Search Results (179)

The digital transformation of education demands a comprehensive understanding of how leadership orientations and digital competencies intersect among educators. This exploratory cross-sectional study examined associations between self-reported leadership orientations, digital skills, and organizational readiness for innovation among 71 primary school teachers in Western Attica, Greece. Using the Multifactor Leadership Questionnaire (MLQ Form-5x) adapted for respondents without administrative roles, we measured leadership self-concept—teachers’ preferences and tendencies regarding leadership—rather than enacted behaviors. This distinction is critical given that 94.4% of participants lacked principal experience; thus, responses reflect aspirational orientations rather than observed behavioral patterns. Descriptive profiling approaches, including K-means clustering and multinomial logistic regression, identified three tentative response pattern groupings: Passive-Moderate (53.5%), Balanced-Active (33.8%), and High-Engagement (12.7%), with observed multivariate differences. After reverse-coding the passive-avoidant items, transformational leadership showed the highest mean score (M = 4.33), followed by passive-avoidant (M = 4.15; reflecting low endorsement of avoidant behaviors) and transactional (M = 3.91). Transformational leadership demonstrated acceptable internal consistency (α = 0.783), while transactional (α = 0.583) and passive-avoidant (α = 0.617) scales showed lower reliability, warranting cautious interpretation. Critical competency gaps emerged in professional digital domains—particularly web development (22.5% deficit) and administrative systems (18.3% deficit)—despite a surplus in consumer technologies such as social media (−29.6%), revealing an ‘aspirational gap’ between leadership self-concept and digital readiness—technology familiarity does not automatically translate to digital leadership capability. Digital skills showed the strongest association with profile membership, with each additional skill associated with a 32–67% increase in the odds of membership in more engaged profiles. These findings suggest digital competency development may be associated with leadership orientation patterns, though the cross-sectional design precludes causal inference. Methodological limitations—including lower scale reliability, weak cluster separation (silhouette = 0.150), and modest sample size—require that findings be interpreted as hypothesis-generating rather than definitive. This work offers preliminary insights relevant to SDG4 (Quality Education) regarding heterogeneity in leadership orientation among primary educators, while highlighting the need for culturally validated instruments and for replication with larger samples. Full article

Background/Objectives: Teacher burnout represents a complex cognitive-emotional syndrome characterized by the interplay between mental exhaustion and emotional dysregulation, threatening educational sustainability during crisis periods. This study employed comprehensive behavioral data analysis to investigate burnout syndrome patterns among Greek teachers during the COVID-19 educational crisis, aiming to identify risk factors and resilience patterns through multiple analytical approaches that capture the syndrome’s multidimensional nature. Methods: A cross-sectional study examined primary and secondary school teachers in Western Greece during the autumn of 2021. Stratified random sampling ensured representativeness across school levels, geographic locations, and employment types. Participants completed the Greek-adapted Maslach Burnout Inventory for Educators, which measured emotional exhaustion, depersonalization, and personal accomplishment. Behavioral data analysis integrated traditional statistical methods with advanced pattern recognition techniques, including classification trees for non-linear relationships, association analysis for behavioral patterns, and cluster analysis for profile identification. Results: The majority of teachers experienced high stress with inadequate coping capabilities. Classification analysis achieved high accuracy in predicting burnout severity, identifying emotional exhaustion as the primary predictor. Deputy teachers demonstrated severe cognitive-emotional strain compared to permanent colleagues across all dimensions, with dramatically reduced personal accomplishment and minimal resources. Association analysis revealed that combined low support and high workload more than doubled burnout risk. Three distinct profiles emerged: Resilient teachers, characterized by older age and permanent employment; At-Risk teachers, showing early warning signs; and Burned Out teachers, predominantly young and in precarious employment. Remote teaching, exceeding half of the workload, significantly increased strain. Multiple regression confirmed emotional exhaustion as the dominant syndrome predictor. Conclusions: Behavioral data analysis revealed complex cognitive-emotional patterns constituting burnout syndrome during educational crisis. Employment precarity emerged as the fundamental vulnerability factor, with young deputy teachers facing dramatically higher syndrome probability compared to supported senior permanent teachers. The syndrome manifests through cascading processes where cognitive overload triggers emotional exhaustion, subsequently reducing personal accomplishment. These findings provide an evidence-based framework for early syndrome identification and targeted interventions addressing both cognitive and emotional dimensions of teacher burnout. Full article

(1) Background: Professional burnout threatens secondary school principals’ well-being and educational quality worldwide. This study investigated burnout prevalence and gender differences among Greek secondary school principals, addressing gaps in understanding gendered manifestations of burnout in educational leadership. (2) Methods: A census survey was conducted with 54 secondary school principals (68.5% male, 31.5% female) from Fokida Prefecture, Greece. The Maslach Burnout Inventory-Educators Survey assessed three burnout dimensions. Mann–Whitney U tests examined gender differences, with effect sizes calculated for practical significance. (3) Results: Emotional exhaustion was prevalent among principals regardless of gender. Significant gender differences emerged in depersonalization, with male principals showing higher emotional distancing (small-to-medium effects). Female principals demonstrated significantly higher personal achievement, maintaining professional efficacy despite equivalent exhaustion. (4) Conclusions: These preliminary findings suggest that while workplace stressors create universal emotional exhaustion, gender shapes burnout manifestation through different coping pathways. Male principals appear more prone to emotional distancing, while female principals sustain achievement through maintained engagement. Pending replication in larger samples, findings support the need for gender-sensitive interventions alongside systemic organizational reforms. Full article

Background: Primary school teachers are experiencing unprecedented occupational stress due to technological demands, varied student needs, and the enduring psychological effects of the COVID-19 pandemic. Although burnout research is extensive globally, evidence regarding Greek primary educators remains scarce, particularly in post-pandemic contexts where Mediterranean cultural values, economic constraints, and centralized governance may yield unique patterns. Methods: This cross-sectional study examined professional burnout among 102 primary school teachers in Achaia prefecture, Greece, during autumn 2022. The Greek-validated Maslach Burnout Inventory-Educators Survey assessed emotional exhaustion, depersonalization, and personal accomplishment. The psychological impact of COVID-19 was evaluated alongside demographic and occupational factors. Analyses included descriptive statistics, nonparametric tests, correlation analyses, hierarchical clustering, and multiple regression models. Results: The sample exhibited mixed burnout profiles, with 42.2% indicating low emotional exhaustion (while 35.3% showed high levels) and 67.6% showing minimal depersonalization. Bivariate analysis revealed that the psychological burden of COVID-19 was significantly correlated with depersonalization (r = 0.339, p < 0.001) but not with emotional exhaustion (r = 0.078, ns) or personal achievement. However, multivariate regression controlling for demographic factors revealed a suppression effect: pandemic burden emerged as the strongest predictor of emotional exhaustion (β = 0.52, p < 0.001), while its association with depersonalization became non-significant. Cluster analysis identified four distinct profiles: Emotionally Strained (49.0%), Resilient (32.4%), Detached (15.7%), and At-Risk (2.9%). Gender significantly predicted emotional exhaustion (model R² = 0.136), while rural location and years of service predicted depersonalization (model R² = 0.225). Conclusions: Greek primary school teachers demonstrated remarkable resilience after the pandemic, maintaining professional effectiveness despite emotional challenges. The suppression effect observed for COVID-19 burden—significantly associated with depersonalization bivariately but with emotional exhaustion multivariately—highlights the importance of examining both direct and demographically mediated stress pathways. The dimensional independence observed, particularly personal achievement's resilience to external stressors, contests unified burnout models and indicates that targeted interventions addressing specific burnout dimensions may be more effective than holistic approaches. Full article

Background/objectives. Emerging viral diseases represent an increasing threat to global health security, driven by environmental change, globalization, and intensified human–animal–environment interactions. The COVID-19 pandemic exposed critical weaknesses in preparedness systems but also demonstrated the transformative potential of recombinant vaccine technologies, which enable rapid, scalable, and safe responses to novel pathogens. We aim to examine the role of recombinant vaccine platforms in the management of emerging viral diseases, emphasizing their contribution to health system preparedness and exploring strategies for their integration into preparedness frameworks. Methods. We synthesized the current evidence on recombinant vaccine platforms (viral vector, protein subunit, DNA, and mRNA) through a targeted review of the scientific literature, regulatory documents, and global health policy reports. Drawing from experiences like COVID-19 (mRNA vaccines) and Ebola (rVSV-ZEBOV), we analyzed the advantages, challenges, and lessons from initiatives such as the CEPI, BARDA, HERA, and WHO frameworks. Results. Recombinant vaccine platforms offer significant advantages for epidemic preparedness through rapid adaptability, standardized production, and strong safety profiles. Nonetheless, challenges remain in manufacturing scalability, cold-chain logistics, regulatory harmonization, and equitable global access. Global initiatives such as the CEPI, WHO-led programs, BARDA, and regional manufacturing networks exemplify this collaborative approach, while regulatory mechanisms have proven to be essential to timely vaccine deployment. Conclusions. Recombinant vaccines have redefined preparedness by coupling scientific innovation with operational agility. Strengthening global coordination, regional production capacity, and public trust is essential to ensure that technological progress translates into equitable and effective public health impacts. Full article

Background: With the worldwide resurgence of Mpox in 2022, understanding its regional features is important. This systematic review aimed to provide an overview of the epidemiology, risk factors, clinical features, and outcomes of Mpox in Saudi Arabia to fill the knowledge gaps in this area. Methods: Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic search was performed on PubMed, MEDLINE (via Ovid), Scopus and Wiley Online Library for case reports and series published on Mpox in Saudi Arabia after 2022. Results: Analysis included eight studies comprising a total of 410 patients with confirmatory data. The cohort was predominantly male (91%), with a mean age of 32.8 years. Extramarital sexual contact was the most frequently identified risk factor (28.8%), whereas most patients (63.4%) had unknown or denied exposure routes. The most common clinical manifestations were fever (97.1%) and rash (96.8%). Dermatological findings were usually pleomorphic. These included umbilicated pustules, crusted papules, and vesiculopustular lesions. Although management was primarily supportive, rare complications, such as keratitis and neurological deficits, were observed. Conclusions: In Saudi Arabia, Mpox primarily affects young adult males, particularly individuals with high-risk sexual behaviors. Much of this transmission remains undetermined, and better contact tracing and focused public health efforts are urgently required. Full article

(1) Background: Education serves as a catalyst for social transformation toward sustainability, yet limited empirical evidence exists regarding primary education’s contribution to regional sustainable development, particularly in island contexts facing unique environmental and economic pressures. This study examined primary education teachers’ perceptions, practices, and challenges in implementing Education for Sustainable Development (ESD) in Zakynthos, Greece. (2) Methods: A triangulated quantitative approach surveyed a representative sample of 105 primary education teachers from the Zakynthos Primary Education Directorate using a 28-item structured questionnaire assessing ESD knowledge, teaching practices, barriers, and improvement strategies. Teacher questionnaire data were triangulated with KEPEA (Center for Environmental Education and Sustainability) program documentation (103 programs, 2020–2025) and school implementation records from 75 participating schools. Data were analyzed using descriptive statistics, Mann–Whitney U tests, Kruskal–Wallis tests, and Spearman correlations. (3) Results: Most teachers (65.7%) reported adequate knowledge of sustainable development concepts, with 75.3% incorporating ESD into teaching practice often or very often. Triangulation revealed convergent findings: environmental sustainability dominated teacher perceptions (67.3%) and KEPEA programming (78.4%), while economic sustainability received limited attention (18.1%). Female teachers demonstrated significantly higher ESD knowledge (U = 892.5, p < 0.05, r = 0.34). The majority (98.1%) considered ESD integration important, yet only 48.5% felt adequately prepared to teach sustainability topics. A notable attitude-action gap emerged: while 86.6% valued community partnerships, only 47.6% engaged frequently, and KEPEA documented 33.7% of formal collaborations. Primary barriers included insufficient curriculum time (61.9%) and limited resources (51.4%). Teachers identified training programs (71.4%) and access to educational materials (71.4%) as priority interventions. (4) Conclusions: Primary education teachers in Zakynthos demonstrate strong commitment to ESD but face structural barriers limiting implementation effectiveness. The environmental-economic imbalance suggests a need for professional development, integrating economic sustainability concepts through place-based approaches relevant to the island’s tourism-dependent economy. The attitude-action gap in partnerships indicates structural rather than attitudinal barriers requiring policy intervention. Findings support targeted teacher training, curriculum reform, and strengthened school-community collaboration to enhance ESD’s contribution to regional sustainable development. Full article

(1) Background: Information and Communication Technology (ICT) integration in secondary education remains a critical challenge despite substantial investments in teacher training and infrastructure. This study investigated ICT certification levels, implementation patterns, and barriers among Greek secondary school teachers to understand the disconnect between policy aspirations and classroom realities. (2) Methods: A quantitative cross-sectional survey design was employed with 108 secondary teachers (61.1% female; mean age 47.3 years; 70.4% with >10 years’ experience) in the Prefecture of Ilia, Greece (response rate: 87.7%). Participants were permanent secondary school teachers employed in public schools during the 2021–2022 academic year; substitute teachers and private school staff were excluded. A three-section structured questionnaire was developed through literature review, expert validation (n = 3), and pilot testing (n = 10). Section A assessed demographics (5 items), Section B measured perceived barriers using a 7-item Likert scale, and Section C assessed implementation practices using a 10-item frequency scale (Cronbach’s α = 0.942). Data were analyzed using descriptive statistics, Mann–Whitney U tests, Kruskal–Wallis tests, and correlation analyses. (3) Results: While 74.1% of teachers held Level A certification, only 25.9% achieved Level B, with overall implementation remaining moderate (M = 2.92/5.00). Leadership support deficiency emerged as the primary barrier (76.9%), followed by inadequate technical support (74.1%). Younger teachers (24–35 years) demonstrated significantly higher ICT implementation than their older colleagues (56+ years), and teachers with less experience showed greater implementation frequency than veteran teachers—a finding that paradoxically challenges the “digital natives” assumption, given the barriers they face. Teachers preferred flexible Internet resources to formal educational software, indicating strategic adaptation to institutional constraints. Key limitations include convenience sampling, cross-sectional design, self-reported measures, and regional specificity. (4) Conclusions: The certification–implementation gap reveals that individual competencies cannot overcome unsupportive institutional environments. Effective ICT integration requires systemic transformation, encompassing leadership development, technical support, and structural reforms beyond traditional teacher training approaches. Full article

Five Cornus mas L. genotypes were analysed based on their attractive colour and high productivity. The ‘Bordo’ cultivar stood out, demonstrating the highest berry weight (3.07 g) and yield per plant (8.24 kg). Close behind was the MH-7-17 selection, with an average yield of 7.37 kg per plant. Both the ‘Bordo’ cultivar and the MH-7-17 selection exhibited excellent agronomic potential, making them ideal candidates for large-scale cultivation. UV-Vis absorption spectroscopy was used to quantify the fruits’ levels of sugars, polyphenols, flavonoids, tannins, anthocyanins and carotenoids (lycopene and β-carotene) and to evaluate their antioxidant capacity. The ‘Bordo’ cultivar had the highest carotenoid content (0.88 mg lycopene and 2.47 mg β-carotene per 100 g), while the TG-J-9-17 and TG-J-20-17 selections had the highest total content of sugars, polyphenols, flavonoids, tannins and anthocyanins and the highest antioxidant capacity. According to the correlations analysis, bigger fruit (which correlated to higher yield) had higher carotenoid content, although lower-level tannin (TTC), flavonoid (TFC), anthocyanin (TAC), and sugar (TSC). Also, total phenolic content (TPC) was positively correlated to TTC, TFC, and radical scavenging activity (RSA), while TFC was positively correlated to TTC, TAC, RSA, but also to TSC. Other positive correlations were those found between TTC and RSA and between lycopene and β-carotene. FTIR spectroscopy was used to identify the characteristic vibrations of the biochemical constituents. Processing the FTIR data using chemometric techniques (principal component analysis and hierarchical clustering analysis) revealed consistent clustering patterns between samples with similar characteristics. Full article

Background: The COVID-19 pandemic forced an unprecedented global transition to emergency remote teaching, fundamentally disrupting traditional higher education delivery methods. This study investigated how Greek higher education students adapted to mandatory distance learning during the acute phase of the COVID-19 pandemic (March 2020 to May 2021), providing baseline evidence of forced technology adoption patterns that can inform understanding of subsequent hybrid learning developments and future educational design. Methods: A quantitative cross-sectional design surveyed n = 477 students from Greek higher education institutions using a structured questionnaire measuring technology access, platform usage, learning modality preferences, challenges encountered, and future educational perspectives. Data analysis employed descriptive statistics, Pearson correlations, and multiple linear regression to identify predictors of distance learning satisfaction and preferences. Results: Most students expressed positive attitudes toward distance learning (67.9%) and reported comfort with online courses (71.6%), with 69.8% strongly preferring hybrid approaches combining synchronous and asynchronous modalities. Internet connectivity emerged as the primary predictor of satisfaction (β = 0.393, p = 0.052), while demographic factors showed minimal influence (R² = 0.048). Most students achieved platform proficiency within ten days (73.6%), though 67.9% recognized that distance learning poses differential accessibility challenges. Conclusions: Despite successful adaptation to emergency remote teaching, students envision a hybrid educational future that strategically integrates online and face-to-face modalities rather than wholesale replacement of traditional methods, emphasizing the need for infrastructure investment and pedagogical innovation while preserving valued social learning dimensions. Full article

Background/objectives: Metabolomics has emerged as a powerful systems-biology tool for deciphering dynamic metabolic alterations occurring during infectious diseases and following vaccination. While genomics and proteomics provide extensive molecular and regulatory information, metabolomics uniquely reflects the biochemical phenotype associated with infection, immune activation, and immunometabolic reprogramming. The objective of this review is to provide an integrated analysis of metabolomics applications across both neglected tropical diseases (NTDs) and non-NTD pathogens, highlighting its dual role in biomarker discovery and vaccine response evaluation. Methods: A comprehensive literature-based synthesis was conducted to examine metabolomic studies in infectious diseases and vaccinology. Metabolic perturbations associated with specific pathogens, as well as vaccine-induced metabolic changes and correlates of immune responses, were systematically analyzed and compared across NTD and non-NTD contexts. Results: Distinct pathogen- and vaccine-associated metabolic signatures were identified, reflecting alterations in glycolysis, amino acid metabolism, lipid remodeling, and immunoregulatory pathways. Comparative analysis revealed both shared and disease-specific metabolic biomarkers across NTDs and non-NTD infections. Importantly, vaccine-related metabolic correlates were shown to mirror immune activation states and, in some cases, predict immunogenicity and response durability. Conclusions: This review bridges metabolomics research in infectious disease pathogenesis and vaccine immunology across the NTD and non-NTD spectrum. By integrating these domains, it introduces the concept of “metabolic immuno-signatures” as predictive and translational tools for evaluating vaccine efficacy and immune response outcomes. Full article

Background and Objectives: The Mediterranean diet is traditionally linked to metabolic balance and improved reproductive health. However, dietary patterns in Mediterranean regions have progressively shifted toward more Westernized models, particularly among women of reproductive age, raising concerns about declining adherence to this historically protective diet. Objective: To assess adherence to the Mediterranean diet among women undergoing assisted reproductive technology (ART) and to explore possible associations with ovarian response and clinical outcomes. Materials and Methods: This prospective observational cohort study was conducted at a reproductive clinic in Sicily between 1 June and 31 July 2022. One hundred women aged 18–40 years undergoing infertility assessment and scheduled for controlled ovarian stimulation were enrolled. Mediterranean diet adherence was evaluated using the validated 14-item MEDAS questionnaire during the first clinical visit. ART-related outcomes, including ovarian response and pregnancy rates, were extracted from medical records. Results: The mean MEDAS score was 7.6 ± 1.2: 93% of women showed moderate adherence, 3% high adherence, and 4% low adherence. No significant associations were found between MEDAS score, and total oocytes retrieved, MII oocytes, or clinical pregnancy. Conclusions: Despite living in a traditionally Mediterranean area, participants demonstrated only moderate adherence to the Mediterranean diet. Although no associations with single-cycle ART outcomes emerged, the findings underscore the need for structured nutritional counseling to reinforce sustained adherence and support long-term reproductive health. Full article

Background/Objectives: School violence represents a significant concern for educational communities worldwide, affecting student well-being and academic development. While prior research has documented prevalence rates and risk factors, limited studies have examined social–cognitive factors associated with antisocial behavior specifically within vocational education contexts using integrated analytical approaches. This exploratory cross-sectional study examined social–cognitive factors—specifically self-reported attitudes about aggression norms, prosocial attitudes, and school climate perceptions—associated with violence-supportive attitudes among Greek vocational students. Methods: A cross-sectional design employed validated self-report instruments and traditional statistical methods. The sample comprised 76 vocational high school students (38.2% male; ages 14–18; response rate 75.2%) from one school in Patras, Greece. Validated instruments assessed attitudes toward interpersonal peer violence (α = 0.87), peer aggression norms across four subscales (α = 0.83–0.90), and school climate dimensions (α = 0.70–0.75). Analyses included descriptive statistics, Pearson correlations with bootstrapped confidence intervals, MANOVA for multivariate group comparisons, independent samples t-tests, propensity score matching for urban–rural comparisons, polynomial regression for developmental patterns, and path analysis for theoretical model testing. Results: Strong associations emerged between perceived school-level and individual-level aggression norms (r = 0.80, p < 0.001, 95% CI [0.71, 0.87]), representing one of the strongest relationships documented in school violence research. Violence-supportive attitudes demonstrated inverse associations with prosocial alternative norms (r = −0.37, p < 0.001, 95% CI [−0.55, −0.16]). Significant gender differences emerged for teacher–student relationships (d = −0.78, p = 0.002), with females reporting substantially more positive perceptions. Propensity-matched urban students demonstrated higher aggression norm endorsement compared to rural students across multiple indicators (d = 0.61–0.78, all p < 0.020). Polynomial regression revealed curvilinear developmental patterns with optimal teacher relationship quality during mid-adolescence (ages 15–16). Path analysis supported a sequential association model wherein school-level norms related to individual attitudes through prosocial alternative beliefs (indirect effect β = −0.22, p = 0.002, 95% CI [−0.34, −0.11]). Conclusions: This preliminary investigation identified social–cognitive factors—particularly normative beliefs about aggression at both individual and environmental levels—as strongly associated with violence-supportive attitudes in Greek vocational education. The exceptionally strong alignment between school-level and individual-level aggression norms (r = 0.80) suggests that environmental normative contexts may play a more substantial role in attitude formation than previously recognized in this educational setting. Gender and urban–rural differences indicate meaningful heterogeneity requiring differentiated approaches. Future research should employ longitudinal designs with multi-informant assessment and larger multi-site samples to establish temporal precedence, reduce method variance, and test causal hypotheses regarding relationships between normative beliefs and behavioral outcomes. Full article

Identifying road surface cracks by semantic segmentation is a difficult problem. This is because segmentation typically detects objects by area, whereas cracks are string-like. Conventional loss functions such as Binary Cross-Entropy (BCE), Dice, and IoU often fail to capture the fine, elongated features of cracks, as they rely on pixel-level, area-based overlap, leading to suboptimal performance. To address this, we investigate one of the skeleton-based losses, the Centerline Dice (clDice) loss, which emphasizes the preservation of tubular structures via soft skeletonization. We improve road crack segmentation by combining clDice with conventional loss functions, systematically evaluating its role by varying the weight parameter and skeletonization iterations. Experiments are conducted on the EdmCrack600 and CrackForest datasets using two segmentation models: a customized CNN-based U-Net++ and a transformer-based SegFormer. Performance is evaluated using the Dice coefficient, IoU, clDice, and Hausdorff Distance. Results show that combining clDice and IoU loss with customized U-Net++ achieves superior performance. Compared to a standard BCE baseline, it improves the Dice coefficient by 4.9 and 2.8 percentage points on EdmCrack600 and CrackForest and improves the clDice score by 3.9 and 1.7 percentage points. These results highlight improved segmentation of thin, linear cracks, supporting practical advancements in road monitoring and segmentation of linear structures. Full article

Background: Social media is increasingly shaping patient decision-making about the choice of healthcare providers. However, its role in the Saudi context remains underexplored. This study aimed to examine the association between social media use and patient decision-making regarding the choice of healthcare providers in Saudi Arabia. Methods: This cross-sectional study used a validated online questionnaire. The study was conducted between December 2023 and May 2024 to assess demographics, social media usage, and decision-making factors. Results: 1242 participants completed the survey; most participants (96.2%) had personal social media accounts. Instagram (41.3%) and X (37.6%) were the preferred platforms to look up or follow doctors. The most influential factors in choosing a healthcare provider included physician qualifications, online reviews, and patient testimonials. While 81.3% believed medical practices should maintain a social media presence, traditional factors remained more decisive than promotional content. Younger participants, females, and those in the health field were significantly more likely to follow doctors online (p < 0.001). Conclusions: Social media plays a notable role in patient decision-making about healthcare provider selection in Saudi Arabia, particularly among younger individuals and those working in the health sector. Nevertheless, clinical qualifications and trust indicators remain paramount. These findings support the need for healthcare professionals to maintain a credible, ethical, and informative digital presence to enhance patient engagement and informed decision-making. Full article