Effect of an integrated-Weight Management Programme on body weight among noncommunicable disease patients in Malaysian government primary care clinics.

The newly developed intervention programme named integrated-Weight Management Programme (i-WMP). Behaviour change wheel was used as the theoretical framework to develop the i-WMP, drawing on the behaviour change techniques. It consisted of dietary advice, physical activity, and behavioural intervention. There was a total of 10 units were included in this programme, as the following: Session 1: Unit 1: What is overweight and obesity? Unit 2: How light am i today? Unit 3: What is my goal? Unit 4: How to eat and drink healthily? Session 2: Unit 5: Walking and brisk walking! Unit 6: Healthy eating and active moving daily plan! Session 3: Unit 7: Did I achieve my goal? Unit 8: Healthy snacking: fibre! Unit 9: 0 Challenge! Unit 10: Healthy eating and active moving daily plan! The i-WMP promoted behaviour change (healthy eating and active moving) on noncommunicable disease patients' existing lifestyle. Hence, it aimed to reduce their body weight healthily as the primary outcome. The secondary outcomes in this trial including improvement of: body mass index; waist circumference; waist-to-height ratio; body fat percentage; knowledge, attitude, and practice towards dietary and physical activity; total physical activity MET-minutes/week and sitting time. Both primary and secondary outcomes were assessed at three different time points: baseline (week 0), immediate post-intervention (week 4), and three months (week 12). The participants from intervention group received three sessions of education programme. Session 1 and 2 were implemented at week 0 and Session 3 was implemented at week 4 by a researcher (Tan Siew Tin, PhD candidate in Public Health). Session 1 and 2 took a total of two hours and 25 minutes, while Session 3 took one hour and 15 minutes. The i-WMP was conducted through face to face in a group of six to 10 participants by using slide presentation and short videos. Each participant was provided with a booklet (which was designed specifically for this study), healthy plate, pedometer and weighing scale. The programme was conducted in the meeting room of respective primary care clinic based on scheduled appointments. Intervention group was taught to eat healthily according to the concept of Quarter Quarter Half in the Malaysian Healthy Plate. They were encouraged to achieve 10,000 steps per day and ultimately minimum 150 minutes of moderate intensity physical activity (brisk walk) per day. They also were asked to weigh themselves by weekly on every Saturday immediate after woke up, then recorded the readings in their booklets and informed the researcher on their measurements via WhatsApp or Short Message Service. The adherence of intervention group's self-reported weekly body weight was expressed in percentage [Yes (received self-reported measurement from intervention group) versus No (did not receive self-reported measurement from intervention group)] from week 0 to week 12. Besides that, the session attendance checklists were used to record participant's attendance for each appointment, this was meant for adherence assessment of both groups (attendance rate).