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  1. Suhaimi AF, Ibrahim N, Tan KA, Silim UA, Moore G, Ryan B, et al.
    BMJ Open, 2020 02 16;10(2):e033920.
    PMID: 32066607 DOI: 10.1136/bmjopen-2019-033920
    INTRODUCTION: People with diabetes are often associated with multifaceted factors and comorbidities. Diabetes management frameworks need to integrate a biopsychosocial, patient-centred approach. Despite increasing efforts in promotion and diabetes education, interventions integrating both physical and mental health components are still lacking in Malaysia. The Optimal Health Programme (OHP) offers an innovative biopsychosocial framework to promote overall well-being and self-efficacy, going beyond education alone and has been identified as relevant within the primary care system. Following a comprehensive cultural adaptation process, Malaysia's first OHP was developed under the name 'Pohon Sihat' (OHP). The study aims to evaluate the effectiveness of the mental health-based self-management and wellness programme in improving self-efficacy and well-being in primary care patients with diabetes mellitus.

    METHODS AND ANALYSIS: This biopsychosocial intervention randomised controlled trial will engage patients (n=156) diagnosed with type 2 diabetes mellitus (T2DM) from four primary healthcare clinics in Putrajaya. Participants will be randomised to either OHP plus treatment as usual. The 2-hour weekly sessions over five consecutive weeks, and 2-hour booster session post 3 months will be facilitated by trained mental health practitioners and diabetes educators. Primary outcomes will include self-efficacy measures, while secondary outcomes will include well-being, anxiety, depression, self-care behaviours and haemoglobin A1c glucose test. Outcome measures will be assessed at baseline, immediately postintervention, as well as at 3 months and 6 months postintervention. Where appropriate, intention-to-treat analyses will be performed.

    ETHICS AND DISSEMINATION: This study has ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-17-3426-38212). Study findings will be shared with the Ministry of Health Malaysia and participating healthcare clinics. Outcomes will also be shared through publication, conference presentations and publication in a peer-reviewed journal.

    TRIAL REGISTRATION NUMBER: NCT03601884.

  2. Silim UA, Suhaimi AF, Moore G, Ryan B, Castle DJ
    Australas Psychiatry, 2019 Jun;27(3):262-266.
    PMID: 30931582 DOI: 10.1177/1039856219834074
    OBJECTIVES: To explore the relevance and adaptability of the Optimal Health Program for mental and primary healthcare providers in Malaysia.

    METHODS: Evaluate stakeholder engagement and training programme for psychiatrists, family medicine specialists, public health specialists, physicians, clinical psychologists, counsellors, and representatives from a patient support group. Evaluate the programme for applicability, as well as participant's knowledge and confidence in using key components.

    RESULTS: The training was very well received in terms of content, training materials and facilitation style. Development of culturally specific materials will be needed. Improvement in the self-rating measurement for knowledge and confidence in using key Optimal Health Program components was reported at the completion of the 2-day training.

    CONCLUSIONS: The Optimal Health Program has potential as a comprehensive socio-culturally responsive self-management programme that is relevant within mental health services and adaptable for task-sharing of mental health care in Malaysia.

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