Publications by authors named "Hock Kuang Lim"

5 Publications

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Personal and Family Factors Associated With High-risk Behaviours Among Adolescents in Malaysia.

J Pediatr Nurs 2019 Sep - Oct;48:92-97. Epub 2019 Jul 29.

Institute for Medical Research, Malaysia.

Purpose: The objective of this study was to investigate the relationships between high-risk behaviours and personal and family factors among adolescents in Malaysia.

Methods: A nationwide data set was examined for this secondary data analysis. The dependent variable was the degree of risk, which was measured based on the number of high-risk behaviours in which adolescents participated. Age, gender, ethnicity, self-rated academic performance, family size, parental marital status and parental academic attainment were included as independent variables. Analyses stratified by educational level were conducted. Odds ratios (ORs) were calculated using ordered logit.

Results: The most common high-risk behaviour among Malaysian adolescents was physical inactivity (35.97%), followed by smoking (13.27%) and alcohol consumption (4.45%). The majority of adolescents had low risks (52.93%), while only a small proportion had high risks (6.08%). Older age was associated with increased odds of having high risks (OR: 1.26). Male adolescents had higher odds of being in a high-risk category compared to female adolescents (OR: 1.28). Compared to Malays, Chinese adolescents had higher odds of being in a high-risk category (OR: 1.71), whereas Indian adolescents had lower odds (OR: 0.65). Excellent academic performance was associated with reduced odds of participating in high-risk behaviours (OR: 0.41).

Conclusion: Personal factors are important determinants of high-risk behaviours. This study provides a better understanding of those adolescent groups that are at greater risk.

Practical Implications: An intervention directed towards reducing participation in high-risk behaviours among adolescents who have both poor academic performance and less-educated parents may yield promising outcomes.
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May 2020

Demographic and lifestyle determinants of time spent in physical activity among Malaysian adolescents.

Int J Pediatr Adolesc Med 2018 Jun 2;5(2):49-54. Epub 2018 May 2.

Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia.

Background And Objectives: The objective of the present study is to examine factors affecting time spent in physical activity among adolescents in Malaysia.

Patients And Methods: A nationally representative data of adolescents that consists of 25399 respondents is used. The demographic (age, gender, education) and lifestyle (fruits and vegetables consumption, carbonated soft drink consumption, cigarette smoking, alcohol drinking, sex behaviour, participation in physical education class, obesity) determinants of physical activity are assessed using binomial regression.

Results: The results show that age is negatively associated with time spent in physical activity. However, being male and education levels are positively related to time spent in physical activity. Having unhealthy lifestyle and being obese are associated with low levels of physical activity. Physical education seems to promote participation in physical activity.

Conclusion: In conclusion, demographic and lifestyle factors play an important role in determining levels of physical activity among adolescents. In order to reduce the prevalence of physically inactive adolescents, policy makers should focus primarily on late adolescents, females, adolescents who engage in unhealthy lifestyle and seldom attend physical education classes, as well as obese adolescents.
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June 2018

Factors associated with participation in physical activity among adolescents in Malaysia.

Int J Adolesc Med Health 2016 Nov;28(4):419-427

Background: The rising prevalence of non-communicable diseases (NCDs) has become a serious public health issue. Among the multi-factorial drivers behind NCDs are modifiable health risk factors, most notably, physical inactivity.

Objective: In response to the nearly global policy priority of encouraging regular participation in physical activity, the objective of the present study is to examine the factors that determine participation in physical activity among Malaysian adolescents.

Methods: Nationally representative data consisting of a large sample size was used. A censored regression model was developed to estimate the likelihood of participation and time spent on physical activity.

Results: There are significant relationships between physical activity and gender, ethnicity, self-rated academic performance, maternal education, household size and time spent on physical education.

Conclusion: The present study provides new insights into the factors affecting physical activity participation among adolescents. Specifically, self-rated excellent academic performance, household size and physical education can increase the likelihood of being physically active. Evidence of the present study implies that policy makers should pay special attention to females, Chinese, adolescents with self-rated poor academic performance and adolescents who have low maternal education.
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November 2016

Smoking among Secondary School Students in Kota Tinggi, Johor, Malaysia--Findings from a Cross-Sectional Study.

Asian Pac J Cancer Prev 2015 ;16(11):4563-70

Institute of Public Health, Kuala Lumpur, Malaysia E-mail :

Background: Smoking is a learnt behavior during adolescence and understanding the factor/s associated with smoking will assist in identifying suitable measures in combating the rising prevalence of smoking among adolescents. This research aimed to identify the factor/s associated with smoking among form four students in Kota Tinggi, Johor. Multistage sampling was used to select a representative sample of students in 2008 and data were collected using a self-administered validated questionnaire. This study revealed that the overall smoking prevalence was 19.0% with a significantly higher proportion of male smokers (35.8%) as compared to females (3.15%). Adolescents who were male (aOR 6.6, 95%CI 2.61-16.4), those who had peer/s who smoked (aOR 4.03, 95% CI 1.31-12.4), and those who studied in rural areas and Felda Settlements ( aOR 4.59, 95 CI 1.11-18.0; aOR 9.42, 95%CI 3.91-29.1) were more likely to smoke in the past one week. On the other hand, adolescents with better knowledge on the hazards of smoking and negative attitudes towards smoking were less likely to smoke (aOR 0.51, 95%CI 0.37-0.72; aOR 0.67, 95%CI 0.46-0.99). Future promotional and interventional programmes on smoking should be considered and the above identified risk factors integrated to reduce smoking prevalence among students of school-going ages in Kota Tinggi. Johor.
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March 2016

Epidemiology of smoking among Malaysian adult males: prevalence and associated factors.

BMC Public Health 2013 Jan 7;13. Epub 2013 Jan 7.

Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia.

Background: Three National Health and Morbidity Surveys (NHMSs) had been conducted in Malaysia in 10-year intervals from 1986-2006. Based on the latest NHMS survey in 2006, we describe the prevalence of smoking and identify the social and demographic factors associated with smoking among adult males in Malaysia.

Methods: A cross-sectional study among 15,639 Malaysian adult males aged 18 years and above was conducted using proportional to size stratified sampling method. The socio-demographic variables examined were level of education, occupation, marital status, residential area, age group and monthly household income.

Results: The prevalence of smoking among adult males in Malaysia was 46.5% (95% CI: 45.5-47.4%), which was 3% lower than a decade ago. Mean age of smoking initiation was 18.3 years, and mean number of cigarettes smoked daily was 11.3. Prevalence of smoking was highest among the Malays (55.9%) and those aged 21-30 years (59.3%). Smoking was significantly associated with level of education (no education OR 2.09 95% CI (1.67-2.60), primary school OR 1.95, 95% CI (1.65-2.30), secondary school OR 1.88, 95% CI (1.63-2.11), with tertiary education as the reference group). Marital status (divorce OR 1.67, 95% CI (1.22-2.28), with married as the reference group), ethnicity (Malay, OR 2.29, 95% CI ( 1.98-2.66; Chinese OR 1.23 95% CI (1.05-1.91), Other Bumis OR 1.75, 95% CI (1.46-2.10, others OR 1.48 95% CI (1.15-1.91), with Indian as the reference group), age group (18-20 years OR 2.36, 95% CI (1.90-2.94); 20-29 years OR 3.31 , 95% CI 2.82-3.89; 31-40 years OR 2.85 , 95% CI ( 2.47-3.28); 41-50 years OR 1.93, 95% CI (1.69-2.20) ; 51-60 years OR 1.32, 95% CI (1.15-1.51), with 60 year-old and above as the reference group) and residential area (rural OR 1.12 , 95% CI ( 1.03-1.22)) urban as reference.

Conclusion: The prevalence of smoking among Malaysian males remained high in spite of several population interventions over the past decade. Tobacco will likely remain a primary cause of premature mortality and morbidity in Malaysia. Continuous and more comprehensive anti-smoking policy measures are needed in order to further prevent the increasing prevalence of smoking among Malaysian men, particularly those who are younger, of Malay ethnicity, less educated, reside in rural residential area and with lower socio-economic status.
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January 2013