Impact of COVID-19 on Public Knowledge and Attitudes Toward Participating in Clinical Trials in Saudi Arabia: A Cross-Sectional Study

Figures & data

Table 1 Sociodemographic Information

		Total		Before COVID19 Pandemic		During COVID19 Pandemic		P-value
		n	%	n	%	n	%
Age	18–30	388	47.2	169	20.6	219	26.6	0.5
	31–42	286	34.8	130	15.8	156	19.0
	43–54	104	12.7	53	6.4	51	6.20
	>54	44	5.4	17	2.1	27	3.3
Gender	Male	337	41.0	154	18.7	183	22.3	0.7
	Female	485	59.0	215	26.2	270	32.9
Marital status	Single	310	37.7	135	16.4	175	21.3	0.6
	Married	512	62.3	234	28.5	278	33.8
Having children	Yes	413	50.2	190	23.1	223	27.1	0.5
	No	409	49.8	179	21.8	230	28.0
Residential area	Village	75	9.1	33	4.0	42	5.1	0.9
	City	747	90.9	336	40.9	411	50.0
Educational level	Uneducated	3	8.2	1	2.7	2	5.5	0.3
	Elementary school	16	1.9	10	1.2	6	0.7
	Middle/high school	227	27.6	93	11.3	134	16.3
	Bachelor’s degree	492	59.9	233	28.4	259	31.5
	Master’s degree	69	8.4	27	3.3	42	5.1
	PhD’s degree	15	1.8	5	0.6	10	1.2
Educational background	Non- medical field	469	57.1	221	26.9	248	30.2	0.6
	Medical field	120	14.6	53	6.5	67	8.2
Reason of the visit	Treatment	287	34.9	134	16.3	153	18.6	0.5
	Follow-up	535	65.1	235	28.6	300	36.5
Regular source of care	Government hospitals	624	75.9	283	34.4	341	41.5	0.6
	Private hospitals	198	24.1	86	10.5	112	13.6
Health insurance	Yes	224	27.3	99	12.0	125	15.2	0.8
	No	598	72.8	270	32.9	328	39.9

Table 2 The Knowledge About Participating in Clinical Trials

Survey Item		Total		Before COVID19 Pandemic		During COVID19 Pandemic		P-value
		n	%	n	%	n	%
Have you been involved in clinical trials before?	Yes	67	8.2	36	4.38	31	3.8	0.1
	No	755	91.9	333	40.5	422	51.3
Do you think Clinical trials are only used as a last resort?	Yes	326	39.7	160	19.5	166	20.2	0.1
	No	496	60.3	209	25.4	287	35.0
Do you know about the Ethics committee before?	Yes	270	32.9	105	12.8	165	20.1	0.02
	No	552	67.2	264	32.1	288	35.04
Do you know whom to contact if you have a problem like an adverse event and serious adverse event in a clinical trial?	Yes	203	24.7	81	9.9	122	14.8	0.1
	No	619	75.3	288	35.04	331	40.3
Do you think the physician can start a clinical trial without the approval of professionals who protect patient rights?	Yes	98	11.9	52	6.3	46	5.6	0.08
	No	724	88.1	317	38.6	407	49.5
Do you know about “Informed consent”?	Yes	308	37.5	136	16.6	172	21.0	0.7
	No	514	62.5	233	28.4	281	34.2

Table 3 Attitudinal of Fear from Participating in a Clinical Trial

Survey Item		Total		Before COVID19 Pandemic		During COVID19 Pandemic		P-value
		n	%	n	%	n	%
I am afraid of the side effects that I will have on a clinical trial.	Strongly agree	178	21.7	71	8.6	107	13.01	0.3
	Agree	315	38.3	155	18.9	160	19.5
	Neutral	193	23.5	83	10.1	110	13.4
	Disagree	84	10.2	36	4.4	48	5.8
	Strongly disagree	52	6.3	24	2.9	28	3.4
I am worried that the treatment I’d receive on a clinical trial would not work for me.	Strongly agree.	96	11.7	48	5.8	48	5.8	0.4
	Agree	273	33.2	121	14.7	152	18.5
	Neutral	258	31.4	106	12.9	152	18.5
	Disagree	133	16.2	62	7.5	71	8.6
	Strongly disagree	62	7.5	32	3.9	30	3.6
I would not ask about clinical trials unless my doctor brought them up first.	Strongly agree.	113	13.8	54	6.6	59	7.2	0.1
	Agree	365	44.4	179	21.8	186	22.6
	Neutral	145	17.6	57	6.9	88	10.7
	Disagree	134	16.3	50	6.1	84	10.2
	Strongly disagree	65	7.9	29	3.5	36	4.4
I do not like to try new treatments until they have been approved to be used.	Strongly agree.	279	33.9	128	15.6	151	18.4	0.6
	Agree	336	40.9	158	19.2	178	21.7
	Neutral	132	16.1	53	6.5	79	9.6
	Disagree	50	6.1	20	2.4	30	3.6
	Strongly disagree	25	3.04	10	1.2	15	1.8
I do not trust drug companies.	Strongly agree.	83	10.1	38	4.6	45	5.5	0.3
	Agree	160	19.5	76	9.2	84	10.2
	Neutral	306	37.2	145	17.6	161	19.6
	Disagree	207	25.2	79	9.6	128	15.6
	Strongly disagree	66	8.02	31	3.8	35	4.3
I am afraid I will be used as a test subject if I join in a clinical trial.	Strongly agree.	122	14.8	61	7.4	61	7.4	0.3
	Agree	296	36.01	137	16.7	159	19.3
	Neutral	190	23.1	75	9.1	115	14
	Disagree	153	18.6	65	7.9	88	10.7
	Strongly disagree	61	7.4	31	3.8	30	3.7
I am worried that going on a clinical trial would burden my family.	Strongly agree.	139	16.9	60	7.3	79	9.6	0.4
	Agree	290	35.3	122	14.8	168	20.4
	Neutral	176	21.4	89	10.8	87	10.6
	Disagree	166	20.2	72	8.8	94	11.4
	Strongly disagree	51	6.2	26	3.2	25	3.04
I am worried that my family would not allow me to participate in a clinical trial.	Strongly agree.	143	17.4	58	7.1	85	10.3	0.1
	Agree	275	33.5	123	15	152	18.5
	Neutral	167	20.3	66	8.03	101	12.3
	Disagree	168	20.4	88	10.7	80	9.7
	Strongly disagree	69	8.4	34	4.1	35	4.3
I am worried that my medical care will not be as good if I join a clinical trial.	Strongly agree.	89	10.8	34	4.1	55	6.7	0.04
	Agree	237	28.8	112	13.6	125	15.2
	Neutral	192	23.4	81	9.9	111	13.5
	Disagree	213	25.9	110	13.4	103	12.5
	Strongly disagree	91	11.1	32	3.9	59	7.2
I would not be able to find transportation to get me to my clinical trial treatment center.	Strongly agree.	67	8.2	28	3.41	39	4.7	0.03
	Agree	253	30.8	128	15.6	125	15.2
	Neutral	268	32.6	104	12.6	164	20
	Disagree	175	21.3	87	10.6	88	10.7
	Strongly disagree	59	7.2	22	2.7	37	4.5
I would not be able to keep up with the clinical trial treatment schedule.	Strongly agree.	71	8.6	32	3.9	39	4.7	0.5
	Agree	281	34.2	138	16.8	143	17.4
	Neutral	225	27.4	96	11.7	129	15.7
	Disagree	197	24	82	10	115	14
	Strongly disagree	48	5.8	21	2.6	27	3.3
I do not trust the medical system.	Strongly agree.	31	3.8	13	1.6	18	2.2	0.6
	Agree	73	8.9	33	4.01	40	4.9
	Neutral	222	27.01	93	11.3	129	15.7
	Disagree	285	34.7	139	16.9	146	17.8
	Strongly disagree	211	25.7	91	11.1	120	14.6
I do not have time to take part in a clinical trial.	Strongly agree.	166	20.2	74	9	92	11.2	0.8
	Agree	282	34.3	124	15.1	158	19.2
	Neutral	211	25.7	92	11.2	119	14.5
	Disagree	114	13.9	57	6.9	57	6.9
	Strongly disagree	49	6	22	2.7	27	3.3
Helping in developing new medications	Strongly agree.	144	17.5	62	7.5	82	10	0.1
	Agree	406	49.4	196	23.8	210	25.5
	Neutral	153	18.6	55	6.7	98	11.9
	Disagree	78	9.5	39	4.7	39	4.7
	Strongly disagree	41	5	17	2.1	24	3
Being part of scientific knowledge	Strongly agree.	121	14.7	55	6.7	66	8.03	0.6
	Agree	387	47.1	184	22.4	203	24.7
	Neutral	182	22.1	74	9	108	13.1
	Disagree	88	10.7	37	4.5	51	6.2
	Strongly disagree	44	5.4	19	2.3	25	3.04
Willing to participate if you were provided with a good consent form explaining the clinical trial’s benefits and risks.	Strongly agree.	88	10.7	53	6.5	35	4.3	0.004
	Agree	334	40.6	160	19.5	174	21.2
	Neutral	199	24.2	77	9.4	122	14.8
	Disagree	129	15.7	49	6	80	9.7
	Strongly disagree	72	8.8	30	3.7	42	5.1
Willing to participate in a clinical trial if you were explained in a completely private setting	Strongly agree.	68	8.3	38	4.6	30	3.7	0.1
	Agree	288	35.04	140	17.03	148	18
	Neutral	207	25.2	86	10.5	121	14.7
	Disagree	175	21.3	71	8.6	104	12.7
	Strongly disagree	84	10.2	34	4.14	50	6.08
Willing to participate in a clinical trial if your physician explained you	Strongly agree.	65	7.9	39	4.7	26	3.2	0.003
	Agree	295	35.9	148	18	147	17.9
	Neutral	209	25.4	88	10.7	121	14.7
	Disagree	167	20.3	63	7.7	104	12.7
	Strongly disagree	86	10.5	31	3.7	55	6.7
Having religious representatives in the clinical trial and an ethics committee will make you more likely to participate in the clinical trial.	Strongly agree.	70	8.5	31	3.8	39	4.7	0.9
	Agree	216	26.3	100	12.2	116	14.1
	Neutral	258	31.4	114	13.9	144	17.5
	Disagree	186	22.6	85	10.3	101	12.3
	Strongly disagree	92	11.2	39	4.7	53	6.5
A belief that by participating in a clinical trial, you will receive the best medical care	Strongly agree.	71	8.6	34	4.14	37	4.5	0.4
	Agree	312	38	152	18.5	160	19.5
	Neutral	266	32.4	112	13.6	154	18.7
	Disagree	125	15.2	50	6.1	75	9.1
	Strongly disagree	48	5.8	21	2.6	27	3.3
Willing to participate in a clinical trial if you were with a family member when a researcher explains clinical trial.	Strongly agree.	33	4.01	17	2.1	16	2	0.5
	Agree	239	29.1	114	13.9	125	15.2
	Neutral	250	30.4	114	13.9	136	16.5
	Disagree	220	26.8	93	11.3	127	15.5
	Strongly disagree	80	9.7	31	3.8	49	6
Willing to participate in a clinical trial if you had more time to think about it.	Strongly agree.	54	6.6	33	4.01	21	2.6	0.01
	Agree	299	36.4	148	18	151	18.4
	Neutral	185	22.5	73	8.9	112	13.6
	Disagree	195	23.7	81	9.9	114	13.9
	Strongly disagree	89	10.8	34	4.14	55	6.7
Willing to participate in a clinical trial if you could obtain information from your physician	Strongly agree.	58	7.1	37	4.5	21	2.6	0.007
	Agree	338	41.1	159	19.3	179	21.8
	Neutral	187	22.7	82	9.9	105	12.8
	Disagree	155	18.9	61	7.4	94	11.4
	Strongly disagree	84	10.2	30	3.6	54	6.6
I completely trust my doctor’s recommendations about a clinical trial	Strongly agree.	69	8.4	33	4.01	36	4.4	0.4
	Agree	346	42.1	162	19.7	184	22.4
	Neutral	247	30.1	108	13.1	139	17
	Disagree	123	15	55	6.7	68	8.3
	Strongly disagree	37	4.5	11	1.3	26	3.2
I am worried about the safety of participating in a clinical trial	Strongly agree.	131	15.9	64	7.8	67	8.2	0.02
	Agree	336	40.9	169	20.6	167	20.3
	Neutral	236	28.7	94	11.4	142	17.3
	Disagree	84	10.2	31	3.8	53	6.5
	Strongly disagree	35	4.3	11	1.3	24	2.9
I trust the information I read about a clinical trial on the internet	Strongly agree.	28	3.4	9	1.1	19	2.3	0.2
	Agree	138	16.8	59	7.16	79	9.6
	Neutral	299	36.4	125	15.2	174	21.2
	Disagree	253	30.8	124	15.1	129	15.7
	Strongly disagree	104	12.7	52	6.3	52	6.3
Clinical trial medications are safer than other medication	Strongly agree.	23	2.8	7	0.9	16	2	0.3
	Agree	96	11.7	39	4.7	57	6.9
	Neutral	312	37.9	152	18.5	160	19.5
	Disagree	256	31.1	114	13.9	142	17.3
	Strongly disagree	135	16.4	57	6.9	78	9.5