BACKGROUND: Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely 'Eat Right, Be Positive About Your Body and Live Actively' (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13-14 years old.
METHODS/DESIGN: Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13-14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity), body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up.
DISCUSSION: It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents.
TRIAL REGISTRATION: UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016, retrospectively registered).
Matched MeSH terms: Feeding and Eating Disorders/prevention & control
BACKGROUND & AIMS: Several questionnaires to screen for eating disorders have been validated in Malaysia. However, these tools are lengthy, and require specialist interpretation. The sick, control, one stone, fat, food (SCOFF) is easy to administer by non-specialists, but has not been validated in Malaysia. Therefore, the aim of our study was to validate the SCOFF on a non-clinical sample of tertiary students to determine if it could identify individuals with an eating disorder.
METHODS: We recruited second year tertiary students from five faculties in a university in Malaysia, from June-November 2014, who could understand English. The SCOFF and the EAT-26 were administered at baseline. Two weeks later, the SCOFF was re-administered to assess for reliability.
RESULTS: A total of 292 students were approached, and all agreed to participate (response rate = 100%). There was moderate correlation between the total SCOFF score with the EAT-26's dieting domain (spearman's rho = 0.504, p < 0.001), bulimia and food preoccupation domain (spearman's rho = 0.438, p < 0.001), and total score (spearman's rho = 0.483, p < 0.001). The internal consistency of the SCOFF was low (Cronbach alpha = 0.470). At retest, kappa scores ranged from 0.211 to 0.591. The sensitivity of the SCOFF was 77.4%, and its specificity was 60.5%. The positive predictive value was 18.9%, and its negative predictive value was 95.8%.
CONCLUSIONS: The SCOFF was found to have adequate convergent validity and stable reliability. However, its internal consistency was low. The SCOFF can still be used in clinical practice. However, its positive results should be interpreted with caution due to its low positive predictive value.
KEYWORDS: Eating disorder; Malaysia; SCOFF; Sensitivity; Specificity; Validation
Matched MeSH terms: Feeding and Eating Disorders/prevention & control