Displaying publications 161 - 180 of 280 in total

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  1. Kimman M, Jan S, Kingston D, Monaghan H, Sokha E, Thabrany H, et al.
    Asian Pac J Cancer Prev, 2012;13(2):421-5.
    PMID: 22524800
    Cancer can be a major cause of poverty. This may be due either to the costs of treating and managing the illness as well as its impact upon people's ability to work. This is a concern that particularly affects countries that lack comprehensive social health insurance systems and other types of social safety nets. The ACTION study is a longitudinal cohort study of 10,000 hospital patients with a first time diagnosis of cancer. It aims to assess the impact of cancer on the economic circumstances of patients and their households, patients' quality of life, costs of treatment and survival. Patients will be followed throughout the first year after their cancer diagnosis, with interviews conducted at baseline (after diagnosis), three and 12 months. A cross-section of public and private hospitals as well as cancer centers across eight member countries of the Association of Southeast Asian Nations (ASEAN) will invite patients to participate. The primary outcome is incidence of financial catastrophe following treatment for cancer, defined as out-of-pocket health care expenditure at 12 months exceeding 30% of household income. Secondary outcomes include illness induced poverty, quality of life, psychological distress, economic hardship, survival and disease status. The findings can raise awareness of the extent of the cancer problem in South East Asia and its breadth in terms of its implications for households and the communities in which cancer patients live, identify priorities for further research and catalyze political action to put in place effective cancer control policies.
    Matched MeSH terms: Health Promotion
  2. Yusof, Z.Y.M., Jaafar, N.
    Ann Dent, 2013;20(1):13-19.
    MyJurnal
    Long term evaluations of impacts of community
    based health promotion programmes are not an easy or
    straightforward task to do due to lack of validated and
    reliable indices. Objective: To develop and test an index
    to measure schoolchildren’s oral health knowledge,
    attitudes, and behaviour as a result of a school-based health
    promotion programme in Malaysia called the Doktor
    Muda (Junior Doctor) Programme (DMP). Materials and
    Methods: The index was developed in English based on
    the DMP module and translated into Malay. The Malay
    version was tested on 174, 11-12 year old schoolchildren.
    Psychometric analysis of the index involved content and
    face validity tests as well as factor analysis, internal and
    test-retest reliability. Results: Factor analysis yielded 3
    factors with groups of items viz. oral health knowledge
    (OHK), oral health attitudes (OHA) and oral health
    behaviour (OHB). The Cronbach’s alpha coefficients of the
    three factors were 0.61, 0.73, and 0.64, respectively. The
    Kappa coefficients were 0.70, 0.77 and 0.73, respectively
    (intraclass correlation coefficients = 0.72, 0.70 and 0.78).
    The final questionnaire comprised 33 items, namely; OHK
    11 items, OHA 15 items, and OHB 7 items. Conclusion:
    The Health Promotion Questionnaire Index (HPQI) to
    measure the DMP impact on schoolchildren’s oral health
    knowledge, attitudes, and behaviours was empirically
    verified to be valid and reliable for use among 11-12 year
    old Malaysian schoolchildren.
    Matched MeSH terms: Health Promotion
  3. Mokhsin A, Mokhtar SS, Mohd Ismail A, M Nor F, Shaari SA, Nawawi H, et al.
    BMJ Open, 2018 12 04;8(12):e021580.
    PMID: 30518581 DOI: 10.1136/bmjopen-2018-021580
    OBJECTIVES: To determine the prevalence of metabolic syndrome (MS), ascertain the status of coronary risk biomarkers and establish the independent predictors of these biomarkers among the Negritos.

    SETTINGS: Health screening programme conducted in three inland settlements in the east coast of Malaysia and Peninsular Malaysia.

    SUBJECTS: 150 Negritos who were still living in three inland settlements in the east coast of Malaysia and 1227 Malays in Peninsular Malaysia. These subjects were then categorised into MS and non-MS groups based on the International Diabetes Federation (IDF) consensus worldwide definition of MS and were recruited between 2010 and 2015. The subjects were randomly selected and on a voluntary basis.

    PRIMARY AND SECONDARY OUTCOME MEASURES: This study was a cross-sectional study. Serum samples were collected for analysis of inflammatory (hsCRP), endothelial activation (sICAM-1) and prothrombogenesis [lp(a)] biomarkers.

    RESULTS: MS was significantly higher among the Malays compared with Negritos (27.7%vs12.0%). Among the Malays, MS subjects had higher hsCRP (p=0.01) and sICAM-1 (p<0.05) than their non-MS counterpart. There were no significant differences in all the biomarkers between MS and the non-MS Negritos. However, when compared between ethnicity, all biomarkers were higher in Negritos compared with Malays (p<0.001). Binary logistic regression analysis affirmed that Negritos were an independent predictor for Lp(a) concentration (p<0.001).

    CONCLUSIONS: This study suggests that there may possibly be a genetic influence other than lifestyle, which could explain the lack of difference in biomarkers concentration between MS and non-MS Negritos and for Negritos predicting Lp(a).

    Matched MeSH terms: Health Promotion
  4. Muhammad Adil ZA, Nur Zawani J, Hazariah AH, Rao G, Zailiza S, Mohd Nasir H
    Med J Malaysia, 2019 Oct;74(5):413-417.
    PMID: 31649218
    INTRODUCTION: A methanol outbreak occurred in the district of Hulu Langat on 16 September 2018. The Hulu Langat District Health Office received 25 notifications of a suspected methanol poisoning from Kajang and Ampang Hospital. An outbreak investigation was done to determine the source followed by a preventive and control measure.

    METHOD: Active case detection was done on cases living quarters and workplaces. Patients were interviewed, and their blood and urine samples were sent for methanol analysis. Samples of suspected alcoholic beverages were also sent for analysis. A suspected case was defined as any person presented with clinical symptoms with a history of consuming alcoholic beverages within five days before symptoms and high anion gap metabolic acidosis. A confirmed case was defined as a suspected case with positive blood and urine methanol.

    RESULTS: In total, there were 25 suspected cases, of which 12 cases were confirmed. The calculated attack rate was 48%. There were six mortalities (50%) secondary to severe metabolic acidosis. The most common presenting symptom was vomiting (75%) and abdominal pain (41.7%). These cases were linked to consumption of illicitly produced alcohol. Samples of the alcoholic drinks were positive containing high level of methanol.

    CONCLUSION: The methanol outbreak in the Hulu Langat was successfully managed. Appropriate control and prevention measures were taken, including health promotion and joint enforcement activities. Steps were taken successfully through collaborations with multiple agencies and cooperation with Selangor Health Departments and the Ministry of Health. Continuous surveillance on the product of liquor, and health promotion are essential to prevent a similar outbreak from happening again in future.

    Matched MeSH terms: Health Promotion
  5. Mohammed Abdelfatah Alhoot, Mohammed Faez Baobaid, Abdelqader MA, Lavannya Rangas Paran, Bavani Kannaiah, Kavitha Balasingam, et al.
    Dengue fever is the most common vector-borne disease and major concern issues in Malaysia. Thus, the present study aimed to evaluate factors influencing knowledge, attitude, and practices regarding dengue fever among patients in Hospital Taiping. A total of 300 patients were incorporated into a descriptive, public based cross-sectional study. The questionnaires were formulated to include several questions on demographic data, knowledge, attitudes, and practices concerning dengue fever. Most of the respondents were from the age group of more than 35 (43.3%). The largest representations of the participants were Malay (59.3%), married (65.7%), SPM is the highest education level (53.3%), and 60.7% of the participants were conscious about dengue fever eruption. Television/radio was voted as the frequent source of information (97.3%). There is no significant relationship between knowledge score and socio-demographic factors. However, around 57.0% of the respondents believe that abdominal pain is not a symptom of dengue fever and 32% convinced that blood transfusion can transmit dengue. No significant correlation was found between attitude and practice score to socio-demographic characters. However, a good practice towards dengue fever is associated with good knowledge (65.4 %) nevertheless it did not influence their attitude. Moreover, the attitude seems to be poor regardless of knowledge level (44.0%). Therefore, more prevention practices to raise the awareness of population toward dengue fever such as health campaigns and health education in school level should be initiated. These activities will aid in fertilizing better attitude and prevention practice towards dengue fever and bring down its incidence in Malaysia.
    Matched MeSH terms: Health Promotion
  6. Nui Jia Jun, Khairil Shazmin Kamarudin, Asma Ali, Noor Salihah Zakaria
    MyJurnal
    Introduction: In Malaysia, private office workers tend to be more physically inactive due to work burden. This study aimed to determine physical activity level, motivation factors and barrier towards physical activity among private office workers. Methods: A cross sectional study using convenience sampling was conducted at nine private com- panies in Selangor involving 106 office workers aged 21 to 55 years old. Self-administered questionnaires includ- ing Global Physical Activity Questionnaire (GPAQ), Physical Activity and Leisure Motivation Scale (PALMS) and Physical Activity Barrier (PAB) were administered. Results: Over half of the respondents (58.5%) were having low physical activity level. The main motivation factors include physical condition, psychological condition and mastery. Meanwhile, tired after work, laziness, lack of discipline, family commitment and adverse weather were the main perceived barriers. A weak positive correlation was found between total motivation score and total physical activity (r=0.296; p=0.002). In contrast, there was a weak negative correlation between barriers and total physical activity (r=-0.237; p=0.015). Conclusion: The current physical activity level, its main motivation factors and barriers among private office workers were identified, providing an opportunity to create effective setting-based health promotion and intervention. It is also recommended that policy suggestions are made to influence and prepare essential partners (e.g. companies and employees) to promote ways of incorporating physical activity into one’s daily routine.
    Matched MeSH terms: Health Promotion
  7. Yong HH, Fong GT, Driezen P, Borland R, Quah AC, Sirirassamee B, et al.
    Nicotine Tob Res, 2013 Aug;15(8):1339-47.
    PMID: 23291637 DOI: 10.1093/ntr/nts241
    In this study, we aimed to examine, in Thailand, the impact on smokers' reported awareness of and their cognitive and behavioral reactions following the change from text-only to pictorial warnings printed on cigarette packs. We also sought to explore differences by type of cigarette smoked (roll-your-own [RYO] vs. factory-made [FM] cigarettes).
    Matched MeSH terms: Health Promotion
  8. Sharif R, Chong KH, Zakaria NH, Ong ML, Reilly JJ, Wong JE, et al.
    J Phys Act Health, 2016 11;13(11 Suppl 2):S201-S205.
    PMID: 27848721 DOI: 10.1123/jpah.2016-0404
    BACKGROUND: The 2016 Malaysia Active Healthy Kids Report Card aims to collect, assess, and grade current and comprehensive data on physical activity (PA) and associated factors in Malaysian children and adolescents aged 5 to 17 years.
    METHODS: This report card was developed following the Active Healthy Kids Canada Report Card protocol. The Research Working Group identified the core matrices, assessed the key data sources, and evaluated the evidence gathered for grade assignments. A grade was assigned to each indicator by comparing the best available evidence against relevant benchmark using a standardized grading scheme.
    RESULTS: Overall Physical Activity, Active Transportation, and Sedentary Behavior were assigned the D grade. The lowest grade of F was assigned to Diet, while School and Government Strategies and Investments were graded higher with a B. Five indicators were assigned INC (incomplete) due to a lack of representative data.
    CONCLUSIONS: The report card demonstrates that Malaysian children and adolescents are engaging in low levels of PA and active commuting, high levels of screen time, and have extremely low compliance with dietary recommendations. More efforts are needed to address the root causes of physical inactivity while increasing the opportunities for children and adolescents to be more physically active.
    MESH: screen time
    Matched MeSH terms: Health Promotion
  9. Aldubayan K, Aljuraiban G, Aldisi D
    Malays J Med Sci, 2019 May;26(3):110-118.
    PMID: 31303855 DOI: 10.21315/mjms2019.26.3.9
    Background: Dietitians play a major role in health promotion and chronic diseases prevention. Graduates from clinical nutrition and dietetics major should be equipped with the necessary knowledge and skills for their role to be more effective. The purpose of this study is to investigate the knowledge and skills needed by current and future graduates in clinical nutrition and dietetics.

    Methods: In this qualitative study, structured interviews by focus groups were conducted. Dietitians from different governmental and private sectors were invited to participate in the study. Focus groups were stratified based on the participants' gender and years of experience to promote self-disclosure. Abridged transcript of relevant and useful points was performed. The transcripts were coded and cross-validated by two researchers.

    Results: A total of four focus groups were conducted. Two focus groups comprise 9 male participants and the other two comprise 10 females. The age of participants ranged 25-40 years old. Participants were employees in Riyadh city with experience that ranged 3-10 years old. Nine themes of the necessary knowledge and skills were identified.

    Conclusion: It is recommended for the Saudi government to create standards specialised for clinical nutrition and dietetics undergraduate and graduate programmes.

    Matched MeSH terms: Health Promotion
  10. Soh SE, Chong YS, Kwek K, Saw SM, Meaney MJ, Gluckman PD, et al.
    Ann Nutr Metab, 2014;64(3-4):218-25.
    PMID: 25300263 DOI: 10.1159/000365023
    BACKGROUND: The dramatic emergence of noncommunicable diseases (NCD) in Asia, albeit with ethnic variation, has coincided with the rapid socioeconomic and nutritional transition taking place in the region, with the prevalence of diabetes rising 5-fold in Singapore in less than 4 decades. The Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study recruited 1,247 expectant mothers of Chinese, Malay, or Indian ethnicity in their first trimester, with detailed longitudinal tracking--through the antenatal period, birth, and the child's first 4 years of life--to examine the potential roles of fetal, developmental, and epigenetic factors in early pathways to metabolic and neurodevelopmental outcomes.

    KEY MESSAGES: A number of findings with a translational and clinical focus have already emerged. In the mothers, we found that changes and differences in food consumption varied across ethnic groups, with persistence of traditional beliefs, during pregnancy and the postpartum period. During pregnancy, higher maternal glucose levels, even in the absence of gestational diabetes mellitus, had graded relations with infant adiposity. Relations between maternal emotional health and birth outcomes and neurodevelopment have been identified. Genotype (25%) and in particular gene × environment interactions (75%) shape interindividual variations in the DNA methylome at birth. The complex effects of fixed genetic variations and different in utero environments can influence the epigenetic status at birth and the later-life phenotype.

    CONCLUSIONS: The richness of the clinical data in 3 ethnicities, the extent of the biospecimen collection, and the extensive infancy and preschool follow-up have allowed us to study the biological pathways that link fetal development to health outcomes. In the coming years, more sophisticated analyses of epigenotype-phenotype relationships will become possible as the children grow and develop. Our studies will lead to the development of clinical and population-based interventions to reduce the burden of NCD.

    Matched MeSH terms: Health Promotion*
  11. Norris SA, Anuar H, Matzen P, Cheah JC, Jensen BB, Hanson M
    BMC Public Health, 2014;14 Suppl 2:S6.
    PMID: 25080995 DOI: 10.1186/1471-2458-14-S2-S6
    BACKGROUND: Malaysia faces burgeoning obesity and diabetes epidemics with a 250% and 88% increase respectively between 1996 and 2006. Identifying the health challenges of young adults in Malaysia, who constitute 27.5 % of the population, is critical for NCD prevention. The aim of the study was two-fold: (1) to achieve consensus amongst stakeholders on the most important challenge impacting the health of young adults, and (2) to engage with stakeholders to formulate a NCD prevention framework.

    METHODS: The Delphi Technique was utilised to achieve group consensus around the most important life and health challenges that young adults face in Malaysia. Subsequently, the results of the consensus component were shared with the stakeholders in an engagement workshop to obtain input on a NCD prevention framework.

    RESULTS: We found that life stress was a significant concern. It would seem that the apathy towards pursuing or maintaining a healthy lifestyle among young adults may be significantly influenced by the broader distal determinant of life stress. The high cost of living is suggested to be the main push factor for young working adults towards attaining better financial security to improve their livelihood. In turn, this leads to a more stressful lifestyle with less time to focus on healthier lifestyle choices.

    CONCLUSIONS: The findings highlight a pivotal barrier to healthier lifestyles. By assisting young adults to cope with daily living coupled with realistic opportunities to make healthier dietary choices, be more active, and less sedentary could assist in the development of NCD health promotion strategies.

    Matched MeSH terms: Health Promotion/organization & administration
  12. Yusof ZY, Jaafar N
    PMID: 24325653 DOI: 10.1186/1477-7525-11-205
    The study objective was to compare children's oral health related quality of life (OHRQoL) in schools with 6 years of implementation of a health promoting school model in Malaysia, i.e. the Doktor Muda Programme (DMP) and in schools without the DMP.
    Matched MeSH terms: Health Promotion*
  13. Merriam S, Muhamad M
    Asian Pac J Cancer Prev, 2013;14(6):3593-601.
    PMID: 23886151
    BACKGROUND: For a number of reasons from cultural compatibility, to accessibility, to cost, traditional healers are a major source of health care in developing countries. In Malaysia, 'en estimated that upwards of 80% of the population consult traditional healers even if simultaneously seeking treatment from the Western medical system. Partially as a result of the widespread practice of visiting traditional healers, cancer diagnosis and treatment in Malaysia is often delayed or interrupted resulting in late presentation, advanced stage diagnosis, and a higher mortality rate than in Western countries. However, there is very little research on the role of traditional healers in cancer treatment in Malaysia.

    MATERIALS AND METHODS: This qualitative study was designed to identify the roles traditional healers play in cancer diagnosis and treatment, with an eye to alleviating the cancer burden through educational responses with four publics in mind-policy makers, Western medical personnel, traditional healers, and the general public. In-depth interviews were conducted with 14 Malay traditional healers, 13 cancer survivors who had seen both traditional healers and Western doctors, and 12 cancer medical specialists.

    RESULTS: Analysis of the data from these 39 participants revealed four roles traditional healers play in cancer treatment-medicinal healer, emotional comforter, spiritual guide, and palliative caregiver.

    CONCLUSIONS: Three roles (emotional, spiritual, palliative) can be seen as complementary to the allopathic system. Emotional and spiritual roles may augment the effectiveness of biomedical treatment. Cancer awareness and education programs need to position traditional healers as complementary, rather than an alternative to Western medical treatment; Validating the roles Traditional Healers can play in cancer treatment in MY through health promotion and education will contribute to alleviating the nation's cancer burden.

    Matched MeSH terms: Health Promotion*
  14. Saleh A, Yang YH, Wan Abd Ghani WM, Abdullah N, Doss JG, Navonil R, et al.
    Asian Pac J Cancer Prev, 2012;13(4):1217-24.
    PMID: 22799308
    BACKGROUND AND AIM: Less than 50% of oral cancer cases are diagnosed at early stages of the disease and this is in part due to poor awareness and lack of knowledge on the signs and symptoms of oral cancer. This study sought to measure the baseline awareness of oral cancer in Malaysia and aimed to increase public awareness and knowledge of oral cancer using a mass media campaign.

    METHODS: Baseline awareness and impact of the campaign was measured using self-administered questionnaires sent via email to individuals. The campaign was aired on two national television channels and the reach was monitored through an independent programme monitoring system.

    RESULTS: 78.2% of respondents had heard of oral cancer, and this increased significantly after the campaign. However, the ability to recognize signs and symptoms remains unchanged. We found that the level of awareness differed between the distinct ethnic subgroups and the reach of the campaign was not uniform across all ethnicities.

    CONCLUSION: This substantial study to measure the oral cancer awareness in Malaysia provides important baseline data for the planning of public health policies. Despite encouraging evidence that a mass media campaign could increase the awareness of oral cancer, further research is required to address the acceptability, comprehensiveness and effectiveness. Furthermore, different campaign approaches may be required for specific ethnic groups in a multi-ethnic country such as Malaysia.

    Matched MeSH terms: Health Promotion*
  15. Wafa SW, Talib RA, Hamzaid NH, McColl JH, Rajikan R, Ng LO, et al.
    Int J Pediatr Obes, 2011 Jun;6(2-2):e62-9.
    PMID: 21604965 DOI: 10.3109/17477166.2011.566340
    CONTEXT: Few randomized controlled trials (RCTs) of interventions for the treatment of childhood obesity have taken place outside the Western world.
    AIM: To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur, Malaysia.
    METHODS: Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds. The intervention was relatively low intensity (8 hours contact over 26 weeks, group based), aiming to change child sedentary behavior, physical activity, and diet using behavior change counselling. Outcomes were measured at baseline and six months after the start of the intervention. Primary outcome was BMI z-score, other outcomes were weight change, health-related quality of life (Peds QL), objectively measured physical activity and sedentary behavior (Actigraph accelerometry over 5 days).
    RESULTS: The intervention had no significant effect on BMI z score relative to control. Weight gain was reduced significantly in the intervention group compared to the control group (+1.5 kg vs. +3.5 kg, respectively, t-test p < 0.01). Changes in health-related quality of life and objectively measured physical activity and sedentary behavior favored the intervention group.
    CONCLUSIONS: Treatment was associated with reduced rate of weight gain, and improvements in physical activity and quality of life. More substantial benefits may require longer term and more intensive interventions which aim for more substantive lifestyle changes.
    Matched MeSH terms: Health Promotion*
  16. Kawarazuka N, Béné C
    Public Health Nutr, 2011 Nov;14(11):1927-38.
    PMID: 21729489 DOI: 10.1017/S1368980011000814
    OBJECTIVE: To build a comprehensive overview of the potential role of fish in improving nutrition with respect to certain micronutrient deficiencies in developing countries.

    DESIGN: A comprehensive literature review was completed. For this the electronic library databases ASFA, CABD and Scopus were systematically searched and relevant references cited in these sources were carefully analysed. The search terms used were 'fish', 'small fish species', 'micronutrients', 'food-based strategies', 'fish consumption' and 'developing countries'. The quality of data on nutritional analyses was carefully reviewed and data that lacked proper information on methods, units and samples were excluded.

    RESULTS: The evidence collected confirmed the high levels of vitamin A, Fe and Zn in some of the small fish species in developing countries. These small fish are reported to be more affordable and accessible than the larger fish and other usual animal-source foods and vegetables. Evidence suggests that these locally available small fish have considerable potential as cost-effective food-based strategies to enhance micronutrient intakes or as a complementary food for undernourished children. However, the present review shows that only a few studies have been able to rigorously assess the impact of fish consumption on improved nutritional status in developing countries.

    CONCLUSIONS: Further research is required in areas such as determination of fish consumption patterns of poor households, the nutritional value of local fish and other aquatic animals and the impact of fish intake on improved nutritional status in developing countries where undernutrition is a major public health problem.

    Matched MeSH terms: Health Promotion*
  17. Mohamed N, Mohd Yusoff MF, Isah N, Othman I, Syed Rahim SA, Paiman N
    Int J Inj Contr Saf Promot, 2011 Mar;18(1):3-10.
    PMID: 20496187 DOI: 10.1080/17457300.2010.487153
    A cross-sectional survey using a self-administered questionnaire was conducted among 793 rear passengers in Malaysia. Logistic regression was performed to analyse the association of rear seatbelt wearing with 12 independent variables. Seven factors were significantly associated with rear seatbelt wearing. Experience of being stopped by an enforcement officer for not wearing rear seatbelt yielded the highest odds ratio 2.3 (p = 0.002) followed by self-consciousness (odds ratio 1.7; p = 0.004), attitude (odds ratio 1.5, p = 0.001), and knowledge (odds ratio 1.4, p = 0.004). Age of participants and their perception of being caught by an enforcement officer were also significantly associated with rear seatbelt wearing, odds ratios were 1.03 (p = 0.004) and 1.1 (p = 0.004), respectively. In contrast, level of education was negatively associated with rear seatbelt wearing (odds ratio 0.59, p = 0.003). It was concluded that enforcement activities, knowledge and attitude on seatbelt wearing play a very important role in improving the rate of rear seatbelt wearing. Thus, efforts to increase these factors should be the special focus in designing education and social marketing activities to advocate rear seatbelt wearing.
    Matched MeSH terms: Health Promotion*
  18. Sirichotiratana N, Sovann S, Aditama TY, Krishnan M, Kyaing NN, Miguel-Baquilod M, et al.
    Tob Control, 2008 Dec;17(6):372-8.
    PMID: 18669557 DOI: 10.1136/tc.2007.024190
    The Association of Southeast Asian Nations (ASEAN) has made tobacco use prevention a primary health issue. All ASEAN countries except Indonesia have ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), the world's first public health treaty on tobacco control.
    Matched MeSH terms: Health Promotion*
  19. Don R
    Forum Nutr, 2003;56:234-6.
    PMID: 15806878
    Matched MeSH terms: Health Promotion/methods*
  20. Masood M, Reidpath DD
    BMJ Open, 2016 Jan 07;6(1):e008173.
    PMID: 26743697 DOI: 10.1136/bmjopen-2015-008173
    OBJECTIVES: Measuring the intraclass correlation coefficient (ICC) and design effect (DE) may help to modify the public health interventions for body mass index (BMI), physical activity and diet according to geographic targeting of interventions in different countries. The purpose of this study was to quantify the level of clustering and DE in BMI, physical activity and diet in 56 low-income, middle-income and high-income countries.
    DESIGN: Cross-sectional study design.
    SETTING: Multicountry national survey data.
    METHODS: The World Health Survey (WHS), 2003, data were used to examine clustering in BMI, physical activity in metabolic equivalent of task (MET) and diet in fruits and vegetables intake (FVI) from low-income, middle-income and high-income countries. Multistage sampling in the WHS used geographical clusters as primary sampling units (PSU). These PSUs were used as a clustering or grouping variable in this analysis. Multilevel intercept only regression models were used to calculate the ICC and DE for each country.
    RESULTS: The median ICC (0.039) and median DE (1.82) for BMI were low; however, FVI had a higher median ICC (0.189) and median DE (4.16). For MET, the median ICC was 0.141 and median DE was 4.59. In some countries, however, the ICC and DE for BMI were large. For instance, South Africa had the highest ICC (0.39) and DE (11.9) for BMI, whereas Uruguay had the highest ICC (0.434) for MET and Ethiopia had the highest ICC (0.471) for FVI.
    CONCLUSIONS: This study shows that across a wide range of countries, there was low area level clustering for BMI, whereas MET and FVI showed high area level clustering. These results suggested that the country level clustering effect should be considered in developing preventive approaches for BMI, as well as improving physical activity and healthy diets for each country.
    KEYWORDS: Body Mass Index (BMI); Intraclass correlation coefficient (ICC); Physical activity (METs)
    Study name: World Health Survey (Malaysia is a study site)
    Matched MeSH terms: Health Promotion/methods*
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