Gaps in knowledge and prevention of kidney stone disease among Palestinian adults: findings from an online cross-sectional survey

巴勒斯坦成年人对肾结石疾病的知识和预防存在不足:一项在线横断面调查的结果

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Abstract

BACKGROUND: Kidney stone disease (KSD) is a common and largely preventable urological condition with rising incidence worldwide. Public knowledge, awareness, and everyday preventive practices are critical for early prevention, particularly in settings with constrained healthcare resources. This study assessed knowledge, awareness, and selected lifestyle practices related to KSD among adults in Palestine and examined sociodemographic factors associated with preventive understanding. METHODS: A cross-sectional online survey was conducted among 510 adults residing in Palestine between January and October 2025 using snowball sampling via social media platforms. Data were collected with a structured questionnaire adapted from a validated Malaysian tool and culturally tailored to the Palestinian context. The survey assessed sociodemographic characteristics, KSD knowledge, awareness of prevention, and dietary and lifestyle practices. Descriptive statistics, χ² tests, t-tests/ANOVA, Pearson correlation, and multivariable linear and logistic regression were used.Methods RESULTS: Participants were predominantly young (median 19 years) and female (81.2%). The mean knowledge score was 3.16 ± 1.74 out of six, indicating moderate understanding. While 94.1% had heard of kidney stones, only 56.3% had heard about ways to prevent them, and detailed knowledge of risk factors such as dehydration, high dietary salt, and animal protein intake was limited. Educational attainment independently predicted higher knowledge (p < 0.001), whereas gender, income, and family history were not significant predictors. A weak but statistically significant positive correlation was observed between knowledge score and a composite healthy-lifestyle index (r = 0.21, p < 0.01), suggesting that greater knowledge is associated with, but does not fully determine, healthier behaviors. CONCLUSION: Among this predominantly young, educated online sample, general awareness of kidney stones was high but comprehensive preventive knowledge and some lifestyle practices remained suboptimal. Given the modest link between knowledge and behavior, public health strategies in Palestine should combine clear educational messages on hydration and diet with practical, culturally appropriate support to address behavioral and structural barriers. Integrating KSD prevention into primary care counseling, school health programs, and community campaigns may help reduce the future burden of kidney stone disease.

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