A school-based study to improve healthy eating habits amongst Malaysian teenagers
| ISRCTN | ISRCTN89649533 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN89649533 |
| Secondary identifying numbers | NMRR-18-965-41783 |
- Submission date
- 28/08/2018
- Registration date
- 02/10/2018
- Last edited
- 30/06/2022
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aim
Recent research has shown that Malaysian adolescents are more likely to have an unhealthy food intake. Therefore, it is crucial to promote healthy eating and the regular intake of meals amongst adolescents, especially in Malaysian schools, as this is where breakfast and lunch are often consumed by adolescents. Therefore, the school canteen plays an important role in influencing, creating and instilling awareness of a healthy diet in schoolchildren. Studies have shown that environmental interventions can play an important role in providing healthier food and drinks. To promote a healthy diet amongst Malaysian adolescents, a canteen-based intervention was considered necessary. This study aims to look at the feasibility and effectiveness of an intervention involving training canteen operators to provide healthy food, and promoting healthy eating practices amongst adolescents.
Who can participate?
Malaysian adolescents aged 14 years at recruitment
What does the study involve?
Six schools will be selected to participate, including schools from rural and urban areas in Selangor and Perak states. Schools will be randomly allocated into 3 groups - 2 intervention groups and 1 control group, with 2 schools in each group.
One of the intervention groups will receive canteen operator training to promote provision of healthy options. The other intervention group will also receive this training, in addition to changing food provision, which will involve a subsidy for fruit, vegetables and kuih, and free drinking water.
The control group will not experience any changes to their usual canteen service.
All schools will have their canteen menu audited by trained dieticians.
Students will have their diet history assessed, along with body measurements and focus group discussions. Sales of food and drink will also be estimated using weekly receipts from canteen operators.
What are the possible benefits and risks of participating?
Participants in this study may benefit from increased healthy options available to them and from encouragement of healthy eating. There are no known risks to participants taking part in this study.
Where is the study run from?
University of Malaya (Malaysia)
Who is funding the study?
1. Academy of Science Malaysia (Newton Ungku Omar Fund) (Malaysia)
2. UK Medical Research Council between the University of Malaya and University of Bristol (UK)
Who is the main contact?
Associate Prof. Dr Hazreen Abdul Majid
hazreen@ummc.edu.my
Contact information
Scientific
Department of Social and Preventive Medicine
Faculty of Medicine
University of Malaya
Kuala Lumpur
50603
Malaysia
 ORCID ID |
0000-0002-2718-8424 |
|---|
Study information
| Study design | Interventional quasi-experimental study |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Quasi-experimental |
| Study setting(s) | School |
| Study type | Prevention |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet |
| Scientific title | Dietary patterns and their relation to cardiometabolic health among Malaysian adolescents: a school-based intervention feasibility study |
| Study acronym | MyHeARTBEaT |
| Study objectives | Adolescents from the intervention arm will engage with possible changes of food choices into healthy options after the intervention to a greater extent than adolescents in the control arm |
| Ethics approval(s) | Medical Research Ethics Committee, University Malaya Medical Centre, 21/03/2018, MREC ID NO: 2018214-6029 |
| Health condition(s) or problem(s) studied | Dietary intake among Malaysian adolescents |
| Intervention | The study will be conducted in 6 secondary schools in Malaysia. The sample will include schools from rural and urban areas in Selangor and Perak states, which will be randomised into 2 intervention arms and 1 control arm, with 2 schools in each arm, by an independent statistician using a computer-generated randomisation method. Intervention 1 will focus on training and change of food provision, whilst intervention 2 will focus on training only. The control group will not receive any intervention and will continue the usual service operation. All schools will have their canteen menu audited by trained dietitians. Study outcome measures will be assessed at the organisational level, and include 3-day diet history assessments, anthropometric measurements and focus group discussion among students conducted at baseline and post-intervention (4 weeks after intervention). Sales of food and drink items will be crudely estimated using weekly receipts from the canteen operators. Intervention 1: Training & enabling healthy food environment 1. Training: Canteen operators will be trained to provide healthy foods and consider alternative methods for cooking by using a training manual which will be developed based on the Malaysian healthy canteen guidelines. 2. Subsidy for fruits, vegetables and low-energy dense (low ED) kuih (traditional cakes). The canteen operators will receive a weekly allowance (the amount can be revised when necessary) for the subsidy of fruit, veg and low ED kuih. 3. Providing free drinking water by installing a proper water container/tank to dispense drinking water. It can be assessed through diet history and focus group discussion with students. 4. All students (Form 2 students) will receive Ringgit Malaysia RM) valued coupons to pay for fruits (given for 2 days per week over 4 weeks) and low ED kuih (given for 2 days per week over 4 weeks). A trained dietitian will deliver the training in these two schools and the canteens will be examined each week to assess the foods provided. Intervention 1 will entail the adjustments to the choice of healthier food options by students which will be mainly led by the research team with the cooperation of food vendor operators. The issue of unhealthy dietary habits and practices will be addressed by encouraging and training the operators on healthy cooking methods, such as steaming and grilling. Intervention 2: Training Intervention 2 involves training only. Canteen operators will be trained to provide healthy foods and consider alternative methods for cooking by using a training manual which will be developed based on the Malaysian healthy canteen guidelines. Control: Control group will receive usual practices of food service delivery by the canteen operators The control group will receive usual practice of food service delivery by the canteen operators - there will be no changes to their food choices or delivery of service. This study will mainly focus on altering the availability of foods/drinks in the school canteen. This 4-week intervention will be divided intervention and control group which involved 6 schools (3 from rural and 3 from urban). |
| Intervention type | Behavioural |
| Primary outcome measure | The following will be assessed using the checklist for healthy school canteens and sales receipts from the canteen by an external evaluator at the baseline, weekly during the intervention and at the end of the intervention: 1. Feasibility of providing healthier food options at the school canteen with cooperation of the food vendors 2. Possible changes of food choices into healthy options among adolescents before and after intervention |
| Secondary outcome measures | 1. Dietary intake (3-days diet history), assessed using a focus group with students who participate in the intervention at the baseline and at the end of the intervention: 2. Anthropometric measurements related to the health outcome, assessed at the baseline and at the end of the intervention: 2.1. Height (without socks and shoes), recorded to the nearest mm using a calibrated vertical audiometer 2.2. Weight (measured with light clothing), recorded to the nearest 0.1 kg using a digital electronic weighing scale 2.3. Waist circumference, recorded to the nearest mm using a non-elastic Seca measuring tape 2.4. Percentage body fat, measured using a portable body composition analyser |
| Overall study start date | 21/02/2018 |
| Completion date | 15/05/2019 |
Eligibility
| Participant type(s) | Healthy volunteer |
|---|---|
| Age group | Other |
| Sex | Both |
| Target number of participants | This study will be conducted among Malaysian adolescents. The sample size targeted for this study covered adolescents aged 14 years old. The total sample size will be estimated around 450 - 480 adolescents taking in to account of about 20% drop-out rate and 50 % response rate. |
| Total final enrolment | 441 |
| Key inclusion criteria | 1. Malaysian adolescent 2. Aged 14 years |
| Key exclusion criteria | 1. Boarding schools 2. Religious schools 3. Vernacular schools |
| Date of first enrolment | 28/08/2018 |
| Date of final enrolment | 15/04/2019 |
Locations
Countries of recruitment
- Malaysia
Study participating centre
University of Malaya
Kuala Lumpur
50603
Malaysia
Sponsor information
University/education
Pusat Pengurusan Geran Penyelidikan
Institut Pengurusan & Pemantauan Penyelidikan (IPPP)
Aras 4, Kompleks Pengurusan Penyelidikan & Inovasi
UNIVERSITI MALAYA
Kuala Lumpur
50603 Lembah Pantai
Malaysia
| Website | https://www.um.edu.my/research-and-community |
|---|---|
"ROR" |
https://ror.org/00rzspn62 |
University/education
Research and Enterprise Development
3rd Floor
Senate House
Tyndall Avenue
Bristol
BS8 1TH
United Kingdom
Bristol
BS8 1TH
England
United Kingdom
| Website | www.bristol.ac.uk/red/ |
|---|
Funders
Funder type
University/education
No information available
No information available
Results and Publications
| Intention to publish date | 15/05/2021 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Data sharing statement to be made available at a later date |
| Publication and dissemination plan | The protocol of study and the results of the intervention will be published in a high-impact peer-reviewed journal in 2019. |
| IPD sharing plan | The data sharing plans for the current study are unknown and will be made available at a later date |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol article | 22/09/2020 | 08/06/2021 | Yes | No | |
| Results article | qualitative study results | 01/06/2021 | 08/06/2021 | Yes | No |
| Results article | qualitative results | 01/09/2021 | 02/09/2021 | Yes | No |
| Results article | 30/06/2022 | 30/06/2022 | Yes | No |
Editorial Notes
30/06/2022: Publication reference added.
02/09/2021: Publication reference added.
08/06/2021: Publication reference added.
23/11/2020: The intention to publish date was changed from 15/05/2020 to 15/05/2021.
21/05/2019: The following changes were made to the trial record:
1. The recruitment end date was changed from 01/04/2019 to 15/04/2019.
2. The overall end date was changed from 15/07/2019 to 15/05/2019.
3. The intention to publish date was changed from 15/07/2020 to 15/05/2020.
4. The total final enrolment was added.
16/10/2018: The following changes were made to the trial record:
1. The recruitment end date was changed from 20/09/2018 to 01/04/2019.
2. The overall trial end date was changed from 15/03/2019 to 15/07/2019.
3. The intention to publish date was changed from 30/05/2019 to 15/07/2020.
