A Multicomponent Workplace Environmental Intervention to Promote Physical Activity among the Staff of Universiti Malaysia Sarawak.

BACKGROUND: Physical inactivity is a significant public health issue affecting working adults because it can increase the risk of noncommunicable diseases. OBJECTIVES: The objective is to determine the outcomes of a multi-component workplace environmental intervention that incorporated physical activity self-regulation (PASR) to promote physical activity (PA) among employees. MATERIALS AND METHODS: This was a 6-month intervention with a two-group, parallel, quasi-experimental study. A total of 11 workplaces were randomly assigned to intervention group (IG) or control group (CG) using a 1:1 allocation ratio. In each group, 84 eligible participants were recruited. The IG was exposed to the organizational support and the PA support components throughout the study. The PASR Scale, International PA Questionnaire, and pedometer were used to measure the outcome at the baseline, 3rd-month, and 6th-month follow-ups, respectively. The repeated measures-analysis of variance analysis was used to determine the changes in the PASR skills, MET-min/week, and step/week over time. RESULTS: The IG had 75 participants (51 females and 24 males) and the CG had 73 participants (52 females and 21 males) at the 6th-month follow-up. Despite there was no statistically significant difference in the outcomes between groups over time, the IG showed significant improvements in total PASR (ηp2 = 0.021), goal setting (ηp2 = 0.024), total MET-min/week (ηp2 = 0.031), housework-related PA (ηp2 = 0.101), and step/week (ηp2 = 0.827) throughout this intervention. CONCLUSION: This intervention was found to be effective in improving the PASR skills, MET-min/week, and step/week of IG participants. Meanwhile, because some effect sizes were small, these findings should be interpreted with caution.

Kajian Rintis Penilaian Literasi Digital: Kesediaan Guru Prasekolah Menggunakan Platform Pembelajaran dalam Talian untuk Pendidikan Pemakanan (A Pilot Study Assessing Digital Literacy: Preschool Teachers’ Readiness to Use Online Learning Platforms in Nutrition Education) / Jurnal Sains Kesihatan Malaysia

@#eToyBox is a learning management system for preschool teachers to improve their health literacy, which ultimately aims to improve children’s obesity-related behaviour. As part of the development process of eToyBox, assessment on digital literacy, acceptance of digitization of education materials, and perceived barriers in adopting online learning is needed. Fifty-four preschool teachers under the Community Development Department (KEMAS) in Kuala Lumpur, Selangor, and Sarawak, who participated in ToyBox Study Malaysia intervention in 2018, took part in this cross-sectional study. An online self-administered questionnaire was used to assess sociodemographic background, use of communication tools and media, and teacher’s views on adapting the ToyBox modules to digital education materials. Respondents were contacted, and questionnaire link was shared through WhatsApp messages. Most participants (74.0%) were Malay females aged 31 to 40 years old. Most participants had internet access (94.4%) and owned at least a smart phone, laptop or tablet (94.4%). Participants perceived their computer skills to be average (75.0%). Majority of respondents (65.0%) reported advanced and higher abilities in word processing and email, but only 22.0% in spreadsheet skills. The main barrier to accessing online material was unstable internet connection (74.1%). Most respondents (90.0%) agree that adapting effective modules to online learning will be beneficial for professional development and teaching practices. In conclusion, most participants supported digitizing Toybox Study Malaysia educational content and were comfortable 72 with its implementation via an online learning platform. The findings from this study can advise future development of online learning materials for preschool teachers in Malaysia.

Depression Level and Its Associated Factors among Postpartum Working Women in Kuching, Sarawak-A Cross-Sectional Study.

Background: Postpartum depression (PD) among women, if left untreated, may result in long-term health and social consequences for them and their families. This cross-sectional study aimed to determine the factors contributing to PD among working mothers in Kuching, Sarawak, Malaysia. Methods: Systematic sampling was used to recruit working mothers who attended Kuching's maternal and child health clinics. They were interviewed with a validated translated questionnaire to obtain data on sociodemographics, health profiles, and Edinburgh Postnatal Depression Scale (EPDS) and postpartum symptoms. Data were analysed using IBM SPSS version 21.0. Results: Out of the total 281 respondents, 15.3% of respondents had depression symptoms. Fatigue (42.7%), back or neck pain (36.3%), breast discomfort (16.4%), dizziness (13.5%) and nipple irritation (11.0%) were the most common physical symptoms experienced by the mothers. Regression analysis showed that working mothers who exhibited higher scores of physical symptoms were 1.26 times more likely to develop PD (adjusted odd ratio 1.26, P < 0.01; 95% CI: 1.071, 1.487). Conclusion: Physical symptoms were the predictors of PD among working mothers.

Postpartum health of working mothers: A prospective study.

Introduction: Most working women experience poor physical and mental health during their postpartum period. This prospective study aimed to describe the physical and mental health issues faced by working mothers during their postpartum period. Methods: Respondents were recruited using the proportional sampling method among mothers who attended the Maternal and Child Health Clinic in the Kuching division in Sarawak, Malaysia. Face-to-face interview was conducted using a questionnaire that consisted of items on socio-demographic data as well as perinatal, prenatal and postpartum factors, and the Edinburgh Postnatal Depression Scale and a checklist of 28 specific postpartum symptoms were used during the first 6 weeks and after 12 weeks of childbirth. Results: A total of 281 respondents participated in this study. Fatigue (42.7%), back or neck pain (36.3%), breast discomfort (16.4%), dizziness (13.5%) and nipple irritation (11.0%) were among the most common symptoms experienced by the mothers during the first 6 weeks after childbirth. There was a significant decrease in the physical symptom scores of the respondents from the first 6 weeks to after 12 weeks of childbirth (1.73±1.96 vs 0.16±0.42; P<0.0005). A significant decrease was also found in the depression scores (6.26±4.26 vs 1.35±1.85, P<0.0005). Conclusion: The prevalence of postnatal depression was higher during the first 6 weeks of postpartum than after 12 weeks of postpartum. Screening and treatment of poor postpartum mental health among working women are essential owing to the impacts on occupational outcomes.

From ToyBox Study to eToyBox: Advancing Childhood Obesity Reduction in Malaysian Kindergartens.

Prevention and treatment of childhood obesity is a global concern, and in Malaysia, it is considered a national public health priority. Determinants of childhood obesity are multifactorial and include factors that directly and indirectly influence energy balance-related behaviours, including energy intake and energy expenditure. Interventions to address childhood obesity that have multiple components at different levels have been shown to be the most influential. The ToyBox-study is a childhood obesity intervention aimed at preschool-aged children and their families that had been shown to be effective in several European countries and so was chosen for adaption for the Malaysian setting. Materials were translated and adjusted for the Malaysian context and audience and implemented in kindergartens in Peninsular Malaysia and Sarawak. However, during the COVID-19 pandemic and lockdown, teaching transitioned to being online. This brought an opportunity to reach a wider audience and consider the long-term sustainability of the intervention, and thus eToybox was born. eToybox aims to bring support for healthy energy balance behaviours directly to the teachers, into kindergartens and homes, to encourage families to be active and eat healthily, and prevent or reduce obesity. Through online innovation, the Toybox Study Malaysia programme has been expanded to enhance its potential to impact the promotion of healthy lifestyles among preschoolers and their families, highlighting the importance of a holistic approach to preventing and treating childhood obesity in Malaysia.

Responses to Stress among East Malaysian Students: Psychometric Properties of the Responses to Stress Questionnaire.

Background: Academic stress is part of a student's life. Chronic stress may result in mental health problems, affecting the adolescent's well-being in adulthood. However, not all types of stress result in a negative effect. Therefore, understanding how adolescents adapt to academic stress can lay the groundwork for preventive interventions. The Response to Stress Questionnaire (RSQ) for academic problems centred on a multidimensional model of responses to stress. However, it has not been tested among Malaysians. Thus, this study aimed to validate the questionnaire among Malaysians. Methods: The questionnaire was translated into the Malay language using forward and backward translation. Data were collected via self-administered questionnaires at a secondary school in Kuching. A validity test was conducted using face and content validation by subject matter experts, and construct validation was performed using exploratory factor analysis (EFA). A reliability test was conducted by checking Cronbach's alpha. Results: Results showed that the questionnaire has good validity and reliability. The EFA resulted in only three dimensions of responses to stress among Malaysian adolescents in contrast to the five dimensions in the original RSQ for academic problems. The Cronbach's alpha showed good reliability of the questionnaire. Conclusion: The questionnaire measuring responses to stress was valid and reliable in assessing the responses of adolescents to academic stress.

Prevalence and associated factors of hypertension among primary school children: A cross-sectional study in Kuching, Sarawak.

Introduction: Hypertension is an emerging health concern among children owing to its increasing prevalence and association with obesity. However, hypertension screening is uncommon, and childhood hypertension-related data are limited. This cross-sectional study determined the prevalence and associated factors of hypertension among primary school children in Kuching, Sarawak. Method: Standard procedures and validated equipment were used to measure blood pressure and anthropometric indicators. The body mass index (BMI)-for-age and waist-to-height ratio (WHtR) were calculated. Questionnaires were used to obtain family sociodemographic data and health history. Results: A total of 1,314 children aged 6-12 years were enrolled, of whom 107 (8.1%) and 178 (13.5%) were hypertensive and pre-hypertensive, respectively. The chi-squared test indicated that hypertension was significantly associated with male sex (P<0.05), >1 standard deviation BMI-for-age (P<0.001), percentage of excess body fat (BF)(P<0.001), 5th to 95th height percentile (P<0.001), >90th excess waist circumference (WC) percentile (P<0.001), >90th WHtR percentile (P<0.001), clerical, service, sales and skilled parental work (P<0.05), excess weight (P<0.05) and cardiovascular disease (P<0.01). Multivariate logistic regression analysis showed that the percentage of excess BF [odds ratio (OR): 4.84, 95% confidence interval (CI): 2.01-11.66] and excess WC (OR: 2.33, 95% CI: 1.15-4.72) were significantly related to hypertension after adjusting for sex and age. Conclusion: The prevalence of hypertension among the study population is higher than that among children worldwide. Childhood hypertension-related factors must be identified to aid in routine blood pressure screening, which is crucial for early detection and intervention to reduce future morbidity burden.

Differences in the food group consumption among university students in Sarawak during the COVID-19 Movement Control Order: A crosssectional study.

Introduction: The COVID-19 Movement Control Order (MCO) has caused a concern on the food consumption among university students. This study aimed to assess food diversity and its relationship with accommodation among university students in Sarawak. Method: This cross-sectional study was conducted among students of the University Malaysia Sarawak in Kota Samarahan during the MCO. Data on socio-demographic characteristics and food diversity were collected using an online questionnaire. Results: A total of 478 respondents participated in this study. The majority of the respondents were women (77.4%), and almost half were Malays (49.6%). Half of the respondents stayed at home with their family, while 36.4% stayed in their college dormitories. Except for legumes, nuts and seeds and milk and milk products, all other food groups were common in the respondents' diet, with the highest consumption observed from cereal and cereal products, followed by meat and meat products and water. One-way ANOVA showed that there were significant differences in the intake of fish and seafood; legumes, nuts and seeds; milk and milk products; and fruits between those who stayed in college dormitories, at home with their families and in rented houses (P<0.01). Conclusion: Despite reduction in food availability and accessibility, the total energy intake of the university students did not change. University students should be continuously educated on the importance of a balanced diet consisting of all food groups.

Influence of mental health on the well-being status among Malaysian adults before and during COVID-19 pandemic.

The coronavirus disease (COVID-19) pandemic has affected the well-being of individuals worldwide. Due to the scarcity of information in the Malaysian context, this study aimed at investigating the changes in well-being before and during the Movement Control Order (MCO) in Malaysia and its association with mental health status. This cross-sectional study was part of a Malaysian non-probabilistic online survey on psychosocial well-being in Malaysia, under the Personal and Family Coping with COVID-19 Global South Research Consortium. A total of 543 respondents (≥18 years old) were recruited using snowball sampling. A validated self-administered questionnaire for assessing sociodemographic characteristics, well-being, anxiety, boredom, and loneliness was circulated on social media platforms (such as Facebook, Twitter, and WhatsApp) and emails. Paired samples t-test, chi-square test, and multinomial logistic regression analyses were applied during data analysis. Results revealed significant changes in the mean scores of well-being, anxiety, boredom, and loneliness before and during MCO (p < 0.05). When comparing with no change in the well-being group, changes in boredom were less likely to be observed in the decreased well-being group (Adj OR = 0.874; p = 0.003) but were more likely to be observed in the group with increased well-being (Adj OR = 1.110; p = 0.002). The findings indicated that the pandemic did not necessarily create adverse effects. Instead, a different perspective is offered, which can be used as a public health strategy to help individuals cope with their mental health needs more positively.

Demographic characteristics are associated with children’s nutritional status: Findings from a pilot study on food insecure households in Simunjan district, Sarawak

@#Introduction: Food insecurity is a public health concern that may lead to malnutrition in children. The purpose of this study was to determine the relationship between demographic characteristics and food security level with nutritional status among children from food-insecure households in Simunjan District, Sarawak. Methods: This study involved a total of 171 mother-and-child pairs from two Maternal and Child Health Clinics (Simunjan and Gedong) using non-probability convenience sampling technique. Food insecurity status was determined using Radimer/Cornell Hunger Food Insecurity Instrument, while child’s weight and height were measured following standard procedures. Chi-squared test of independence and binary logistic regression were used during data analysis. Results: The prevalences for household food insecurity, individual food insecurity, and child hunger were 70.8%, 15.2%, and 14.0%, respectively. The main nutritional problems for children aged 24–59 months were underweight (17.9%) and stunting (17.9%), while for children aged 60–144 months were overweight and obesity (27.5%). Children of mothers over 34 years old (AOR=2.367; 95% CI: 1.085, 5.164), and those aged 60–144 months (AOR=3.619; 95% CI: 1.521, 8.613) had increased odds of being overweight or obese. Meanwhile, children of working mothers (AOR=6.526; 95% CI: 1.108, 38.449) were more likely to have a thinness problem than children of unemployed mothers. However, no association was found between the severity of food insecurity with children’s nutritional status. Conclusion: Malnutrition in children remains a public health concern in Simunjan District, and it is linked to mother’s age and employment status. An intervention programme is required to ameliorate the situation.

Examining gender difference in disordered eating behaviour and its associated factors among college and university students in Sarawak.

Background: Disordered eating is common among late adolescents and young adults who pursue an idealised body image. Aims: This study aims to determine the prevalence of disordered eating between males and females and its associated factors among college and university students in Sarawak. Methods: A cross-sectional study involving 20 public and private colleges and universities in Sarawak, from September 2017 to March 2020. Respondents completed self-administered questionnaires both in the English and Malay language. Data about sociodemographic characteristics, body mass index, eating attitude, body dissatisfaction, perceived sociocultural pressure, self-esteem, drive for muscularity and perfectionism were collected. Results: A total of 776 respondents (male: 30.9%; female: 69.1%) aged 19 to 25 years old took part in the study. The overall prevalence of disordered eating was 25.2% (95% confidence interval (CI) 21.9; 28.7) with females (28.6%, 95% CI 24.6; 32.9) higher than males (15.6%, 95% CI 10.5; 21.9). Multivariate analysis showed for both male and female models, perceived sociocultural pressure (male: ß = 1.125, p < 0.01; female: ß = 1.052, p = 0.003), drive for muscularity (male: ß = 1.033, p = 0.017; female: ß = 1.032, p < 0.01) and perfectionism (male: ß = 1.098, p = 0.02; female:ß = 1.119, p < 0.01) were predictors for disordered eating. Conclusion: The prevalence of disordered eating among college and university students in Sarawak was high. The findings suggest that although there were gender differences in the prevalence of disordered eating, its associated factors were the same. The findings of this study will be useful for designing and implementing disordered eating prevention and intervention programme.

A Multilayer Perceptron Neural Network Model to Classify Hypertension in Adolescents Using Anthropometric Measurements: A Cross-Sectional Study in Sarawak, Malaysia.

This study outlines and developed a multilayer perceptron (MLP) neural network model for adolescent hypertension classification focusing on the use of simple anthropometric and sociodemographic data collected from a cross-sectional research study in Sarawak, Malaysia. Among the 2,461 data collected, 741 were hypertensive (30.1%) and 1720 were normal (69.9%). During the data gathering process, eleven anthropometric measurements and sociodemographic data were collected. The variable selection procedure in the methodology proposed selected five parameters: weight, weight-to-height ratio (WHtR), age, sex, and ethnicity, as the input of the network model. The developed MLP model with a single hidden layer of 50 hidden neurons managed to achieve a sensitivity of 0.41, specificity of 0.91, precision of 0.65, F-score of 0.50, accuracy of 0.76, and Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of 0.75 using the imbalanced data set. Analyzing the performance metrics obtained from the training, validation and testing data sets show that the developed network model is well-generalized. Using Bayes' Theorem, an adolescent classified as hypertensive using this created model has a 66.2% likelihood of having hypertension in the Sarawak adolescent population, which has a hypertension prevalence of 30.1%. When the prevalence of hypertension in the Sarawak population was increased to 50%, the developed model could predict an adolescent having hypertension with an 82.0% chance, whereas when the prevalence of hypertension was reduced to 10%, the developed model could only predict true positive hypertension with a 33.6% chance. With the sensitivity of the model increasing to 65% and 90% while retaining a specificity of 91%, the true positivity of an adolescent being hypertension would be 75.7% and 81.2%, respectively, according to Bayes' Theorem. The findings show that simple anthropometric measurements paired with sociodemographic data are feasible to be used to classify hypertension in adolescents using the developed MLP model in Sarawak adolescent population with modest hypertension prevalence. However, a model with higher sensitivity and specificity is required for better positive hypertension predictive value when the prevalence is low. We conclude that the developed classification model could serve as a quick and easy preliminary warning tool for screening high-risk adolescents of developing hypertension.

Quality of life among undergraduate university students during COVID-19 movement control order in Sarawak.

BACKGROUND AND AIMS: This study aimed to examine the quality of life (QoL) and health satisfaction of undergraduate university students in Sarawak during MCO and its association with socio-demographic profiles. METHODS: In this cross-sectional study, QoL and satisfaction of health of 503 undergraduate university students (63.4% females) from a public university was assessed online using the World Health Organization QoL (WHOQOL)-BREF instrument. RESULTS: The overall QoL and satisfaction with health were 3.7 ± 0.87 and 3.9 ± 0.82, respectively. Male students showed significantly lower mean scores for the environmental domains than female students (63.37 ± 16.21 vs 68.10 ± 14.00, P < .01). Students who lived inside the campus (vs outside campus) showed significantly lower mean score for the physical health (61.49 ± 13.94 vs 67.23 ± 13.93, P < .01), environmental health (58.35 ± 15.07 vs 70.49 ± 13.21, P < .01), overall QoL (3.39 ± 0.90 vs 3.84 ± 0.83, P < .01), and satisfaction with health (3.71 ± 0.90 vs 3.97 ± 0.77, P < .01). Students with parent's income below RM5000 (vs parent's income more than RM5000) had significantly lower mean score for the environmental domain (65.06 ± 14.35 vs 68.20 ± 15.74, P < .05). Others ethnicity scored significantly lower than Bumiputera Sarawak and Malay while Bumiputera Sarawak scored significantly lower than Chinese in physical health domain (Malay = 65.73 ± 13.40, Chinese = 63.24 ± 15.35, Bumiputra Sarawak = 67.35 ± 13.30, Others = 60.84 ± 15.88, P < .05). Malay (69.99 ± 15.20) scored significantly higher than other ethnicities (Chinese = 63.58 ± 15.80; Bumiputera Malaysia = 65.23 ± 13.66; others = 63.98 ± 15.59) in environmental domain (P < .01). When comparing between religions, the results also showed there were significant differences between different religion groups in overall QoL (Islam = 3.75 ± 0.93, Christianity = 3.77 ± 0.79, Others = 3.34 ± 1.14, P < .05), physical health (Islam = 65.00 ± 13.86, Buddhism = 68.40 ± 11.99, Christianity = 64.77 ± 14.94, Others = 61.00 ± 16.03, P < .05), and environmental health (Islam = 69.66 ± 15.48, Buddhism = 64.99 ± 11.36, Christianity = 64.87 ± 15.61, Others = 62.13 ± 16.28, P < .05). CONCLUSION: By understanding university students' QoL in this global disaster, relevant authorities would provide a better rehabilitation and assistance to those affected ones.

The Effects of a 7000-Step Goal and Weekly Group Walking Program for Overweight and Obese Elderly People in Sarawak, Malaysia: A Quasi-experimental Study.

OBJECTIVES: Physical inactivity is the fourth leading global risk factor for mortality, followed by obesity. The combination of these risk factors is associated with non-communicable diseases, impaired physical function, and declining mental function. The World Health Organization recommends physical activity to reduce the mortality rate. Thus, this study examined the effects on anthropometric measurements of a 12-week walking program for elderly people in Samarahan, Sarawak, Malaysia with a 7000-step goal and weekly group walking activities. METHODS: A quasi-experimental study was conducted involving 109 elderly people with a body mass index (BMI) ≥25.0 kg/m2. BMI, body composition, and average daily steps were measured at baseline, 6 weeks, and 12 weeks. Data were analyzed using SPSS version 26.0, and repeated-measures analysis of variance with the paired t-test for post-hoc analysis was conducted. RESULTS: In total, 48 participants in the intervention group and 61 participants in the control group completed the study. A significant interaction was found between time and group. The post-hoc analysis showed a significant difference between pre-intervention and post-intervention (within the intervention group). The post-intervention analysis revealed an increase in the mean number of daily steps by 3571.59, with decreases in body weight (-2.20 kg), BMI (-0.94 kg/m2), body fat percentage (-3.52%), visceral fat percentage (-1.29%) and waist circumference (-2.91 cm). Skeletal muscle percentage also showed a significant increase (1.67%). CONCLUSIONS: A 12-week walking program combining a 7000-step goals with weekly group walking activities had a significant effect on the anthropometric measurements of previously inactive and overweight/obese elderly people.

Validity and Reliability of a Food Frequency Questionnaire (FFQ) to Assess Dietary Intake of Preschool Children.

As there are few food frequency questionnaires (FFQ) to assess the dietary intake of preschool children, this study examined the validity and reliability of an FFQ for this purpose. A total of 210 preschoolers aged 4 to 6 years participated in the validation study, while a subsample of 66 participants joined the reliability study. The FFQ is modified from the ToyBox-study and South East Asian Nutrition Surveys (SEANUTS), and comprised 108 food items from 13 food groups. A three-day estimated dietary record (3DR) was used as reference and reliability was assessed through a second administration of the FFQ (FFQ2), four weeks after the first administration (FFQ1). For the validation study, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ and 3DR. Cross-classification of quartile analysis showed moderate agreement between the two methods. As for reliability, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ1 and FFQ2. Cronbach's alpha values (0.708 to 0.824) and intraclass correlation coefficients (0.710 to 0.826) showed good agreement between repeated FFQs. The results suggest that the FFQ has acceptable validity and good reliability. Hence, the FFQ can be used to assess preschool children's food intake.

DIFFERENTIALS IN SEXUAL AND REPRODUCTIVE HEALTH KNOWLEDGE AMONG EAST MALAYSIAN ADOLESCENTS.

The aim of this study was to assess the knowledge of East Malaysian adolescents on sexual and reproductive health issues. Data were collected in March-July 2015 from 2858 adolescents aged 13-18 years from selected East Malaysian secondary schools using a self-administered questionnaire. Twelve items relating to sexual and reproductive health were used to measure respondents' knowledge based on their responses 'True', 'False' or 'Don't know', with the proportion of correct answers being the variable of interest. Cronbach's alpha for the twelve items was 0.761 and the mean knowledge score was 6.8. While the majority of the respondents knew that a woman can get pregnant if she has sex with a man and that HIV and AIDS can be transmitted through sexual intercourse, knowledge about Malaysia's abortion laws, that a woman can get pregnant if she has sex only once and that people with sexually transmitted infections may look healthy was poor. Older respondents and those from urban schools reported significantly higher knowledge than younger respondents and those from rural schools, respectively. More emphasis should be given in schools to the specific topics for which low levels of sexual and reproductive health knowledge were found, with greater attention being given to younger adolescents and those in rural areas.

An intervention based on the stages of change, health profiles and physical activity levels of overweight and obese adults in Sarawak, Malaysia – a feasibility study

@#Introduction: Physical inactivity is the one of the leading causes of major non-communicable diseases in the world. The aim of this study is to assess the feasibility of an intervention program based on the stages of change, physical activity levels and health profiles of selected overweight and obese adults in Sarawak. Methods: This intervention study was carried out using selected overweight and obese adults in Sarawak. A total of 75 participants were placed in the intervention group, and 80 respondents were placed in the control group participated. Respondent-determined weekly aerobic exercise sessions were conducted for six months. The Malay version of the long-form International Physical Activity Questionnaire (IPAQ) and Transtheoretical model of change (TTM) questionnaire were used, together with anthropometric measurements and the collection of venous fasting blood profiles. Data was entered and analyzed using SPSS Version 20. Results: The intervention group had significant better stage transitions compared to the control group (p<0.01). They also had significantly lower total cholesterol, although both groups showed significant results (difference= 0.53, p<0.01; difference= 0.38, p=0.01). The respondent-determined intervention program was effective in improving stage transition; however, an intervention of longer duration could provide more conclusive health outcomes. Conclusion: Physical activity plays a role in assisting overweight and obese adults to be more active and healthier.

Mental Health Status and Its Associated Factors Among Caregivers of Psychiatric Patients in Kuching, Sarawak

@#Introduction: Caregivers have a high risk of mental health disorders. The quality of patient care is inseparable from the mental health status of caregivers. The objective of this research was to study the mental health status among caregivers of psychiatric patients and its associated factors. Method: A cross-sectional study was conducted among 198 caregivers in Kuching from January till July 2014. The respondents were recruited using systematic sampling and were required to provide information on sociodemographic and environmental factors as well as complete the Hospital Anxiety and Depression Scale (HADS) questionnaire. The data was analysed using the IBM SPSS Statistical Software Version 20.0. Results: The prevalence rates of anxiety and depression among caregivers were 32.8% and 27.8%, respectively. The caregiver’s age (OR=0.97, 95% CI = 0.953 - 0.996), the perception of caregiving as an economic burden (OR= 2.70, 95% CI= 1.256 - 5.803) and the dependence of the patient (OR= 2.27, 95% CI= 1.087 - 4.719) were associated with anxiety. A caregiver who was male (OR= 2.21, 95% CI= 1.143 - 4.262), a caretaker who held the perception that a patient was dependent on them (OR=2.53, 95% CI= 1.203 - 5.337) , and a caretaker who lacked stress-coping skills (OR=2.48, 95% CI= 1.030 - 5.973) were found to be significant factors in depression. Conclusion: A high prevalence of probable anxiety and depression among caregivers points to the need to screen caregivers. There is a vital need to train healthcare workers to be able to detect early anxiety and depression. Culturally sensitive research should be carried out for different ethnicity, and improving the support system for caregivers is necessary