Awareness and knowledge of vitamin D deficiency among Palestinian adults recruited online: a cross-sectional study.

Abstract

Background: Vitamin D deficiency remains a major public health concern in the Middle East and North Africa despite abundant sunlight. The public's understanding of vitamin D sources, risk factors, and preventive practices may influence recognition and prevention of deficiency, yet data from Palestine remain limited. This study assessed awareness and knowledge of vitamin D deficiency among Palestinian adults recruited online and examined whether knowledge differed according to sociodemographic characteristics and vitamin D-related experiences.

Methods: An analytical online cross-sectional study was conducted among Palestinian adults using an adapted Arabic self-administered questionnaire distributed through social media between November and December 2025. The instrument assessed sociodemographic characteristics, vitamin D-related experiences, and knowledge across benefits, sources/determinants, and toxicity domains. Knowledge scores ranged from 0 to 14, and scores greater than 7 were classified as adequate knowledge, consistent with the source instrument. Descriptive statistics, bivariate analyses, and multivariable logistic regression were performed using SPSS version 25.

Results: A total of 756 respondents were included (mean age 27.5 ± 9.9 years; 79.1% female). The mean knowledge score was 10.21 ± 2.25, and 88.8% of participants were classified as having adequate knowledge. Correct responses were highest for skeletal benefits and the role of sun exposure in vitamin D production. Lower correct response rates were observed for items related to vitamin D toxicity, vegetarian-related risk, and the effect of darker skin pigmentation on deficiency risk. Higher mean knowledge scores were observed among males, single participants, participants without children, and those who had undergone vitamin D testing or had taken supplements. However, no independent predictors of adequate knowledge were identified in the adjusted logistic regression model.

Conclusions: Palestinian adults in this online non-probability sample demonstrated a generally high level of vitamin D knowledge, particularly regarding bone health and sun exposure. However, important gaps persisted in specific domains, especially toxicity and less commonly recognized risk factors. Because the sample was recruited online and was disproportionately female and highly educated, the findings should be interpreted as descriptive of this sampled group rather than representative of all Palestinian adults.