R1 Presentation 4.0

Community Profile and Resources
&
Proposal For Community Diagnosis
Group H (PBL 14 & PBL 15)
Kok Lanas, Kelantan
[25 September 2013]
Residency 1
Introduction to Group H
Supervisor: Prof. Madya. Dr. Norsaadah Bachok

Ahmad Shafaeez b Abdul Satar 110758 Amira Hafiza bt Nor Rani 110762
Belinda Teo Sing Yee 110767 Choo Gee Lynn 110776
Danusha a/p Arumugam 110778 Lam Chun-Hau 110812
Kok Chee Lim 110810 Mohamad Azdri b Azman 110821
Marlene Ing Yin Zin 110820 Mohd Hisyam b Rosdi 110824
Mohd Hafizuddin b Mohd Salleh 107465 Norshazwani bt Mohd Izhar 110842
Noor Ayuni bt Abu Yamim 110838 Nur Amirah Fazira bt Malzuki 110844
Nor Amira bt Md Isa 110840 Sharalini bt Zainuddin 107524
Nor Annasuhah Najwa bt Zakaria 110841 Sharon Lai Hui Yee 110873
Nurul Syazwani bt Hamid Sultan 110857 Tan Zhi Yan 110890
Tan Zeng Guang Gareth 110889 Yogapriya a/p Muniandy 110904
1
Part 1
Community Profile and Resources
2
List of Main Points
1. Introduction to Operational Area
2. Objectives
3. Methodology
4. Results of Survey
Form B - Family Profile
Form C Individual Profile
5. Discussion
6. Conclusion
3
[1] Introduction to Operational Area
Operational Area: Kok Lanas, Daerah Ketereh,
Jajahan Kota Bharu, Kelantan.
Head of Village: Hasan B. Awang Kechik
PJKKKP: Hj Halim B. Jusoh
Size: 3 km
2
Number of Houses: 1092
Population: 5060 people
4
List of Infrastructures Available
1. Politeknik Kota Bharu
2. Sekolah Menengah Kok Lanas
3. Sekolah Kebangsaan Desa Pahlawan
4. Masjid Mukim
5. Klinik Kesihatan Kok Lanas
6. Klinik Swasta

5
Kok Lanas (circled)
6
7
Nearest Clinic/Hospital
Average Distance from Kok Lanas
(km)
Klinik Kesihatan Kok Lanas 1.0
Private Clinic 1.0
Hospital Universiti Sains Malaysia
(HUSM)
22.0
Hospital Machang 22.0
Hospital Raja Perempuan Zainab II
(HRPZ)
26.0
Healthcare Facilities in Kok Lanas
8
[2] Objectives
General Objective
To acquire appropriate knowledge and skills to identify, describe and conduct
health resources and community profile survey of the operational area
Specific Objectives
To determine the socioeconomic status of the villagers of Kok Lanas.
To identify the health-related practices & usages of health services by villagers
of Kok Lanas.
To identify the main health problems in Kok Lanas.
Adapted from Community and Family Case Studies Handbook Phase II 4th Edition July 2010
9
[3] Methodology
Study Design: Cross Sectional Study
Study Area: Kok Lanas, Ketereh, Kelantan
Study Period: 15
th
-19
th
March 2013
Study Population: All villagers of Kok Lanas
Sample Size: Number of houses as determined
by the CFCS secretariat (150)

10
[3] Methodology (cont.)
Inclusion Criteria Exclusion Criteria
1. Respondents were residents of
the operational area for more
than 2 years.
1. Residents who refused to be
interviewed.
2. Single students who lived in
the area.
3. Residents that were not
available throughout the
residency period.
11
Sampling Method:
Stratified Proportionate Random Sampling
Total number of houses: 1092
Sample size: 178 houses
Strata: Suburban housing (60%), rural housing (40%)
Sample frame for each strata:
Suburban (107/655 houses)
Rural (71/437 houses)
Systematic random sampling was used to select the intervals
within each strata of the population
Interval of Suburban Area (655/107) = 6.1 every 6
th

Interval of Rural Area (437/71) = 6.2 every 6
th

12
Methods of Data Collection:
- Structured Interview based on the questionnaires (Form B and C)
provided by the secretariat of CFCS.
- Observation of the subjects height, weight, waist and hip
measurements using the appropriate tools.
Research Tools:
1. Questionnaires
- Form B: Family Profile
- Form C: Individual Profile
2. Measuring Tape (to measure the height and waist & hip
circumferences)
3. Weighing Scale (to measure the weight)

13
Data Management & Analysis:

Data Entry:
- SPSS Version 21.0

Descriptive Statistics:
- Numerical data (mean & standard deviation)
- Categorical data (frequency & percentage)
14
[4] Results of Survey
Form B: Family Profile
B1 Socioeconomic Status
B2 Health-related
Practices
B3 Utilization of Health
Services
B4 Health & Social
Problems Among
Teenagers & Adults
15
Figure 1 Monthly Household Income of Villagers
in Kok Lanas [n=178]
16
Figure 2 Number of Family Members in Each Household
[n = 178]
17
Figure 3 Number of Bedrooms in Each Household [n = 178]
18
Figure 4 Type of Household Appliances in Each Household
[n=178]
Each selection is non-mutually exclusive
19
Figure 5 Type of Water Supply of Each Household
[n = 178]
20
B2 Health-related
Practices
Services
B4 Health & Social
Problems Among
Teenagers & Adults
21
Bo led water,
24.2%
Boiled water,
84.3%
Raw water,
11.8%
Figure 6 Type of Drinking Water of Each Household
[n=178]
22
Dustbin Availability in Kitchen Frequency Percentage (%)
Available 171 96.1
Not available 7 3.9
Frequency of Emptying the Dustbin Frequency Percentage (%)
Once a day 127 74.3
Twice a day 24 14.0
Once in 2 days or more 20 11.7
Method of Garbage Disposal Frequency Percentage (%)
Open burning 34 19.1
Buried 1 0.6
Open disposal 3 1.7
River or drain disposal 8 4.5
Majlis daerah 129 72.5
Recycled 3 1.7
Table 1 Garbage Management of Each Household
[n = 178]
23
Types of Toilet (n=178) Frequency Percentage (%)
Septic / Flush toilet 135 75.8
Pour toilet 42 23.6
Pit toilet 1 0.6
Distance from Septic Tank to Well, in m (n=85) Frequency Percentage (%)
1- 10m 39 45.9
11- 20m 25 29.4
21- 50m 18 21.2
More than 50m 3 3.5
Household Usage of Toilet (n=178) Frequency Percentage (%)
Every member uses toilet 176 98.9
Not every member uses toilet 2 1.1
Table 2 Waste Management of Each Household [n=178]
24
Figure 7 Sewage Management System of Each Household
[n = 178]
77.0%
23.0%
Drainage System
Yes
No
65.2%
34.8%
Sanitary
Yes
No
25

Figure 8 Frequency of Buying Food Outside per Week
by Each Household [n=178]
26
Refrigerator
57.3%
Without
refrigerator
41.6%
Throw away
1.1%
Figure 9 Method of Keeping Leftover Food by Each
Household [n=178]
27
Figure 10 Types of Animals Reared by Each Household
[n = 178]
Each animal reared is non-mutually exclusive
28
Figure 11 Types of Pests in Each Household
[n = 178]
29
Figure 12 Pest Control Methods Used in Each Household
[n = 178]
30
B2 Health-related
Practices
Services
B4 Health & Social
Problems Among
Teenagers & Adults
31
Type of Service
Use of the service
(%)
Visit 1-5 times (%)
Government Hospital 17.9 15.1
Government Clinic 55.1 46.1
Private Hospital 6.4 5.0
Private Clinic 26.3 23.0
Pharmacy 39.1 32.6
Sundry / Retailer 35.3 15.7
Bomoh / Sinseh 3.2 2.2
Homeopathy Clinic 1.3 1.1
Other (Supermarket) 1.3 1.1
Table 3 Utilization of Modern and Traditional Services
in the Past 3 Months to Buy Medication [n = 178]
32
B2 Health-related
Practices
Services
B4 Health & Social
Problems Among
Teenagers & Adults
33
Figure 13 Reports of Social Problems among Local
Teenagers (12-17 years old) in the Past 12 Months [n=178]
Each social problem is non-mutually exclusive
34
Figure 14 Reports of Domestic Violence & Physical Abuse
In the Past 12 Months [n=178]
Domestic violence and physical abuse are non-mutually exclusive
35
Form C: Individual Profile
C1 Socio-demographics
C2 Anthropometric Status
C3 Occupational Profile
C4 Medical Health
Problems
C5 Dental & Oral Health
C6 Smoking & Exercise
C7 Womens Health &
Breastfeeding
36
The total number of respondents involved in this survey is
641 people.
Among all 641 respondents:
- 96.7% were Malay, 2% were Chinese, 0.3% were Thai and
0.9% were from other ethnics.
- 96.7% were Muslims, 2.2% were Buddhists, 0.5% were
Christians and 0.6% were from other religions.
- Male population: 47.1% (302 people)
- Female population : 52.9% (339 people).
Socio-demographics
37
Infant (<1)
2%
Toddler (1x<5)
9%
Child (5x<12)
12%
Adolescent
(12x<18)
13%
Adult (18x<65)
59%
Geriatric (65)
5%
Infant (<1 year old)
= 2% (n=13)

Toddler (1 x < 5)
= 9% (n=59)

Child (5 x < 12 years old)
= 12% (n=77)

Adolescent (12 x < 18)
= 13% (n=80)

Adult (18 x < 65 years old)
= 59% (n=380)

Geriatric ( 65 years old and
above) (defined by NCBI)
= 5.0% (n=32)

Figure 15 Distribution of Respondents By Age Group
[n=641]
38
Table 4 Distribution of Highest Education Level Among Adults
( 18 years old) [n =412]
Education Level Frequency Percentage (%)
Not schooling 29 7.0
Primary 62 15.0
Secondary 260 63.1
Tertiary 61 14.8
Total 412 100.0
39
Marital Status (Adult) Frequency Percentage (%)
Single 75 18.2
Married 315 76.5
Widow/Widower 22 5.3
Total 412 100.0
Table 5 Marital Status of Respondents ( 18 years old)
[n = 412]
40
C4 Medical Health
Problems
C7 Womens Health &
Breastfeeding
41
BMI Classification
Frequency Percentage (%)
Male Female Total Male Female Average
< 18.50 Underweight 15 16 31 8.0 7.1 7.5
18.50-24.99 Normal weight 96 92 188 51.3 40.9 45.6
25.00-29.99 Pre-obese 55 73 128 29.4 32.4 31.1
30.00 Obese 21 44 65 11.2 19.6 15.8
Total 187 225 412 100
Table 6 Body Mass Index of Respondents ( 18 years old)
[n = 412]
Adapted from WHO International Classification of BMI (valid for Asians)
(http://apps.who.int/bmi/index.jsp?introPage=intro_3.html)
42
Figure 16 Waist-to-Hip Ratio of Respondents ( 18 years old)
[n = 412]
95.2%
4.8%
Male (n=187)
1.00
> 1.00
51.6%
48.4%
Female (n=225)
0.85
> 0.85
NHMS III, 2006 cut-off point for waist-hip ratio (male: 1.00; female: 0.85)
43
C4 Medical Health
Problems
C7 Womens Health &
Breastfeeding
44
Figure 17 Types of Occupation among Respondents ( 18 years old)
[n=412]
45
Figure 18 Level of Activity of Employed Adults ( 18 years old)
[n = 181]
Strenous Work
56%
Non-Strenous
Work
44%
46
Figure 19 Major Health Complaints at Workplace by Employed
Adults ( 18 years old) [n = 181]
Each health complaint is non-mutually exclusive
47
C4 Medical Health
Problems
C7 Womens Health &
Breastfeeding
48
Chronic Diseases
of Respondents
Percentage (%) Family History of
Chronic Diseases
Percentage (%)
Diabetes 7.0 Diabetes 18.6
Hypertension 10.3 Hypertension 21.2
Asthma 8.1 Asthma 13.4
Heart Disease 1.7 Heart Disease 6.4
Stroke 1.1 Stroke 2.7
Tuberculosis (TB) 0.5 Tuberculosis (TB) 1.6
Physically
Handicapped
0.9 Physically
Handicapped
2.0
Other Conditions:
- Allergy
- Gout
- Cancer
5.8 Other Conditions:
- Allergy
- Gout
- Cancer
5.8
Table 7 Chronic Diseases Among Respondents and Family
History of Such Conditions [n=641]
Each condition is non-mutually exclusive
49
Table 8 Medical Problems of Respondents in the
Past 2 Months [n = 641]
Medical Problems faced in Last 2 Months Percentage (%)
Diarrhea 4.7
Cough (more than 2 weeks) 8.0
Fever 23.7
Flu 25.3
Other Problems
- Vomiting
- Sore Throat
- Chest Pain
3.3
Each medical problem is non-mutually exclusive
50
Table 9 Medical Problems Among Children
(< 6 Years) [n = 85]
Medical Problems Faced by Child Percentage (%)
Cough at night 13.6
Wheezing/noisy breathing 3.9
Ear Discharge 1.0
Flu 22.3
Sputum early in the morning 6.8
Throat problem/hoarseness 1.0
Each medical problem is non-mutually exclusive
51
C4 Medical Health
Problems
C7 Womens Health &
Breastfeeding
52
18.1
17.2
12.8
3.9
0
10
20
30
40
50
60
70
80
90
100
Oral problems (in the
last 6 months)
Need dentures Not comfortable when
chewing
Chew betel nuts
P
e
r
c
e
n
t
a
g
e

o
f

R
e
s
p
o
n
d
e
n
t
s

(
%
)

Oral Problems
Figure 20 Oral Problems Among Respondents [n = 624]
Each oral problem is non-mutually exclusive
53
Variables Frequency Percentages (%)
Frequency of Brushing Teeth per Day (n =
624)
Once
Twice
When necessary

86
457
81

13.8
73.2
13.0
Gargle or Brush After Eating (n=641) 337 52.6
Gargle or Brush Before Sleep (n=641) 428 66.8
Frequency of Dental Visits (n=624)
Never
Once in 6 months
Once in a year
When necessary or pain only

109
71
25
419

17.5
11.4
4.0
67.1
Table 10 Brushing of Teeth & Dental Visits
Each variable is non-mutually exclusive
54
C4 Medical Health
Problems
C7 Womens Health &
Breastfeeding
55
Figure 21 Smoking Status of Respondents ( 12 years old)
[n = 492]
56
Figure 22 Number of Cigarettes Smoked per Day Among Respondents
(12 years old) *n=108+
57
Figure 23 Money Spent on Cigarettes per Day (RM) by
Respondents (12 years old) [n = 108]
58
Figure 24 Factors that Influenced Respondents to start smoking
(12 years old) [n=108]
59
Friends/peers
68.5%
Parents, 0.9%
Siblings, 1.9%
Other family
members, 5.6%
Other factors
23.1%
Figure 25 Physical Activities in the Past Week Among Adults
(18 years old) *n = 412+
Each physical activity is non-mutually exclusive
60
C4 Medical Health
Problems
C7 Womens Health &
Breastfeeding
61
Womens Health Practice Frequency Percentage (%)
Pap smear 131 58.2
Breast self examination 131 58.2
Family planning 66 29.3
Dental checkup during pregnancy 120 53.3
Table 11 Health Practice for Adult Women
( 18 years old) (n=225)
Each method is non-mutually exclusive
62
Figure 26 Breastfeeding by Childbearing Women
[n=153]
63
Figure 27 Number of Gravida of Married Women
[n = 167]
64
Figure 28 Number of Parity of Married Women
[n = 167]
65
Figure 29 Number of Abortions of Married Women
[n = 168]
66
Home
41%
Workplace
11%
Road
39%
School
5%
Hospital
4%
Places of Accident
Figure 30 Accidents and Physical Injury in the Past One Year Among
Respondents [n = 54]
Accident Happened : Yes 8.4% (54 people)
No - 91.6% (587 people)
67
[5] Discussion
5.1 Household Background

5.2 Medical Health
Problems

5.3 Womens Health
5.4 Smoking

5.5 Accidents & Physical
Injury

68
5.1 Household Background
Of Households in Kok Lanas
69
Household background
(Income)
Absolute poverty in the country is measured based on the Poverty Line Income
(PLI). The PLI takes into account the minimum requirements for food,
clothing, shelter, and other regular expenditures that are necessary to
maintain a decent standard of living in a household.
The monthly household income, as defined by the Ministry of Women, Family
& Community Development in 2010 for Peninsular Malaysia:
- extreme poor ( RM440 per month)
- poor ( RM750 per month)
- low-income ( RM 2,000 per month)

(http://www.pemandu.gov.my/gtp/upload/999afc34-141a-4c5c-801f-45701389df74.pdf)
70
According to Malaysia's Chief Statistician, Dr Abdul Rahman Hasan:
The average household income in Kelantan in 2012, is RM3,168.
http://www.nst.com.my/opinion/columnist/average-household-income-in-
kelantan-still-low-1.351654
Our study in Kok Lanas suggests that the average monthly household
income here is lower (RM 1807.03).
Based on our findings, about 66% of households in Kok Lanas earn less
than RM 2,000 per month.
The majority of villagers are either unemployed or self-employed,
which could be the reason of low income. Approximately 71.9% of
women and 24.7% of men are unemployed, while 10.4% of women and
38.0% of men are self-employed.

71
5.2 Medical Health Problems
5.3 Womens Health
5.4 Smoking
72
Issues Analysis of Group H Study Comparison References
Body Mass Index
(age 18 years old)
7.5% underweight

31.1% pre-obese

15.8% obese
Lower

Higher

Higher
8.5% underweight
(NHMS III, 2006)

29.1% overweight
(NHMS III, 2006)

14.0% obese
(NHMS III, 2006)
Waist to Hip Ratio
(age 18 years old)
48.4% adult females > 0.85

4.8% adult male >1.00
Higher

Lower
26.0% adult females
>0.85
(NHMS III,2006)

7.3% adult males >1.00
(NHMS III, 2006)
Diabetes Mellitus 7.0% respondents Lower 11.6% Malaysian Adult
Population
(NHMS III, 2006)
Hypertension 10.3% respondents Lower 32.2% Malaysian Adult
Population
(NHMS III, 2006)
73
Asthma 8.1% respondents Higher 4.53% Malaysian Adult
Population
(NHMS III, 2006)

Heart Disease 1.7% respondent Higher 1.2% Malaysian Adult
Population
(NHMS III, 2006)

Smoking No adolescents
(age: 13-17 years old)

35.7 % adults males
(age: 18 years old)
Lower

Higher
14.7% adolescents
(NHMS III, 2006)

52.6% adult males
(WHO, 2006)
Back Pain 27.1% employed adults
22.1% of unemployed
adults
Higher
11.6% Malaysian adult
population
(Malaysian Lower Back pain
Guide)
74
Breastfeeding 80.0% in children less than
12 months old
Lower

First 12 months 94.7%
(NHMS III, 2006)

Pap Smear
Examination
58.2% female respondents Higher 43.7% Malaysian female
(NHMS, 2006)
Breast Self
Examination (BSE)

58.2% female respondents Higher 57.1% Malaysian female
(NHMS III, 2006)
Family Planning
Practice
29.3% female respondents Lower 52.3% Malaysian female
(Lembaga Pembanguna
Keluarga Negara LPPKN)
75
5.5 Accidents & Physical Injury
Among Residents in Kok Lanas
76
Accidents and Physical Injury
Based on our study, it can be seen that only 8.4% of the
respondents have had an accident or physical injury over the past
year.
Among these respondents, 41% had accidents at home.
This is followed by 39% on the road. This is higher than the
percentage of road accidents by state where Kelantan has only 2.2%
of road accidents based on a survey by the Royal Malaysian Police in
2007.
The higher incidence of accidents or injuries at home could be
simply due to carelessness or the condition of the living space.

77
Conclusion
The top 5 medical problems in Kok Lanas that we identified were:
1. Back Pain (27.1%)
2. Obesity (15.8%)
3. Hypertension (10.3%)
4. Asthma (8.1%)
5. Diabetes Mellitus (7.0%)
From these, we decided to select back pain as our community
diagnosis because its prevalence was more than double that of the
national prevalence among adults.
78
Part 2
A Study of Back Pain In The
Community of Kok Lanas
79
Introduction
Back: Posterior part of the trunk from the neck to the pelvis
Pain: A more or less localized sensation of discomfort, distress or
agony resulting from the stimulation of specialized nerve endings
(Dorlands Illustrated Medical Dictionary 31
st
Edition)
The major risk factors for back pain are:
1) aging (usually >30 years old)
2) overweight
3) lack of exercise
4) occupational hazards, such as repeating bending and lifting and
long hours of standing or sitting
(News-Medical Net; Dr Ananya Mandal, 2013)

80
Summary of Community Profile
The community diagnosis is based on the findings from the study we
carried out during Residency 1 in Kok Lanas.

Total Respondents =
641
Adults = 412/641
Employed with
back pain = 49/181
(27.1%)
Unemployed with back
pain = 51/231
(22.1%)
81
Rationale
1. There is a high prevalence of back pain problems among the
employed residents of Kok Lanas, which is 27.1%. This is higher than
the national prevalence rate of back pains, which is only 11.6%.
(Veerapen et. al, A COPCORD Study on Musculoskeletal Pains in Malaysia; 2007)
2. Most of our adult residents hold occupations like office workers and
manual workers which put them at risk of suffering from severe back
pains that can be highly detrimental to health.
3. A high number of Kok Lanas adult residents also do not practice any
form of exercise (43.6%) which can lead to back pains.
(based on our survey results)
82
Rationale (cont.)
4. The back pain prevalence rate among the public in United States is
24.6%
(Deyo RA et. al, Back pain prevalence and visit rates: estimates from U.S. national surveys; 2002)
5. A few cross sectional studies conducted in the past few years showed
high prevalence of back pain among:
commercial vehicle drivers (60.4%)
(Shamsul Bahri Mohd Tamrin et. al, The Association between Risk Factors and Low Back Pain among
Commercial Vehicle Drivers in Peninsular Malaysia; 2007)
83
Rationale (cont.)

health care providers in Sibu Hospital, Malaysia (72.5%)
(Wong et. al, Prevalence and Risk Factors Associated with Low Back Pain Among Health Care
Providers in a District Hospital; 2010)
batik workers in Kelantan (75.4%)
(Razlan Musa, Work-Related Musculoskeletal Symptoms Among Batik Workers in Kelantan;
1998)
dental personnel (44.9%)
(Razan Abdul Samat et. al, Prevalence and Associated Factors if Back Pain among Dental
Personnel In North-Eastern State of Malaysia; 2011)

84
Objectives
General objectives :
To study the prevalence, level of knowledge, attitude and
practice (KAP) score of back pain and its associated factors
among residents of Kok Lanas.

85
Objectives (cont.)
Specific objectives:
1. To determine the prevalence of back pain among residents of Kok
Lanas.
2. To determine the level of knowledge on back pain among the
residents in Kok Lanas.
3. To determine the attitudes of residents in Kok Lanas towards back
pain.
4. To determine whether the residents of Kok Lanas are practicing
ergonomic daily routines.
5. To determine the associated factors of back pain.

86
Methodology
Study Design: Cross Sectional Study
Study Area: Kok Lanas, Ketereh, Kelantan
Study Period: 1
st
-5
th
October 2013
Study Population: All adult residents of Kok Lanas
Inclusion Criteria:
All the adult residents aged 18 and above.
Permanent residents who agree to participate.
Exclusion Criteria
Those who cannot be contacted throughout the residency
Mentally-ill respondent
87
Sample size calculation for prevalence of
adults with back pain
Andrew M.B, Joanne E.J, Rachelle B, et al, Individuals with chronic low
back pain have greater difficulty in engaging in positive lifestyle
behaviors than those without back pain: An assessment of health
literacy (2011), page 6 of 10, table 3
88
Sample Size Calculation
Sample size is calculated using the single proportion formula:

The objective is to determine the sample size to obtain a confidence interval of
95%. Therefore Z

= 1.96 (95% CI)
The precision is estimated to be 10%. Therefore, = 0.1

Thus, n = 125 adult respondents are required
n
z
2
*P(1 P)
Domain for risk factor
of back pain
Prevalence
(%)
Sample size (n) (n) + expected drop-
out rate (30%)
Prevalence of back pain 24.6 71 93
Good knowledge 48.6 96 125
Good attitude 45.2 95 124
Good practice 43.2 94 123
89
Sample size calculation for proportion of
adults with obesity and back pain
Mohamud WN, Musa KI, Khir AS, et al, Prevalence of overweight
and obesity among adult Malaysians: an update. (2011), Internet
Communication at 12.39am from
http://www.ncbi.nlm.nih.gov/pubmed/21393108
90
Sample Size Calculation
Sample size is calculated using the two proportion {Pococks) formula:

Type I error is taken to be 0.05. Therefore Z

= 1.96 (95% CI)
Type II error is taken to be 0.80. Therefore Z

= 0.84
Proportion of obesity among general adult population, P
0
= 19.5% = 0.195, taken
from previous study.
Proportion of obesity among adults with back pain, P
1
= 40% 0.40, based on
researchers opinion.

Thus, n = 192 adult respondents are required to estimate the proportion of adults with
obesity who also suffer back pain.
n
P
1
(1 P
1
) +P
0
(1 P
0
)
(P
1
P
0
)
2
z
+z
2
Calculation
Method
Sample size, n,
per group
Non-response (30%) Total Sample (x2)
Using the
formula
= n
= 74
= n x 0.30
= 30
Total (after consider non response)
= 74+22=96
n x 2 = 96 x 2
= 192
91
Sampling Methods:
By using random sampling methods and by using SPSS Statistics
version 21.0.
Sampling unit = house
(since around 200 adults are needed for our sample size, we assume
there are 2 adults in each household, hence we will require 100
houses)
Sampling interval:
Total houses = 1092
Needed houses = 100
Interval is calculated by 1092/100 every 10
th
house

92
93
Research Tools:
A structured interviewer guided questionnaire will be prepared by emphasizing on
1. socio-demography (such as, age, gender, marital status, races, education level)
2. occupational background (such as, shift work, working hours etc)
3. medical history (such as, smoking status, previous injury etc)
4. questions about back pain (such as, frequency, severity and location of pain etc)
5. attitude (such as, preventive measures, injury management etc)
It has 5 rating scores ranged from strongly agree to strongly disagree, scoring will
be given range from 1 to 5 depending on the positivity of the statement.
6. knowledge, (such as, knowledge on causes of pain, posture and exercise etc)
The score has 3 rating of Yes, No and Do Not Know. Score will be given range
between 0 to 2 depending on the question.
7. behavior or practice toward back pain. (such as, daily routines that can cause back
pain etc)
It consists of 3 possible answer range from the worst to best choice with scoring
of 0 to 2 respectively.

5, 6 and 7 will be summed and categorized into good and poor level based on 75%
score as the cut off point.

(Phase validated by comprehension and language using 100 sample questionnaires)

Data Analysis
Data Entry:
- SPSS Version 21.0

Descriptive Statistics:
- Numerical data (mean & standard deviation)
- Categorical data (frequency & percentage)

Data analysis will be conducted using Chi Square, Fisher
Exact Test, Independent t Test and One-way ANOVA.

Tables, graphs, bar charts and pie charts will be used to present
the data.

94
Dummy table on Socio-demographic
Factors of Residents aged 18
Factors Frequency
(%)
Mean (SD) Median (IQR)
Age
Sex
Race
Occupation
95
Table 1 : Socio-demographic characteristics of respondents (n=200)
Dummy Chart on Prevalence of Back Pain
among Residents aged 18
Yes
50%
No
50%
96
Figure 1 : Prevalence of back pain among villagers of Kok Lanas (n=200)
Dummy Table on Knowledge about
Back Pain among Residents aged 18
Frequency (%)
Yes No Do not know
Knowledge
Mean (SD) total score of knowledge
Frequency (%) of good and poor knowledge
97
Table 2: Responses on knowledge questions of respondents (n=200)
Dummy Table on Attitude towards Back pain
Frequency (%)
Strongly
agree
Agree Neutral Disagree Strongly
disagree
Attitude
Mean (SD) total score of attitude
Frequency (%) of good and poor attitude
98
Table 3: Responses on attitude among respondents (n=200)
Dummy Table on Practices to Prevent
Back Pain among Residents aged 18
Frequency (%)
Best practice Moderate practice Poor practice
Carrying backpack
Carrying heavy object
Sitting posture
Stretching exercise
Sleeping mattress
99
Table 4 : Responses of Back Protecting Practices among respondents (n=200)
Mean (SD) total score of practice
Frequency (%) of good and poor practice
Dummy Table on Factors Associated with Back Pain
100
Table 5: Factors associated with back pain among respondents of
Kok Lanas (n=200)
Criteria
Frequency of back pain
(%)
P value
Yes No
Age
Sex
Occupation
Knowledge
Attitude
Practice
Gantt Chart
Week 8
(29/9/2013-5/10/2013)
Week 9
(6-10/10/2013)
Preparation for Residency 2
Community Residency 2
(data collection)
Data entry and data analysis
Preparation for PowerPoint
Presentation on community diagnosis
and intervention for Residency 3,4
Preparation for residency 3
Writing report
101
REFERENCES
1. National Health and Morbidity Survey III (Vol II), 2006
2. Ministry of Health (MOH), Health Facts, Kuala Lumpur, Malaysia, 2008
3. Ministry of Health (MOH), Oral Health Division, Kuala Lumpur, Malaysia, 2004
4. Lembaga Pembangunan Perancang Keluarga dan Negara (LPPKN), 25
September 2011, http://www.lppkn.com.my
5. Department of Statistic Malaysia, 25 September 2011,
http://www.stat.gov.my
6. Ministry of Women, Family and Community Development, NKRA Low
Household Income, http://www.kpwkm.gov.my

102
REFERENCES (cont.)
8. Noor Saadah Bachok, Journal of Acceptance and knowledge of family
planning among Muslim women in rural villages of Kelantan, 2007, Page 3
9. Asmani R & Aziah D, Pap Smear Screening Among Women in
Mukim Jaya Setia, Kelantan, Malaysia Journal of Public Health
Medicine 2007.
10. T O Lim, Z Morad, Prevalence, Awareness, Treatment and
Control of Hypertension in the Malaysian Adult Population, 2004.
11. Verapeen, et .al: Musculoskeletal Pain in Malaysia: A COPCORD Survey
(2007)

103
References (cont.)
12. Razlan M., Win Kyi, Rampal K.G., Work-Related Musculoskeletal
Symptoms Among Batik Workers in Kelantan (2000)
13. Deyo RA, Mirza SK, Martin BI. Back pain prevalence and visit rates: estimates
from U.S. national surveys, 2002. Department of Medicine, University of
Washington, Seattle, WA, USA. deyo@u.washington.edu

104
Thank You
By CFCS Group H Session 2012-2014

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