PERTANIKA JOURNAL OF SCIENCE AND TECHNOLOGY

The objective of this study was to identify the psychological factors (perceived barriers to, perceived benefits of, and perceived self-efficacy toward weight reduction) associated with body mass index (BMI) among overweight (OW) and obese children. A cross-sectional survey was carried out among primary school children in Kedah, Malaysia. A multistage randomised cluster sampling technique was used in this study. The socio-demographic data were collected from the parents, and the researchers took anthropometric measurements of the children. A set of validated instruments were used to assess perceived benefits of weight reduction, perceived barriers to weight reduction, perceived self-efficacy in dietary practice and perceived self-efficacy in exercise among the participants. Data were analysed by using SPSS software for Windows Version 25.0. A total of 398 OW and obese children aged 10 and 11 years old (221 boys and 177 girls) were recruited. Based on the socio-demographic data, the father’s educational level was found to be significantly associated with the child’s body mass index (BMI) (2 = 7.873, p = 0.049). There were no significant differences in mean scores for perceived benefits, perceived barriers, and perceived self-efficacy in dietary practice and exercise between the OW and obese groups (p>0.05). However, perceived self-efficacy in exercise was significantly associated with BMI among OW and obese children (p<0.05). Health perceptions and beliefs variables are important and should be included in any future weight management programme among OW and obese children.

• Ahmad, A., Zulaily, N., Shahril, M. R., Fadzli, E., Syed, H., & Ahmed, A. (2018). Association between socioeconomic status and obesity among 12-year-old Malaysian adolescents. PLoS ONE, 13(7), Article e0200577. https://doi.org/10.1371/journal.pone.0200577

• Allison, K. R., Dwyer, J. J. M., & Makin, S. (1999). Perceived barriers to physical activity among high school students. Preventive Medicine, 28(6), 608-615. https://doi.org/10.1006/pmed.1999.0489

• Andajani-Sutjahjo, S., Ball, K., Warren, N., Inglis, V., & Crawford, D. (2004). Perceived personal, social and environmental barriers to weight maintenance among young women: A community survey. International Journal of Behavioral Nutrition and Physical Activity, 1(1), 1-7. https://doi.org/10.1186/1479-5868-1-15

• Anuar, M. Z., Lim, C. T., Low, W. Y., & Harun, F. (2005). Factors affecting nutritional status of Malaysian primary school children. Asia-Pacific Journal of Public Health, 17(2), 71-80. https://doi.org/10.1177/101053950501700203

• Buscemi, S., Castellini, G., Batsis, J. A., Ricca, V., Sprini, D., Galvano, F., Grosso, G., Rosafio, G., Caravello, M., & Rini, G. B. (2013). Psychological and behavioural factors associated with long-term weight maintenance after a multidisciplinary treatment of uncomplicated obesity. Eating and Weight Disorders, 18.4, 351-358. https://doi.org/10.1007/s40519-013-0059-2

• Champion, V. L., & Skinner, C. S. (2008). The health belief model. In D. Kasprzyk (Ed.), Health Behavior and Health Education (pp. 45-65). John Wiley & Sons, Inc.

• da Cunha Feio Costa, L., Silva, D. A. S., dos Santos Alvarenga, M., & de Assis Guedes de Vasconcelos, F. (2016). Association between body image dissatisfaction and obesity among schoolchildren aged 7-10 years. Physiology and Behavior, 160, 6-11. https://doi.org/10.1016/j. physbeh.2016.03.022

• Department of Statistics Malaysia. (2017). Press release report of household income and basic amenities survey 2016. Department of Statistics Malaysia. https://www.dosm.gov.my/v1/index.php?r=column/pdfPrev&id=RUZ5REwveU1ra1hGL21JWVlPRmU2Zz09

• Department of Statistics Malaysia. (2020). Glossary A-Z. Department of Statistics Malaysia. https://www.dosm.gov.my/v1/index.php?r=column/cglossary2&menu_id=eWd2VFdIZ2xpdzBmT2Y0a0pweDcwQT09&keyword=SjNETFJISStNdFk1d0szYmpYcVU4QT09&release=1#

• Faghri, P., Simon, J., Medina T, H., & Gorin, A. (2016). Effects of self-efficacy on health behavior and body weight. Journal of Obesity & Weight Loss Therapy, 06(06), Article 329. https://doi.org/10.4172/2165-7904.1000329

• Fitzgerald, N., & Spaccarotella, K. (2009). Barriers to a healthy lifestyle: From individuals to public policy. An Ecological Perspective, 47(1), 1-3.

• Gnavi, R., Spagnoli, T. D., Galotto, C., Pugliese, E., Carta, A., & Cesari, L. (2016). Socioeconomic status, overweight and obesity in prepuberal children: A study in an area of Northern Italy. European Journal of Epidemiology, 16(9), 797-803.

• IPH. (2017). National health and morbidity survey (NHMS) 2017: Key findings from the adolescent health and nutrition surveys. Institute for Public Health. https://iku.moh.gov.my/images/IKU/Document/REPORT/NHMS2017/NHMS2017Infographic.pdf

• IPH. (2019). National health and morbidity survey 2019: NCDs – Non-communicable diseases: Risk factors and other health problems (Technical Report – Volume 1). Institute of Public Health. https://iku.moh.gov.my/images/IKU/Document/REPORT/NHMS2019/Report_NHMS2019-NCD_v2.pdf

• Jabatan Pendidikan Negeri Kedah. (2019). Maklumat asas pendidikan Jabatan Pendidikan Negeri Kedah (Edisi Bilangan 3/2019) [Basic education information Kedah State Education Department (3/2019 Ed.)]. Jabatan Pendidikan Negeri Kedah.

• Kim, N. Y., Jeong, L. S., & Kim, J. S. (2011). A comparative study on the self-efficacy and health promoting behavior between obese and normal weight middle school students. Journal of Korean Academy of Community Health Nursing, 13(3), 828-837.

• Lazzeretti, L. (2015). Assessment of psychological predictors of weight loss: How and what for? World Journal of Psychiatry, 5(1), article 56. https://doi.org/10.5498/wjp.v5.i1.56

• Lemeshow, S., Hosmer, D. W., Klar, J., Lwanga, S. K., & World Health Organization. (1990). Adequacy of Sample Size in Health Studies. Chichester.

• Lim, Y. H., Park, M. S., Kim, Y., Kim, H., & Hong, Y. C. (2015). Effects of cold and hot temperature on dehydration: A mechanism of cardiovascular burden. International Journal of Biometeorology, 59(8), 1035-1043. https://doi.org/10.1007/s00484-014-0917-2

• MASCO. (2020). Malaysia standard classification of occupations 2013. Ministry of Human Resources Malaysia. https://www.dosm.gov.my/v1/uploads/files/4_Portal%20Content/3_Methods%20%26%20Classifications/2_List%20of%20References/updated%202019/MASCO_2013_EBOOK_BI.pdf

• Manios, Y., Kourlaba, G., Kondaki, K., Grammatikaki, E., Anastasiadou, A., & Roma-Giannikou, E. (2009). Obesity and television watching in preschoolers in greece: The genesis study. Articles Epidemiology, Obesity, 17(11), 2047-2053. https://doi.org/10.1038/oby.2009.50

• Miri, S. F., Javadi, M., Lin, C., Irandoost, K., & Pakpour, A. H. (2017). Health related quality of life and weight self-efficacy of life style among normal-weight , overweight and obese Iranian adolescents: A case control study. International Journal of Pediatrics, 5(47), 5975-5984. https://doi.org/10.22038/ijp.2017.25554.2173

• Moore, S. E., Harris, C., & Wimberly, Y. (2010). Perception of weight and threat to health. Journal of the National Medical Association, 102(2), 119-125. https://doi.org/10.1016/s0027-9684(15)30499-5

• Mostafavi, F., Salahshoori, A., Sharifirad, G., & Hassanzadeh, A. (2014). An assessment of the role of perceived benefits, barriers and self-efficacy in predicting dietary behavior in male and female high school students in the city of Izeh, Iran. Journal of Education and Health Promotion, 3(8). https:// doi.org/10.4103/2277-9531.127558

• Mukherjee, S., Leong, H. F., & Wong, X. X. (2016). Waist circumference percentiles for Singaporean children and adolescents aged 6-17 years. Obesity Research and Clinical Practice, 10, S17-S25. https://doi.org/10.1016/j.orcp.2016.04.004

• Musaiger, A. O., Al-Mannai, M., Tayyem, R., Al-Lalla, O., Ali, E. Y. A., Kalam, F., Benhamed, M. M., Saghir, S., Halahleh, I., Djoudi, Z., & Chirane, M. (2013). Perceived barriers to healthy eating and physical activity among adolescents in seven arab countries: A cross-cultural study. The Scientific World Journal, 2013, Article 232164. https://doi.org/10.1155/2013/232164

• Norimah, A. K., Nasir, M. T. M., Hazizi, A. S., Suraya, P., Loh, S. H., & Nurliyana, A. R. (2014). Association of body weight status and socio-demographic factors with food habits among preschool children in Peninsular Malaysia. Malaysian Journal of Nutrition, 20(3), 303-315.

• Okop, K. J., Mukumbang, F. C., Mathole, T., Levitt, N., & Puoane, T. (2016). Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: A qualitative study. BMC Public Health, 16(1), 1-13. https://doi.org/10.1186/s12889-016-3028-7

• Park, D. Y. (2011). Utilizing the health belief model to predicting female middle school behavioral intention of weight reduction by weight status. Nutrition Research Practice, 5(4), 337-348. https://doi.org/10.4162/nrp.2011.5.4.337

• Rodríguez-Ventura, A. L., Pelaez-Ballestas, I., Sámano-Sámano, R., Jimenez-Gutierrez, C., & Aguilar-Salinas, C. (2014). Barriers to lose weight from the perspective of children with OW/obesity and their parents: A sociocultural approach. Journal of Obesity, 2014, Article 575184. https://doi.org/10.1155/2014/575184

• Saghafi-Asl, M., Aliasgharzadeh, S., & Asghari-Jafarabadi, M. (2020). Factors influencing weight management behavior among college students: An application of the health belief model. PLoS ONE, 15(2), 1-15. https://doi.org/10.1371/journal.pone.0228058

• Sánchez-Villegas, A., Pimenta, A. M., Beunza, J. J., Guillen-Grima, F., Toledo, E., & Martinez-Gonzalez, M. A. (2010). Childhood and young adult OW/obesity and incidence of depression in the SUN project. Obesity, 18(7), 1443-1448. https://doi.org/10.1038/oby.2009.375

• Serour, M., Alqhenaei, H., Al-Saqabi, S., Mustafa, A. R., & Ben-Nakhi, A. (2007). Cultural factors and patients’ adherence to lifestyle measures. British Journal of General Practice, 57(537), 291-295.

• Sharifi, N., Mahdavi, R., & Ebrahimi-Mameghani, M. (2013). Perceived barriers to weight loss programs for overweight or obese women. Health Promotion Perspectives, 3(1), 11-22. https://doi.org/10.5681/hpp.2013.002

• Shin, H., Shin, J., Liu, P., & Dutton, G. R. (2011). Self-efficacy improves weight loss in overweight / obese postmenopausal women during a 6-month weight loss intervention. Nutrition Research, 31(11), 822-828. https://doi.org/10.1016/j.nutres.2011.09.022

• Simmonds, M., Llewellyn, A., Owen, C. G., & Woolacott, N. (2016). Predicting adult obesity from childhood obesity: A systematic review and meta-analysis. Obesity Reviews, 17(2), 95-107. https://doi.org/10.1111/obr.12334

• Sit, C. H. P., Kerr, J. H., & Wong, I. T. (2008). Motives for and barriers to physical activity participation in middle-aged Chinese women. Psychology of Sport and Exercise, 9(3), 266-283. https://doi.org/10.1016/j.psychsport.2007.04.006

• Soliman, N. M., Elsayied, H. A. E., & Shouli, M. M. (2018). Application of HBM among youth at high risk for obesity in West Bank (Palestine). American Journal of Nursing Science, 7(3-1), 86-96. https://doi.org/10.11648/j.ajns.s.2018070301.23

• Tergerson, J. L., & King, K. A. (2002). Do perceived cues, benefits, and barriers to physical activity differ between male and female adolescents? Journal of School Health, 72(9), 374-380. https://doi.org/10.1111/j.1746-1561.2002.tb03562.x

• Tseng, M. C., Lee, Y. J., Chen, S. Y., Lee, M. B., Lin, K. H., Chen, P. R., & Lai, J. S. (2002). Psychobehavioral response and weight loss prediction in a hospital-Based weight reduction program. Journal of the Formosan Medical Association, 101(10), 705-711.

• WHO. (2019). Growth reference data for 5-19 years. World Health Organisation. https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age

• WHO. (2021). Obesity and overweight: Fact sheet. World Health Organisation. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight