Knowledge, attitudes, and practices of Lebanese physicians on the screening of pediatric dyslipidemias: a KAP cross-sectional study.

Introduction: Pediatric dyslipidemia is common worldwide, especially in Lebanon, and is associated with increased long-term cardiovascular risk. However, international screening recommendations are still controversial. In Lebanon, no study has assessed physicians' knowledge, attitudes, and practices (KAPs) about this screening. Methods: A cross-sectional online questionnaire-based study was conducted among pediatricians, family medicine physicians, and endocrinologists practicing in Lebanon. The questionnaire assessed knowledge, attitudes, screening practices, and perceived barriers regarding pediatric dyslipidemia. Associations between variables were examined using univariate and multivariable analyses. Results: A total of 245 physicians participated in the study. Performance on the nine selected knowledge items was low (mean score of 53.2 ± 22.1 out of 100, median 55.6), with gaps mainly related to the prevalence of pediatric dyslipidemia in Lebanon and familiarity with international recommendations. Attitudes toward screening were generally favorable (mean score of 77.8 ± 14.2 out of 100, median 80), although 56.3% of participants reported concerns about family anxiety. Screening practices were heterogeneous and primarily relied on targeted screening when risk factors were present. Screening in adolescents was performed (always or most of the time) by 40.3% of endocrinologists, 32.6% of family medicine physicians, and 19.3% of pediatricians, with laboratory test costs and parental consent being the main obstacles (49.8% and 33.9%, respectively). The score based on the nine selected knowledge items showed a weak positive correlation with the attitude score (Spearman's ρ = 0.135, p = 0.035). Attitude scores differed significantly across reported screening-frequency categories (p<0.001). In multivariable analysis, female sex, family medicine practice, and practice in Beirut/Mount Lebanon (BML) were independently associated with higher score on the nine selected knowledge items (p=0.015, p<0.001, and p=0.005, respectively). Conclusion: Despite favorable attitudes, insufficient knowledge and contextual barriers limit the systematic implementation of pediatric dyslipidemia screening in Lebanon. Actions that combine training, harmonization of recommendations, and improved access to screening could strengthen pediatric cardiovascular prevention.