Objective: This study aims to develop, validate and determine the reliability of an interactive multimedia strategy to prevent tobacco use among the young (TUPY-S) from an adolescents’ perspective. Methods: A descriptive study design was utilized. A modular instruction guideline by Russel (1974) was followed in the entire process, comprising a feasibility study, a review of existing modules, specification of the objectives, identification of the construct criterion items, learner analysis and entry behavior specification, establishment of the sequence instruction and media selection, a tryout with students and a field test. Result: Feasibility was agreed among the researchers and the school authorities. Culturally suitable rigorously developed tobacco use preventive strategies delivered using information technology (IT) are lacking in the literature. The objective of TUPY-S is to prevent tobacco use among adolescents living in Malaysia. Identified construct criterion items include knowledge, attitude, intention to use, self-efficacy, and refusal skill. The target population was early adolescents belonging to generation-Z. Content was developed from the adolescents’ perspective and delivered using IT in Malay language. Content validity, assessed by six experts in the field and module development, was good at 86%. The students’ tryout showed satisfactory face validity subjectively and objectively (85.5%) and high alpha Cronbach reliability (0.91). Conclusion: TUPY-S was confirmed to suit early adolescents of the current generation living in Malaysia. It demonstrated good content validity among the experts, satisfactory face validity and reliability among the target population. TUPY-S is ready to be evaluated for its effectiveness among early adolescents.
There are several methods available for assessment of sodium intake, including dietary and urinary excretion, which are fraught with methodological difficulties. Therefore, the aim of this study was to validate dietary and urinary excretion methods against 24-hour urinary excretion method in estimating sodium intake in Malaysian adults. A cross-sectional study has been carried out between November to December 2015. About 1568 adults aged 18 to 59 years old have participated from 16 study sites located in the 13 states and two federal territories of Malaysia. The study collected basic socio-demographic data and habitual dietary intake by Food Frequency Questionnaire (FFQ). Respondents were also asked to complete a two-day food intake diary (2FD) and collect their 24-hours urine and spot urine using standard protocols. A total of 1116 adults successfully completed the survey, yielding a response rate of 71%. Sodium intake from 24-hour urine excretion was estimated at 2585.9mg/day which is above the recommendation by World Health Organization (WHO). The 2FD showed the nearest mean estimate to the reference method but the spot urine with Tanaka’s predictive equation showed the least bias. The estimation of sodium from spot urine alone or with Kawasaki’s predictive equation and FFQ method showed poor mean estimates and a large bias compared to the reference method. The 2FD and spot urine with Tanaka’s prediction equation can be good alternatives for estimating daily sodium intake at the population level but not at the individual level.