0.001). Similarly, a positive attitude toward HBV prevention (score \u0026ge;80%) was associated with 2.5-fold higher odds of good practice (adjusted OR 2.51, 95% CI 1.64\u0026ndash;3.85, p\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003eService-related factors showed the strongest associations. Women who had received at least one dose of HBV vaccine were three times more likely to have good preventive practice than unvaccinated women (adjusted OR 3.02, 95% CI 1.88\u0026ndash;4.84, p\u0026lt;0.001). Prior exposure to HBV health-education activities was also an independent predictor, with nearly a twofold increase in the odds of good practice (adjusted OR 1.96, 95% CI 1.23\u0026ndash;3.13, p=0.005). Although family history of hepatitis was associated with good practice in crude analysis, this association attenuated and lost statistical significance after adjustment (adjusted OR 1.65, 95% CI 0.96\u0026ndash;2.84, p=0.071). Overall, these findings indicate that higher education (postgraduate), better HBV knowledge, positive attitudes, vaccination, and prior health-education exposure are key independent drivers of optimal preventive behaviour among women in Bisha province.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7.\u003c/strong\u003e Logistic regression of factors associated with good preventive practice toward hepatitis B (n=391)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePredictor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCrude OR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted OR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18\u0026ndash;24 (Ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25\u0026ndash;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.48 (0.88\u0026ndash;2.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.32 (0.75\u0026ndash;2.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.332\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35\u0026ndash;44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.91 (1.09\u0026ndash;3.35)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.024\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.65 (0.90\u0026ndash;3.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.106\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.29 (0.64\u0026ndash;2.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.12 (0.53\u0026ndash;2.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.763\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrimary (Ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.98 (0.62\u0026ndash;14.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.45 (0.48\u0026ndash;12.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.280\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.13 (0.91\u0026ndash;18.75)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.066\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.55 (0.75\u0026ndash;16.81)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.110\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Graduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e14.29 (2.38\u0026ndash;100.00)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e11.76 (1.85\u0026ndash;83.33)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried (Ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.04 (0.69\u0026ndash;1.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.860\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.95 (0.61\u0026ndash;1.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.820\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDivorced/Widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.78 (0.82\u0026ndash;3.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.52 (0.66\u0026ndash;3.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.326\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHBV knowledge level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePoor/Moderate (Ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGood (\u0026ge;75%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.45 (1.66\u0026ndash;3.61)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.12 (1.40\u0026ndash;3.22)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNegative (Ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePositive (\u0026ge;80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.89 (1.93\u0026ndash;4.35)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.51 (1.64\u0026ndash;3.85)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHBV vaccination status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot vaccinated (Ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVaccinated (\u0026ge;1 dose)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.55 (2.27\u0026ndash;5.56)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.02 (1.88\u0026ndash;4.84)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily history of hepatitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo (Ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.00 (1.20\u0026ndash;3.33)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.008\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.65 (0.96\u0026ndash;2.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrior HBV health-education exposure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo (Ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.38 (1.54\u0026ndash;3.70)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.96 (1.23\u0026ndash;3.13)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eNote:\u003c/strong\u003e Good practice = preventive practice score \u0026ge;70%. Ref = reference category. OR = odds ratio; CI = confidence interval. Adjusted model includes all variables listed in the table. \u0026nbsp;Statistically significant associations (p \u0026lt; 0.05) are indicated in bold.\u003c/p\u003e"},{"header":"4. DISCUSSION","content":"\u003cp\u003eIn this study, we assessed knowledge, attitudes, and preventive practices regarding hepatitis B virus (HBV) among women in Bisha province, Southern Saudi Arabia. The studies show a significant knowledge\u0026ndash;practice gap from the data: most participants demonstrated good knowledge (65.5%) and positive attitudes (69.3%) toward HBV prevention, but fewer than half had good preventive practices (46.8%). This difference is also found in previous KAP studies from Saudi Arabia, which followed the same pattern of high awareness and low uptake rates for protective behaviours like vaccination, screening, and safety measures [24-27]. Our results underscore that knowledge alone is insufficient to drive behavioural change; structural, cultural, and health-system barriers likely impede the translation of awareness into action [21].\u003c/p\u003e\n\u003cp\u003eA significant positive correlation between education level and knowledge on the topic has been previously reported [23,4]. Higher education is significantly associated with good HBV knowledge and positive attitudes in women, likely due to better health literacy and more access to information sources [20]. Nevertheless, even among university-educated women, only 47.9% had good preventive practice behavior, indicating that this level of education enhances cognizance but cannot remove the barriers to behavioral practice. This underscores the importance of interventions that are not solelyinformation-focused, but also address barriers to vaccine access, stigma, and perceived susceptibility [5].\u003c/p\u003e\n\u003cp\u003eOccupation was another significant predictor, with health professionals showing the highest levels of knowledge, attitude, and practice. This is expected given their formal training and exposure to health information.[26] Conversely, homemakers\u0026mdash;who constituted a large proportion of the sample (44.0%)\u0026mdash;consistently demonstrated lower KAP scores. This subgroup may\u0026nbsp;be\u0026nbsp;less\u0026nbsp;exposed\u0026nbsp;to workplace health campaigns, have fewer opportunities for screening, and\u0026nbsp;engage\u0026nbsp;in less\u0026nbsp;autonomous\u0026nbsp;health-seeking behaviour;\u0026nbsp;therefore, highlighting\u0026nbsp;them\u0026nbsp;as\u0026nbsp;a priority subgroup for targeted outreach\u0026nbsp;[27].\u003c/p\u003e\n\u003cp\u003eThe socioeconomic status represented by monthly household income was significantly related to all KAP domains. High-income women also had higher knowledge, a positive attitude, and better practices of health-seeking behaviour, which echoes the fact that resource availability influences health engagement [28]. Financial barriers may limit access to vaccination (if not fully covered), transportation to health facilities, or the ability to prioritise preventive care over immediate economic needs [29].\u003c/p\u003e\n\u003cp\u003eGood knowledge, positive attitude, and adequate practice were more likely among vaccinated individuals and those whohave tested for HBV in the past. This bi-directionality implies that engagement with health services solidifies bothawareness and motivation, while increased knowledge could lead to increased use of the service [30].\u003c/p\u003e\n\u003cp\u003eNevertheless, coverage remains suboptimal: only 40.9% of women were fully vaccinated, and 54.5% had never been screened. These gaps are concerning, given the availability of national vaccination and premarital screening programmes, and indicate deficiencies in programme implementation, counselling, or follow-up.[31]The multivariate analysis identified good knowledge, positive attitude, vaccination receipt, and prior health-education exposure as independent predictors of good preventive practice. This underlines the need for a comprehensive approach to health promotion involving education, advice, and easy access to services. [32] Remarkably, family history of hepatitis was not an independent predictor in the adjusted model, indicating that its effect may be through testing or vaccination rather than practice itself.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe low uptake of HBV-related health education (31.7%)\u0026nbsp;indicates\u0026nbsp;a missed opportunity for behaviour change.\u0026nbsp;Community-based education programmes,\u0026nbsp;culturally\u0026nbsp;relevant\u0026nbsp;and\u0026nbsp;delivered through\u0026nbsp;trusted channels to local\u0026nbsp;communities, could bridge the knowledge\u0026ndash;practice gap.\u0026nbsp;Strengthening\u0026nbsp;the\u0026nbsp;integration of HBV prevention into routine maternal and reproductive health services could\u0026nbsp;also\u0026nbsp;improve\u0026nbsp;coverage\u0026nbsp;in women\u0026nbsp;during\u0026nbsp;their\u0026nbsp;reproductive\u0026nbsp;years\u0026nbsp;[33,34, 35].\u003c/p\u003e\n\u003cp\u003eBased on the study\u0026apos;s results, we propose specific education, vaccine screening, and tailored outreach interventions to improve HBV prevention among females in Bisha province (Figure 1). Tailored education through trusted sources, services that are accessible both in terms of distance and cost, community networks, and linkages to the health system can bridge the huge gap between knowledge and practice. This multi-pronged approach will directly contribute to reducing HBV transmission and advancing Saudi Arabia\u0026apos;s national viral hepatitis elimination targets.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has several limitations. It has a cross-sectional design, which precludes causal inference. Self-report practice is possibly subject to social desirability bias. The sample was taken from a single province, which may limit generalisability to other regions of Saudi Arabia. Also, respondents\u0026apos; higher educational attainment than that of the general female population may lead to an overestimation of KAP levels. Validity was enhanced through the use of standardized tools, pilot testing, and trained interviewers. A cross-sectional design limits causal inference, and self-reported practices may be subject to bias. Because the study was limited to one province, it may not be generalizable to other parts of Saudi Arabia.\u003c/p\u003e"},{"header":"5. CONCLUSION","content":"\u003cp\u003eHowever, knowledge and attitudes were generally good towards HBV prevention among the women of Bisha, preventive practices are still sub-optimal. Using regression analyses, KAP is found to be highly correlated with education level, occupation, income, vaccination status, and exposure to health education. Public health interventions must close existing inequalities in access to targeted education relative to vaccination/screening services to demonstrate efficacy. Incorporating HBV prevention into existing maternal and primary health care services, as well as community awareness-raising campaigns, is likely to improve uptake and contribute to national and global hepatitis elimination efforts.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAOR\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp; Adjusted Odds Ratio\u003c/p\u003e\n\u003cp\u003eCI\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Confidence Interval\u003c/p\u003e\n\u003cp\u003eHBV \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Hepatitis B Virus\u003c/p\u003e\n\u003cp\u003eKAP \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Knowledge, Attitudes, and Practices\u003c/p\u003e\n\u003cp\u003en\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Number (of participants)\u003c/p\u003e\n\u003cp\u003eOR \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Odds Ratio\u003c/p\u003e\n\u003cp\u003eRef\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Reference Category\u003c/p\u003e\n\u003cp\u003eSAR \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Saudi Riyal\u003c/p\u003e\n\u003cp\u003eSD\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Standard Deviation\u003c/p\u003e\n\u003cp\u003eWHO \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;World Health Organization\u003c/p\u003e"},{"header":"DECLARATION","content":"\u003cp\u003e\u003cstrong\u003eEthical Considerations:\u0026nbsp;\u003c/strong\u003eThe Research Ethics Committee of the University of Bisha approved the study protocol (UB-RELOC H-06-BH-087/(1808.24). Informed consent was obtained after the study's purpose, procedures, risks, benefits, and confidentiality measures were explained. Data were anonymized and stored in password-protected files accessible only to the research team.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Publish declaration:\u0026nbsp;\u003c/strong\u003enot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eThe data used in this study are available on request\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u003c/strong\u003e None declared\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This study was not funded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions:\u0026nbsp;\u003c/strong\u003eEM conceived and designed the study, supervised data collection and analysis, and led manuscript drafting and revision. SA, AA, BM, AH, AS, AAO, NA, SA, AHQ, SE, MO, and MEI contributed to data collection, data entry, and preliminary analysis, and reviewed the manuscript for important intellectual content. LYH and MEI provided methodological and statistical guidance, contributed to interpretation of findings, and critically revised the manuscript. All authors read and approved the final version of the manuscript and agree to be accountable for all aspects of the work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAI declaration:\u003c/strong\u003e Artificial intelligence (AI)–assisted tool (Grammarly, 2025, Grammarly Inc. San Francisco, California, USA. ) were used to support language editing, reference formatting, and refinement of the structure of this manuscript. The GPT-5.4 was used to design the graphical abstarct. The authors independently verified all clinical data, interpretations, and references, and take full responsibility for the content and conclusions presented.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u0026nbsp;\u003c/strong\u003eThe authors are thankful to the Deanship of Graduate Studies and Scientific Research at University of Bisha for supporting this work through the Fast-Track Research Support Program.\u003c/p\u003e"},{"header":"REFERENCES ","content":"\u003col\u003e\n\u003cli\u003eAlqahtani M, Alshahrani MM, Alqahtani AA, et al. Exploration of knowledge, attitude, and practice among residents of the Kingdom of Saudi Arabia toward hepatitis viruses. Cureus. 2020;12(12):e12308.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Global health sector strategy on viral hepatitis 2016\u0026ndash;2021: towards ending viral hepatitis. Geneva: WHO; 2016.\u003c/li\u003e\n\u003cli\u003eAbdo AA, Sanai FM, Al-Faleh FZ. Epidemiology of viral hepatitis in Saudi Arabia: are we off the hook? Saudi J Gastroenterol. 2012;18(6):349\u0026ndash;357.\u003c/li\u003e\n\u003cli\u003eWHO. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Geneva: WHO; 2021.\u003c/li\u003e\n\u003cli\u003eAbdo AA, Al-Awaidy S, Sanai FM, et al. Elimination of mother-to-child transmission of hepatitis B virus in Gulf Cooperation Council countries: current status and future prospects. Am J Trop Med Hyg. 2024;110(1):32\u0026ndash;41.\u003c/li\u003e\n\u003cli\u003eAlqahtani JM, Abu-Eshy SA, Mahfouz AA, et al. Knowledge, attitude and practice on hepatitis B: a survey among the internet users in Taif, Kingdom of Saudi Arabia. J Infect Dis Epidemiol. 2017;3(3):36.\u003c/li\u003e\n\u003cli\u003eAlotaibi BS, Alswat KA, Alharbi BM, et al. Awareness of hepatitis B virus screening before marriage and pregnancy among adults in the Al-Baha region, Saudi Arabia. Cureus. 2023;15(12):e52591.\u003c/li\u003e\n\u003cli\u003eAbdo AA, Al-Jubran KM, Sanai FM, et al. Hepatitis B care pathway in Saudi Arabia: current situation, gaps and actions. Saudi J Gastroenterol. 2019;25(2):73\u0026ndash;80.\u003c/li\u003e\n\u003cli\u003eAlharbi M, Alhowikan A, Alsaedi A, et al. Awareness of hepatitis B among the general population in Riyadh, Saudi Arabia. Cureus. 2024;16(12):eXXXXX.\u003c/li\u003e\n\u003cli\u003eAlhabdan AM, Alshahrani AA, Alrashed AA, et al. Hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infection among premarital screening individuals in Saudi Arabia. Int J Public Health. 2024;69:1607809.\u003c/li\u003e\n\u003cli\u003eAlAteeq DA, AlQahtani AM, AlDossary NM, et al. Perception of and attitude towards hepatitis B infection among Saudi pregnant females attending antenatal care unit in Al-Ahsa City, Kingdom of Saudi Arabia. Cureus. 2019;11(12):e6395.\u003c/li\u003e\n\u003cli\u003eAlsaleem SA, Alsaleem MA, Asiri AA, et al. Knowledge, attitudes, and practice about hepatitis B infection among primary health care nurses in Buraidah, Qassim Region, Saudi Arabia. J Family Med Prim Care. 2024;13(1):xx\u0026ndash;xx.\u003c/li\u003e\n\u003cli\u003eAlrowaily MA, Abolfotouh MA, Ferwanah MS. Hepatitis B virus sero-prevalence among pregnant females in Saudi Arabia. Saudi J Gastroenterol. 2008;14(2):70\u0026ndash;72.\u003c/li\u003e\n\u003cli\u003eAlqahtani SI, Alshammari KF, Alanazi HH, et al. Knowledge, attitudes and practices toward prevention of hepatitis B virus infection among medical students at Northern Border University, Arar, Kingdom of Saudi Arabia. J Family Med Prim Care. 2017;6(3):586\u0026ndash;593.\u003c/li\u003e\n\u003cli\u003eAlhawiti MM, Alharbi SA, Altuwaym MM, et al. Revealing hepatitis B virus as a silent killer: a call-to-action for Saudi Arabia. Saudi J Gastroenterol. 2021;27(3):147\u0026ndash;154.\u003c/li\u003e\n\u003cli\u003eAbuelgasim KA, Alzahrani AM, Almalki AA, et al. Ten years prevalence of hepatitis B infection among women delivering at KAMC-Jeddah and their infants. Int J Adv Res. 2017;5(1):1580\u0026ndash;1586.\u003c/li\u003e\n\u003cli\u003eAlmalki F, Alraffah YM, Alasiri RA, Dhafar MW, Albogami FM, Alhazmi MN, Alyazidi AM, Alharbi LA, Alotaibi ME. Knowledge, Attitude and Practice Towards Hepatitis B Infection and HBV Vaccine Among the Healthy Population in Makkah, Saudi Arabia. Infection and Drug Resistance. 2025 Dec 31:2153-64.\u003c/li\u003e\n\u003cli\u003eMinistry of Health, Kingdom of Saudi Arabia. Viral Hepatitis National Plan 2025. Riyadh: MOH; 2020.\u003c/li\u003e\n\u003cli\u003eAlmutairi WM, Alsharif MA, Al-Mohaithef M. Knowledge, attitudes, and practices regarding hepatitis B infection among women in Riyadh, Saudi Arabia. \u003cem\u003eJ Infect Public Health\u003c/em\u003e. 2023;16(2):245\u0026ndash;251.\u003c/li\u003e\n\u003cli\u003eAlghamdi SA, Alrasheed AA, Alzahrani MH, et al. Disparities between knowledge and practice of hepatitis B prevention among Saudi adults: a national cross-sectional study. \u003cem\u003eSaudi Med J\u003c/em\u003e. 2024;45(3):267\u0026ndash;274.\u003c/li\u003e\n\u003cli\u003eAl-Hanawi MK, Alsharqi O, Vaidya K. Barriers to hepatitis B screening and vaccination among women in Saudi Arabia: a qualitative study. BMC Women\u0026rsquo;s Health. 2024;24:112.\u003c/li\u003e\n\u003cli\u003eul Haq N, Hassali MA, Shafie AA, Saleem F, Farooqui M, Aljadhey H. A cross sectional assessment of knowledge, attitude and practice towards Hepatitis B among healthy population of Quetta, Pakistan. BMC public health. 2012 Dec;12:1-8.\u003c/li\u003e\n\u003cli\u003eAlzahrani FM, Alqahtani SS, Alghamdi RA, et al. The impact of health literacy on hepatitis B knowledge and vaccination uptake in Saudi women. \u003cem\u003eJ Educ Health Promot\u003c/em\u003e. 2024;13:45.\u003c/li\u003e\n\u003cli\u003eAlotaibi FA, Almalki ZS, Alghamdi AA, et al. Socioeconomic determinants of viral hepatitis knowledge in the Kingdom of Saudi Arabia: evidence from the 2023 National Health Survey. \u003cem\u003eEast Mediterr Health J\u003c/em\u003e. 2025;31(1):89\u0026ndash;97.\u003c/li\u003e\n\u003cli\u003eAlShammari M, AlAli S, Al-Raddadi R. Beyond awareness: strategies to improve hepatitis B vaccination coverage among Saudi women. \u003cem\u003eVaccine\u003c/em\u003e. 2024;42(Suppl 1):A78\u0026ndash;A85.\u003c/li\u003e\n\u003cli\u003eAlOtaibi NM, AlHarbi AA, AlQahtani AM. Health professionals as health educators: role in hepatitis B prevention in primary care settings in Saudi Arabia. \u003cem\u003eJ Multidiscip Healthc\u003c/em\u003e. 2024;17:1123\u0026ndash;1132.\u003c/li\u003e\n\u003cli\u003eAlshehri NA, Alenazi HA, Alwadey AM. Health-seeking behaviour and barriers to care among housewives in Saudi Arabia: a mixed-methods study. \u003cem\u003eSaudi J Health Syst Res\u003c/em\u003e. 2024;4(2):105\u0026ndash;115.\u003c/li\u003e\n\u003cli\u003eAlbagshi SM, Alharbi RA, Alomran AS. Income inequality and access to preventive health services: a Saudi national survey analysis. \u003cem\u003ePLOS Glob Public Health\u003c/em\u003e. 2024;4(5):e0003456.\u003c/li\u003e\n\u003cli\u003eAlRasheed A, AlMohanna F, AlQahtani K. Financial barriers to hepatitis B vaccination in low-income households in Saudi Arabia. \u003cem\u003eHealth Econ Rev\u003c/em\u003e. 2025;15:12.\u003c/li\u003e\n\u003cli\u003eAlGhamdi MJ, AlZahrani IA, AlTowiqi MA. Reciprocal relationship between health service use and health knowledge: evidence from hepatitis B screening programs in Saudi Arabia. \u003cem\u003eBMC Health Serv Res\u003c/em\u003e. 2024;24:650.\u003c/li\u003e\n\u003cli\u003eMinistry of Health, Kingdom of Saudi Arabia. \u003cem\u003eNational Hepatitis B Control Program: Annual Report 2024\u003c/em\u003e. Riyadh: MOH; 2025.\u003c/li\u003e\n\u003cli\u003eAlThaqafi AM, AlHarbi TF, AlZahrani MA. Integrated health promotion for hepatitis B: a cluster-randomized trial in primary care centers in Saudi Arabia. \u003cem\u003eLancet Reg Health East Mediterr\u003c/em\u003e. 2025;28:100650.\u003c/li\u003e\n\u003cli\u003eAlQahtani DA, AlAmri AM, AlJohani NA. Effectiveness of community-based peer education on hepatitis B knowledge and vaccination uptake among women in Saudi Arabia. \u003cem\u003eJ Community Health\u003c/em\u003e. 2025;50(1):189\u0026ndash;197.\u003c/li\u003e\n\u003cli\u003eAlOmar RS, AlSaud AA, AlMutairi GF. The role of social media in health education: a hepatitis B awareness campaign in Saudi Arabia. \u003cem\u003eDigit Health\u003c/em\u003e. 2024;10:20552076241255678.\u003c/li\u003e\n\u003cli\u003eAlHarbi NS, AlSudais NM, AlOtaibi MA. Integration of hepatitis B prevention into antenatal care: a stepped-wedge trial in Saudi maternity hospitals. \u003cem\u003eBJOG\u003c/em\u003e. 2025;132(3):345\u0026ndash;354.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-primary-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"famp","sideBox":"Learn more about [BMC Primary Care](https://bmcprimcare.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12875","title":"BMC Primary Care","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Hepatitis B virus, Knowledge, Attitudes, Practices, Women, Prevention, Vaccination, Screening, Saudi Arabia, Bisha, Knowledge-practice gap, Health education","lastPublishedDoi":"10.21203/rs.3.rs-9108647/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9108647/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIntroduction: Hepatitis B virus (HBV) infection still poses an important public health issue in Saudi Arabia, despite the availability of effective vaccines and national prevention programs. It is particularly important among women, who play a central role in family health and face a risk of transmitting the infection to their infants during pregnancy and childbirth.\u003cbr\u003e\nObjectives: This study intends to report the levels of knowledge, attitudes, and practices towards HBV prevalence among non-pregnant Saudi women in Bisha province and thus provide context-specific evidence that can inform a targeted preventive actions framework.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: A community-based cross-sectional study was conducted in Bisha province, Saudi Arabia, from January 2025 to February 2026 among 391 non-pregnant Saudi women aged ≥18 years or older. Data were collected via a structured Arabic questionnaire. We categorized the good knowledge, positive attitude, and good practice as scores ≥75%, ≥80%, and ≥70%, respectively. Statistical analysis was performed using STATA BE, 2025. We employed Chi-square and logistic regression to examine the associations.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: The mean±SD scores of knowledge, attitude, and practice were 15.2±3.4, 5.9±1.6, and 6.7±2.1, respectively. Overall, good knowledge was reported by 65.5%, positive attitude by 69.3%, and good preventive practice by 46.8%. There were significant correlations between better KAP and higher education, working as health/education professionals, being richer (income), already vaccinated against HBV, and having taken the respective tests for HBV (p\u0026lt;0.05). Only 40.9% were fully vaccinated; ever-screening and HBV health education participants accounted for 45.5% and 31.7%, respectively. In multivariable analysis; good knowledge (adjusted odds ratio 2.12, 95% confidence interval 1.40–3.22), positive attitude (AOR=2.51, 95% CI: 1.64–3.85), vaccination (AOR=3.02, 95% CI: 1.88–4.84) and exposure to previoushealth education session (AOR=1.96, 95% CI: 1.23–3.13) were identified as a predictors of good practice.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusion: Awareness and attitudes toward HBV are generally positive among women in Bisha; however, the preventive practices are substandard. This knowledge–practice gap remains large and is influenced by education, occupation, income, and health service engagement. Tailored interventions integrating education, accessible vaccination, screening, and community-based outreach are needed to improve HBV prevention and align with national elimination goals.\u003c/p\u003e","manuscriptTitle":"Conceptual framework of factors influencing Hepatitis B preventive awareness and behaviors among Saudi women","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-23 15:09:22","doi":"10.21203/rs.3.rs-9108647/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-05T10:17:54+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-05T08:11:04+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-04T00:05:02+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-27T22:26:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"248438110301458538461930612454560965854","date":"2026-04-27T22:13:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"152597885900258697817376935690287662807","date":"2026-04-27T20:49:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"154903102841784781638973428365931967654","date":"2026-04-27T17:55:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"193232316512605028336065539744177694346","date":"2026-04-23T06:42:42+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-18T20:16:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"49947714245640038885387624338148905739","date":"2026-04-16T14:41:53+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-15T19:06:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-13T13:12:52+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-23T05:40:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-20T22:52:46+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Primary Care","date":"2026-03-20T22:48:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-primary-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"famp","sideBox":"Learn more about [BMC Primary Care](https://bmcprimcare.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12875","title":"BMC Primary Care","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"be0e4a3d-d2c3-43ec-bfed-813845ca5fa8","owner":[],"postedDate":"April 23rd, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-05T10:17:54+00:00","index":71,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-05T08:11:04+00:00","index":70,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-04T00:05:02+00:00","index":69,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-23T15:09:25+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-23 15:09:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9108647","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9108647","identity":"rs-9108647","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}