Rabia Allari
Khaldoun Hamdan1
Nedal Alfasfos- 1Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
- 2Department of Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College, London, United Kingdom
- 3Department of Nursing Education, Istiklal Hospital, Amman, Jordan
Background: Improving quality, efficiency, and environmental responsibility in healthcare requires sustainability, a concept that is gaining increasing recognition. In low-and middle-income countries such as Jordan, however, little is known about how healthcare professionals perceive sustainability.
Aim: This study aimed to assess healthcare professionals’ perceived knowledge, attitudes, and behaviors regarding healthcare sustainability and the correlation between their perception and demographic characteristics in Jordan.
Methods: A descriptive correlational design was utilized in this study. The validated Sustainability Consciousness Questionnaire (SCQ-S) was used to electronically gather data from 306 healthcare professionals employed by private hospitals in Amman, Al Zarqa, and Al Salt between January and May 2025. SPSS v 26 was used to conduct ANOVA tests and descriptive statistics.
Results: About 286 (93.5%) of participants scored higher than the midpoint of SCQ-S, indicating a high level of overall sustainability consciousness (M = 101.35, SD = 19.74). Environmental sustainability behaviors scored lowest (M = 10.77, SD = 2.71), while economic sustainability knowledge scored highest (M = 11.64, SD = 2.61). The ANOVA test revealed significant differences in HCP sustainability knowledge scores based on their specializations (F 3.61(3,302), p = 0.014). And based on their age (F = 4.07(3,302), p = 0.007). Older physicians and healthcare professionals scored higher than younger nursing staff (p < 0.05). Social media was the main source of information for more than half of the participants, 167 (54.6%), who were not familiar with the Sustainable Development Goals.
Conclusion: Although Jordanian healthcare professionals have a strong awareness of and positive attitudes toward sustainability, this is not always reflected in their behavior, particularly when it comes to environmental practices. To close this knowledge and behavior gap, health education must incorporate sustainability and sustainable development goals content in addition to institutional support and behavior empowerment.
1 Introduction
One of the most important sectors for providing services to any community is the healthcare sector, which is undergoing fast change and evolution. The healthcare industry’s organizational culture necessitates ongoing adjustments in the creation of strategies to enhance healthcare quality performance (Abid et al., 2023). Globally, healthcare organizations are increasingly adopting sustainable practices, but there is a lack of perspectives from low- and middle-income countries (Rivera, 2016; Berniak-Woźny and Rataj, 2023; Kuiter et al., 2025). Sustainability is “development that meets the needs of the present without compromising the ability of future generations to meet their own needs.” (Brundtland and Khalid, 1987). This definition is still thought to be the most comprehensive way to explain the concept of sustainability (Gulzar et al., 2023).
On September 25, 2015, the UN General Assembly adopted the Sustainable Development Goals (SDGs), which are a component of the Sustainable Development Agenda. They include 169 sub-goals that address social, economic, and environmental issues in addition to 17 universal goals (United Nations, 2015). The long-term SDGs are to improve the natural environment, build sustainable communities, and raise the standard of living for people everywhere (Mulyadi et al., 2023). These overarching, transformative, and encompassing goals, which draw attention to the real issues facing humanity (Nazar et al., 2018), were unveiled as a roadmap laying out a path to global sustainability for people, the environment, and economic prosperity by 2030 (Klein, 2020). Because the SDGs tackle global issues that are essential to human life, they have an impact on all stakeholders, including governments, civil society, non-profits, and the private sector. Given their resources and practices, large private sector organizations can play a significant role in achieving the SDGs. (United Nations, 2024).
Healthcare organizations safeguard and improve public health, but their environmental impact can negatively influence the health of humans and other living things (Marimuthu and Paulose, 2016). Therefore, hospitals and other healthcare organizations must be sustainable to promote human health and wellbeing. However, sustainability measures in healthcare structures must ensure that the quality of services provided by healthcare organizations, as well as access to and cost of healthcare, are not compromised to benefit both clients and healthcare organizations (Marimuthu and Paulose, 2016). Another critical issue that needs to be addressed in relation to sustainability in the healthcare sector is the management of waste disposal and air pollution. Consequently, it is increasingly urgent for healthcare institutions to count on a multidisciplinary team competent in many aspects of sustainability. In addition, the healthcare sector has to apply sustainability strategies to reduce its negative effects on both the economy and the environment (Molero et al., 2021).
Several challenges in healthcare and other service industries could hamper growth. Increasing work costs, restrictive environmental laws and rules, and intense competition. These pressures have been causing service providers to comply with environmental laws and regulations, as well as to become more environmentally friendly to reduce waste, increase efficiency, and protect their profits and position in the market. As sustainability becomes one of the central organizational strategies in use today, businesses have sought creative techniques to incorporate it into various functions (AlJaberi et al., 2020). Jordan is no exception in recognizing the enormous threats to the planet associated with increased use of natural resources. The country faces strong demand for both energy and water because of population growth, urbanization, and significant development in the construction sector (Ministry of Energy and Mineral Resources, 2019).
Jordan is among the world’s most water-scarce countries, with few freshwater resources (World Bank, 2024). Approximately one-third of greenhouse gas emissions and 40% of global energy consumption are produced by the construction sector (Ministry of Energy and Mineral Resources, 2019). Sector-by-sector electrical energy usage shows that households use the most (41%), while businesses use the least (17%). This includes the expensive consumers of electricity, including banks, hospitals, and hotels. As a result, Jordan established challenging objectives and a systematic strategy to lower energy use through efficient demand management.
Maximizing the benefits of sustainability measures inside a healthcare organization requires a global awareness of sustainability-based operations. To accomplish sustainability goals and consistently enhance quality and financial performance, according to Marimuthu and Paulose (2016), hospital operations sustainability measures may be divided into four categories: community, environment, customer, and staff. An examination of the literature on sustainability in the healthcare sector served as the foundation for the same study’s findings. The categories were represented by Marimuthu and Paulose as follows by the framework: (1) Environment-oriented sustainability in the healthcare sector, which aims to reduce costs while simultaneously improving environmental pollution through appropriate chemical handling and effective waste management (such as recycling water and using fewer hazardous chemicals). In the meantime, recycling is being used to cut down on rising treatment costs, green technology is being used to lower carbon dioxide, and ecologically friendly architecture and design techniques are being used to create therapeutic spaces. (2) As part of sustainability measures, customer-oriented sustainability focuses on healthcare workers’ understanding of the need to give patients high-quality care and attempts to balance patient expectations with available resources. Technology is essential for directing healthcare facilities toward sustainability, in addition to using state-of-the-art technology to deliver high-quality treatment and services to patients. According to Marimuthu and Paulose (2016), improving patient satisfaction is one of the most important ways to raise service quality and is closely related to healthcare sustainability. (3) An organization demonstrates its concern for its employees by promoting a healthy work environment and providing patients with high-quality services. This is known as employee-oriented sustainability. In the healthcare services sector, sustainability is adjusting healthcare operations to changing needs while preserving the health and wellbeing of employees. Oriented sustainability focuses on healthcare workers’ understanding of the need to give patients high-quality care and attempts to balance patient expectations with available resources. Therefore, the health sector’s transition to sustainability may be aided by improving the caliber of the healthcare professional staff, promoting sustainability in the face of perceived antiquated practices, and employing a longitudinal layout of supplies and equipment to boost workers’ satisfaction. (4) Community-oriented sustainability, in which rural areas and their inhabitants are negligent, have limited access, and make medical errors. Technology has been used to upgrade this community’s sustainability-based contributions. In response to public concerns, the healthcare industry also takes action to minimize pollution and save resources, and the principle of “Nonmaleficence” has become a guiding principle for their professional behavior (Marimuthu and Paulose, 2016).
In Jordan, the actions of the SDGs are meant to assist the country in improving throughout the next 15 years. The activities are meant to promote wellbeing and ensure healthy lives for individuals of all ages (Khader et al., 2021). Jordan still has a long way to go before reaching the SDGs, despite notable advancements in the health sector (Khader et al., 2021). Among these issues are the growing burden of the Syrian refugee crisis on Jordan’s healthcare system, the lack of long-term data to track the temporal evolution of implemented indicators, and the insufficient funding for Jordan’s planning and execution of sustainable development. Nonetheless, if Jordan follows and monitors SDG goals, the country is expected to have a better level of health by 2030 (Khader et al., 2021). Single research was carried out in Jordan to offer several sustainable alternative improvements and analyze a single hospital design in accordance with sustainability criteria (Al Shamas, 2020). Additionally, an economic study of the proposed sustainable upgrades to the hospital facility was carried out to ascertain whether they could be executed. Al Shamas’s research indicates that hospitals are considered to be significant consumers of resources. Sustainable hospital design optimizes quality and efficiency and minimizes negative impacts on the environment and human health. The study suggests that planning for hospital construction in Jordan should consider environmental and economic sustainability. The proposed changes in Al Shama’s research resulted in a decrease in the level of water and electricity consumption.
The Ministry of Health (MOH) in Jordan unveiled its 2023–2025 strategy, which is centered on delivering an integrated sustainable health system that improves individual and societal health and offers safe, equitable, high-quality, and efficient preventive, curative, rehabilitative, and palliative health services (Ministry of Health, 2023). Eight major pillars underpin the new strategy, which aims to improve the quality of services provided to locals and guarantee their fair distribution. These pillars complement the executive program of the economic modernization vision and the SDGs. The strategy is based on three core pillars, which are improving the effectiveness and efficiency of human resources; improving the quality of secondary and tertiary care services; and improving the quality of basic health care services. Additionally, it includes improving crisis and disaster response, preparedness, and response to climate change consequences and refugees (Ministry of Health, 2023). Moreover, it entails enhancing insurance coverage, enhancing the efficacy and efficiency in financial resource management, enhancing the efficacy and efficiency of information technology and digitalization, enhancing readiness and response to financial resource management, and enhancing and developing infrastructure and supply management with sustainability (Ministry of Health, 2023).
There is an increasing amount of research attempting to explain how employees participate in corporate sustainability efforts in the workplace (Harrach et al., 2020; Kramer and Porter, 2011). It is more evident than ever that firms must have engaged employees to strategically support sustainable management (Harrach et al., 2020). It is of international interest to learn how healthcare professionals (HCPs) perceive their knowledge, attitude, and practices in a sustainable healthcare sector. This paper will fill an untapped area of research on how Jordanian HCPs perceive knowledge, attitude, and practices toward healthcare sustainability, and correlate their perception with demographics. The findings of this research can act as a basis for additional studies on this subject and bring attention to the healthcare sector’s responsibility in achieving sustainability objectives. In addition, this study can be used to establish proper standards and specifications for future HCPs and update job descriptions in the healthcare industry to incorporate specific abilities that enhance sustainability initiatives. Professional development experts can use findings from this study to plan programs to be provided to HCPs, such as sustainability-focused outcomes. This study is unique because, as far as the researcher is aware, no previous research in Jordan has examined the HCPs’ knowledge, attitude, and behavior regarding sustainability and the correlation between knowledge, attitude, behavior, and selected demographic characteristics. So, the study will fill a gap in the literature by assessing healthcare professionals’ perceived knowledge, attitudes, and behaviors regarding healthcare sustainability and the correlation between their perception and demographic characteristics in Jordan.
2 Methods and materials
2.1 Research design
A descriptive correlational study was utilized to establish the correlation between different factors and to generate standing representations of variables to gauge the perspective of HCPs (Devi et al., 2022).
2.2 Sampling strategies
The researchers used a non-probability convenience sampling strategy, which is the simplest way to contact the sample, to choose participants. This might be due to geographical closeness, availability at a certain time, or a willingness to participate in the research (Roy, 2019). All HCPs (including nurses, physicians, pharmacists, and allied health sciences workers) working in private hospitals in the central Jordanian regions of Amman, Al Zarqa, and Al Salt made up the accessible population in the chosen settings. The G*Power 3.1.10 software was used to determine the sample size (Faul et al., 2007). The minimal sample number needed to perform the ANOVA test was 280 (power = 0.95, α = 0.05, and medium effect size = 0.25). To prevent incomplete surveys and participant withdrawal, an additional 20% was included. Thus, 330 was the very minimum anticipated sample size needed. Only HCPs who are (a) full-time employees and (b) have worked in the same hospital settings for at least a year are eligible to be included in the sample, excluding participants who were on leave during that time.
2.3 Setting
The World Bank lists Jordan as the top healthcare service provider in the region and in the top five worldwide, demonstrating the country’s highly developed healthcare sector. Military and university hospitals, as well as governmental and private hospitals, make up the country’s healthcare system (Tamimi et al., 2024). Now, Jordan has 121 hospitals that serve both Jordanian and foreign patients. There are 71 private hospitals, 33 government hospitals, 15 military hospitals, and two university hospitals (Tamimi et al., 2024). This research covered the private hospitals in Amman, Al Zarqa, and Al Salt that have the largest capacity in central Jordan. Due to their high personnel numbers and high occupancy rates, the private hospitals with the largest capacity were the settings chosen for this study. Because of the following reasons: First, it is evident that Jordan’s private health sector has undergone outstanding growth over the past century and contributes a lot to the national economy, particularly through medical tourism. Another reason to choose a private setting is, private hospitals are better at adopting new methods, practices, and sustainability approaches, which makes them a good locale for the assessment of one’s approach to the concept of sustainability. The third reason is that the private hospitals are more withholding in policymaking, resource allocation, and quality management systems, so they have a number of organizational and financial models. This freedom provides unique conditions to prove how sustainability reasoning works in a setting where patient satisfaction, accreditation standards, and strong competition for the market are among the most critical factors. Beyond this, private hospitals are under increasing pressure to observe the international standards set by Joint Commission International, the majority of which place excellence on sustainability factors, among others, such as waste management, energy efficiency, and environmental preservation. Therefore, it is indispensable and appropriate for this study to further assess the green healthcare practices of the healthcare professionals in the area. Finally, special attention is given to private hospitals, which helps avoid the risk of inconsistency of institutional frameworks and, as a result, of a point of comparison. This targeted approach, therefore, maximizes the experiment’s internal validity and provides it with a better and, at the same time, more engaging way to interpret its findings.
2.4 Instrument
An electronic self-administered questionnaire was distributed, which included the following sections:
Section one: Demographic Characteristics: age, gender, educational level, specialization, years of experience, management level, familiarity with SDGs, and Sources of information about SDGs.
Section two: The short version of the Sustainability Consciousness Questionnaire-Short (SCQ-S) developed by Gericke et al. (2019) was utilized. SCQ-S was built on UNESCO’s model and definition of sustainable development (economic, social, and environmental dimensions). It is aimed to measure the public’s knowledge, attitude, and behavior relating to the three classical domains of sustainable development: economic, social, and environmental. The survey includes a 27-items on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). There are 3 subscales in the instrument: “Sustainability Knowingness Scale,” the “Sustainability Attitudes Scale,” and “the Sustainability Behavior Scale.” Each subscale consists of nine questions divided into three domains: “economic,” “social,” and “environmental.” Gericke et al. (2019) validated the psychometric properties of the instrument and reported that it’s a valid and reliable instrument. Cronbach’s α for each subscale, knowingness, attitudes, and behavior, was 0.70, 0.78, and 0.72, respectively. In the current study, Cronbach’s alpha was 0.95 for the SCQ-S total scale and 0.94, 0.84, and 0.91 for the knowledge, attitude, and behavior sections of SCQ-S, respectively.
2.5 Translation of the English instruments and validity
Since the HCPs of Jordanian healthcare organizations/hospitals speak Arabic as their first language, the English instrument was translated into Arabic. Forward-backward translation, pilot testing, and final validation were all part of the procedure. The translation instructions of Tsang et al. (2017) served as the model for this procedure. This procedure included a series of sequential actions performed by multilingual specialists who possess a high level of fluency in both English and Arabic, as well as a deep understanding of healthcare terminology.
At first, the questionnaire was translated into Arabic by two separate, native Arabic speakers who are skilled in English, have experience in healthcare, and understand the concepts of “Sustainability.” The forward translation process seeks to create an Arabic version of the questionnaire that is conceptually equal to the original English form. This involves ensuring that the items remain intact while also being culturally appropriate to the Jordanian setting.
Following that, a retroversion was carried out, in which the original Arabic rendition was translated back into English by two more multilingual persons who were not part of the first translation process. These professionals had a high level of knowledge and skill in healthcare. The objective of this retroversion is to confirm that the Arabic rendition preserves the initial significance of the English questionnaire. The discrepancies between the original English text and the backward-translated version were found and examined to maintain conceptual coherence.
After the process of translating the text back to its original language, a committee was formed to conduct a review. This committee consisted of the original translators, the translators who worked on the backward translation, and specialists in the subject area. The committee analyzed the original English questionnaire, the Arabic version translated from English, and the English version translated back from Arabic to address any inconsistencies, improved the translation, and reached a consensus on the most precise and culturally suitable Arabic version of the questionnaire.
The validity of the Instruments was assessed using face validity. Three Jordanian healthcare management specialists who are proficient in Arabic and with substantial expertise in basic healthcare environments were asked to assess this instrument to determine its validity. Each specialist provided a brief explanation of the study, its instruments, and its contents. This kind of validity is the straightforward initial stage in determining the overall validity of the Instruments, which is concerned with whether a measure initially appears to be pertinent and appropriate for the subject it is evaluating (Polit and Beck, 2020). The experts used the following criteria to produce a description for each statement on instruments: (a) Pertinent to the measurement it is making. (b) Suitable for the participants. (c) Sufficient for its intended use.
2.6 Pilot study
Following the validation procedures, a pilot study was conducted involving 10% of the total study participants (N = 30) employed in private hospitals across Jordan. These participants met the inclusion criteria but were excluded from the main analysis to prevent any potential bias. The pilot study was conducted to ensure that the instrument’s items are clear and understandable, feasibility of the research design, to determine the preliminary reliability of the translated questionnaires, and to determine how long it takes to complete the questionnaire. It took an average of 5 min to finish the questionnaire. Although modest changes were made to clarify language and remove ambiguity in some words, participants reported that the questions were generally clear and pertinent. With Cronbach’s alpha of 0.96 for the SCQ-S total scale, and 0.97, 0.81, and 0.94 for the knowledge, attitude, and behavior sections of SCQ-S, the instrument’s internal consistency was deemed adequate. There were no significant procedural or logistical problems. The research instrument was decided to be suitable for use in the primary investigation, considering these findings.
2.7 Ethical considerations
The Institutional Review Boards (IRBs) of Al-Ahliyya Amman University (4/01-2025) and the selected hospital administrations provided their ethical approvals. The aim of the study was explained to the participants, and they were all allowed to provide their informed consent before responding to the questionnaire electronically. They were also reminded of their right to confidentiality and the fact that participation was optional, with guarantees that they may leave the study at any moment without incurring any fees. Participants received a cover letter on the beginning page of the electronic questionnaire detailing the objectives of the study, as well as their ability to withdraw at any moment, and a promise of anonymity. Only the primary researcher has access to the data, and participants’ confidentiality was preserved. This includes the use of password-protected, encrypted databases to store data. The instrument’s developers officially permitted the use of SCQ-S.
2.8 Data collection
The study instrument was distributed electronically to get the required sample size. The period of data collection was from January 2025 to May 2025. Participants were also requested to participate in the study online using their personal email and social media platforms such as Facebook and WhatsApp. A cover letter, participant information sheet, and permission form outlining the objectives of the research and participation were included on the first page of the online survey. After receiving approval from the hospital administration, the researcher visited each department and unit to speak with the managers to give permission to distribute the electronic questionnaire for eligible participants from all healthcare specialties.
2.9 Data analysis
Data analysis was conducted using IBM SPSS version 26. Data was checked for normality, outliers, and missing information. Missing data were examined using frequency distributions and descriptive statistics; none were observed, as the electronic distribution mandate required answering all questions. Both numerical and graphical methods were used to evaluate normality. The Shapiro–Wilk test was applied, and p-values greater than 0.05 indicated a normal distribution. Skewness and kurtosis values were calculated to assess the symmetry and peakedness of the distributions. Graphically, histograms and Normal Q–Q plots were used to inspect the distributions of continuous variables visually.
Following that, central tendency and dispersion measures, such as mean, percentages, standard deviation, and frequency, were used to calculate descriptive statistics of the participants’ demographic data. The mean and standard deviation of HCPs’ assessments of their knowledge, attitudes, and behaviors regarding sustainability were assessed. Since the SCQ-S is a Likert scale with five-point responses across multiple items that comprise a total scale, it is considered an interval-level scale (Norman, 2010). ANOVA was used to examine the relationships between healthcare workers’ knowledge, attitude, behavior, and sociodemographic characteristics. A p-value of less than 0.05 was deemed statistically significant.
3 Results
3.1 Demographic characteristics of the participants
This study successfully included 306 out of 330 recruited participants, which represents a 92.7% response rate. The health care professionals, 60% of them were nurses, 65% were females, and 58.8% were aged between 22 and 34 years. The majority of them held a bachelor’s degree (n = 221, 72.2%), had less than 5 years of experience (n = 146, 47.7%), and did not have a managerial role (n = 112, 36.6%). The responses indicated that 167 health care professionals (54.6%) were not familiar with SDGs. And social media was the main source of information about SDGs among participants (n = 76, 24.8%) (See Table 1).
Table 1. Demographic characteristics of the health care professionals (N = 306).
3.2 Health care professionals’ sustainability consciousness
The results of the sustainability questionnaire revealed a high level of sustainability consciousness among HCPs (M = 100.9, SD = 18.84) out of 135, with almost 286 (93.5%) scoring above the midpoint. The sustainability subscales scores showed close values, with a mean of 34.53 (SD = 7.44) for knowledge, 33.09 (SD = 6.29) for attitudes, and 33.3 (SD = 6.9) for sustainability behavior. The lower domain mean scores were for environmental sustainability behaviors (M = 10.77, SD = 2.71), while the highest domain mean scores were for economic sustainability knowledge (M = 11.64, SD = 2.61) (see Table 2).
Table 2. Health care professionals’ sustainability consciousness scores according to domains (N = 306).
More specifically, the higher agreement between respondents were for the items “Respecting human rights is necessary for sustainable development” (M = 3.96, SD = 1.02) on the social-knowledge domain, “I think it is important to reduce poverty” (M = 3.96, SD = 1.06) on the economic-attitudes domains and “Wiping out poverty in the world is necessary for sustainable development” (M = 3.93 SD = 0.99) on the economic-knowledge domain. On the other hand the least agreements were for the items “I think that using more natural resources than we need does not threaten the health and wellbeing of people in the future” (M = 2.79, SD = 1.19) on the attitude-environment domain, “I often purchase second-hand goods over the internet or in a shop” (M = 3.42, SD = 1.04) on the behavior-economic domain, and “I always separate food waste before putting out the rubbish when I have the chance” (M = 3.51, SD = 1.11) on the behavior-environment domain (see Table 3).
Table 3. Description of health care professionals’ sustainability consciousness items (N = 306).
3.3 Sustainability consciousness scores and health care professionals’ demographics
The ANOVA test revealed significant differences in HCP sustainability knowledge scores based on their specializations, F (3.302) = 3.61, p = 0.014, with 0.19 effect size. The Tukey HSD post hoc analysis showed that physicians (M = 36.98) have significantly higher scores than nurses (M = 33.57). Also, the ANOVA test revealed significant differences in HCP sustainability knowledge scores based on their age, F (3,302) = 4.07, p = 0.007, with 0.2 effect size. The Tukey HSD post hoc analysis showed significant differences between HCPs aged between 22–34 (M = 33.72) and those aged between 45–55 (M = 38.18), and between HCPs aged 35–44 (M = 34.38) and those aged between 45–55 (M = 38.18).
Similar trends were found with the sustainability attitudes and HCPs’ age, F (3,302) = 2.66, p = 0.048, with 0.16 effect size. Since the significance level of the ANOVA model was marginal, the Tukey HSD post hoc analysis failed to show significant differences between HCPs aged between 22–34 (M = 32.51) and those aged between 45–55 (M = 35.31), with p = 0.059. No significant differences were found between the sustainability scales and other sociodemographic characteristics.
4 Discussion
Our study examined HCPs’ perceived knowledge, attitudes, and behaviors regarding healthcare sustainability and the correlation between these perceptions and demographic characteristics in Jordan. In interpreting these findings, we refer directly to the patterns presented in Section 4, including the generally high sustainability consciousness scores (4.1), the weaker performance in environmental behaviors (4.2), and the demographic variations across age and professional groups (4.3). These results collectively frame the following discussion of cultural, organizational and systemic factors that may explain these patterns.
Overall, participants demonstrated high levels of sustainability consciousness, with over 93% scoring above the midpoint across knowledge, attitudes, and behavior domains. This finding aligns with international studies reporting that healthcare professionals increasingly recognize sustainability as an important aspect of healthcare delivery (Dunphy, 2014; Rizan et al., 2020; Sherman et al., 2021; Yeboah et al., 2024; McCauley et al., 2024; Huang et al., 2024; Guihenneuc et al., 2024; Alonazi and Alkhateeb, 2025; Rawashdeh et al., 2025; Lister et al., 2025). However, the results revealed disparities across domains. Environmental sustainability behaviors, such as recycling and waste segregation, scored the lowest, suggesting that while HCPs recognize the importance of sustainability, translation into consistent behaviors remains limited. This gap may reflect the lack of recycling infrastructure and lack of public awareness in Jordan (Sharaf, 2023; Ghazal et al., 2023) despite the fact that Jordan is actively tackling its waste challenge through initiatives in recycling and waste-to-energy (Leaders International, 2025). These findings are supported by national research indicating persistent systemic and cultural barriers to environmental action in Jordan. Arabiyat et al. (2024) demonstrate that effective recycling and waste segregation depend on robust institutional systems, infrastructure, and sustained public engagement; without these enabling conditions, individual intentions rarely translate into consistent behaviors. Similarly, Aljaradin et al. (2011) found that low public awareness, unclear responsibilities for waste separation, and limited willingness to participate in recycling have long constrained environmental practices nationally. Together, these studies help explain why Jordanian HCPs in our sample, despite strong sustainability knowledge and attitudes, reported lower engagement in environmental behaviors; the wider socio-institutional context does not consistently support, incentivize, or normalize environmentally sustainable actions. This echoes research indicating that individual, institutional, infrastructural, socio-cultural, and political factors can hinder or enable sustainable practice (Elson and Murphy, 2025; McCauley et al., 2024; Zurynski et al., 2023; Aboueid et al., 2023; Brand et al., 2021).
Cultural and contextual factors shape sustainability behaviors through values norms and historical context. These contextual realities help explain why environmentally responsible behaviors fall behind knowledge and attitudes. Importantly, evidence from cross-cultural sustainability research reinforces this contextual explanation. Tam (2024) highlights that pro-environmental behavior is not driven by attitudes alone but is deeply shaped by cultural norms, institutional expectations, and social perceptions of responsibility. In cultural contexts with higher power distance, such as many Middle Eastern healthcare systems, individuals may view environmental action as a responsibility of leaders or institutions rather than a personal obligation, which can inhibit individual behavior even when attitudes are favourable. Similarly, Vighnesh et al. (2024), studying sustainable behavior in a non-Western context, demonstrate that structural constraints, social norms, and culturally embedded expectations profoundly influence whether individuals translate pro-environmental values into action. These insights suggest that weaker environmental behaviors among Jordanian HCPs must be understood within broader sociocultural and institutional systems, not only at the individual level. Strong agreement with statements on human rights, equity, and poverty reduction suggests that HCPs in Jordan perceive social and economic sustainability as highly relevant. Conversely, weaker agreement with environmental behaviors, such as waste reduction or purchasing second-hand goods, may reflect cultural norms, limited systemic support, or a lack of institutional emphasis on environmental sustainability in healthcare facilities. This is consistent with Na’amneh and Al Husban’s (2012) analysis of second-hand clothing practices in Jordan, which shows that consumption behaviors are strongly shaped by socio-cultural identity dynamics. Their study found that second-hand purchasing is often socially stigmatised and associated with lower economic status, meaning that such practices may not be widely accepted or culturally endorsed despite their environmental benefits. These socio-cultural perceptions help explain why participants in our study demonstrated weaker agreement with behaviors such as buying second-hand goods or reducing consumption. Therefore, environmental considerations may be outweighed by cultural norms related to identity, status, and social acceptability. Addressing these contextual barriers is essential for promoting behavioral change.
A noteworthy finding in our study was that more than half of the participants reported unfamiliarity with the SDGs. This low level of awareness is likely influenced by several interrelated factors. First, sustainability and SDG-related content are not yet systematically integrated into undergraduate or postgraduate healthcare curricula in Jordan, resulting in limited formal exposure during professional preparation. Second, organizational priorities within healthcare institutions tend to focus on immediate clinical service delivery, with fewer structured opportunities for staff to engage with global sustainability frameworks such as the SDGs. Third, our findings showed that many participants rely primarily on social media for sustainability-related information, which may provide fragmented, inconsistent, or superficial coverage of the SDGs compared with formal educational or institutional sources. Although this reflects global trends, reliance on unverified sources raises concerns about misinformation and the limited integration of sustainability education in formal healthcare training in Jordan. Similar trends were reported in China (Xiao et al., 2016), Pakistan (Buriro et al., 2018), and USA (May and Noel, 2019), Egypt, and Saudi Arabia (Moustafa and Elsabahy, 2022). However, Xiao et al. (2016) argue that the growing influence of media and advertising in disseminating knowledge about climate change presents an opportunity to leverage these platforms more effectively to educate nurses on the issue. These findings are consistent with global analyses showing that SDG progress and sustainability behaviors are heavily influenced by cultural and political contexts. Leal Filho et al. (2020) note that insufficient SDG awareness, weak institutional prioritization, and cultural norms that do not fully embed sustainability contribute to uneven engagement across sectors, particularly in environmental domains. This global pattern reinforces our findings that low SDG familiarity and limited environmental behaviors among Jordanian HCPs are not solely individual issues but reflect broader cultural and organizational dynamics. To address these gaps, consistent with global recommendations on preparing the health workforce for sustainable practice (World Health Organization (WHO), 2023), integrating SDG-aligned content into health education programs, including nursing, medicine, and allied health, could strengthen foundational sustainability knowledge. Embedding SDGs within continuing professional development (CPD), organizational training programs, and hospital-based sustainability initiatives may also enhance familiarity and application in practice. Furthermore, aligning institutional sustainability efforts with national and global SDG targets, and clearly communicating these connections to staff, could help reinforce the relevance of the SDGs to everyday healthcare practice. Together, these targeted educational and organizational strategies could play a crucial role in improving SDG literacy and supporting more effective sustainability engagement across the healthcare workforce.
In a recent systematic review, Topcu and Kiraz (2025) reported that HCP in many settings perceived sustainability as secondary to their clinical responsibilities. Such findings algin with the well-documented intention-behavior gap in sustainability research where individuals express strong pro-environmental values but encounter structural, contextual, or institutional barriers that inhibit the translation of intention into consistent action (Kollmuss and Agyeman, 2002). As both Tamimi et al. (2024) and Vighnesh et al. (2024) argue, intention–behavior gaps are often culturally mediated, particularly in non-Western contexts where norms, authority structures, and institutional constraints shape pro-environmental decision-making.
Importantly, the study identified significant differences in sustainability knowledge and attitudes across specializations and age groups. Older HCPs demonstrated stronger attitudes and knowledge compared to younger colleagues. These findings align with prior research identifying age as a key factor influencing sustainability awareness. Studies across higher education and professional contexts indicate that older individuals often exhibit greater sustainability consciousness, likely due to accumulated experience, exposure to institutional initiatives, and an enhanced understanding of long-term consequences (Levine and Strube, 2012; Michael et al., 2020; El-Hamed et al., 2022; Badruddin, 2024; Mohamed et al., 2024; Magobe et al., 2025). These findings suggest that sustainability attitudes develop through professional and personal experience, and a need to integrate sustainability principles early in healthcare education and continuing professional development to foster engagement across all age groups.
Our study also found significant differences in sustainability knowledge based on professional specialization with physicians scoring higher than nurses. These differences may reflect variations in training exposure, professional responsibilities, and accumulated life and clinical experience. The observed differences between physicians and nurses may, however, also reflect the historical and cultural dominance of physicians within the Jordanian healthcare system (Al-Bustanji et al., 2024). Physicians traditionally occupy positions of higher authority and decision-making power, granting them greater access to information, professional autonomy, and institutional influence compared with nurses (Almukhaini et al., 2022). These hierarchical dynamics may contribute to the observed disparities in sustainability knowledge, as those in leadership or authoritative roles are more likely to be exposed to strategic discussions and policy initiatives related to sustainability. Addressing these professional hierarchies through inclusive, interdisciplinary education and leadership opportunities may therefore be essential to promoting equitable sustainability engagement across healthcare professions. Furthermore, interventions should be tailored to professional groups and career stages, ensuring that nurses and early-career staff receive targeted support to build sustainability capacity. A noteworthy finding was that over half of the participants reported unfamiliarity with the Sustainable Development Goals (SDGs). Similar findings were reported in Saudi Arabia (Alonazi and Alkhateeb, 2025).
These findings provide important insights into sustainability awareness within the healthcare sector, highlighting strengths as well as areas requiring targeted interventions.
4.1 Strengths and limitations
This study utilized the SCQ-S, which was developed by Gericke et al. (2019). This tool is grounded in the UNESCO model of sustainable development. Although the SCQ = S is not derived from a formal behavior change theory, it provides a theoretically informed framework for assessing sustainability consciousness, which allows meaningful interpretations of this study’s findings. However, it is recommended that future research follow sustainability theory or behavior-change models that will guide design and interpretation. This study achieved a high response rate and included a diverse sample of HCPs, enhancing representativeness. However, as a cross-sectional design, it captures perceptions at one point in time and cannot establish causality between demographic characteristics and sustainability perceptions; the use of self-report measures introduces potential recall and social desirability biases, particularly relevant for socially valued topics such as sustainability; the reliance on convenience sampling may have introduced selection bias, as respondents may differ systematically from non-respondents; and the inclusion of only a limited number of healthcare facilities restricts geographic representation, thereby limiting the generalisability of the findings to all regions and healthcare settings in Jordan. The study recognizes that a focus only on private hospitals may restrict the generalizability of findings to the public sector, as one might expect a potential difference in sustainability agendas among private and public institutions, due to compulsory alignment with governmental policies (for public institutions) or less budget constraints (for private institutions). Yet, private hospitals in central Jordan are varied with respect to organizational structure and a high number of patients, as well as exposure to sustainability initiatives becoming prevalent within public hospitals. Hence, the results contribute to the understanding of sustainability consciousness among healthcare professionals and represent a base for future research in different healthcare contexts.
4.2 Implications for practice and policy
This study provides baseline evidence to inform policy and educational initiatives to enhance sustainability in Jordanian healthcare. Interventions should focus on strengthening environmental behaviors, embedding SDG awareness in curricula, and tailoring strategies to professional roles and age groups. At a policy level, hospital leadership and national health authorities could integrate sustainability into accreditation, clinical guidelines, and professional development programs.
5 Conclusion
This national snapshot of Jordanian healthcare professionals shows high sustainability consciousness overall, but a knowledge–behavior gap, with environmental behaviors (e.g., waste separation, low-impact purchasing) falling behind knowledge and attitudes. More than half were unfamiliar with the SDGs, and younger HCPs and nurses reported significantly lower sustainability knowledge than physicians and older HCPs. These patterns suggest that targeted capability-building by discipline and career stage is needed to translate awareness into routine practice.
Embedding sustainability within the health sector is a multifaceted and interconnected endeavour that requires coordination across systems, disciplines, and policies (Berniak-Woźny and Rataj, 2023). Hospitals should prioritize behavioral enablers such as clear green clinical protocols (e.g., waste segregation at the point of use). Embedding sustainability in quality improvement (QI) (e.g., medication, energy, and waste pathways) can link environmental, safety, and cost outcomes and make behaviors measurable.
Pre- and post-registration curricula should integrate SDG education (Engebretsen et al., 2025), case-based and simulation activities, and interprofessional courses that reflect real team decision-making. Short courses and mentorship for early-career staff can address the lower scores among younger HCPs and nurses, with assessment moving beyond knowledge checks to observed behaviors in practice.
Future work should test behavior-change interventions that close the knowledge–behavior gap, use longitudinal designs to track durability, include qualitative studies to explore context-specific barriers, and link behaviors to hard outcomes (carbon, waste, cost, safety). Adapting and validating Arabic instruments will strengthen measurement across settings.
Overall, translating strong intent into consistent action will require aligned interventions across practice, education, and policy, with particular support for younger clinicians and nurses, the groups most pivotal to sustaining change.
Data availability statement
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
Ethics statement
The studies involving humans were approved by Al-Ahliyya Amman University/Faculty of nursing IRB. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.
Author contributions
RA: Funding acquisition, Writing – original draft, Software, Formal analysis, Resources, Visualization, Supervision, Project administration, Validation, Conceptualization, Investigation, Data curation, Methodology, Writing – review & editing. KH: Formal analysis, Writing – original draft, Data curation, Methodology. NA: Methodology, Validation, Data curation, Writing – original draft, Resources, Visualization. ZZ: Writing – original draft, Validation, Writing – review & editing. RA-H: Methodology, Data curation, Writing – original draft.
Funding
The author(s) declare that no financial support was received for the research and/or publication of this article.
Acknowledgments
The authors thank the nurses at selected settings in Jordan for their participation.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement
The authors declare that Gen AI was used in the creation of this manuscript. Grammarly was used for editing some parts, such as the abstract and 2 sentences in the introduction.
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References
Abid, G., Contreras, F., Rank, S., and Ilyas, S. (2023). Sustainable leadership and wellbeing of healthcare personnel: a sequential mediation model of procedural knowledge and compassion. Front. Psychol. 13:1039456. doi: 10.3389/fpsyg.2022.1039456,
Aboueid, S., Beyene, M., and Nur, T. (2023). Barriers and enablers to i`mplementing environmentally sustainable practices in healthcare: a scoping review and proposed roadmap. Healthc. Manage. Forum 36, 405–413. doi: 10.1177/0840470423118360,
Alonazi, A., and Alkhateeb, A. (2025). Knowledge, Attitude, and Practice of Environmental Sustainability Measures Among Physical Therapists in Healthcare.
Al Shamas, R. M. (2020). Evaluation of sustainability standards in hospital design: case study in Jordan. Available online at: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.iu.edu.jo/files/thesis/2020/68762.pdf
Al-Bustanji, M. F., Rayan, A., Eshah, N. F., Masa'deh, R., Baqeas, M. H., Rayyan, N., et al. (2024). Nurses’ perceptions of nurse–physician collaboration and quality of care in public hospitals. SAGE Open Nurs. 10:1-8. doi: 10.1177/23779608241286767,
AlJaberi, O. A., Hussain, M., and Drake, P. R. (2020). A framework for measuring sustainability in healthcare systems. Int. J. Healthc. Manag. 13, 276–285. doi: 10.1080/20479700.2017.1404710
Aljaradin, M., Persson, K. M., and Al-Itawi, H. I. (2011). Public awareness and willingness for recycle in Jordan. Int. J. Acad. Res. 3, 508–510.
Almukhaini, S., Weeks, L. E., Macdonald, M., Martin-Misener, R., Al Ismaili, Z., Macdonald, D., et al. (2022). Advanced practice nursing roles in Arab countries in the eastern Mediterranean region: a scoping review. JBI Evid. Synth. 20, 1209–1242. doi: 10.11124/JBIES-20-00002,
Arabiyat, O., Al-Bakri, J. T., Kölsch, F., Al-Omari, S., and Aladwan, H. (2024). Enhancing sustainable solid waste management through separate source collection. Glob. J. Environ. Sci. Manag. 10, 1345–1358. doi: 10.22034/gjesm.2024.03.24
Badruddin, A. (2024). Impact of demographic profile on sustainability learning: a management education students’ survey. Int. J. Manag. Educ. 22:100984. doi: 10.1016/j.ijme.2024.100984
Berniak-Woźny, J., and Rataj, M. (2023). Towards green and sustainable healthcare: a literature review and research agenda for green leadership in the healthcare sector. Int. J. Environ. Res. Public Health 20:908. doi: 10.3390/ijerph20020908,
Brand, G., Collins, J., Bedi, G., Bonnamy, J., Barbour, L., Ilangakoon, C., et al. (2021). “I teach it because it is the biggest threat to health”: integrating sustainable healthcare into health professions education. Med. Teach. 43, 325–333. doi: 10.1080/0142159X.2020.1844876,
Brundtland, G. H., and Khalid, M. (1987). Our common future, world commission on environment and development report. Oxford, UK: Oxford University Press.
Buriro, N. A., Mureed, S., Kumar, R., Ahmed, F., Hussain, K., and Fatima, A. (2018). Nurses’ perception, knowledge and information sources on climate change and health at Dow University hospital Karachi. J. Liaquat Univ. Med. Health Sci. 17, 265–271. doi: 10.22442/jlumhs.181740590
Devi, B., Lepcha, N., and Basnet, S. (2022). Application of correlational research design in nursing and medical research. J. Xi'an Shiyou Univ. Nat. Sci. Ed. 65, 60–69.
Dunphy, J. L. (2014). Healthcare professionals' perspectives on environmental sustainability. Nurs. Ethics 21, 414–425. doi: 10.1177/0969733013502802,
El-Hamed, A., Mohamed, S., Rashed, S. A., and Ali, H. M. (2022). Faculty of nursing students’ attitudes toward sustainable development goals. Assiut Scientific Nursing Journal 10, 199–206.
Elson, B., and Murphy, B. (2025). A survey of attitudes, behaviors and barriers to environmental sustainability among healthcare staff at an NHS trust. BMJ Lead. :leader-2025. doi: 10.1136/leader-2025-001301,
Engebretsen, E., Greenhalgh, T., and Han, P. K. (2025). Educating healthcare students in the sustainable development goals: from translational science to translational humanities. Med. Humanit. 51, 428–434. doi: 10.1136/medhum-2025-013292,
Faul, F., Erdfelder, E., Lang, A.-G., and Buchner, A. (2007). G*power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods 39, 175–191. doi: 10.3758/BF03193146,
Gericke, N., Boeve-de Pauw, J., Berglund, T., and Olsson, D. (2019). The sustainability consciousness questionnaire: the theoretical development and empirical validation of an evaluation instrument for stakeholders working with sustainable development. Sustain. Dev. 27, 35–49. doi: 10.1002/sd.1859
Ghazal, M., Parvaneh, F., Hammad, A., and Mohamed, Y. (2023). “Simulation Modeling For Sustainable Construction: A Case Study To Highlight The Social Aspect” in In 2023 Winter Simulation Conference (WSC) (IEEE), 2686–2697.
Guihenneuc, J., Cambien, G., Blanc-Petitjean, P., Papin, E., Bernard, N., Jourdain, B., et al. (2024). Knowledge, behaviours, practices, and expectations regarding climate change and environmental sustainability among health workers in France: a multicentre, cross-sectional study. Lancet Planet. Health 8, e353–e364. doi: 10.1016/S2542-5196(24)00099-8,
Gulzar, Y., Eksili, N., Caylak, P. C., and Mir, M. S. (2023). Sustainability consciousness research trends: a bibliometric analysis. Sustainability 15:16773. doi: 10.3390/su152416773
Harrach, C., Geiger, S., and Schrader, U. (2020). Sustainability empowerment in the workplace: determinants and effects. Sustain. Manag. Forum | NachhaltigkeitsManagementForum 28, 93–107. doi: 10.1007/s00550-020-00505-1
Huang, A., Cooke, S. M., Garsden, C., Behne, C., and Borkoles, E. (2024). Transitioning to sustainable, climate-resilient healthcare: insights from a health service staff survey in Australia. BMC Health Serv. Res. 24:475. doi: 10.1186/s12913-024-10882-8,
Khader, Y. S., Khatatbeh, M., and Aouididi, O. M. S. (2021). Baseline health-related data for monitoring sustainable development goals in Jordan. Handb. Healthcare in the Arab World, 1789–1811. doi: 10.1007/978-3-030-36811-1_163
Klein, A. (2020). Sustainable development goals best practices—one year in. Available online at: http://csr-asia.com/newslettersustainable-development-goals-best-practices-one-year-in (Accessed November 2, 2024).
Kollmuss, A., and Agyeman, J. (2002). Mind the gap: why do people act environmentally and what are the barriers to pro-environmental behavior? Environ. Educ. Res. 8, 239–260. doi: 10.1080/13504620220145401
Kuiter, S. G., Herrmann, A., Mertz, M., Quitmann, C., and Salloch, S. (2025). Should healthcare professionals include aspects of environmental sustainability in clinical decision-making? A systematic review of reasons. BMC Medical Ethics 26:78.
Leal Filho, W., Eustachio, J. H. P. P., Caldana, A. C. F., Will, M., Lange Salvia, A., Rampasso, I. S., et al. (2020). Sustainability leadership in higher education institutions: An overview of challenges. Sustainability 12:3761.
Leaders International (2025). Jordan is actively tackling its waste challenge through initiatives in recycling and waste-to-energy. Available online at. https://www.leadersinternational.org
Levine, D. S., and Strube, M. J. (2012). Environmental attitudes, knowledge, intentions and behaviors among college students. J. Soc. Psychol. 152, 308–326. doi: 10.1080/00224545.2011.604363,
Lister, H. E., Mostert, K., Ramkilawon, G., Oelschig, C., Ntiyane, O., Richardt, E., et al. (2025). Namibian Healthcare Professionals’ Knowledge, Attitudes and Practices Regarding Environmental Sustainability in Healthcare. International Journal of Environmental Research and Public Health 22:751.
Magobe, M., Ngaruko, D., Mtae, H. G., Mkwizu, K. H., and Kitulo, A. (2025). Demographics and economic sustainability consciousness for sustainable development in higher education institutions: study of Tanzania. Asian J. Dist. Educ. 20, 39–50. Available online at: https://www.asianjde.com/ojs/index.php/AsianJDE/article/view/832
Marimuthu, M., and Paulose, H. (2016). Emergence of sustainability based approaches in healthcare: expanding research and practice. Procedia Soc. Behav. Sci. 224, 554–561. doi: 10.1016/j.sbspro.2016.05.437
May, K., and Noel, D. (2019). School nurses and climate change. Annu. Rev. Nurs. Res. 38, 275–286. doi: 10.1891/0739-6686.38.275,
McCauley, P. R., Mathur, K., Miab, R. K., Cohen, N., Henriques-Thompson, K., and Gopinath, J. (2024). Environmental sustainability, healthcare workers and healthcare students: a literature review of attitudes and learning approaches. Health Prof. Educ. 10:12. doi: 10.55890/2452-3011.1293.
Michael, F. L., Sumilan, H. E. L. M. I., Bandar, N. F. A., Hamidi, H. A. N. A., Jonathan, V. I. C. T. O. R. I. A., and Nor, N. M. (2020). Sustainable development concept awareness among students in higher education: A preliminary study. Journal of Sustainability Science and Management 15, 113–122.
Ministry of Energy and Mineral Resources (2019). Annual report 2019. Available online at: https://www.memr.gov.jo/ebv4.0/root_storage/en/eb_list_page/annual_report_2019.pdf (Accessed November 2, 2024)
Ministry of Health (2023). The strategic plan of the Ministry of Health for the years 2023-2025. Available online at: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.moh.gov.jo/ebv4.0/root_storage/ar/eb_list_page/%D8%A7%D9%84%D8%AA%D9%82%D8%B1%D9%8A%D8%B1_%D8%A7%D9%84%D8%B3%D9%86%D9%88%D9%8A_%D9%84%D8%A7%D8%B5%D8%A7%D8%A8%D8%A7%D8%AA_%D8%A7%D9%84%D8%B3%D8%B1%D8%B7%D8%A7%D9%86_%D8%A7%D9%84%D9%85%D8%B3%D8%AC%D9%84%D8%A9_%D9%81%D9%8A_%D8%A7%D9%84%D8%A7%D8%B1%D8%AF%D9%86_%D9%84%D8%B9%D8%A7%D9%85_2022.pdf
Mohamed, M. A. E. S., Ghallab, E., Hassan, R. A. A., and Amin, S. M. (2024). Sustainability consciousness among nursing students in Egypt: a cross-sectional study. BMC Nurs. 23:343. doi: 10.1186/s12912-024-01990-1,
Molero, A., Calabrò, M., Vignes, M., Gouget, B., and Gruson, D. (2021). Sustainability in healthcare: perspectives and reflections regarding laboratory medicine. Ann. Lab. Med. 41, 139–144. doi: 10.3343/alm.2021.41.2.139,
Mulyadi, D., Ali, M., Ropo, E., and Dewi, L. (2023). Correlational study: teacher perceptions and the implementation of education for sustainable development competency for junior high school teachers. J. Educ. Technol. 7, 299–307. doi: 10.23887/jet.v7i2.62728
Na’amneh, M. M., and Al Husban, A. K. (2012). Identity in old clothes: The socio-cultural dynamics of second-hand clothing in Irbid, Jordan. Social Identities 18, 609–621.
Nazar, R., Chaudhry, I. S., Ali, S., and Faheem, M. (2018). Role of quality education for sustainable development goals (SDGS). Int. J. Soc. Sci. 4, 486–501. doi: 10.20319/pijss.2018.42.486501,
Norman, G. (2010). Likert scales, levels of measurement and the “laws” of statistics. Adv. Health Sci. Educ. 15, 625–632. doi: 10.1007/s10459-010-9222-y,
Polit, D., and Beck, C. (2020). Essentials of nursing research: appraising evidence for nursing practice. Philadelphia: Lippincott Williams & Wilkins.
Rawashdeh, M., Ali, M. A., McEntee, M., El-Sayed, M., Saade, C., Kashabash, D., et al. (2025). Assessment of the role of experience in shaping sustainability perceptions within radiography. Radiography 31, 103–111. doi: 10.1016/j.radi.2024.10.029,
Rizan, C., Reed, M., Mortimer, F., Jones, A., Stancliffe, R., and Bhutta, M. F. (2020). Using surgical sustainability principles to improve planetary health and optimise surgical services following the COVID-19 pandemic. The Bulletin of the Royal College of Surgeons of England 102, 177–181.
Rivera, A. J. (2016). Leader consciousness and its influence on sustainability initiatives within non-profit healthcare organizations. Phoenix: Grand Canyon University.
Roy, M. (2019). Sampling methods: a survey. Res. Methodol. Soc. Sci., 181–205. doi: 10.4324/9780367810344-10
Sharaf, F. M. (2023). Assessment of urban sustainability—the case of Amman City in Jordan. Sustainability 15:5875. doi: 10.3390/su15075875
Sherman, J. D., Andersen, M. P. S., Renwick, J., and McGain, F. (2021). Environmental sustainability in anaesthesia and critical care. Response to Br J Anaesth 2021; 126: e195–e197. British Journal of Anaesthesia 126, e193–e195.
Tamimi, A., Al-Abbadi, M., Tamimi, I., Juweid, M., Ahmad, M., and Tamimi, F. (2024). The transformation of Jordan’s healthcare system in an area of conflict. BMC Health Serv. Res. 24:1033. doi: 10.1186/s12913-024-11467-1,
Topcu, O., and Kiraz, E. D. E. (2025). Exploring Knowledge, Attitudes, and Behaviours Towards Sustainable and Green Healthcare Systems: A Scoping Review. Asian Journal of Environment and Ecology 24, 112–129.
Tsang, S., Royse, C. F., and Terkawi, A. S. (2017). Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J. Anaesth. 11:80. doi: 10.4103/sja.SJA_203_17,
United Nations (2015). Sustainable development goals 17 goals to transform our world. Available online at: https://www.un.org/en/exhibits/page/sdgs-17-goals-transform-world (Accessed November 2, 2024).
United Nations (2024). Transforming our world the 2030 agenda for sustainable development| Department of Economic and Social Affairs. Available online at: https://sdgs.un.org/2030agenda (Accessed November 2, 2024).
Vighnesh, N. V., Patil, B., and Chandrashekar, D. (2024). Evolving a conceptual framework for sustainable e-waste management: A consumer typology based on environmental behavior. Journal of Indian Business Research 16, 55–83.
World Health Organization (WHO) (2023). Operational framework for building climate resilient and low carbon health systems. Geneva: World Health Organization; Licence: CC BY-NC-SA 3.0 IGO.
World Medical Association (2000). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Bulletin of the World Health Organization 79, 373–374.
World Bank. (2024). Sustainability Review 2023. Available online at: https://openknowledge.worldbank.org/entities/publication/fe71a57b-feb3-468e-87a6-92834928b13c
Xiao, J., Fan, W., Deng, Y., Li, S., and Yan, P. (2016). Nurses’ knowledge and attitudes regarding potential impacts of climate change on public health in central of China. International Journal of Nursing Sciences 3, 158–161.
Yeboah, S. D., Gatsi, J. G., Appiah, M. O., and Fumey, M. P. (2024). Examining the drivers of inclusive growth: A study of economic performance, environmental sustainability, and life expectancy in BRICS economies. Research in Globalization 9:100267.
Keywords: healthcare professionals, sustainability, attitude, knowledge, sustainable development goals, Jordan
Citation: Allari R, Hamdan K, Alfasfos N, Zahran Z and Al-Harazneh R (2025) Sustainability knowledge, attitudes, and behaviors among healthcare professionals in Jordan. Front. Sustain. 6:1733087. doi: 10.3389/frsus.2025.1733087
Edited by:
Ioannis Politis, Aristotle University of Thessaloniki, GreeceReviewed by:
Radhwan Hussein, Ninevah University, IraqAristomenis Kopsacheilis, Aristotle University of Thessaloniki, Greece
Copyright © 2025 Allari, Hamdan, Alfasfos, Zahran and Al-Harazneh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Rabia Allari, Ui5hbGxhcmlAYW1tYW51LmVkdS5qbw==
†ORCID: Rabia Allari, orcid.org/0000-0003-0892-346X