{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:40:43Z","timestamp":1789486843969,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Nursing"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To assess sustainability awareness, behaviors, attitudes, and commitment among nursing and medical students in eight MENA countries, and to identify predictors of commitment to sustainability in future practice.<\/jats:p>\n <\/jats:sec>\n \n Design and Sample<\/jats:title>\n \n A multinational cross\u2010sectional survey (\n n<\/jats:italic>\n = 2,284) of eligible students (\u2265 18 years) from Iraq, Egypt, Yemen, Libya, Saudi Arabia, Palestine, Syria, and Oman.\n <\/jats:p>\n <\/jats:sec>\n \n Measurements<\/jats:title>\n Data were collected using a demographics\/awareness tool; the 29\u2010item Behavior Scale Towards Sustainable Environmental Education; the 5\u2010item Sustainability Attitudes in Nursing Survey\u20132; and a 5\u2010item commitment scale. All instruments underwent forward\u2013backward Arabic translation and pilot testing.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Awareness and sustainability behaviors were moderate. Energy\u2010saving practices were the most common behavior. Although attitudes toward sustainability in healthcare education were generally positive, only 11.8% of students described themselves as \u201cvery committed.\u201d Country, income, and academic level were significantly associated with awareness and behavior. In regression analysis, self\u2010reported behavior (\n \u03b2<\/jats:italic>\n = 0.464), awareness (\n \u03b2<\/jats:italic>\n = 0.166), and attitude (\n \u03b2<\/jats:italic>\n = 0.134) significantly predicted commitment (\n \n R\n 2<\/jats:sup>\n <\/jats:italic>\n = 0.385).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Commitment to sustainability was most strongly associated with self\u2010reported sustainability behavior, followed by awareness and attitudes; however, the cross\u2010sectional self\u2010report design prevents causal or enacted\u2010behavior interpretations. Curricula should emphasize applied, practice\u2010based sustainability training, and future longitudinal or intervention studies should test whether such training improves sustainable practice over time. Limitations include self\u2010report, non\u2010probability sampling, and cross\u2010sectional design.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/phn.70185","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:25:04Z","timestamp":1789478704000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Nursing and Medical Students' Attitudes Towards Sustainable Environmental Education Across Eight MENA Countries: A Multinational Cross\u2010Sectional Study"],"prefix":"10.1111","author":[{"given":"Hussein Kadhim","family":"Hussein","sequence":"first","affiliation":[{"name":"College of Nursing University of Warith Al\u2010Anbiyaa Karbala Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3964-7269","authenticated-orcid":false,"given":"Alaa Hamza","family":"Hermis","sequence":"additional","affiliation":[{"name":"College of Nursing Al\u2010Qadisiyah University Al\u2010Diwaniyah Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2144-8706","authenticated-orcid":false,"given":"Ammar Abdulhamza","family":"Abdulhassan","sequence":"additional","affiliation":[{"name":"College of Nursing Al\u2010Qadisiyah University Al\u2010Diwaniyah Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kahtan Hadi","family":"Hussein","sequence":"additional","affiliation":[{"name":"College of Nursing University of Babylon Babil Iraq"},{"name":"College of Nursing Al Mustaqbal University Babil Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7445-1537","authenticated-orcid":false,"given":"Wissam Mohammed","family":"Kareem","sequence":"additional","affiliation":[{"name":"College of Nursing Al Mustaqbal University Babil Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taliaa Mohsen","family":"Al\u2010Yafeai","sequence":"additional","affiliation":[{"name":"College of Nursing Ras Al Khaimah Medical and Health Sciences University Ras Al Khaimah UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1344-2050","authenticated-orcid":false,"given":"Nasiru Mohammed","family":"Abdullahi","sequence":"additional","affiliation":[{"name":"Department of Community, Psychiatric and Mental Health Nursing, College of Nursing Qassim University Buraydah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2939-3555","authenticated-orcid":false,"given":"Nadia Mohamed Ibrahim","family":"Wahba","sequence":"additional","affiliation":[{"name":"College of Nursing Prince Sattam Bin Abdulaziz University Al Kharj Saudi Arabia"},{"name":"Faculty of Nursing Port Said University Port Said 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