Evaluation of the Impact of Enhanced Primary Health Care Intervention Programme in Malaysia: A Repeat Cross-sectional Pre-Post Quasi Experimental Study Introduction Non-communicable diseases (NCD) lead to substantial mortality and morbidity worldwide. Malaysia is currently experiencing an epidemic of NCDs. This paper aims to evaluate the effectiveness of the Enhanced Primary Health Care (EnPHC) intervention in reducing the prevalence of undiagnosed diabetes, undiagnosed hypertension, and undiagnosed hypercholesterolemia as well as NCD risk factors in the population after about one year of intervention. Methodology This is a repeat cross-sectional pre-post quasi-experimental study comparing intervention and control groups. The target population included adults aged 30 years and above living within the 40 selected clinics' catchment areas for at least six months. Data were collected using face-to-face interviews and clinical assessments. A difference-in-difference (DID) analysis was used to determine the effect of the EnPHC intervention. Results The percentage of the population screened for diabetes mellitus, hypertension, and hypercholesterolemia increased from the baseline status by 8.7%, 9.9%, and 9.2%, respectively. The prevalence of undiagnosed diabetes mellitus and hypercholesterolemia decreased from the baseline status by 17.6% and 13.7% compared to the control group. However, the EnPHC intervention did not affect the prevalence of overweight, obesity and smoking. Conclusion The EnPHC intervention contributed to the reduction in the prevalence of undiagnosed NCDs. A more extended period of intervention would be required to show the effect on NCD risk factors. Further strengthening of the intervention would be needed for implementation in other localities

Introduction: The use of e-cigarettes has increased rapidly around the world including in Malaysia. However, a significant proportion of people who started using e-cigarettes later discontinued using them. The aim of this study is to identify prevalence of former e-cigarette use and factors associated with quitting, among Malaysian adults. Methods: This study is a part of a national household survey examining the use of e-cigarettes among Malaysian adults aged 18 years and above in 2016. A multistage stratified cluster sampling method was used in the survey. A bilingual (Malay and English) structured questionnaire was used and data was collected via face-to-face interview. Prevalence of current e-cigarette use and former e-cigarette use were determined. A multiple logistic regression model was used to identify factors associated with quitting e-cigarettes. Results: A total of 4,288 adults participated in the survey, where 110 (3.2%) and 289 (8.6%) were identified as current and former e-cigarette users respectively. The following factors were significantly associated with quitting e-cigarette use: e-cigarette users who had no exposure to e-cigarettes at the workplace (aOR = 2.70; 95% CI: 1.39, 5.24); the perception that e-cigarette is more harmful to others compared to tobacco smoke (aOR = 2.46; 95% CI: 1.22, 4.97); and the perception that e-cigarettes do not help people to maintain cigarette abstinence (aOR = 2.19; 95% CI: 1.23, 3.92). Conclusions This study contributes to a better understanding of the factors associated with cessation of e-cigarettes. Findings from this study can assist any e-cigarette cessation intervention measures.

Introduction: Community health workers/volunteers (CHW) are health workers who are trained but do not possess a formal professional certificate. They are members of the community who live and work in that particular community. This study aimed to determine factors associated with not performing health screening activities by volunteers under KOSPEN; a community-based intervention programme, initiated by Ministry of Health Malaysia in October 2013. Methods: Data from the “Evaluation of the implementation of KOSPEN programme in Malaysia 2016” was used,a cross-sectional study which was carried out in randomly selected KOSPEN localities throughout Malaysia. The response rate was 94.9%. A pre-tested, self-administered questionnaire was used. Descriptive statistics andlogistic regression analysis was applied using Statistical Package for Social Sciences (SPSS) version 20. Results: 700 volunteers were included in this study. Majority were female (65.7%), aged 50-59 years (30.9%), had secondary education (65.3%), employed (55.7%.) and married (80.4%). Several issues were identified by the volunteers; funding (47.2%), module content and comprehensibility (11.4% respectively), submitting returns (17%). Multivariate logistic regression showed that volunteers who never attended training (aOR 2.79; 95% CI:1.66, 4.67) and who felt the content of the training module was inadequate (aOR 2.693; 95% CI: 1.46, 4.98) were more likely did not perform screening activities in the community. Conclusion Volunteers who were not trained and those who felt the content of the training module was inadequate did not carry out screening activities. These findings will be useful for stakeholders to make improvements to the programme for a more successful implementation.