Predictors of Consanguinity Marriage Decision in Saudi Arabia: A Pilot Study

2.1. Study Design A pilot study was conducted among university students in Saudi Arabia to gather information over a three-month period, from January 22, 2022, to April 22, 2022. The data was collected through an online questionnaire that participants completed on their own. 2.2. Population and Inclusion Criteria The study focused on unmarried Saudi university students. 2.3. Research Instruments and Tools of the Study The research utilized a questionnaire consisting of 60 questions. Questionnaires were chosen as they are a cost-effective and efficient method for collecting data from a large number of participants, allowing for standardized data collection. The knowledge and perceived threat questions were based on two previous tools, with nine questions adapted from Miri-Moghaddam et al. [17] and three questions from Al-ghubishi et al. [18]. The researchers modified and added questions to tailor them to the target population. The questionnaire comprised five sections: Section 1: This section included ten sociodemographic questions covering nationality, age, gender, marital status, academic status, academic level, type of university, specialty, type of residence, and residential area. Section 2: This section contained 32 questions assessing knowledge about genetic blood disorders. Correct answers were assigned a value of 1, while incorrect answers were assigned a value of 0. The maximum possible score was 32. The median score, 9, was used as the cutoff point. Scores of 9 or higher were considered indicative of good knowledge, while scores below 9 indicated poor knowledge. Section 3: This section comprised six questions examining perceived threats associated with genetic blood disorders. Participants responded to the questions using a 3-point Likert scale, resulting in a maximum score of 18. The cutoff points for scoring were determined at the first and third quartiles. Scores equal to or below 10 were categorized as low perceived threats, scores of 11–14 indicated moderate perceived threats, and scores of 15 or above suggested high perceived threats. Section 4: This section consisted of two questions measuring attitudes using a 3-point Likert scale. The total possible score was 6. The cutoff points were determined at the first and third quartiles. Attitudes were classified as poor (score of 4 or below), moderate (score of 5), or good (score of 6). Poor attitudes represented participants who supported or preferred consanguineous marriage, while good attitudes indicated participants who opposed consanguineous marriage and did not support it. Section 5: This section included two questions evaluating norms using a 3-point Likert scale. The total possible score was 6. The cutoff points were determined at the first and third quartiles. A total norm score of 4 or below was considered poor, 5 indicated moderate norms, and 6 represented good norms. Poor norms referred to participants who supported or preferred consanguineous marriage, while good norms indicated participants who opposed consanguineous marriage and did not support it. Additionally, poor indicated a participant's perception of their family's attitude supporting consanguineous marriage, while good indicated a participant's perception of their family's attitude opposing consanguineous marriage and not supporting it. Lastly, a multiple-choice question was included regarding participants' intended marriage decision when a couple's premarital examination did not match. The available answer choices were categorized as follows: 3 for a good decision, 2 for neutrality, and 1 for a poor decision. Participants who chose 'poor' indicated a willingness to continue the marriage regardless of the premarital screening result, while those who selected 'good' indicated an intention to seek genetic counseling to make an informed decision. 'Neutral' represented participants who were undecided about their future

2.1 研究设计
本研究于2022年1月22日至2022年4月22日的三个月周期内，针对沙特阿拉伯的大学生开展了一项预试验研究（pilot study），旨在收集相关研究数据。数据通过在线问卷的形式采集，由参与者自行独立完成填写。

2.2 研究对象与纳入标准
本研究聚焦于未婚的沙特籍大学生群体。

2.3 研究工具与研究方法
本研究采用一套共计60个题项的问卷开展数据收集。选择问卷作为数据收集工具，原因在于其具备成本效益高、采集效率突出的优势，可面向大规模参与者开展标准化的数据收集工作。
其中，关于知识认知与感知威胁的题项改编自两项既往研究工具：9个题项改编自Miri-Moghaddam等人[17]的研究，3个题项改编自Al-ghubishi等人[18]的研究。研究者对问卷进行了修改与补充，以使其适配本次研究的目标人群。
该问卷共分为五个部分：
第1部分：该部分包含10道社会人口学问题，涵盖国籍、年龄、性别、婚姻状况、学业身份、学历层次、院校类型、专业、居住类型以及居住区域等信息。
第2部分：该部分包含32道题项，用于评估参与者对遗传性血液疾病的认知水平。问卷采用计分规则：答对计1分，答错计0分，满分值为32分。以中位数9分作为分界阈值：得分≥9分判定为认知水平良好，得分<9分则判定为认知水平较差。
第3部分：该部分包含6道题项，用于考察参与者对遗传性血液疾病相关威胁的感知程度。参与者采用3级李克特量表（Likert scale）进行作答，满分值为18分。分界阈值基于第一四分位数与第三四分位数确定：得分≤10分归类为低威胁感知，11~14分为中等威胁感知，≥15分则为高威胁感知。
第4部分：该部分包含2道题项，采用3级李克特量表（Likert scale）测量参与者的态度倾向，满分值为6分。分界阈值基于第一四分位数与第三四分位数确定：得分≤4分归类为态度较差，5分为态度中等，6分为态度良好。其中，态度较差指参与者支持或偏好近亲通婚（consanguineous marriage），态度良好则指参与者反对且不支持近亲通婚（consanguineous marriage）。
第5部分：该部分包含2道题项，采用3级李克特量表（Likert scale）评估社会规范认知，满分值为6分。分界阈值基于第一四分位数与第三四分位数确定：总得分≤4分归类为社会规范认知较差，5分为中等，6分为良好。社会规范认知较差指参与者感知其家庭支持近亲通婚（consanguineous marriage），良好则指参与者感知其家庭反对且不支持近亲通婚（consanguineous marriage）。
此外，问卷还设置了一道多选题，用于调查参与者在伴侣婚前检查结果不匹配时的婚姻决策意向。答案选项按决策质量分为三类：3分代表优质决策，2分代表中立，1分代表劣质决策。选择“劣质决策”的参与者表示，无论婚前筛查结果如何，均愿意继续这段婚姻；选择“优质决策”的参与者则表示，将寻求遗传咨询（genetic counseling）以做出理性决策；“中立”则指参与者对未来决策尚未明确。