Effectiveness of education intervention, with regards to physical activity level and a healthy diet, among Middle Eastern adolescents in Malaysia: A study protocol for a randomized control trial, based on a health belief model.

BackgroundAmong the most urgent public health challenges, of the twenty-first century, is obesity. This can be attributed to its relationship with several non-communicable diseases (NCDs), as well as premature mortality. Being overweight or obese is a major concern not only in high-income countries, but also in low-income and middle-income countries, particularly in urban areas. Several studies have highlighted the prevalence of obesity, among Middle Eastern-descent adolescents, studying in Arabic secondary schools, located in Malaysia. Intervention studies, directed at Middle Eastern adolescents in Malaysia, are limited. This paper, describes the protocol, for an integrated health education intervention process. Titled 'Healthy lifestyle', it is a primary prevention process, aimed at curbing obesity and disordered eating, among Middle Eastern secondary school adolescents, aged 13-14 years old, residing in Malaysia.Methods and anticipated resultsA cluster randomized controlled study will be conducted, involving 250 Middle Eastern adolescents, in Arabic schools in Malaysia. The participants will be randomly assigned to the intervention and control groups. While the intervention group participates in six weeks of fortnightly six sessions (45 minutes per session), the control group will carry on with their regular curriculums, and normal physical activity routines. The variables which will be evaluated include anthropometric measurements, knowledge, attitude, daily routines, physical activity, sedentary behaviour, food assessment, eating attitudes test-26, and a structured questionnaire based on the HBM. Data will be collected from the intervention and control groups at baseline, post-intervention, and two months following the intervention. Data analysis will be performed by way of the SPSS Statistics software version 26. The generalized estimating equation (GEE) will be used, to test the effect of the intervention program, with regards to the selected variables (outcomes), between and within-group at baseline, as well as six weeks and two months following intervention, after adjusting for clustering. Outcomes will be assessed at each time point, along with a derived average over all three-time points; thus, ensuring that both the cumulative and overall effects are determined.ConclusionsThis trial will provide useful information for improving the knowledge, attitude, and practices of Middle Eastern adolescents, with regards to body weight status, physical activity level, nutrition status (BMI and dietary intake), and disordered eating. This will go a long way, towards ensuring their adherence to appropriate physical activities, and a healthy diet, to keep non-communicable diseases at bay.Trial registrationThis study is registered at NCT: NCT05694143

Intimate Partner Violence During COVID-19 Restrictions: A Study of 30 Countries From the I-SHARE Consortium.

Intimate partner violence (IPV) causes substantial physical and psychological trauma. Restrictions introduced in response to the COVID-19 pandemic, including lockdowns and movement restrictions, may exacerbate IPV risk and reduce access to IPV support services. This cross-sectional study examines IPV during COVID-19 restrictions in 30 countries from the International Sexual HeAlth and REproductive Health (I-SHARE) study conducted from July 20th, 2020, to February, 15th, 2021. IPV was a primary outcome measure adapted from a World Health Organization multicountry survey. Mixed-effects modeling was used to determine IPV correlates among participants stratified by cohabitation status. The sample included 23,067 participants from 30 countries. A total of 1,070/15,336 (7.0%) participants stated that they experienced IPV during COVID-19 restrictions. A total of 1,486/15,336 (9.2%) participants stated that they had experienced either physical or sexual partner violence before the restrictions, which then decreased to 1,070 (7.0%) after the restrictions. In general, identifying as a sexual minority and experiencing greater economic vulnerability were associated with higher odds of experiencing IPV during COVID-19 restrictions, which were accentuated among participants who were living with their partners. Greater stringency of COVID-19 restrictions and living in urban or semi-urban areas were associated with lower odds of experiencing IPV in some settings. The I-SHARE data suggest a substantial burden of IPV during COVID-19 restrictions. However, the restrictions were correlated with reduced IPV in some settings. There is a need for investing in specific support systems for survivors of IPV during the implementation of restrictions designed to contain infectious disease outbreaks

The determinants of sexual-risk behaviour among incarcerated adolescents in Malaysia - a mixed methods study / Nik Daliana binti Nik Farid

The purpose of this study was to determine the proportion of sexual-risk behaviour (SRB) and its associated factors among incarcerated adolescents within the Malaysian welfare-institution system. This group of adolescents were chosen because they had been identified as participating in SRBs, so using them would facilitate identification of determinants involved. The study employed a sequential, mixed-method approach that combined qualitative and quantitative data. Quantitative data was collected using a self-administered questionnaire; variables used in the questionnaire were identified from applying the Social Ecological Model (SEM). The qualitative phase consisted of in-depth interviews and written essays. The questionnaires were completed by 1082 adolescents, while 29 participants were interviewed and wrote essays. All participants were recruited from 22 welfare institutions in Peninsular Malaysia, were between 12 and 19 years old and comprised 86.9% Malay, 8.5% Indian and 3.5% Chinese. Overall, 62.3% of incarcerated adolescents had engaged in sexual intercourse. The mean age at first sexual intercourse for both genders was 14 years. Sexual intercourse in the study population was associated with individual factors such as female gender (OR = 1.75, 95% CI = 1.11–2.74), alcohol use (OR = 1.80, 95% CI = 1.10–2.94), illicit drug use (OR = 1.85, 95% CI = 1.07–3.22), permissive attitude toward premarital sex (OR = 4.34, 95% CI = 2.17–8.70), a history of child sexual abuse (OR = 5.41, 95% CI = 3.52–8.32) and viewing pornography (OR = 2.84, 95% CI = 1.65–4.89). Among the study subjects who had initiated sex, 55.1% were found to have engaged in SRBs. The qualitative findings showed that belief in “sex as an expression of love” was a strong reason for initiating sexual intercourse. This finding was further confirmed by methodological triangulation. The study recommends that sexual and reproductive health (SRH) programmes focusing on individual determinants of sexual initiation and SRB should be developed for adolescents in Malaysia

Determinants of shisha use among secondary school students in Sudan

Background: Shisha smoking has re-emerged in the Middle East in the last two decades and has spread rapidly in these communities. Information about shisha smoking in adolescents in Sudan is deficient. Hence, the aim of this study is to estimate the prevalence of shisha smoking among adolescents and determine the associated factors. Methods: This study is a school based cross sectional study among secondary school students in Khartoum State - Sudan that targets both male and female students aged 14-17 years. A total of 3387 students from 29 public and private schools were selected by multi stage random sampling. The participants completed an anonymous self-administered questionnaire which was based on Arabic version of the Global Youth Tobacco Survey (GYTS). Results: The response rate was 100% in schools and among participants, 57.3% were females and 51.6% were from public schools. The overall prevalence of those who had ever smoked shisha was 13.4%, and among male students the prevalence was 16.8%, while it was 10.9% in females. The associated factors were poor academic performance OR 2.90 CI 95% (1.21-6.94), friends smoking shisha OR 2.39 CI 95% (1.65-3.45), friends smoking cigarettes OR 2.76 CI 95% (1.90-4.01), peer pressure to smoke shisha OR 13.76 CI 95% (7.86-24.07) and unexpectedly restriction of selling shisha to minors OR 2.21 CI 95% (1.28-3.82). Conclusion: The prevalence of those who had ever smoked shisha is among the lowest in Middle East region; therefore, regular surveillance system is needed. A well-structured peer based comprehensive tobacco control programmes that are supported by strict and rigorous anti-tobacco regulations which control both commercial and social resources of tobacco are needed to contain this issue among adolescents. © 2019 The Author(s)

In-depth examination of issues surrounding the reasons for child marriage in Kelantan, Malaysia: a qualitative study

Objective: To examine individual, familial, community and societal issues surrounding the reasons for child marriage in Kelantan, Malaysia. Design: Qualitative study by means of semistructured interviews with women and key informants, using social-ecological model as a conceptual framework. Setting: Interviews were conducted in Kota Bharu district, Kelantan, a northeast state in Peninsular Malaysia. Participants: Eighteen women of reproductive age (18 to 44 years old) that experienced their first marriage below the age of 18, as well as five key informants, consisting of a government officer, a community leader, an officer from religious department and two mothers. The women were recruited from a reproductive health clinic. The key informants who had specialised knowledge related to child marriage were selectively chosen. Results: Three themes emerged that aligned with the social-ecological model: immaturity in decision-making, family poverty and religious and cultural norms. Conclusions: The findings imply that sex education and awareness-building activities regarding the consequences of child marriage must be implemented to eradicate child marriage in Malaysia. Such implementation must be coordinated as a team-based approach involving experts in such fields as law, religion, psychology, social-welfare and public health. In order to increase the awareness of child marriage consequences, the target for awareness must extend not only to the adolescent girls and their families, but also to the community and society at large by clearly communicating the negative consequences of and addressing the drivers for child marriage

The Determinants of Mental Health Literacy among Young Adolescents in Malaysia

Mental health literacy (MHL) is an established multifaceted concept that comprises mental health knowledge, help-seeking, and stigma. Adequate MHL (i.e., the ability to correctly recognize mental health disorders alongside having the intention to seek help) is able improve mental health outcomes among individuals. This study aims to examine the determinants of MHL among young Malaysian adolescents. A cross-sectional study was conducted among 1400 adolescents between 13 and 14 years old from nine national secondary schools in Selangor state, Malaysia. Sociodemographic determinants assessed included gender, age, ethnicity, smoking status, alcohol consumption, history of being bullied, feeling lonely, parental marital status, and parental income which were assessed using the Global School Based Student Health Survey. MHL was assessed using the Mental Health Literacy and Stigma questionnaire. Several factors were significantly associated with adequate levels of MHL following multivariate analysis, such as being female (AOR = 1.68; 95% CI 1.12, 2.52), older adolescents (AOR = 1.56; 95% CI 1.07, 2.30), not smoking (AOR = 1.99; 95% CI 1.20, 4.26), not consuming alcohol (AOR = 1.23; 95% CI 1.18, 2.41), and not feeling lonely (AOR = 1.25; 95% CI 1.06, 1.85). Addressing these determinants could be key in assisting the development of policies and programs to prevent mental health disorders among adolescents, which are currently on the rise

STROBE statement—checklist of items that should be included in reports of observational studies.

STROBE statement—checklist of items that should be included in reports of observational studies.</p

Sociodemographic characteristics of the respondents (n = 367).

Sociodemographic characteristics of the respondents (n = 367).</p