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  1. Rasyidah G, Wafa SW
    Heliyon, 2020 Jun;6(6):e04059.
    PMID: 32551377 DOI: 10.1016/j.heliyon.2020.e04059
    Background: There is evidence suggesting that the school environment does have prominent contributions to the rise of childhood obesity.

    Aim: The objective of this study was to assess the school environment by interviewing the teachers and compare the school environment score between rural and urban schools in Terengganu, Malaysia.

    Methods: Thirty-two teachers from 16 primary schools in Terengganu were interviewed using a set of validated Malay version "School Environmental Mapping" questionnaire. A total of 76 items consisting of four domains of school environment factor: physical (what is available) with 41 items; economic (what the costs are) with nine items; political (what the rules are) with nine items; and socio-cultural (what the attitudes and beliefs are) with 17 items. Every item was questioned using an initial closed question followed by an open question when the criteria were not met or need further information regarding those particular items.

    Results: The present study revealed that the school environment of school in state of Terengganu is still low and not satisfied. Based on the schoolteacher's information and observation, there are significant barriers to promoting healthy eating and physical activity at school e.g. limited financial and budget allocation; lack of school facilities; lack of manpower to organise and monitor the programme; lack of participation and cooperation from parents; and no enforcement and serious action from authorized personnel on street hawkers near the school. This is reflected by the score achieved for 16 schools in Terengganu was only 63.05%. The political environment indicated the highest score among the domains, which was 77.78%, whereas, the lowest score was an economic environment (50.00%). Upon comparing between the urban and rural areas, the present study reported that there was a significant difference between school settings (p < 0.001) for an overall school environment, in which the rural areas had a significantly higher score than urban counterparts (64.86% vs 59.34%, p < 0.001). For each domain of the school environment, the findings showed that only two domains (physical and political environment) were significantly different between school settings.

    Conclusion: This study revealed that the level of a healthy school environment among schools in both settings is still not satisfied. Addressing the obesogenic elements of school environments is one of the strategies in prevention since the school environments exert a great influence on children's behaviour.

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