Materials and Methods

This study involved retrospectively analyzing a foundational data set originally collected via an anonymous cross-sectional survey distributed among residents of KSA between March and May 2017. To establish a pre-vision 2030 snapshot, this study aimed to: (a) assess public awareness and exposure to organ donation campaigns, (b) measure support and positive perceptions toward donation after death, (c) determine the prevalence of organ donor card possession, and (d) examine how these factors vary across demographic groups.

Data source and variables

The analyzed data set was derived from a self-administered Arabic questionnaire designed to be accessible to an appropriate reading level. Content validity was established through a pilot test involving 15 adults, where their feedback helped to refine the questionnaire's linguistic clarity, logical flow, and cultural appropriateness prior to deployment.

For this retrospective analysis, data were extracted across three primary domains: (a) socio-demographic characteristics (e.g., age, gender, education level, employment status, and region of residence); (b) awareness and commitment, including public awareness of and exposure to organ donation campaigns, the prevalence of organ donor card possession, and baseline support for ODAD; and (c) reasons for non-support, where participants who indicated “No” to the preceding support question (“Do you support organ donation after death?”) were subsequently prompted with “If 'No’, Why?” and provided with options to specify their primary rationale from a predefined list. Responses were securely collected through a web-based form hosted by SurveyMonkey™ (SurveyMonkey Inc., San Mateo, California, USA), and all data were exported as a Microsoft Excel™ file for analysis.

Participant recruitment and sampling

The original convenience sample was recruited via a web-based form disseminated through major social media platforms and widely used communication applications. Eligible participants were adult residents (citizens and non-citizens) of KSA. The cover page of the questionnaire served as the consent form, informing participants about the study's purpose, confidentiality, and voluntary nature. Submission of the completed survey was considered implied consent. No personal identifying data were collected. This study was reviewed and approved by the Institutional Review Board of King Abdulaziz University, Jeddah, Saudi Arabia.

Statistical analysis

Descriptive statistics were used to characterize the study population and report key outcomes (such as awareness, support, and card possession) as proportions based on the number of valid (non-missing) responses for each respective question. To identify associations between various demographic predictors and these key outcomes, odds ratios (ORs) were calculated with 95% confidence intervals, and multivariable logistic regression was performed. Pearson's chi-squared test was utilized to compare categorical demographic variables and key outcomes. Responses from participants who stated “unsure” or “I do not know” to key questions were excluded from the analysis for OR calculations and logistic regression. The percentage distribution of reported reasons for non-support was analyzed and stratified by gender. A p-value ≤0.05 was considered to indicate a statistically significant difference. All statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) for Windows v.25.0 (IBM Corp., Armonk, NY, USA).