Prevalence of Being Obese, Overweight, and Underweight Among Jordanian Children and Adolescents Based on International Growth Standards

Objectives: The rise of obesity and other nutrition-related conditions among children and adolescents is a global challenge, particularly in the Middle East. This study aimed to determine the prevalence of being underweight, overweight, and obese among Jordanian children and adolescents using the body mass index (BMI) percentiles of the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) standards. Methods: This retrospective cross-sectional/longitudinal study analyzed 58,474 (42.6% males; 57.4% females) height, weight, and BMI-for-age records from 31508 healthy Jordanian children and adolescents aged 2–19 years. The data were retrieved from the Ministry of Health’s nationwide electronic database (2017–2023) and assessed using the CDC and WHO growth standards. Logistic regression was performed to assess the variables associated with overweight/obese status. Results: The prevalence of being underweight, overweight, and obese varied by the reference used, as more cases of being obese and underweight were reported when applying the CDC standards. The regression models showed the males had significantly lower odds of being overweight and obese than the females. Increased age was associated with higher odds of being overweight and obese, with annual increases observed across all age groups. Conclusions: Using the WHO and CDC standards, the prevalence of being underweight was higher in the males aged 6 years and older, while being overweight and obese was more prevalent in the females. The observed annual increase in the prevalence of being overweight and obese underscores the need for targeted strategies. Growth references tailored to regional profiles may improve national nutrition policies for Jordanian children and adolescents

Evaluating the validity of international standards of Height, weight, and body mass index on Jordanian children and adolescents

Background: the variations in a child's overall body shape and figure among different countries are attributable to differences in genetics, environmental factors, and the interaction between these elements. This study aims to evaluate the validity, reliability, and appropriateness of ap-plying the international growth standards to Jordanian children and adolescents aged 2-19 years old. Methods: 65828 Jordanian children and adolescents (43% males; 57% females) aged 2-19 years old were selected from the Hakeem Program database and various private schools across Jordan. Height-for-age, weight-for-age, and body mass index (BMI)-for-age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The z-score for each record was computed based on international equations. Results: Mean z-scores for height-for-age, weight-for-age, and BMI-for-age for both genders showed significant deviation from the international standards across most age intervals. It was found that in most age groups, Jordanian children and adolescents were shorter and lighter than the CDC and WHO standards, except for females at ages ≥ 16 years which were heavier with higher BMI-for-age values than CDC standards based on weight-for-age and BMI-for-age equations. Moreover, Jordanian males at ages ≥ 12 years had lower BMI-for-age values than the CDC standards. Conclusions: Jordanian children and adolescents showed significant deviations in their measurements from international standards and growth reference values. The development of a population-specific growth chart is highly recommended to enhance the accuracy of evaluating children’s and adolescents' wellness

The Development of Standardized National Head Circumference Growth Charts for Jordanian Children Aged 0-5 Years:A longitudinal and cross-sectional study

Background: Head circumference (HC) is a key indicator of growth and brain development in children, used to identify abnormalities like microcephaly and macrocephaly. While WHO growth standards are widely adopted, they may not account for regional variations due to genetic, environmental, and socio-economic factors. This study aimed to develop and validate national HC growth charts for Jordanian children aged 0–5 years and compare them with WHO standards. Methods: This study analysed 628456 HC measurements from 250276 Jordanian children (51.6% boys, 48.4% girls) aged 0–1800 days, using data from the Hakeem program. Only healthy children were included. HC measurements followed international guidelines, and data were analysed using the LMS statistical method. Percentiles were calculated, and growth patterns were compared with WHO standards. Results: National HC-for-age growth charts were developed for the 3rd, 15th, 50th, 85th, and 97th percentiles. Median percentiles for Jordanian children aligned with WHO standards, but the 3rd percentile was lower, particularly for girls after 840 days. The 97th percentile diverged after 240 days, with larger HC measurements observed in Jordanian children. Conclusions: This study provides the first validated HC growth charts for Jordanian children, addressing the limitations of international standards in reflecting regional variations. These charts offer clinicians and public health professionals a precise tool for assessing and monitoring growth, promoting better health outcomes in Jordanian children

Assessing mental health literacy in Jordan: a factor analysis and Rasch analysis study

Background Mental health literacy (MHL) research in Jordan is sparse and validated MHL measures are lacking. The present study validated a Jordanian version of the Mental Health Literacy Scale (MHLS) and examined Jordanian individuals’ MHL. Method A Google Forms survey was designed, and the link was shared through various Jordanian social media platforms. Factor analysis and Rasch analysis were performed to validate the Jordanian version of the MHLS. Binary logistic regression was performed to assess variables associated with MHL. Results The Jordanian MHLS was administered to 974 participants (74.4% females; median age 27 years). The mean MHL score of the participants was 71.1% indicating average literacy levels. The factor analysis indicated that 27 items distributed across four factors had the best model fit. The Rasch analysis confirmed item separation reliability and person reliability. The regression showed a correlation between educational attainment, income, marital status and MHL level. These findings emphasize the role of educational attainment in MHL, pointing to the necessity of integrating mental health education into formal curricula to enhance MHL across all societal levels. Stigma and limited-service availability act as barriers to mental health service and access, which compound the challenge of improving MHL. Targeted educational interventions and policy reforms may help improve MHL, thereby contributing to improving mental health outcomes in Jordan and potentially other similar settings

Validation of an Arabic tool for assessing vaccination literacy: A factor and Rasch analysis

Vaccine literacy is a significant part of health literacy. Although several tools have been developed to assess vaccine literacy, such tools are lacking in Arabic. Validating an Arabic version of a tool that evaluates vaccine literacy is critically important, as it would aid in understanding the decision-making process regarding vaccinations among individuals in Arabic-speaking countries. Therefore, the current study aimed to validate an Arabic tool for assessing vaccine literacy in adult vaccination. An online questionnaire was distributed to people throughout Jordan by sharing the questionnaire link via various social media platforms. The reliability and validity of the Arabic version of the vaccination literacy assessment tool (HLVa-Ar) were evaluated using factor analysis and Rasch analyses. The two-factor model generated fit indices were in the acceptable range (χ2/df = 2.48, RMSEA = 0.06, SRMR = 0.05, GFI =0.94, CFI = 0.97, and TLI =0.96). Cronbach’s alpha for functional Vaccination literacy (VL) and interactive/critical VL were 0.91 and 0.88 respectively. The Rasch analysis indicated acceptable infit/outfit values and high item and person separation reliabilities for the two factors (0.852, 0.868, and 0.771, 0.818 respectively). Overall, the 420 participants displayed a good understanding of the general benefits and importance of vaccination. The HLVa-Ar was shown to be a valid and reliable tool that portrayed a wide range of vaccination literacy levels in the studied sample and provided valuable insights into participants’ vaccination knowledge. The findings emphasize the need for developing targeted strategies to improve vaccination literacy and increase vaccination rates