Effectiveness of a school-based intervention on knowledge, attitude and practice on healthy lifestyle and body composition in Malaysian adolescents

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Abstract

Background

The ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL) intervention programme was developed to prevent overweight and disordered eating in Malaysian adolescents. This study aimed to evaluate the effectiveness of the EPaL programme on knowledge, attitudes and practices on healthy lifestyle and body composition (body mass index z-score [zBMI], waist circumference [WC] and body fat percentage [BF%]) among adolescents.

Methods

All measures were taken at three time points: before intervention (Pre), after intervention (Post I) and 3 months after intervention (Post II). The intervention group (IG) participated in the EPaL programme for 16 weeks, whereas the comparison group (CG) received no intervention. Seventy-six adolescents (IG: n = 34; CG: n = 42) aged 13–14 years were included in the final analysis. Repeated measures analysis of covariance (ANCOVA) was used to assess the impact of the EPaL intervention programme on the measures between groups (IG and CG) at Post I and Post II.

Results

The IG reported significantly higher knowledge scores at both Post I (adjusted mean difference = 3.34; 95% confidence interval [CI] = 0.99, 5.69; p = 0.006) and Post II (adjusted mean difference = 2.82; 95% CI = 0.86, 4.78; p = 0.005) compared with the CG. No significant differences between the IG and CG were found at either Post I or Post II in attitudes, practices, zBMI, WC and BF%. The proportion of participants who were overweight or obese was consistent from Pre to Post II in the IG (35.3%) and increased from 26.2% at Pre to 28.5% at Post II in the CG, but the difference was not statistically significant. The proportion of participants who had abdominal obesity in the IG decreased from 17.6% at Pre to 14.7% at Post II and increased from 16.7% at Pre to 21.4% at Post II in the CG, but the differences were not statistically significant.

Conclusion

Despite no significant reduction of body composition, this programme shows the positive effect on the adolescents’ knowledge regarding healthy lifestyle. This study contributes to the evidence on the effectiveness of school-based health interventions in Malaysian adolescents.

Trial registration

UMIN Clinical Trial Registration UMIN000024349. Registered 11 October 2016.

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Most cited references 41

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Shared risk and protective factors for overweight and disordered eating in adolescents.

D Neumark-Sztainer, Kristin Wall, J. Haines … (2007)

Weight-related problems, including obesity, eating disorders, and disordered eating, are major public health problems in adolescents. The identification of shared risk and protective factors for these problems can guide the development of relevant interventions to a broad spectrum of weight-related problems. This paper examines the prevalence and co-occurrence of overweight, binge eating, and extreme weight-control behaviors (vomiting, diet pills, laxatives, and diuretics) in adolescents and identifies shared risk and protective factors from within the socioenvironmental, personal, and behavioral domains for these three adverse weight-related outcomes. Data were collected at Time 1 (1998-1999) and Time 2 (2003-2004) on 2516 adolescents participating in Project EAT (Eating Among Teens). Data were analyzed in 2006-2007. Weight-related problems were identified in 44% of the female subjects and 29% of the male subjects. About 40% of overweight girls and 20% of overweight boys engaged in at least one of the disordered eating behaviors (binge eating and/or extreme weight control). Weight-teasing by family, personal weight concerns, and dieting/unhealthy weight-control behaviors strongly and consistently predicted overweight status, binge eating, and extreme weight-control behaviors after 5 years. Family meals, regular meal patterns, and media exposure to messages about weight loss were also associated with weight-related outcomes, although the strength and consistency of associations differed across outcomes and gender. Weight-specific socioenvironmental, personal, and behavioral variables are strong and consistent predictors of overweight status, binge eating, and extreme weight-control behaviors later in adolescence. These findings support the need for research to determine if decreasing weight-related social pressures, personal weight concerns, and unhealthy weight-control behaviors can contribute to reductions in obesity in children and adolescents.

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Nutrition knowledge and food consumption: can nutrition knowledge change food behaviour?

Anthony Worsley (2002)

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Is Open Access

Modified intention to treat reporting in randomised controlled trials: systematic review

Iosief Abraha, ALESSANDRO MONTEDORI (2010)

Objectives To determine the incidence and characteristics of randomised controlled trials that report using the modified intention to treat approach, and how the approach is described. Design Systematic review. Data sources PubMed, Embase, Cochrane central register of controlled trials, ISI Web of Knowledge, Ovid, HighWire Press, Science-Direct, Ingenta, Medscape, BioMed Central, Springer, and Wiley, from inception to December 2006. Main outcome measures Incidence of trials in which use of modified intention to treat was reported, and how the approach was described (classified according to the type and number of deviations from the intention to treat approach). Results 475 randomised controlled trials reported use of a modified intention to treat analysis. Of these, 76 (16%) were published in five highly cited general medical journals. The incidence of all trials that reported use of modified intention to treat published in journals indexed in Medline increased from 0.006% in 1982-6 to 0.5% in 2002-6 (P<0.001 for linear trend). When the description of the modified intention to treat was examined in each trial, 192 (40%) reported one type of deviation from the intention to treat approach, 261 (55%) reported two or more types, and 22 (5%) did not describe any type. In 266 (56%) of the trials the deviation was related to the treatment received, in 196 (41%) to a post baseline assessment, in 118 (25%) to a baseline assessment, in 108 (23%) to a target condition, and in 23 (5%) to follow-up. Post-randomisation exclusions occurred in 380 (80%) trials. The results reported by 270 of the 352 (77%) superiority trials favoured the drug under investigation. All of the 123 trials using equivalence or non-inferiority methods to investigate interventions reported results that favoured their assumptions. Conclusions Randomised controlled trials that report using a modified intention to treat are increasingly being published in the medical literature. The descriptions of such an approach were ambiguous, and may cover any type of descriptions for exclusion, such as missing data and deviation from protocol. Explicit statements about post-randomisation exclusions should replace the ambiguous terminology of modified intention to treat.

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Author and article information

Contributors

Sharifah Intan Zainun Sharif Ishak: sharifah_intan@msu.edu.my

Yit Siew Chin: chinys@upm.edu.my

Mohd. Nasir Mohd. Taib: nasir.jpsk@gmail.com

Yoke Mun Chan: cym@upm.edu.my

Zalilah Mohd. Shariff: zalilahms@upm.edu.my

Journal

Journal ID (nlm-ta): BMC Pediatr

Journal ID (iso-abbrev): BMC Pediatr

Title: BMC Pediatrics

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2431

Publication date (Electronic): 14 March 2020

Publication date PMC-release: 14 March 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 122

Affiliations

[1 ]GRID grid.444504.5, Department of Healthcare Professional, Faculty of Health and Life Sciences, , Management and Science University, ; 40100 Shah Alam, Selangor Malaysia

[2 ]GRID grid.11142.37, ISNI 0000 0001 2231 800X, Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, , Universiti Putra Malaysia, ; 43400 Serdang, Selangor Malaysia

[3 ]GRID grid.11142.37, ISNI 0000 0001 2231 800X, Research Centre of Excellence for Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, , Universiti Putra Malaysia, ; 43400 Serdang, Selangor Malaysia

Article

Publisher ID: 2023

DOI: 10.1186/s12887-020-02023-x

PMC ID: 7071695

PubMed ID: 32171276

SO-VID: 757a87f3-5883-4570-b24a-b37c379e49f1

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 1 July 2019

Date accepted : 9 March 2020

Custom metadata

ScienceOpen disciplines: Pediatrics

Keywords: overweight,obesity,adolescent,intervention,peer-led,malaysia,knowledge,body composition

Data availability:

ScienceOpen disciplines: Pediatrics

Keywords: overweight, obesity, adolescent, intervention, peer-led, malaysia, knowledge, body composition

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Effectiveness of a school-based intervention on knowledge, attitude and practice on healthy lifestyle and body composition in Malaysian adolescents

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Most cited references 41

Shared risk and protective factors for overweight and disordered eating in adolescents.

Nutrition knowledge and food consumption: can nutrition knowledge change food behaviour?

Modified intention to treat reporting in randomised controlled trials: systematic review

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