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Community Based Intervention through 1 Stop Centre for Health: A Community Empowerment Approach in Malaysia

Author(s): Noraryana Hassan1
Affiliation(s): 1Ministry of Health, Melaka, Malaysia
1st country of focus: Malaysia
Relevant to the conference theme: Non-communicable chronic diseases
Summary (max 100 words): This paper presents the outcome results of a 6 months structured intervention program  among 107 subjects in a  community in Pantai Peringgit, Melaka, Malaysia which aimed to reduce  Non Communicable diseases (NCD) risk factors and improve walking stamina.
Background (max 200 words): Obesity is an epidemic in Malaysia and Melaka has one of the highest prevalence of people with obesity in the country. Experts propose that the possible reasons are sedentary lifestyles and over eating which contribute to the fast growth of obesity and is responsible for deaths caused by Non Communicable diseases (for example  ischemic heart diseases, diabetes, and hypertension).  A structured intervention program through community empowerment was found to be effective in making changes in sedentary lifestyle and unhealthy eating.
Objectives (max 100 words): The objective of this study was to reduce the NCD risk factors among the community in Pantai Peringgit Melaka through a structured 6 months community based intervention program.
Methodology (max 400 words): This is a cross sectional study with structured community based intervention.  A total of 107 people in the Pantai Peringgit Community were recruited in the study.  Study subjects were chosen from those who conducted self screening of NCD risk factors and agreed to the intervention. All screening and intervention programs were conducted in the community centre called 1 Stop Centre For Health. Screening and intervention activities were conducted by 10 volunteers in this community lead by the Pantai Peringgit community leaders. Community leader and the volunteers were trained by the Melaka State Health Department in the two main parts components of the intervention screening and intervention. The intervention began in March 2011.  The 107 participants were divided into 8 groups. The intervention programs were easily monitored by the volunteers and community leader in these smaller groups. In order to reduce dropout rate, competitions were held among the groups. Examples of physical activities include aerobic, brisk walking and football games which were carried out twice a week. The diet intervention was carried out by 4 series of health education talks, 4 cooking demonstrations and cooking competitions. Screenings of pre and post intervention included individual BMI, random blood sugar and blood pressure. All data were monitored by the individual through a web system which was then monitored by the Melaka State Health Department. To see the improvement of walking stamina of the intervention groups, every individual in each group had to walk for 5 km and the mean time for each group was recorded.
Results (max 400 words): A total of  number 34 (31.8 % ) men and 73  (68.2 %) women agreed to participate in the intervention program. The mean age was 46.8±17.1. In the pre assessment screening 20.6%  were in the group of normal weight , 35.5 % overweight and 43.0 % obese. After the 6 months intervention the percentage of overweight increased to 38.3%,  however the obesity group reduced to 41.1%.  Percentage of normal BMI remains the same. The mean sugar level was 7.4±7.1 in the pre assessment screening reduced to 5.3 ±1.2 after 6 months intervention (p<0.001). The mean for systolic blood pressure reduced from 134.3±25.1 to 120.2±20.3 (p<0.001) and mean for diastolic reduced from 82.8 ±18.2 to 72.4 ±9.2 (p<0.001). For random blood sugar level the mean reduced from 7.4 ±7.1 to 5.3 ± 1.2. 2 (p<0.001). The mean time to complete 5 km walk between the groups improved from 65 minutes before the intervention to 43.9 after 3 months and to 40 minutes after 6 months.
Conclusion (max 400 words): Structured Community based intervention with the concept of community empowerment has reduced the NCD risk factors of Pantai Peringgit community. The percentage of people in the obese group reduced after the 6 month intervention. Mean systolic blood pressure, mean diastolic blood pressure and mean fasting sugar level showed significant reduction.  Walking stamina among the group has also improved.

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