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Title: The role of psychosocial behavioural determinants, knowledge and the school environment in preventing childhood obesity in Malaysia
Author: Mohd Abd Majid, Hayati Adilin
ISNI:       0000 0004 2716 1090
Awarding Body: University of Nottingham
Current Institution: University of Nottingham
Date of Award: 2011
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Introduction: Malaysia is experiencing an increase in the prevalence of childhood obesity/overweight. This current study included the investigation of the psychosocial behavioural determinants and school environmental factors that could potentially mediate healthier eating in the school setting. Methods: In stage 1 of the work presented here, a survey was conducted in 8 randomly selected schools (4 urban/ 4 rural) in Terengganu. It involved 1000 children aged 10-12 yr. Weight and height were measured. Questionnaire to investigate psychosocial factors based on the Theory of Planned Behaviour (TPB) (attitude, subjective norm, perceived behaviour control, i.e. self-efficacy/ barriers) combined with knowledge were developed and validated (Cronbach's alpha ranged from 0.61-0.83). Chi-square tests and multinomial regression analyses were used to determine the association between psychosocial constructs and knowledge with weight status and sociodemographic factors. In stage 2 of the work, whole school mapping assessed the school environment on 4 levels (physical, economic, political and sociocultural) in these 8 schools, plus a further 4 randomly selected schools from the same area (6 rural; 6 urban in total). Results: The findings showed that nearly one-quarter (21.4%) of the sample was overweight/obese (WHO cut-offs), which was most prevalent in boys, urban children, older children and those in the higher socio-economic group (p<0.001). Findings for psychosocial constructs highlight that those who were in this overweight/obese category were significantly (p<0.0001) more likely to have negative attitudes (OR 31.52), more barriers (OR 24.12) less self efficacy (OR 19.00) and less subjective norm (OR 17.46) as well as low intention to eat healthily (OR 1.50) and less healthy eating behaviour (OR 23.56) compared with underweight and normal weight children. Interestingly, there was greater knowledge among obese children, but no significant difference in healthy eating behaviour, suggesting that knowledge alone does not help to improve behaviour to prevent obesity. No significant difference (p>0.05) between knowledge of obesity and psychosocial factors (with all the TPB constructs) also further supported the conclusion that increasing knowledge needs to be supported by enhancing other factors influencing behaviour in order to strengthen children's intention to eat healthily. Findings indicate there is much room for improvement in the physical, economic, policy and socio-cultural environments to improve healthy eating and physically active in the schools surveyed. Conclusion: The findings suggest that psychosocial factors among obese /overweight children need to be modified holistically. Enhancing knowledge and improving the school environment to help increase children's intention to eat healthily and be more physically active are required in order to prevent overweight/obesity among children.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RJ Pediatrics