Team 1 Proposal 12.4.15

FACULTY OF MEDICINE AND HEALTH
SCIENCES
DEPARTMENT OF NUTRITION AND DIETETIC
PKK3405 Nutrition and Health Promotion II
(SEMESTER 2 2014/2015)
TEAM 1: 1HEART
(PROPOSAL)
Date of Submission: 12th April 2015
Lecturer: Dr. Chin Yit Siew
No
Name
Matric No.
.
1.
Mohamad Syazwan b. Hisham
166739
2.
Lim Shin Yeh
167248
3.
Siti Huzaifah bt Mohamed Hussien
1667873
4.
Noorshamimi bt Muhammad Rosli
169406
5.
Choo Poh Yee
169570
6.
Yeoh Wei Ching
169603
7.
Nurul Huda bt Abdullah Tauhid
170150
Signature
Table of Contents
ABSTRACT........................................................................................................................2
INTRODUCTION...............................................................................................................2
PRIORITY POPULATION.................................................................................................5
PLANNING MODEL..........................................................................................................6
GOAL AND OBJECTIVES..............................................................................................10
INTERVENTION PLAN...................................................................................................14
MODULES AND EDUCATION DEVELOPMENT PROCESS......................................22
PLAN OF TRAINING OF TRAINERS (TOT).................................................................25
EVALUATION PLAN.......................................................................................................30
MANAGEMENT PLAN...................................................................................................40
MARKETING PLAN........................................................................................................56
REFERENCES..................................................................................................................59
APPENDIXES...................................................................................................................63
A GRANT PROPOSAL FOR 1HEART:

INTERVENTION PROGRAM TO REDUCE THE CARDIOVASCULAR RISK
FACTORS BY PROMOTING HEALTHY EATING AMONG EMPLOYEES IN
TENAGA NASIONAL BERHAD
By
Choo Poh Yee, Lim Shin Yeh, Mohamad Syazwan Bin Hisham, Noorshamimi Bt
Muhammad Rosli, Nurul Huda Bt Abdullah Tauhid, Siti Huzaifah Bt Mohamed Hussien,
Yeoh Wei Ching
ABSTRACT
As the result of rapid technology advancement and market globalization, the
demand for the services and products become increasingly high. This results in change in
social organizational at worksite (such as introduction of shift work and overtime system)
as well as change in individual behaviours (such as poor nutrition, physical inactivity and
smoking). The coupling effect of these behavioural risk factors with the high prevalence
of physiological risk factors such as of hypertension, hypercholesterolemia, diabetes and
overweight/obesity among working adults makes them having high tendency of
becoming the victims for cardiovascular diseases. Therefore, we planned a health
promotion program named 1Heart in order to address this health issue among the
employees who work at the National Load Despatch Center (NLBC) Building in
headquarter of Tenaga Nasional Berhad (TNB). PRECEDE-PROCEED Model was used
in identifying the risk factors among our priority population and in planning the program.
Health Belief Model was also applied in designing the activities of intervention program
to assist change toward healthy eating practices. Non-experimental pre-test and post-test
study design will be used to evaluate the effectiveness of our program. The uniqueness of
our program is that the whole program was customized according to the condition of our
priority population to ensure their needs are met.
INTRODUCTION
Cardiovascular diseases (CVDs) are defined as a group of disorders of the heart
and blood vessels, including coronary heart disease, cerebrovascular disease, peripheral
arterial disease, rheumatic heart disease, congenital heart disease, deep vein thrombosis
and pulmonary embolism (World Health Organization [WHO], 2015). According to
WHO (2015), CVDs is the world number one cause of death, which has contributed to
approximately 17.5 million deaths in 2012 (31% of all global deaths) and this number of
deaths is expected to be increased by 25 million by 2025. Low and middle-income
countries were also experienced dramatic rise in mortality due to CVDs (Yusuf, Reddy,
Ounpuu, & Anand, 2001). This statement is further supported by WHO (2011) in a global
status report which mentioned that over 80% of cardiovascular deaths occurred in lowand middle-income countries. As consistent with the worldwide trend, CVDs had been
the principal cause of death in government hospitals in Malaysia since year 1994, which
accounted for 23% of deaths (Zambahari, 2004) and continually remained as top in year
2013, which accounted for 24.4% of deaths (Ministry of Health Malaysia, 2014).
As CVDs have contributed the largest proportion (36%) of total deaths among
Malaysian aged 30-70 years (WHO, 2014), this shows that the focus now should be put
on the Malaysian working adults because they are within the range of productive age of
20-65 years old. Besides, the prevalence of underlying physiological risks of CVDs such
as raised blood pressure, raised cholesterol, diabetes and being overweight/obesity
(WHO, 2011) are also high in Malaysia. According to National Health Morbidity Survey
IV (2011), the prevalence of hypertension, hypercholesterolemia, diabetes mellitus and
overweight/obesity among adults were 32.7%, 35.1%, 15.2% and 60.5% respectively.
Meanwhile, the preliminary findings done by Social Security Organization (SOCSO)
Health Screening Program (Darus, Hoe & Isahak, 2013) among Malaysian employees
also showed that 19% had hypertension, 58% had hypercholesterolemia and 15% had
diabetes. The similar condition was happened in our priority group, in which among the
employees who had attended the health screening of Grid System Operator (GSO) Total
Wellness Program in December 2014, more than half were overweight/obese (64%) and
pre-hypertension/hypertension (51%) while about 12.8% were pre-diabetic. In
correspondence with this, Liau et al. (2010) reported that 93.5% of the employees were
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categorized as having high risk for future cardiovascular events based on the definition of
National Cholesterol Education Program (NCEP).
All the evidence shown above indicates that there is an urgent need to overcome
this health issue because the costs of CVDs are staggering (WHO, 2011). The increasing
CVDs burden has great global economic implications as it causes billions of dollars loss
in national income annually in the worlds most populous nations (WHO, 2011). The total
cost of CVDs in USA was $457.4 billion in year 2006, which the direct (e.g.
hospitalization, drugs and physician visits) and indirect (e.g. productive losses due to
premature death) costs contribute $292.3 billion and $164.1 billion respectively (Tarride
et al., 2009). The total costs of CVDs in USA were estimated to be $444 billion in year
2010 (Centers for Disease Control and Prevention [CDC], 2010), and estimated to
increase rapidly to $656 billion in year 2015 and double to $1208 billion in year 2030
(Mozaffarian et al., 2015). Meanwhile, total costs of CVDs to the economies in six
European economies (France, Germany, Italy, Spain, Sweden and the UK) are estimated
at 102.1 billion in 2014 (Centre for Economics and Business Research, 2014). There
was no record cost of CVDs in Malaysia. These evidences provide strong support on the
need of intervention programme to address this health issue.
In fact, CVDs and these physiological risks are preventable. Behavioural risk
factors such as tobacco use, physical inactivity, and unhealthy diet were found to be
responsible for about 80% of coronary heart disease and cerebrovascular disease (Lopez,
Mathers, Ezzati, Jamison, & Murray, 2006). As employees spend most of their time in the
worksite, the working environment can influence their dietary pattern, physical activity
and weight control behaviour (Shimotsu, French, Gerlach, & Hannan, 2007). Besides,
worksite is an ideal setting to promote healthy lifestyle behaviours (Proper & van
Mechelen, 2008) due to the existence of social networks, large population of employees,
and the long hours they spent at work. Increasing interest in lifestyle-related health
problems among employees makes the importance of health promotion in worksite
become widely recognized (Muto & Yamauchi, 2001). Thus, worksite health promotion
program which promote healthy lifestyle behaviour is needed to combat this global health
issue.
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A literature review prepared for the WHO/WEF Joint Event concluded that
worksite health promotion program addressing physical activity and diet are effective in
changing healthy lifestyle as well as improving health-related outcomes, including risk
factors of cardiovascular disease (Proper & van Mechelen, 2008). Nutrition education
program should be implemented among the employees as many studies conducted among
the worksite employees have reported a significant improvement in overall health status.
For example, a quasi-experimental trial done on with a follow up of 2 years has been
carried out in Kuala Lumpur. The intervention group was security guards of a public
university and the comparison group was security guards from a teaching hospital of the
same university. The intervention group had received intensive individual and group
nutrition and physical active counselling. After the program implementation, there is a
statistically significant reduction in the mean total cholesterol levels in the intervention
group (Moy, Ab Sallam, & Wong, 2008). Furthermore, a multi-component health
promotion program was conducted in Japan and the program focused on cardiovascular
disease risk factors through lectures, practical training, individual counselling, group
discussion and self-education. The finding showed to be effective in improving obesity,
high blood pressure, and hyperlipidemia (Muto & Yamauchi, 2001). These successful
interventions can be served as references for our intervention planning.
PRIORITY POPULATION
Our priority population consists of the employees who work at the National Load
Despatch Center (NLBC) Building in headquarter of Tenaga Nasional Berhad (TNB),
which is located at Bangsar, Kuala Lumpur. The total number of employees is estimated
about 400 people who aged 20-60 years, with the ratio of male and female is almost
equal. They are made up of diverse ethnicities in which majority are Malays. Besides,
majority of them are white-collar who work in the office while only few are blue-collar
who work as technicians.
Through the observation during need assessment (primary data), we observed that
the food available in the cafeteria was less healthy and high in fat. Most food items were
fried and they are the most popular food choice among the employees. Besides, most of
the vegetables are cooked with coconut milk. The availability of fruits and vegetables are
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also limited in the cafeteria. Therefore, we assume that most of the employees have high
intake of saturated fat but low intake of fruits and vegetables. Through the interview with
Key Opinion Leaders (primary data), we were informed that sports facilities are available
in the worksite and some of them will utilize them before or after working hour.
However, most of the employees were stress and having weight problems. Weight loss
competitions were organized annually 5 years ago but were stop since 2 years ago due to
the issue of faulty weight loss method with the aim of winning the grand prizes. The
finding of health screening from GSO Total Wellness Program (secondary data)
conducted among the employees in December 2014 showed that the employees have
serious overweight/obese and pre-hypertension/hypertension problems. This showed that
the employees possess the behavioural and physiological risk factors of CVDs listed by
WHO. As the self-administered need assessment questionnaire was unable to be
conducted in time, we assume that the employees have risk for CVDs. The risk factors of
CVDs were assessed using PRECEDE-PROCEED Model, which will be further
elaborated in the next section.
PLANNING MODEL
Figure 1: Framework of PRECEDE-PROCEED Model

In our intervention program, we decided to adopt and apply PRECEDEPROCEED Model in our program planning as well as in our need assessment.
PRECEDE-PROCEED Model includes PRECEDE portion which focuses on diagnostic
planning and PROCEED portion which focuses on implementation and evaluation of
health promotion program (Green & Kreuter, 2005). This model provides comprehensive
guidelines from planning, implementation to evaluation. It is capable to facilitate
identification of the desired outcomes at the planning process, which determines the
evaluation metrics (Green & Kreuter, 2005). Besides, this model was built on various
health behavioural theories such as health belief model, health promotion model, and
social learning theory (Green & Kreuter, 2005), and have strong theoretical base which
enable us to develop health promotion program successfully.
During need assessment, the identification of health problem (Phase 1 and Phase
2), behavioural and environmental risk factors (Phase 3), factors affecting behaviour and
environment (Phase 4) and resources in terms of policy and organisation (Phase 5) were
included. As for the Phase 1 and Phase 2, they provide guideline for us to understand and
identify the health problems or concerns and the quality of life of employees. Based on
the primary and secondary data we collected, we identified the health problem among
TNB employees as CVDs. After identification of CVDs under epidemiological
assessment, we assessed the behavioural and environmental risk factors that contribute to
this health problem (Table 1) during Phase 3.
Table 1: Risk and protective factors contributed to CVDs
Health
Genetic
Risk Factors
High blood pressure
High cholesterol concentration
Overweight and obesity
High blood glucose level
Family history
Protective Factors
Behavioural
Tobacco use
Unhealthy diet (Low consumption of
Sufficient physical activity

Eating plenty of fresh fruit
and vegetables
Low alcohol consumption
High HDL cholesterol
fruits and vegetables, high salt

consumption, high consumption of
Environmenta
l
saturated fats and trans-fatty acids

Physical inactivity
Harmful use of alcohol
Shift work
Work pace
Work organization
Lead exposure and noise
Environmental tobacco smoke in
workplace
Occupational exposure to carbon
monoxide
Sources: Australian Institute of Health and Welfare, 2011; Carnethon et al., 2009; WHO,
2011.
Among the risk factors above, we focus on behavioural risk factors only as
genetic risk factor is non-modifiable while environmental risk factors cannot be
overcome through this intervention program due to limited resources. After that, we
identified the predisposing, reinforcing and enabling factors which could act as supports
or barriers that can reduce or contribute to CVD during Phase 4. These risk factors are
then illustrated in the table as shown below:
Table 2: Predisposing, reinforcing and enabling factors contributed to CVDs
Predisposing factors
Age
Sex
Ethnicity
Increased
Reinforcing factors
Psychosocial factors
Enabling factors
Effort-enabling
such as depression,
imbalance (low salary,
lack of social support,
lack of social approval,
understanding and high
social isolation, and
fewer career
level of health literacy

Educational level
Perception on the
stressful conditions at
work
Not having a partner
Prize incentives
opportunities)
High cost of healthy
food
Little access to health
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susceptibility of getting
the diseases
Perceived severity of
the diseases
Benefits of health-
related behaviours
Lack of time
Laziness
Self-efficacy
Perception of needs
Limited knowledge
Low level of awareness
education activities
Accessibility to health
promotion
Quality of current
health promotion
Lack of health
promotion
Poor accessibility to
health knowledge
Accessibility and
availability of sport
facilities
Accessibility and
availability of healthy
foods
Low socioeconomic
status
Healthy lifestyle policy
in workplace
Sources: A. Wartak et al., 2011; Bggild & Knutsson, 1999; Carnethon et al., 2009;
WHO, 2007; Harrington, 2001; Kivimki et al.,2002; Li et al., 2009; Sabzmakan et
al.,2013; Sokejima & Kagamimori, 1998
The Ottawa Charter outlines five areas for health promotion action and the first
one is to build health public policy (WHO, 1986). The last phase of PRECEDE portion is
administrative and policy assessment. Capabilities and the availability of resources such
as human resource, financial resource and materials were then determined. To obtain
adequate resources to support our program, we have been engaged with several private
companies for sponsorship purpose. Furthermore, we were also able to get help from
TNB as they were willing to help us to photocopy all pre- and post-test questionnaires as
well as prepare 2 meals for all the participants who present on the implementation day.
Volunteers will also be recruited to increase our manpower and help us to carry out the
program smoothly and successfully. Apart from this, we will also obtain the approval
letter from TNB before carrying out our program.
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After implementation of our intervention program, PROCEED portion of this

model will be used by us to carry out process, impact and outcome evaluations to
evaluate our program effectiveness and efficiency. However, only process and impact
objectives will be evaluated. Action, environmental, and outcome objectives will not be
evaluated due to time constraint.
The risk factors identified through our need assessment were prioritized using the
2x2 prioritization matrix. We focus on the risk factors which have the high severity and
high feasibility among our priority population (Figure 2).
Figure 2: Prioritization matrix of risk factors of CVDs
GOAL AND OBJECTIVES

Goal
1. To reduce the cardiovascular risk factors by promoting healthy eating and active
living among employees.
Process Objectives
1. Before implementation day, at least 10 volunteers will be recruited to help out the
intervention program.
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2. Before implementation day, all the committees and volunteers will attend training
of trainer (TOT) session.
3. Before implementation day, all the financial resources, education materials,
equipment and supplies will be gathered and prepared by organizing committee.
4. Before implementation day, at least 30 employees of Tenaga Nasional Berhad will
be recruited.
5. Before intervention program, the level of knowledge and attitude on healthy
lifestyle of all the participants will be assessed.
6. During implementation day, at least 60% of the recruited employees of Tenaga
Nasional Berhad will be participating in our intervention program.
7. During implementation day, all the activities will be carried out as planned.
8. After implementation day, at least 80% participants give at least good rating to
our facilitators and program.
9. After implementation day, all the stakeholders give at least good rating.
Impact Objectives (Learning Objectives)
A) Awareness
1. All of the participants will be able to identify at least 3 risk factors of
cardiovascular disease at the end of the implementation day.
2. All of the participants able to identify their Body Mass Index (BMI) and body fat
percentage at the end of the implementation day.
B) Knowledge
1. At least 80% of the participants will be able to define the Body Mass Index (BMI)
classification after the implementation day.
2. At least 80% of the participants will be able to state the numbers of serving size
for each food group to be consumed every day according to Malaysian Food
Guide Pyramid after the implementation day.
3. At least 80% of the participants will be able to identify food sources of dietary
fibres after the implementation day.
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4. At least 80% of the participants will be able to differentiate foods that contain
high saturated fat and high unsaturated fat respectively after the implementation
day.
5. At least 80% of the participants will be able to identify the dietary pattern that can
reduce the risk of cardiovascular diseases after the implementation day.
6. At least 80% of the participants will be able to explain on how the risk factors will
lead to cardiovascular diseases after the implementation day.
7. At least 80% of the participants will be able to identify the recommendation for
fat intake, salt intake, fibre intake and physical activity after the implementation
day.
C) Attitude
1. At least 60% of the participants will agree to reduce intake (reduce amount or
frequency taken) of high-fat food after implementation day.
frequency taken) of high sugar content food and drink after implementation day.
frequency taken) of high salt content food and drink after implementation day.
4. At least 60% of the participants will agree to adopt healthy lifestyle (smoking,
stress, alcohol) after implementation day.
5. At least 60% of the participants will agree to increase fruits and vegetables intake
after implementation day.
6. At least 60% of the participants will agree that they have the choice for healthy
balanced diet.
7. At least 60% of the participants will justify the reason of choosing healthy food
over less healthy food.
D) Skill
1. At least 60% of the participants will able to choose the healthy food over the less
healthy food.
2. At least 60% of the participants will able to prepare healthy balanced meals
according to Malaysian Food Guide Pyramid during implementation day.
3. At least 60% of the participants will able to perform physical activity during
implementation day.
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Impact Objectives (Behavioural objectives)

1. At least 50% of the overweight/obese participants are able to reduce their BMI
and body fat composition after 6 months of the intervention program.
2. At least 50% of participants will consume at least 3 servings of vegetables and 2
servings of fruits after 6 months of the intervention program.
3. At least 50 % of participants will be able to practise healthy balanced diet after 6
months of the intervention program.
4. At least 50 % of participants will be able to maintain a diet lower in fat content of
after 6 months of the intervention program.
5. At least 50 % of participants will be able to maintain a diet which is lower in fat
content after 6 months of the intervention program.
6. At least 50 % of participants will be able to practise healthy balanced diet after 6
Impact Objectives (Environmental Objectives)
1. At least 50% of participants will encourage their colleagues to reduce high-fat
food intake after 6 months of the intervention program.
2. At least 50% of participants will encourage their colleagues to increase the fruits
and vegetables intake after 6 months of the intervention program.
3. The authority can make the intervention program as compulsory for at least once
a year to ensure the sustainability of the programs impact after 6 months of
Outcome Objective
1. At least 30 of the overweight/obese participants will be able to achieve a healthy
body weight status after 1 year of the intervention program.
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INTERVENTION PLAN
Numerous interventions commonly used the Health Belief Model (HBM) theory
in their health education and health promotion programs (Hayden, 2013). This theoretical
model provides a narrower and sharper focus of health behaviours based on few
constructs, namely perceived seriousness, perceived susceptibility, perceived benefits,
perceived barriers and cues to action (Figure 3). An additional construct of self-efficacy is
also included. In our intervention program 1Heart, we will apply the Health Belief
Model as our guidelines to plan and implement the activities for the eight components in
the model (Figure 4) for building a comprehensive intervention program. Due to time
constraint and limited resources, our program will cover up to the 5 th component which is
the opportunity to practice the healthy eating behaviour.
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Figure 3: Health Belief Model
15
Fig
ure 4: Model for Building a Comprehensive Intervention
Perceived seriousness refers to beliefs about the seriousness of a condition and
its consequences (Hayden, 2013). In the other words, it is a personal judgment of the
seriousness of that condition. Brighten Your Heart is an example of activity during our
program which aims to increase awareness of participants on prevalence and risk factors
of CVDs. Poster and pamphlets related to risk factors of CVDs obtained from Ministry of
Health, Malaysia will be presented and distributed to participants.
Perceived susceptibility refers to a persons subjective estimation of his or her
own risk of developing a particular health condition according to O'Donnell (2001).
Health screening will be carried out during the program and all the data will be recorded
in their personal report card. This will enable the participants to know their measurement
of weight, height and body fat composition. In Where Are You? activity, it allows
participants to get assistance from qualified facilitators on calculating their own BMI as
well as classifying BMI and body fat percentage respectively according to standard cutoff points. Next, facilitators will guide them to set their goals for each health status. This
16
allows participants to aware of their body weight status as it is one of the CVDs risk
factor.
According to Tones & Tilford (2001), perceived threat is a combination of
perceived susceptibility and perceived severity. The higher perceived threat, the more
motivated the person is to take action to reduce threat.
Perceived benefits, perceived barriers, cues to action and self-efficacy are
incorporated in activities such as simple healthy cooking competition and Choose My
Plate. Perceived benefits refer to subjective estimation of effectiveness of that
recommendations in removing the threat or taking action to reduce the risk or
seriousness. Whereas perceived barriers refer to any negative aspects of following the
recommendations. Additional elements like self-efficacy which define as confidence in
ones ability to take action according to O'Donnell (2001) and cues-to-action which
refers to strategies to activate readiness to change will be implemented in our last
session of intervention. Activities mentioned before will equip participants with
knowledge and skills to adopt healthy eating. In addition, participants will believe they
have the ability to improve and maintain their healthy weight status at the end of the
program as well as improve the cardiovascular health. These activities help to encourage
and empower participants in preparing and choosing a healthy balanced meal. In the same
activity also, it allows participants to apply concept of Balanced, Moderate, Variety
Furthermore, participants will be able to practice skill of choosing more healthy foods
over less healthy foods during the simple healthy cooking competition.
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Table 3: Intervention plan

Activities
Brighten Your
Descriptions
Objective(s)
Intervention
Strategies
First Component: Education and Awareness Building
Prevalence of cardiovascular disease, risk To increase the awareness Health
Heart
factors and consequences of CVDs will be
of participants on the
communication
(Torchlight
illustrated in info-graphic style on the
prevalence of
strategy
exhibition)
mahjong papers, and pasted on wall.

Torchlight will be pointed on the mahjong
cardiovascular diseases,
papers in the dark room and the facilitators
negative consequences.
Puzzle your
Heart
(Board
exhibition)
give explanation.
Participants who have/havent done health
screening will be invited to this session.
Conducted simultaneously with health
screening.
Self-prepared education materials showing the
risk factors and consequences of CVDs will
be pasted on the exhibition board.
Facilitators will explain on how the risk factors
Construct(s) of
Health Belief Model
Perceived
susceptibility
Perceived severity
its risk factors and
To increase the awareness Health

of participants on the
communication
prevalence of
strategies
Perceived
susceptibility
Perceived severity
cardiovascular diseases,
its risk factors and
negative consequences.
lead to CVDs.
Testing 1,2,3
(Health
Second Component: Personal Assessment

Weight and height measurement, and body fat To assess the participants Health-related
percentage of participants will be assessed
BMI and body fat
community service
Perceived
susceptibility
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screening)
Where are
and recorded in their report card.
composition
Third Component: Goal Setting
Facilitators will ask participants about their
To raise the awareness
you?
(Consultation)
understanding on BMI and educate them to

calculate their own BMI.
Facilitators will show the BMI and body fat
among participants of
their body weight
status.
strategy;
Health-related
community service
strategy
Health
percentage classifications and ask the
communication
participants to determine their body weight
strategy
Perceived
susceptibility
Self-efficacy
status respectively.
Facilitators will guide participants to set their
1Heart Forum
goals for each health status.

Fourth Component: Knowledge and Skill Building
Facilitators will role-play the characters
To equip the participants Health
such as Pegawai Sains Pemakanan (PSP),
with knowledge and
moderator, and clients in an imaginary
skill of adopting healthy
forum.
The client will ask PSP on the questions
eating pattern.
communication
strategy
Health education
Perceived barrier
Perceived benefits
Cues to action
Self-efficacy
strategy.
related to healthy lifestyle that mean to
improve cardiovascular health.

The questions asked will take into
consideration on the employees' problems or
concerns written down in the pre-test
questionnaire.
Throughout the forum, the real audiences
19
are also free to ask their own questions
Oishi Simple
regarding to the topic.

Fifth Component: Opportunity to Practice Behaviour
Food ingredients will be prepared for the
To encourage and
Health
participants.
2 participants in one group will be requested
healthy cooking
competition
to prepare a sandwich/bread sushi roll and a
drink.
Participants can randomly choose the types
of the ingredients according to the amount
that has been fixed to make a
sandwich/bread sushi roll.

Participants are requested to justify their
choice of ingredients and their choice will
be evaluated.
empower participants to
prepare a simple and
nutritious homemade
meal.
To allow participants to
communication
Behaviour
Perceived barrier
Perceived benefits
Cues to action
Self-efficacy
Perceived barrier
Perceived benefits
Cues to action
Self-efficacy
modification
activities
practice the skill of

choosing healthier food
products over less
healthy food products.
apply concept of
"Balanced, Moderate,
Variety" according to
Malaysian Food Guide
Choose My
Plate
Different types of foods (meat & fish,
Pyramid
To encourage and
vegetables, fruits, and cereals) with different
empower participants to
cooking methods will be displayed.

Participants are required to pick the food
choose a healthy
Health
communication
Behaviour
modification
20
according to the food group concept in My
Plate.
The choice of meal will be evaluated.
balanced meal.
activities
practice skill of
choosing more healthy
foods over less healthy
foods.
apply concept of
"Balanced, Moderate,
1HEART
Recall
Variety"
Sixth component: Relapse Prevention Program
After our program, all the participants will be
To motivate and remind
Health
added into social media such as Facebook
group and WhatsApp group.
Weekly motivation note will be sent through the
social media to motivate and remind
participants to continue
communication &
practice skill and
environmental
knowledge learnt from
change strategies
program.
(social
Self- efficacy
Cues to action
participants.
One-to-one
Nutrition
environment);
Seventh Component: Monitoring Progress of The Target Population
Participants will be assigned to a nutrition
To review participant
Health education,
counsellor after six month.
progress in making
health
counselling
healthy eating changes
communication &
session
such as reduce high fat
behaviour
foods intake and
modification
Self- efficacy
Cues to action
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increase fruits and
strategies
vegetables intake to
achieve their goals.
Eighth Component: Redefining Participants Goals
The authority can make the intervention
To help participant to Health
Follow-up
intervention
program as compulsory for at least once a
program
year to ensure the sustainability of the

programs impact.
maintain the healthy
eating.
To make sure
colleagues will still be
able to practice
healthy diet which is
Self- efficacy
communication
Health-related
community service
Behaviour
modification
strategies
lower in fat and high

in fibre.
MODULES AND EDUCATION DEVELOPMENT PROCESS

Modules will be developed according to the following activities to assist in delivering the key messages effectively to the
participants.
Table 4: Modules
Activities
Key messages
Learning outcome
Remark
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Torchlight
Exhibition:
Brighten Your
Heart
Board exhibition:
Overview of CVDs based on WHO

Prevalence of CVDs globally
Prevalence of CVDs in Malaysia
Risk factors of CVDs according to
CVDs
Module is based on
prevalence of CVDs by WHO
Participants are aware on
their health status
Educate on BMI calculations

Introduce on BMI cut-off points
classifications based on WHO

Introduce on body fat cut-off points
Goal Setting:
Participants are able to
define BMI classification

Participants are aware on
classifications based on WHO
Module is based on WHO

instructions.
Module is based on WHO

classifications
their health status
Educate on Malaysian Food Guide
the numbers of serving
Pyramid
Introduce on number of serving sizes
in each food groups.

Emphasize on dietary fibers from
be consume every day
Building: 1Heart
Forum
factor.
Personal Assessment
Knowledge and Skill

identify risk factors of
genetic, behavioural & environmental
Puzzle Your Heart
Where are you?
Participants are able state

size for each food group to
according to Malaysian
vegetables & fruits food groups
Food Guide Pyramid

Module is based on
Malaysian Food Pyramid

Clients (Huda &Yeoh)
PSP (Wan & Mimi)
Moderator (Volunteer)
Runner (Iffah)
Coordinator (Shin Yeh)
Goal setting (PY)
identify food sources of
23
dietary fibers.
differentiate foods that
contain high saturated of
fat & high unsaturated fat.

justify the reason of
choosing healthy food
Opportunity to
Practice Behaviour:
Oishi Simple
Cooking
Introduce on examples of healthier
food products in meal preparation.

Introduce on examples of less healthy
food products in meal preparation.

Introduce on nutritious homemade
Competition
over less healthy food.

Participants will able to
choose the healthy food
meal recipes.
over the less healthy food.

Participants will able to
Module is based on
Pyramid
Module is based on Malaysia
Dietary Guidelines
prepare healthy balanced

meals according to
Opportunity to
Pyramid.
Balanced meal in a single plate
prepare healthy balanced
Practice Behaviour:
according to Key Message 1 in
meals according to
Choose My Plate
Malaysian Dietary Guidelines.
Malaysian Dietary
Module is based on Malaysia

Dietary Guidelines
Guidelines.
24
25
PLAN OF TRAINING OF TRAINERS (TOT)

Activity 1 and 2:
Activity
Torchlight Exhibition:
Board Exhibition: Puzzle
Activity Duration
Activity Objectives
Brighten Your Heart

Your Heart
10 minutes
30 minutes
To increase the participants awareness on:
Training Objectives
1.
2.
3.
1.
The prevalence of cardiovascular diseases;

Its risk factors, and
Its negative consequences
Every trainee is able to list the accurate and latest
information about the prevalence of cardiovascular diseases
at the end of the training session.

2. Every trainee is able to list every risk factor of
cardiovascular diseases at the end of the training session.
3. Every trainee is able to list the negative consequences of
Materials/Equipmen
t
Procedure
cardiovascular diseases at the end of the training session.

Presentation slides
Educational modules
1. All the trainees will be gathered in one of the tutorial room

in the faculty.
2. Before the training session starts, all the prepared materials
will be distributed to the trainees.
3. Presentation slides will be displayed on the screen along
with the teaching session throughout the training session.
4. At the end of the session, a summary of the training session
will be provided by the trainer to the trainees.
Activity 3:
Activity
Activity Duration
Activity Objectives
Training Objectives
Health Screening- Testing 1, 2, 3

30 minutes
To assess the participants BMI and body fat composition
1. Every trainee is able to use the correct technique in
measuring weight and height of the participants at the end of
the training session.
26
2. Every trainee is able to use the correct technique in using the

Body Fat Analyser device to measure the body fat
percentage of the participants at the end of the training
session.
3. Every trainee is able to calibrate every instrument correctly
Materials/Equipmen
t
Procedure
1.
at the end of the training session.

SECA stadiometer
OMRON HBF-306 Body Fat Analyser
TANITA THD-306 weighing scale
Standard of Procedure (SOP) of health screening
Presentation slides
All of the measuring instruments will be installed before the
training session starts.

in the faculty.
3. Before the training session starts, SOP will be distributed to
the trainees.
5. Before the hands-on practice, all the instruments are being
calibrated by the trainees.
6. Chance is provided to each of the trainee to measure weight,
height and body fat composition.
Activity 4:
Activity
Activity Duration
Activity Objectives
Group Consultation & Goal Setting- Where are you?

15 minutes
To make the participants aware of their body weight status and
body fat percentage which are the potential risk factors of
Training Objectives
cardiovascular diseases
1. Every trainee is able to classify the body weight status and
body fat composition correctly according to the cut-off
points at the end of the training session.
2. Every trainee is able to explain the classification of body
27
weight status and body fat composition and provide

consultation according the respective results at the end of the
training session.
Classification of body weight status and body fat
Materials/Equipmen
composition
Counselling modules
Presentation slides
Question paper
Procedure
in the faculty.
2. Before the training session starts, all of the needed materials
will be distributed to the trainees.
4. All of the trainees will be given a question paper to calculate
and classify the body weight status and body fat percentage.
Activity 5:
Activity
Activity Duration
Activity Objectives
Forum- 1HEART Forum

45 minutes
To equip participants with knowledge and skill to adopt healthy
eating to improve and maintain healthy body weight status as
Training Objectives
well as improve cardiovascular health.

Every trainee is able to explain the ways to adopt healthy eating
and maintain body weight status based on Malaysian Dietary
Guidelines and Malaysian Food Guide Pyramid at the end of the
Materials/Equipmen
t
Procedure
training session.
Malaysia Food Guide Pyramid
Malaysian Dietary Guidelines (MDG)
Educational modules
Presentation slides
28
in the faculty.
2. Before the training session starts, Malaysia Food Guide
Pyramid and MDG will be brought by the trainees and other
materials will be distributed to the trainees.
Activity 6& 7:
Activity
Activity Duration
Activity Objectives
Choose My Plate
Oishi Simple healthy cooking
competition
20 minutes
1. To encourage and empower participants to choose a
healthy balanced meal.
2. To allow participants to practice skill of choosing more
healthy foods over less healthy foods.
3. To allow participants to apply concept of "Balanced,
Moderate, Variety" based on Malaysia Food Guide
Training Objectives
Pyramid.
1. Every trainee is able to explain the procedure of the whole
activity at the end of the training session.
2. Every trainee is able to explain the rules and regulations of
the activity at the end of the training session.
3. Every trainee is able to understand the differences between
more healthy and less healthy foods at the end of the
Materials/Equipmen
Procedure
1.
training session.
Standard of Procedure (SOP) for the activity
Activity Rules and Regulations
Educational module
Presentation slides
All the trainees will be gathered in one of the tutorial room
in the faculty.
2. Before the training session starts, all of the materials will
be distributed to the trainees.
29

4. A pre-run of the activity will be carried out before the
training session ends.
5. At the end of the session, a summary of the training
session will be provided by the trainer to the trainees.
EVALUATION PLAN
The evaluation tools used to evaluate process, impact and outcome objectives are
tabulated as following:
Table 5: Evaluation plan and tools
Process Objectives
Process
1. Before implementation day, at least 10
Objectives
Evaluation Tools
Volunteer registration
volunteers will be recruited to help out the
form
- identify the number of
intervention program
committees and volunteers will attend
volunteer recruited
TOT attendance list
- identify the
training of trainer (TOT) session.
attendance of the
2. Before implementation day, all the
committees and
resources, education materials, equipment and
volunteers
Process checklist
- identify the type of
supplies will be gathered and prepared by
the resources and its
organizing committee.
amount that are needed
3. Before implementation day, all the financial
4. Before implementation day, at least 30
employees of Tenaga Nasional Berhad will be

recruited.
5. Before implementation day, the level of
for the program

Participants registration
form
Knowledge and
knowledge and attitude on nutrition and

30
physical activity of all recruited employees of
Attitude Questionnaire
TNB will be assessed.
(Pre-& Post-test
questionnaire)
- identify the level of
knowledge and attitude
employees of TNB will be participated in our
of the TNB employees

Registration form
- identify the number of
TNB employees that
6. During implementation day, at least 30
has attended to our

7. During implementation day, all the activities
will be carried out as planned.
program
Activities checklist
- identify the timing of
all the activities in the
8. After implementation day, at least 80%
participants give at least good rating to our
program
Participants feedback
form
- use to evaluate the
facilitators and program.
satisfaction of the
9. After implementation day, all the stakeholders
give at least good rating.
program process
Stakeholders feedback
form
- use to evaluate the
satisfaction of the
Impact Objectives (Learning Objectives)

Learning
1. All of the participants will be able to identify
objectives
(Awareness)
program process
Evaluation Tools
Pre-& Post-test
at least 3 risk factors of cardiovascular

disease at the end of the implementation day.
2. All of the participants will be able to identify
questionnaire
Observation checklist
Pre- & Post-test
their Body Mass Index (BMI) and body fat

percentage at the end of the implementation
Learning
objectives
day.
1. At least 80% of the participants will be able
to define the Body Mass Index (BMI)
questionnaire
31
(Knowledge)
classification after the implementation day.

2. At least 80% of participants will be able to
state the numbers of serving size for each
Pre- & Post-test

questionnaire
food group to be consumed every day

according to Malaysian Food Guide Pyramid
after the implementation day
to identify food sources of dietary fibres after
Pre- & Post-test

questionnaire
the implementation day.

to differentiate foods that contain high
Pre- & Post-test

questionnaire
saturated fat and high unsaturated fat

respectively after the implementation day.
to identify the dietary pattern that can reduce
Pre- & Post-test

questionnaire
the risk of overweight/obesity and

cardiovascular diseases after the
implementation day.
Learning
1. At least 60% of the participants will agree to
objectives
reduce intake (reduce amount or frequency
(Attitude)
taken) of high-fat food after implementation

day.
Pre- & Post-test

questionnaire
reduce intake (reduce amount or frequency
Pre- & Post-test

questionnaire
taken) of high sugar content food and drink

after implementation day.
increase fruits and vegetables intake after
Pre- & Post-test

questionnaire
implementation day.
32
4. At least 60% of the participants will agree
that they have the choice for healthy balanced

diet after implementation day.
5. At least 60% of the participants will justify
Pre- & Post-test

questionnaire
the reason of choosing healthy food over less

healthy food after implementation day.
Learning
objectives
(Skill)
1. At least 60% of the participants will able to

choose the healthy food over the less healthy
food during implementation day.
2. At least 60% of the participants will able to
prepare healthy balanced meals according to
Malaysian Food Guide Pyramid and My Plate
during implementation day.

Impact Objectives (Behavioural Objectives)
Behavioural
1. At least 50% of the overweight/obesity
Objectives
participants are able to reduce their BMI and
Evaluation Tools
Body weight status
record card
body fat composition after 6 months of the

2. At least 50% of participants will consume at
least 3 servings of vegetables and 2 servings
Follow-up
questionnaire
of fruits after 6 months of the intervention

program.
3. At least 50 % of participants will be able to
practise healthy balanced diet after 6 months

of the intervention program.
questionnaire
maintain a diet which is lower in fat content

after 6 months of the intervention program.
maintain a diet lower in sugar content after 6
Follow-up
questionnaire
maintain a dietlower in fat content of after 6

Follow-up
Follow-up
questionnaire
Follow-up
questionnaire
33

Impact Objectives (Environmental Objectives)
Evaluation Tools
Environmenta
Follow-up
1. At least 50% of participants will
l Objectives
questionnaire
encourage their colleagues to reduce highfat food intake after 6 months of the
2. At least 50% of participants will
encourage their colleagues to increase the
Follow-up
questionnaire
fruits and vegetables intake after 6 months

of the intervention program.
3. The authority can make the intervention
program as compulsory for at least once a

year to ensure the sustainability of the
programs impact after 6 months of
Outcome Objective
Outcome
At least 50% of the overweight/obese participants
Objective
will be able to achieve a healthy body weight
Evaluation Tool
Body weight status
record card
status after 1 year of the intervention program.
Study Design
Non-experimental pre-test and post-test design is used for our intervention
program as no control group is used to compare with the intervention group. Therefore,
this design is unable to control factors that affect the validity of the results. Nevertheless,
this design can still generate supportive and comprehensive evidence of the program
effectiveness (McKenzie, Neiger & Thackeray, 2013). Based on this study design, pretest and post-test evaluation on the knowledge and attitude of cardiovascular diseases will
be conducted to test on effectiveness of our intervention programs by comparing the preand post-test result. However, the limitation is that the results are of limited significance
because changes could be occur due to impact of other intervention programs held or
other events.
34
Sampling of Subjects
We used convenience sampling method to select our participants (employees from
NLDC Building) who will attend and participate fully throughout our intervention
program during implementation day. Besides, the participants must be those who have
completed and submitted both pre- and post-test questionnaires. Our targeted participants
should be at least 30 people in order to gain certain level of power to test for the
effectiveness of our intervention program. By considering to the non-response rate, we
have set the maximum target participants to 50 people. Besides, this is an approach that
used to maintain the quality of our program as the human and financial resources
available to us are limited.
The inclusion and exclusion criteria are listed as below:
1.
2.
3.
4.
5.
Inclusion criteria
Both male and female
All ethnicity
Aged 18 years and above
Both day and shift work employees
Both white- and blue-collar
Exclusion criteria
1. Those do not sign informed consent
form
2. Those do not understand Bahasa
Malaysia or English
3. Pregnant women
4. Physically disability
Measures/ Instruments
In this program, we used Health Belief Model to help us understand about healthrelated behaviour of participants and design our intervention program. For planning
model, we used the PRECEDE-PROCEED model as our reference. Next, we also used
self-developed pre- and post-test questionnaire to measure the program effectiveness.
During personal assessment session, TANITA digital weighing scale and SECA
stadiometer will also be used to measure body weight and height respectively. Also, we
use Omron body fat analyser to measure body fat. BMI will be calculated in our program,
and categorized using BMI classification from World Health Organization (2000). Lastly,
self-developed feedback form is also used to evaluate participants satisfactions.
Data Collection Methods
35
Data collection is done through self-administered pre-test and post-test

questionnaires. The pre-test questionnaire is distributed to the participants before the
program in order to evaluate their knowledge and attitude level on cardiovascular
diseases. Besides, post-test questionnaire is given to them at the end of the program.
Same set of questionnaire will be used for both pre-test and post-test. Moreover, the body
weight status of participants is obtained during the anthropometry measurement byusing
TANITA weighing scale and SECA body meter to calculate their BMI. BMI of the
participants will then be calculated and categorized according toBMI classification from
World Health Organization (2000).
Limitation of the Evaluation Plan
Due to the time constraint, we are not able to evaluate the long-term outcome,
causing our inability to measure the long term effectiveness of our program. As this is
self-reported data, bias and reluctant to answer questionnaire might cause our outcome
result to be inaccurate.
Ethical Consideration
First of all, a permission letter was brought along during the first visit to TNB.
Once the management had accepted our suggestion on the health promotion program,
another letter was sent to them to obtain the consensus from the management of TNB. We
also obtained the permission from the management to have our marketing promotion at
the NLDC building. Moreover, consent form and information sheet will be distributed to
the participants prior the data collection of pre-test questionnaire as well as the
intervention program. All of the participants will be also informed that all the data
obtained from this intervention will be kept private and confidential and will be used for
academic purpose only.
Statistical analysis
The data collected will be analysed by using IBM SPSS 20. We will analyse the
total scores of the questionnaire by using paired t test. Paired t-test is used to determine
whether there is a statistically significant difference in the mean scores of knowledge and
36
attitude level of the participants among the intervention group before and after
There will be nine parts in the self-administered pre- and post-test questionnaire:
(A) Socio-demographic background
There are 13 items being included in this component such as age, sex,
ethnicity, marital status, nationality, education background, monthly income, job
position, department, length of service, working hour, mode of transport to
workplace, and distance from home to workplace.
(B) Knowledge
There are 9 items being included in this component to assess their
knowledge towards the risk factors of CVDs and the Malaysian Food Guide
Pyramid. Each question will contribute 1 mark if the answer is correct and 0 mark
for wrong answer, with the possible total mark ranges from 0 to 9. Some
questions in knowledge part are set in reverse scale.
(C) Attitude
There are 9 items being included in this component to assess their attitude
toward healthy eating. Each question is set using Likert 5-point scale (1-strongly
agree, to 5-strongly disagree).
The total scores of knowledge and attitude parts will be sum up respectively for both preand post-test questionnaires.
(D) Frequency of food consumption
We use self-report method for this component. The subjects are required to
recall their frequency of consumption for each food category for the past one
week. The included food categories are high-fat food, high-sugar food, high-salt
food, milk and milk products, vegetables, fruits and sweet beverages. The
frequency of consumption for each food category is defined in continuous
37
variable and the result will be generated and presented in mean and standard
deviation.
(E) Physical activity level
Short International Physical Activity Questionnaire (IPAQ) is used to
determine their physical activity level. This short IPAQ consists of seven items
that identify the frequency and time spend on three specific types of physical
activity level which are walking, moderate intensity activity and vigorousintensity activity during the seven days prior to the questionnaire administration.
Metabolic Equivalent (MET) values will be used to analyse the data obtained
using IPAQ. For each type of activity, the MET-minutes per week are calculated
as follows (IPAQ, 2004):
1. Walking MET-minutes/week = 3.3 walking minutes walking days
2. Moderate MET-minutes/week = 4.0 moderate intensity activity minutes
moderate activity days
3. Vigorous MET-minutes/week = 8.0 vigorous intensity activity minutes
vigorous activity days
Total physical activity MET-minutes/week = sum of walking + moderate + vigorous
MET-minutes/week scores
The score for total physical activity MET-minutes/week is then categorized
into low, moderate and vigorous physical activity levels according to the IPAQ
categorical classification (IPAQ, 2004).
Table 6: Categorical classification for physical activity level
Criteria
Level of Physical activity
No activity is reported OR
Some activity is reported but not enough to meet
Low
Categories 2 or 3.
Either of the following 3 criteria
Moderate
3 or more days of vigorous activity of at least 20

38
minutes per day OR

5 or more days of moderate-intensity activity and/or
walking of at least 30 minutes per day OR

5 or more days of any combination of walking,
moderate-intensity or vigorous-intensity activities
achieving a minimum of at least 600 MET-
minutes/weeks.
Any one of the following 2 criteria
Vigorous-intensity activity on at least 3 days and
accumulating at least 1500 MET-minutes/week OR

7 or more days of any combination of walking,
moderate-
or
vigorous-intensity
High
activities
accumulating at least 3000 MET-minutes/week.

(F) Smoking Behaviour
Self-report method is used to assess subjects smoking behaviour.
(G) Anthropometric assessment
Self-report method is used to obtain subjects weight and height measurement.
(H) Current health problem
Subjects have to self-report their current health status.
(G) Cafeteria condition
The subjects are required to state the frequency of having meals in the workplace
cafeteria. They will be required to comment on the food availability in the
cafeteria and state whether they are satisfied with the food available in the
cafeteria.
MANAGEMENT PLAN
Identification and Allocation of Resources
i)
Personnel
All team members are involved throughout the process of planning, implementing
and evaluation of program. Each of us will be in-charged for specific portfolio (Table 5)
39
and be given specific tasks and responsibilities during implementation day according to
the plan of action (Table 8). Besides that, we will recruit our mirror group Team 6 as our
volunteers. Training will be provided to ensure the volunteers understand the programs
flow as well as their responsibilities during the program day.
ii)
Curriculum and instructional Resources

Education materials, such as pamphlet, brochure and poster regarding to the
cardiovascular disease risk factor will be obtained from Ministry of Health. Besides that,
we will also develop the teaching module and create our own materials for all activities
during the program.
iii)
Space
Our intervention program will be held at Tenaga Nasional Berhad meeting room
of NLDC Building will be used to carry out all activities of our program.
iv)
Equipment and Supplies

We will use most of the equipment and supplies provided by Tenaga Nasional
Berhad.
Equipment: Laptop (2), TANITA weighing scale (x2), SECA stadiometer (x2)
Supplies: PA system (2); Laptop cable (2) ; Microphone(5); Projector (2); Screen
(1); Audio Cable (2); Partition board (4); Long Tables (6); Small
table (8); Speaker (x1)
v)
Financial Resources
Department of Nutrition and Dietetics will subsidy RM300 for us to run the
intervention program Due to budget constraint, we also seek for sponsorship from the
other companies.
Organizational Chart and Role of Staffs
40
Advisor
Dr Chin YitSiew
Director / Public
Relation
Secretary
Noorshamimi Bt
Muhammad Rosli
Assessment/ Logistic
/Technical Executive
Choo Poh Yee
Treasurer/ Sponsorship
Siti Huzaifah Bt Mohamed
Intervention/ Education
activity Executive
Mohamad Syazwan Bin
Training/ Protocol
Executive
Food Executive
Nurul Huda Bt Abdullah
Figure 5: Organization chart of Team 1

Roles and Responsibilities of Key Staff Members
Table 7: Portfolio and responsibilities
41
Portfolio
Director/Public
Relation Executive
Secretary
Treasurer
Assessment/
Logistic /Technical
Executive
Task/Responsibilities
Plan and conduct the meeting
Monitor tasks of the team members and ensure each task is
accomplished according to timeline.

Coordinate and assign human resource to optimize
performance within timelines and budget guidelines

Responsible in strategies to promote the intervention
program.
Record issues, decision and discussion during the meeting
Deal with all letters and documentation matters
Estimate the budgets for the intervention program
Control the expenses for the program to prevent over
budget
Prepare a financial report
Look and deal for sponsorships
Plan need assessment
In charge in the preparation of material needed for the
program
Look for equipment and supplies needed during
intervention program (e.g. projector, partition board, long
Intervention/
tables)
Prepare the presentation slides, music and video for the
intervention program
Plan and coordinate the activities for the intervention
program
Manage personnel resources for each activity
Coordinate and assign human resource for the intervention
Education activity
Executive
Training/Protocol
program
Planning floor layout
Plan and develop education module
Plan and coordinate the training for trainee session before
Executive
Food Executive
the implementation day

Prepared standard operation procedure (SOP) throughout
the program.
Prepare food for intervention program
Deal with caterer
42
43
Table 8: Gantt chart

Week
Tasks
Set up committee and team building
Brainstorming on tasks for each executive
Determine the target group
Conduct critical review
Determine health issue
Development of SOP
Search and contact for potential targeted agencies.
Prepare and send permission letter to visit
Prepare memorandum of agreement (MoA)
Prepare simple proposal for targeted agency
Deal with targeted agency to conduct intervention program
Field visit
Conduct need assessment
Analyze data from need assessment
Application for sponsorship
Preparation of grant proposal
Plan marketing strategy
Presentation of Proposal
Preparation of Pre and Post Questionnaire
Send invitation letter to VIPs
Get approval from sponsorship companies
Application of education materials from MOH
Apply equipment and instruments needed
Development of teaching module and materials
Development of evaluation tools and protocol
Training the trainers
10 11 12 13 14
44
Preparation of teaching module and materials

Baseline data collection
Implementation of intervention program
Evaluation of program
Data entry and analysis
Development of program evaluation report
Presentation of program evaluation report
45
Table 9: Tentative program

Time
Activity
8.45am- 9.00am
9.00am-9.15am
9.15am- 9.25am
9.25am- 9.55am
Registration and Pre Test Evaluation

Heaven Time
Torchlight Exhibition: Brighter Your Heart
Health Screening and Broad Exhibition
9.555am-10.10am
10.10am-10.55am
10.55am- 11.15am
11.15am-11.35am
11.35am-11.50am
11.50am-12.00pm
Consultation and Goal Settings: Where are You?

1HEART Forum
Interactive Games: Choose My Plate
Interactive Games: Simple and Health Cooking Competition: Oishi
Recaps and Post Test Evaluation
Heaven Time
Plan of action
Our program will be conducted on 24th April 2015, from 8.45am to 12.00pm.
Every team member is assigned with different tasks and responsibilities to be fulfilled
which is shown as below:
Table 10: Plan of action
Activity
Registration and Pre
Test Evaluation
Task
Set up registration counter
Participants need to sign
consent form
Torch Light
Exhibition:
Brighten Your
Get ready for the light to

be turned-off
Resources
Papers
Pen
Tables
Table cloth
Tagging
Chair
Registration
form
Pre-test
questionnaire
Multimedia
(video)
Manila card
Marker pen
Torch light
Person In charge
Iffah
Shin Yeh
Huda
Shazwan
46
Heart
Assistant will be turning on
the torchlight and point
at the section of the

presentation
Battery
Cellophane tape
Presentation
slide
Moderator will slowly lead

from one section to
Opening ceremony
another section
Introduce organizer
committee
PA system
Microphone
Poh yee
Yeoh
Mimi
Shazwan
Iffah
Shin Yeh
Huda
Huda
Iffah
battery
Personal Assessment :
Health Screening
Testing 1, 2 , 3
Give record card to the
Chairs
Table
participants
Chairs
Measure height,
Pens
weight, BMI and body
Weighing scale,
fat
wall-mounted
Write the result on their
stadiometer ,
record card
BIA
Name list of
participants
Record card
(Paper with
health screening
result,
categories and
goals format
column)
Board Exhibition:
Exhibition set up
Puzzle Your Heart
Assist and explain

information to
Masking tape
Heart Puzzle
car
Poster
47
participants
Board
Ready with projector,
PA system
& Goal Setting
PA system and slide
LCD screen
(Health status):
presentation
Projector
Moderator will teach
Chairs
Slide
Personal Assessment
Consultation Where
are You?
participants how to
calculate BMI
Shazwan
Huda
Yeoh
Mimi
Shin Yeh
Iffah
Huda
Shin Yeh
BMI and blood
according WHO BMI
pressure)
Pens
their status
Ready with projector
PA system
and PA system.
LCD screen
Assistant get ready to
Projector
demonstrate simple
Microphone
Participants need to set
(indicator of
the participants
Poh yee
Mimi
presentation
Moderator will consult
classification
their goal according

Energizer: Follow
me
exercise to the
battery
participants
Knowledge
Teaching :1HEART
Forum
Ready with projector
PA system
and PA system.
LCD screen
Moderator and panel
Projector
need to ready with their
Microphone
script
Games: Choose My
Ready with food
pictures and plate

Moderator need to brief
Plate
battery
Speech
Chairs
Food Pictures
Plastic Plate
48
to the participants what

Games: Simple
should they do
Set up place for
cooking competition
All the ingredients
need to be prepare
Moderator need to brief
Healthy Cooking
Competition:
Oishi
to the participants what
Moderator will recaps

the overall section and
Mimi
Poh Yee
Huda
Tuna and
Sardine
Mayonnaise,
Margarine and
should they do
Recaps Sessions
Whole meal and
White bread
Seaweed
Black pepper
Carrot and
Tomato
Tupperware,
Spoon and Plate

PA system
Projector
Post-test
questionnaire
Program
feedback form
Pen
Shazwan
clarify the purpose of
having each activities.

Moderator will
conclude the purpose
Post-test Evaluation
of the games
Distribute questionnaire
and to participants
Collect back the

questionnaire after
participants completed
Mimi
Yeoh
it
Resource Planning
We will receive the maximum funding of RM500 from Department of Nutrition
and Dietetics to organize this health promotion program. However, we had also been
looking for additional funding or sponsorship collaboration with companies/industries
49
listed below which produce different types of product items, for examples food and
beverage industries and supplement companies to overcome the problem of limited
financial resources. We also requested the Key Opinion Leaders to sponsor us on the
printing materials as well as the meals for the participants.
Sponsorship
Table 11: Company List for Sponsorship Application
No
Company
Items
.
1.
Inbisco Marketing & Sales Sdn.
10 packets of KOPIKO Brown
2.
Bhd.
Ee-Lian Enterprise (M) Sdn Bhd
12 packets MAYORA Wonder Wheat

200x Elianware multipurpose keeper
3.
GINVERA Marketing Enterprise Green Tea Body Milk/ Lavender Body Milk
4.
Sdn Bhd
POKKA CORPORATION LTD
Samples
200x Pokka Jasmine Green
5.
Abbott Laboratories (M) Sdn
Abbott Calcium Milky Chew
6.
Bhd
Worthy Book
Vouchers
7.
Khong Guan Enterprise
200 Assorted flavor Biscuits
8.
URC Snack Foods (M) Sdn.
Magic Twin (Assorted Flavor)
9.
Bhd.
The Lion Group
Cash RM500
10.
TC Boy Marketing Sdn. Bhd.
Ready-to-serve Tuna Products (assorted
11.
Kotra Pharma (M) Sdn. Bhd
flavor), Sardines Tomato Sauces, Red Salmon

Appeton essential Activ-C 500
12.
Blackmores Malaysia
200x Blackmores buffered C
13.
Spritzer Bhd
200x Spritzer Pop
14.
Contra Enterprise Sdn. Bhd
200x MARIGOLD UHT milk
50
15.
YLF Manufacturing Sdn. Bhd.
25 packets IKO Sugar Free Oatmeal Crackers
16.
Justlife Group Sdn Bhd
200x Organic Sunflower Oil
17.
Kee Wee Hup Kee Trading (M)
Le Moulin Organic Choc's Sesame Biscuits

25 packets EGO Oat Digestive Cracker
18.
Sdn Bhd
Fonterra Brands Malaysia Sdn.
200x Anlene (19-50 years old)
No. Bhd. FactoryItem

Operation Purpose
19. Hup Seng Perusahaan Makanan
Printing Materials
(M) Sdn Bhd
1
Program
Distribute to the
20. Hawley & Hazel Marketing
feedback forms participants for
(Malaysia) Sdn Bhd
page)
evaluation
21. (1
Lee
Biscuits (PTE.)
LTD. of
22.
Quantity
Price per
Total (RM)
unit
(RM)
200x KERK Naturel
Royal
Crackers
50
0.10
5.00 x
200x Darlie All Shiny White Charcoal Clean
copies
2
Toothpaste,
=10.00
12 packets LEE Nutri Multi-grain biscuits
program.
12 packets LEE Spirulina Filled Crackers
The Italian Baker Sdn
Bhd
200x Massimo Duetto 100% Whole Wheat
-intervention group
-control group Strawberry

Tatawa Industries
(M)
Sdn. Bhd.
Fruit0.10
& Wheat Oatmeal Crunch
223. Consent
form
Distribute
to the 100x Tatawa
50
5.00
+ 100xcopies
Tatawa Nut & Wheat Oatmeal Crunch
(1 page)
participants during
intervention day.
The budget for the materials or ingredients needed were calculated and distributed as
below.
Table 12: Estimated Budget
51
Information
Show to participants
sheets
during intervention
copies
(laminate)
day.
Printing
For game, awareness, 10 x 20
educational
assessment, distribute copies
material
material booklet.
1.50
1.50
0.10
20.00
0.10
10.00
0.60
21.00
0.10
3.40
0.60
12.00
(black)
(1 booklet = 10
5
Health Report
sheets)
For intervention
2 x 50
(2 page)
program
copies
Food image
For intervention
35
program
copies
1 paper = 6 picture
Marketing
34
Fliers
copies
8
Poster
Marketing
20
copies
Subtotal (RM)
Activity Materials
1
Manila card
Will be used for
10
0.80
8.00
exhibition and game

Decoration for
pieces
20 units
0.20
4.00
1 packet
7.80
7.80
Glue
game
Will be used for
2 bottles
0.60
1.20
Cello tape 18
exhibition and game

Will be used for
3 units
2.70
8.10
mm
Double sided
exhibition and game

Will be used for
5 units
1.00
5.00
tape 18mm
Permanent
exhibition and game

Will be used for
3 units
1.60
4.80
Marker pen
Thumb nail
exhibition and game

Will be used for
1 unit
2.00
2.00
Cup Board
exhibition
Will be used for
10 unit
2.50
25.00
Colour paper
82.90
exhibition and goal

3
A4 paper
setting
Will be used for
exhibition,
registration,
assessment, and
52
MARKETING PLAN
Situation Analysis
SWOT Analysis
A. Strength
1. Comprehensive planning of the program which involves raising their
awareness, giving knowledge related to healthy eating through forum,
changing their attitude and giving the platform for them to practice the skills.
2. Provide free service of health screening.
3. Provide goodies bag with various sponsorship items.
B. Weakness
1. First exposure to worksite health promotion and there is only short-term
relationship with the stakeholder.
C. Opportunity
1. TNB had given workshop or training for healthy lifestyle every year.
However, they did not have the opportunity to practice what they had learnt.
We able to provide the platform for them to practice the knowledge learnt
from the program.
2. They have the Biggest Loser competition every year. However, they did not
use the healthy way to lose weight. Hence, they might seek for healthier way
to lose weight through our program.
3. Large number of overweight/ obesity employees in TNB.
D. Threat
1. According to TNB, they will be going to organize the safety week during May
which may be overlapped with some of our activities. The employees might
choose either one and as a result of low turnout rate.
2. From their previous experience, the turnout rate for health promotion program
is very low.
Marketing Objective
During implementation day, at least 30 employees of Tenaga Nasional Berhad will
participate in our intervention program.
Marketing Strategies
53
Target Market
1. Primary target audience: TNB NLDC Building employees.
2. Secondary target audience: Human Resources Executive (Decision Makers)
Marketing Mix
1. Product: Reduce cardiovascular risk factors by promoting healthy eating and
active lifestyle.
2. Price: High quality of health promotion program with comprehensive intervention
plan.
3. Place: Carry out in the setting whereby the target group is located.
4. Promotion: Email and Whatsapp messages will be sent to the target market
through the person-in-charge in TNB. Besides, promotion will be carried out in
cafeteria featured with distribution of fliers and announcement.
Action Program
Week
7
Mid-term
Date
8 April
15 April
Implementation
Develop marketing plan
Poster Promotion through Email and WhatsApp
16 April
22 April
23 April
messages
Promotion of program I
Promotion of program II
Poster Promotion through Email and WhatsApp
24 April
messages
Program evaluation
break
8
Marketing Evaluation
1. Through evaluation form
2. Through interview the participants how they heard about the program.
54
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Shimotsu, S. T., French, S. A., Gerlach, A. F., & Hannan, P. J. (2007). Worksite
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(2009). A review of the cost of cardiovascular disease. The Canadian Journal of
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Yusuf, S., Reddy, S., unpuu, S., & Anand, S. (2001). Global burden of cardiovascular
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58
APPENDIXES
Floor plan:
1. Meeting Room
2. Foyer
59
Letters:
Rujukan kami: UPM/JPD/PKK3405/12
Tarikh: 15 April 2015
Pengarah
Bahagian Pendidikan Kesihatan
Kementerian Kesihatan Malaysia
Aras 1-3, Blok E10, Kompleks E
Pusat Pentadbiran Kerajaan Persekutuan
62590 Wilayah Persekutuan Putrajaya
Malaysia
Melalui dan salinan ,
Dr. Chin Yit Siew
Pensyarah Kanan/Penyelaras Kursus
PKK 3405 (Penggalakan Pemakanan dan Kesihatan II)
Jabatan Pemakanan dan Dietetik
Fakulti Perubatan dan Sains Kesihatan
Universiti Putra Malaysia
Tuan,
MEMOHON KEBENARAN UNTUK MENDAPATKAN BAHAN-BAHAN
PENGAJARAN/MAKLUMAT UNTUK MENJALANKAN PROGRAM
1HEART DALAM KALANGAN PEKERJA TENAGA NASIONAL BERHAD
Dengan segala hormatnya saya merujuk kepada perkara di atas, dimaklumkan bahawa
pelajar-pelajar yang disenaraikan dalam senarai di bawah ialah pelajar-pelajar Tahun 3,
program Bacelor Sains (Pemakanan dan Kesihatan Komuniti), dari Fakulti Perubatan dan
Sains Kesihatan, Universiti Putra Malaysia. Kami dikehendaki mengambil kursus PKK
3405 Penggalakan Pemakanan dan Kesihatan dan mengadakan satu program promosi
kesihatan yang bertema 1HEART di Tenaga Nasional Berhad untuk memenuhi syarat
kursus tersebut.
N
o
1.
2.
3.
4.
5.
6.
7.
Nama
Mohamad Syazwan Bin Hisham
Lim Shin Yeh
Siti Huzaifah Bt Mohamed Hussien
Noorshamimi Bt Muhammad Rosli
Choo Poh Yee
Yeoh Wei Ching
Nurul Huda Bt Abdullah Tauhid
No. Matrik
166739
167248
167873
169406
169570
169603
170150
60
Program promosi kesihatan ini bertujuan untuk memberi pendedahan tentang

kepentingan makan dengan sihat untuk mengurangkan risiko mendapat penyakit jantung
dalam kalangan pekerja. Kami bercadang untuk mengadakan program 1HEART ini di
Tenaga Nasional Berhad (Research), pada 24 April 2015 (Jumaat), dari pukul 8.30 pagi
hingga 12.30 tengah hari.
Bahan-bahan pengajaran atau maklumat-maklumat dalam bentuk brosur, poster, risalah,
buku, resipi, bahan bacaan dan bahan pengajaran yang berkenaan dengan program
1HEART ini amat diperlukan bagi menjayakan program 1HEART ini. Seandainya
pihak Tuan mempunyai sebarang pertanyaan, sila hubungi pengarah program
1HEART, saudara Yeoh Wei Ching di talian 0174400527. Segala pertimbangan dan
kerjasama yang diberikan oleh pihak Tuan saya dahului dengan ribuan terima kasih.
Sekian.
BERILMU BERBAKTI
Yang menjalankan tugas,
______________________
(YEOH WEI CHING)

Pengarah Program 1HEART,
Jabatan Pemakanan dan Dietetik,
Fakulti Perubatan dan Sains,
Universiti Putra Malaysia.
61
Rujukan kami: UPM/JPD/PKK3405/A/12

Tarikh: 7 April 2015
Ir. Gurcharan Singh
Pengurus Besar Kanan
System Operation Department
Transmission Division
Tenaga Nasional Berhad
No 129, Jalan Bangsar
59200 Kuala Lumpur
Melalui,
Dr. Chin Yit Siew
Pensyarah Kanan/Penyelaras Kursus
PKK 3405 (Penggalakan Pemakanan dan Kesihatan II)
Jabatan Pemakanan dan Dietetik
Fakulti Perubatan dan Sains Kesihatan
Tuan,
MEMOHON KEBENARAN UNTUK MENGADAKAN PROGRAM 1HEART
Dengan segala hormatnya saya merujuk kepada perkara di atas. Di sini, saya ingin
mewakili sekumpulan pelajar Tahun 3, program Bacelor Sains (Pemakanan dan
Kesihatan Komuniti), dari Fakulti Perubatan dan Sains Kesihatan, Universiti Putra
Malaysia, untuk memohon jasa baik Tuan untuk mempertimbangkan permohonan kami
bagi mengadakan satu program promosi kesihatan yang bertema 1HEART di Tenaga
Nasional Berhad.
Program ini bertujuan untuk memberi pendedahan tentang kepentingan makan dengan
sihat untuk mengurangkan risiko mendapat penyakit jantung.
Butiran-butiran bagi program 1HEART adalah seperti berikut:
Tarikh : 24 April 2015 (Jumaat)
Masa : 8.45 pagi hingga 12.00 tengahari
Tempat : Bangunan NLDC, Tenaga Nasional Berhad
Kami amat berharap agar pihak Tuan dapat mempertimbangkan dan meluluskan
permohonan kami untuk menjalankan program 1HEART di Tenaga Nasional Berhad.
Seandainya pihak Tuan mempunyai sebarang pertanyaan, sila hubungi pengarah program
1HEART, saudara Yeoh Wei Ching di talian 0174400527 atau emelkan kepada
Dominic_yeohwc@live.com.my. Segala pertimbangan dan kerjasama yang diberikan
oleh pihak Tuan saya dahului dengan ribuan terima kasih.
62
Sekian.
BERILMU BERBAKTI
Yang menjalankan tugas,
___________________________
(YEOH WEI CHING)
Pengarah Program Promosi Kesihatan II,
Kumpulan Satu,
Jabatan Pemakanan dan Dietetik,
Fakulti Perubatan dan Sains,
Universiti Putra Malaysia.
63
Rujukan kami : UPM/FPSK/JPD/PKK3405/A25

Tarikh
: 6 April 2015
Yeo Hiap Seng (Malaysia) Berhad
7, Jalan Tandang,
46050 Petaling Jaya,
SELANGOR DARUL EHSAN
Through and copy:
Dr. Chin Yit Siew,
Course Coordinator of Nutrition and Health Promotion II (PKK 3405)
Department of Nutrition and Dietetics,
Faculty Medicine & Health Sciences,
43400 UPM Serdang
SELANGOR DARUL EHSAN
Dear Sir/Madam,
APPLICATION: SPONSORSHIP FOR HEALTH PROMOTION PROGRAM
With regards to the matter above, we are a group of third year students from Bachelor of
Science (Nutrition and Community Health), who will be organizing a Health Promotion
Program.
For Sir/Madam, information, this program is one of the prerequisites for us to complete
the coursework PKK 3405 Nutrition & Health Promotion II. We are the representatives
from Team 1 for this course and we will be organizing a health promotion program for
the employees of Tenaga Nasional Berhad (TNB) Sdn. Bhd and TNB Research Sdn. Bhd.
The objective of the program is to improve the dietary pattern and physical activity level
among the employees. The details of the program are as follows:
Program
Target Group
Date
Venue
: Health Promotion Program among company employees

: 200 participants
: 23th & 24th April 2015
: TNB Sdn. Bhd. & TNB Research Sdn. Bhd.
With this, we would like to request product sponsorship from Yeo Hiap Seng (Malaysia)
Berhad. The details of sponsorship are as below:
Product name
170g Yeos Sardin
170 Yeos Seri Kaya
Amount
20 units
20 units
64
We sincerely hope to gain from your sponsorship and support as this would help us to
make a great success in our health promotion program. Thank you for your consideration.
If you have any question regarding to this application, you may contact our person in
charge for sponsorship, Mr. Yeoh Wei Ching with the contact number 017-4400527 or
email to dominic_yeohwc@live.com.my
We look forward to hearing from you soon.
Thank you.
Yours sincerely,
(YEOH WEI CHING)

Director of Team 1 Health Promotion Program,
Bachelor of Science (Nutrition and Community Health)
Faculty of Medicine and Health Sciences
65
Simple Proposal for Sponsorship:
PROPOSAL
Health Promotion Program among

Employees
DATE
23th April 2015 & 24th April 2015
VENUE
Tenaga Nasional Berhad Sdn. Bhd.
Tenaga Nasional Berhad Research Sdn. Bhd.
ORGANIZED BY
Third Year Students
Bachelor of Science (Nutrition and Community Health)
Faculty of Medicine and Health Sciences
INTRODUCTION
66
We are 3rd year students of Bachelor Science (Nutrition and Community Health) from
Nutrition and Dietetics Department, Faculty of Medicine and Health Sciences, Universiti
Putra Malaysia. Currently, we are going to organize a health promotion program among
the employees at Tenaga Berhad Nasional (TNB) Sdn. Bhd. and Tenaga Berhad Nasional
(TNB) Research Sdn. Bhd. to fulfill one of our course requirements in Nutrition and
Health Promotion subject. We believe that a strategic partnership with you at the health
promotion program will be mutually beneficial to both.
We would like to propose to you to come in as a sponsor for our health promotion
program. The purpose of this program is to reduce the risk of cardiovascular diseases
among the employees of both TNB by increasing their health awareness and promoting
healthy lifestyle. We think that you would be a great fit and the health promotion program
would be an outstanding opportunity to raise your brands awareness.
WHAT SPONSORSHIP OF THE HEALTH PROMOTION PROGRAM CAN DO

FOR YOU?
As a featured sponsor, you would be prominently featured in front of a crowd of a total

estimated 200 employees for both TNB Sdn. Bhd. and TNB Research, many of whom are
part of your target market. As you can see from the nature of the program, it is clearly
apparent how you will benefit from this relationship:
1. A platform to fulfill your companys corporate social responsibility.
2. A great chance to promote your products with a diverse target audience.
3. Enhance your companys corporate image in promoting a healthy living and bring
positive impact towards the society.
4. Provide an excellent return on investment by providing visibility and an
opportunity to demonstrate your organizations interest in promoting a healthy
living.
Tentative Program
Date
: 23 April 2015 and 24 April 2015

67
Venue
: TNB Sdn. Bhd. and TNB Research
Target participants : 200 employees of TNB Sdn. Bhd. and TNB Research
Table 1: Tentative Program

Activity
Duration
(hour)
Health Screening
2
Nutrition
Counseling
Exhibition
-1
Healthy Cooking
Demonstration
Games-oriented
activities
Description
BMI, body fat composition, blood glucose test,
total cholesterol test
Conducted by well-trained 3rd year students of
UPM Bachelor Science of Nutrition and
Community Health who equipped with relevant
knowledge and skills.
Focusing on healthy eating by using several
models such as Malaysian Food Pyramid
and MyPlate.
Focusing on strategies to cope with stress.
Focusing on physical fitness such as
exercise during sitting in front of desk.
Focusing on healthy cooking methods.
Hand-on activities conducted by the students in

order to give them opportunity to practice
healthy lifestyle in daily routine.
Provide knowledge and skill that promote
healthy lifestyle
Provide platform to carry out physical activity
Health Talk
Aerobic Dance
68
Participants Consent Form:
Consent Form
Program Title:
1Heart
A Health Promotion Program to Reduce theCardiovascular Disease Risk Factors by
Promoting Healthy Eating among Employees in Tenaga Nasional Berhad (TNB)
I (full name)
... hereby voluntarily agree to take
part in the program stated above.
I have been informed about the nature of the program in terms of methodology, possible
adverse effects and complications (refer to Information Sheet). I understand that I have
the right to withdraw from this program at any time without assigning any reason
whatsoever. I also understand that this study is confidential and all information provided
with regards to my identity will keep private and confidential.
Signature ..
(Participant)
Date :..
69
Participants Information Sheet:

INFORMATION SHEET
Please read the following information carefully, do not hesitate to discuss any questions
you may have with us.
Introduction
We are 3rd year students of Bachelor Science (Nutrition and Community Health) from
Nutrition and Dietetics Department, Faculty of Medicine and Health Sciences, Universiti
Putra Malaysia. Currently, we are planning to conduct a health promotion program to
reduce the cardiovascular disease (CVD) risk factors by promoting healthy eating among
employees in Tenaga Nasional Berhad (TNB). Based on World Health Organization,
CVD is the number one cause of death globally. However, some of the risk factors which
cause CVD are modifiable. One of them is unhealthy eating. Therefore, our program
entitled 1Heart will provide essential information of healthy eating for the employees
in TNB. Prior to the health promotion program, a questionnaire will be given to the
participants to collect the information related to unhealthy eating for our further program
planning.
What will you have to do?
Read the instruction carefully and answer each question in the questionnaire honestly.
There is no absolute right or wrong concerning on the questions.
Who should not included the program?
Employees who are not working in NLDC building will be excluded in this program.
What will be the benefits of the study?
The participants will be gaining knowledge to improve awareness, knowledge, attitudes
and practices regarding healthy eating habits to reduce CVD risk factors. In addition,
each participant will receive some goodies after completing the program and answer both
pre and post questionnaires.
Is there any risk?
No risk.
Is there any possible drawback?
No possible drawback.
Will the information and my identity remain confidential?
Yes. All the information and participants identity will be kept private and confidential
and used for this academic purpose only.
Who should I contact if I have additional questions on the program?
If you have further inquiries, please do not hesitate to contact Yeoh Wei Ching at 017-440
0527.
70
Pre-test Questionnaire (English version):
Knowledge and Attitude Questionnaire

The purpose of this questionnaire is to identify the knowledge and attitude of employees
on the nutrition related to heart diseases. This questionnaire will ask about questions any
risk
relation with heart diseases, lifestyle and medical history. For your information, your
participation in this questionnaire is voluntary and all of the information collected will be
kept as confidential.
PART A: Please fill in the following personal information.
1. Age:_______ years
2. Gender:
Male
Female
3. Ethnicity:
Malay
Chinese
Indian
Others, please specify: _______________
4. Marital status:
Single
Married
5. Nationality:
Malaysian
Non- Malaysian
6. Education background:
SPM
STPM/Matriculation
College/University
7. Monthly income:
< RM 2,000
RM 2,000-3,999
RM 4,000-5,999
RM 6,000-7,999
RM 8,000-9,799
RM 9,800-19,999
RM 20,000-25,999
RM 26,000
8. Job position: ____________________________________

9. Department: ____________________________________
71
10. Length of service:______ years _______ months

11. Working hour: ________ hours per day
12. Mode of transport to workplace:
Own Car
Motorcycle
LRT
_______________
Fetched by spouse using car

Fetched by spouse using motorcycle
Others, please specify:
13. Distance from home to workplace: ______________ km

PART B: Please choose the correct answer for each of the following question.
1. Which of the following is/are related to cardiovascualr diseases? Pleasse tick (/) on
your choice(s). Your answer can be more than one.
Blood pressure
Low intake of fruits and vegetable
Blood cholesterol
High intake of high fat foods
Blood sugar
Low intake of milk and milk products
Cancer
Smoking
Overweight/obesity
Physical activity
2. According to World Health Organization (2000), the normal range of body mass
index (BMI) for adult is _______.
A. <18.5 kg/m2
C. 18.5 - 24.9 kg/m2
2
B. 25 - 29.9 kg/m
D. > 30 kg/m2
3. Which of the following are the foods contain high saturated fat?
I. Fast foods
IV. Coconut milk
II. Butter
V. Vegetable oils
III. Nuts
A. I and II
C. I, II and IV
B. I, II and III
D. I, II and V
4. Saturated fat is more healthy than unsaturated fat.
The statement above is true or false?
A. True
B. False
5. Consuming high sugar content food and drink will not contribute to high calorie
intake.
A. True
B. False
72
6. Which of the following correctly describe the serving size of the following food
groups?
Food groups
I.
Rice, noodle, bread, cereals and tubers
II. Vegetables
III. Fruits
IV. Milk and milk products
V. Fish, poultry, meat and legumes
A. I, II and III only

B. II, III and IV only
Serving size
8-12 servings
3 servings
2 servings
1-3 servings
-2 servings: poultry, meat and egg
1 serving: fish
-1 serving: legumes
C. I, II, III and V only

D. All of the above
7. Which of the following is/are the food source(s) for the dietary fiber?
I.
Vegetables
II.
Fruits
III.
Wholegrain products
A. I and II
B. I and III
C. II and III
D. All of the above
8. Which type of the following dietary pattern can help reduce risk of heart diseases?
A. Low intake of high fat food
B. High intake of vegetables
C. High intake of and fruits
D. All of the above.
9. Maintain healthy weight can indirectly reduce the risk of heart diseases.
B. True
B. False
PART C: Please choose the answer that best describe you for each of the following
question.
Statements
Strongl
y Agree
Agree
Neither
agree
nor
disagree
Disagre
e
Strongly
Disagree
73
1. I will reduce eating high fat foods

such as fried chicken/fish, currypuff
and dishes that cooked with coconut
milk.
2. I will reduce eating sweet foods such
as kuih-muih or sweetened beverages
such as carbonated drink, syrup and
milk tea.
3. I will not request to reduce sugar or
condensed milk when ordering my
drink.
4. I will choose only my favourite foods
in a meal regardless to the variety and
amount of the meal.
5. I will include fruits and vegetables in
my daily diet.
6. I am able to choose healthy balanced
diet.
7. I cannot practice healthy balanced
diet at my workplace setting.
8. I will eat at least 2 servings of fruits
daily.
9. I will eat at least 3 servings of
vegetables daily.
PART D: Please answer all of the following questions by choosing only one (1)
answer.
74
1. In the past one (1) week, how many day(s) in last week you have taken the following
food?
Food
a) High fat food (e.g. fried chicken/fish,
curry puff, dishes that cooked with
coconut milk)
b) Food high in sugar (e.g. kuih-muih,
pudding, desserts)
c) Food high in salt (e.g. junk food, sausage,
soy sause)
d) Milk and milk products (e.g. cheese,
yogurt)
e) Vegetables
f) Fruits
g) Sweet drink (e.g. carbonated drink, syrup,
milk tea)
How many day(s) in last week you

have taken the food?
0
0
0
1
1
2
2
3
3
4
4
5
5
6
6
7
7
PART E: The following questions ask about the time you spend doing different types
of physical activity in last 7 days. Please think about the activities and time you
spend at work (as part of your household chores and yard work), to travel, and for
recreation, exercise or sport.
1. In last week, on how many days do you do vigorous-intensity activities (e.g. carrying
heavy loads, running, football, aerobic dancing) for at least 10 minutes continuously?
________ days per week
2. On a typical day, how much time do you spend doing vigorous-intensity activities?
________ hours _______ minutes
3. In last week, on how many days do you do moderate-intensity activities (e.g. general
house chores, cycling, swimming) for at least 10 minutes continuously?
4. On a typical day, how much time do you spend doing moderate-intensity activities?
5. In a typical week, on how many days do you walk for at least 10 minutes
continuously to get to and from places?
6. On a typical day, how much time do you spend in walking?
75
7. On a typical day, how much time do you spend sitting or lying down (during
working, reading, watching television)?
PART F: Please answer the following questions.
1. Do you smoke?
Yes
I have quit smoking (Proceed to PART E)
No (Proceed to PART E)
2. How long have you been smoking?
__________ years OR _________ months
3. How many days in a week do you smoke?
__________ days per week
4. How many stick of cigarette do you smoke in a days?
__________ sticks per day
PART G: Please fill in your most recent weight and height.
1. When is your last measurement for the height and weight?
__________________________ (e.g. 3 weeks ago/2 months ago)
2. Height: ________ kg
3. Weight: ________ cm
PART H: Answer all of the following questions by choosing the statement(s) that
is/are related to you. You may choose more than one answer.
1. Do you have any of the following health problem(s) currently?
Heart disease
High blood cholesterol
Stroke
High blood pressure
Diabetes
High blood glucose
None (Proceed to PART G)
2. Among the medical condition(s) that you have chosen, which of it/them have
received with the medical treatment?
Heart disease
High blood cholesterol
Stroke
High blood pressure
76
Diabetes
Does not get any treatment
High blood glucose
PART I: Please answer the following question.

1. How frequent do you have your meals in the cafeteria at your worksite?
2. Do you have any comment/suggestion(s) for the food available in the cafeteria (e.g.
taste, number of food choice, cooking methods, hygiene)? What is/are your
suggestion(s)?
Food is too oily, I hope the food can be less oily
Food is too salty, I hope the food can be less salt
Food is too sweet, I hope the food can be less sweet
Most of the food are fried food, I hope the food can be cooked with healthier
cooking methods
Lack of choice for vegetables
Lack of choice for fruits
Food are uncovered and exposed
Others, please state at space provided below:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
3. Do you satisfy with the food or food choice available in the cafeteria?
Yes
No
4. What is/are the nutrition topic(s) related to heart diseases that you concerned. Your
comment(s) and suggestion(s) is/are important for us to improve our coming program
that organized at your workplace.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
END OF THE QUESTIONNAIRE
Pre-test Questionnaire (Bahasa Melayu version):
THANK YOU FOR YOUR PARTICIPATION AND COOPERATION
Soal Selidik
77
Tujuan soal selidik ini adalah untuk mengenalpastikan tahap pengetahuan dan sikap
pekerja terhadap pemakanan yang berkaitan dengan penyakit jantung. Soal selidik ini
akan bertanya tentang maklumat sosiodemografi, pengetahuan dan sikap anda terhadap
pemakanan, gaya hidup anda, dan sejarah perubatan anda. Untuk makluman anda,
penyertaan anda adalah secara sukarela dan segala maklum balas anda adalah sulit.
BAHAGIAN A: Sila jawab semua maklumat peribadi berikut.
1. Umur:_______ tahun
2. Jantina:
Lelaki
Perempuan
3. Bangsa:
Melayu
Cina
India
Lain-lain, sila nyatakan: _______________
4. Status perkahwinan:
Bujang
Berkahwin
5. Kewarganegara:
Warganegara
Bukan warganegara
6. Latar belakang pendidikan:

SPM
STPM/Matrikulasi
Kolej/Universiti
7. Pendapatan bulanan:
< RM 2,000
RM 2,000-3,999
RM 4,000-5,999
RM 6,000-7,999
RM 8,000-9,799
RM 9,800-19,999
RM 20,000-25,999
RM 26,000
8. Jawatan: _________________________________________________
9. Jabatan: _________________________________________________
10. Tempoh berkhidmat di tempat kerja ini: ______ tahun _______ bulan
11. Masa berkerja: ________ jam sehari
12. Jenis pengangkutan ke tempat kerja:
Kereta sendiri
Motosikal
Suami/isteri hantar - kereta

Suami/isteri hantar - motosikal
78
LRT
_______________
Lain-lain, sila nyatakan:
13. Jarak dari rumah ke tempat kerja: ______________ km

BAHAGIAN B: Sila pilih jawapan yang betul bagi setiap soalan berikut.
1. Antara berikut yang manakah berkaitan dengan penyakit jantung? Sila tandakan (/)
pada pilihan anda. Jawapan anda boleh lebih daripada satu pilihan.
Tekanan darah
Kekurangan pengambilan sayur dan buah
Kolesterol darah
Gula darah
Kanser
Berat badan berlebihan/Obesiti
Pengambilan makanan yang berlemak

Kekurangan pengambilan produk tenusu
Merokok
Aktiviti fizikal
2. Berdasarkan kepada World Health Organization (2000), julat normal indeks jisim
badan (BMI) untuk orang dewasa adalah___________.
A. <18.5 kg/m2
C. 18.5 - 24.9 kg/m2
2
B. 25 - 29.9 kg/m
D. > 30 kg/m2
3. Yang manakah antara berikut adalah makanan yang mengandungi lemak tepu yang
tinggi?
IV. Makanan segera
IV. Santan
V. Mentega
V. Minyak Sayuran
VI. Kekacang
C. I and II
C. I, II and IV
D. I, II and III
D. I, II and V
4. Lemak tepu lebih sihat daripada lemak tak tepu.
Pernyataan di atas itu adalah benar atau salah?
A. Benar
B.Salah
5. "Pengambilan makanan dan minuman yang tinggi kandungan gula tidak akan
menyumbang kepada kalori yang tinggi."
Pernyataan di atas adalah benar atau salah?
A. Benar
B.Salah
6. Antara berikut yang manakah menghuraikan saiz sajian kumpulan makanan berikut
dengan betul?
I.
II.
Kumpulan makanan
Nasi, mi, roti, bijirin, produkbijirin,
danubi-ubian
Sayur-sayuran
Saiz sajian
8-12 sajian
3 sajian
79
III. Buah-buahan
IV. Susudanproduktenusu
V. Ikan, ayam, daging, telurdanlegume
C. I, II and III only
D. II, III and IV only
2 sajian
1-3 sajian
-2 sajian: ayam, dagingdantelur
1 sajian: ikan
-1 sajian: legum
C. I, II, III and V only
D. Semua yang di atas
7. Antara berikut yang manakah merupakan sumber serat?

IV.
Sayur-sayuran
V.
Buah-buahan
VI.
Produk bijirin penuh
E. I and II
F. I and III
G. II and III
H. Semua yang di atas
8. Apakah jenis corak pemakanan berikut yang dapat mengurangkan risiko penyakit
jantung?
A. Kurang pengambilan makanan yang tinggi lemak
B. Pengambilan sayur-sayuran yang banyak
C. Pengambilan buah-buahan yang banyak
D. Semua yang di atas
9. Mengekalkan berat badan yang sihat secara tidak langsung dapat mengurangkan
risiko penyakit jantung.
Pernyataan di atas adalah benar atau salah?
A. Benar
B.Salah
BAHAGIAN C: Sila jawab semua soalan berikut dengan memilih satu (1) pilihan
yang paling sesuai dengan keadaan anda.
Pernyataan
1. Saya akan kurangkan makan

makanan yang tinggi lemak seperti
ayam goreng/ ikan goreng, karipap
Sangat
setuju
Setuju
Tidak
Pasti
Tidak
setuju
Sangat
Tidak
Setuju
5
80
2.
3.
4.
5.
6.
7.
8.
9.
dan makanan yang masak dengan

santan.
Saya akan kurangkan makan
makanan manis seperti kuih-muih
atau minuman manis seperti
minuman berkabonat, air syrup, teh
susu .
Saya tidak akan minta untuk
kurangkan gula atau susu pekat manis
ketika memesan minuman.
Saya akan hanya memilih makanan
kegemaran saya tanpa mengambil
kira jumlah dan jenis makanan yang
disediakan.
Saya akan tambah buah-buahan dan
sayur-sayuran dalam hidangan
makanan harian saya.
Saya mampu memilih hidangan
makanan yang seimbang dan sihat.
Saya tidak boleh mengamalkan
pemakanan yang seimbang dan sihat
di tempat kerja saya.
Saya akan makan sekurangkurangnya 2 sajian buah-buahan
setiap hari.
Saya akan makan sekurangkurangnya 3 sajian sayur-sayuran
setiap hari.
BAHAGIAN D: Sila jawab semua soalan berikut dengan memilih satu pilihan
sahaja.
81
1. Pada satu (1) minggu yang lepas, berapa hari dalam seminggu anda telah mengambil
makanan/minuman berikut?
Makanan
h) Makanan tinggi lemak (contoh: ayam
goreng/ ikan goreng, karipap dan
makanan yang masak dengan santan)
i) Makanan tinggi gula (contoh: kuih manis,
puding, pencuci mulut)
j) Makanan tinggi garam (contoh: makanan
ringan, sosej, kicap)
k) Susu dan produk tenusu (contoh: keju,
yogurt)
l) Sayur-sayuran
m) Buah-buahan
n) Minuman manis (contoh: minuman
berkabonat, air syrup, teh susu)
Berapakah hari dalam seminggu anda

telah ambil makanan berikut?
0
0
0
1
1
2
2
3
3
4
4
5
5
6
6
7
7
BAHAGIAN E :Soalan-soalan berikut bertanya tentang masa yang anda gunakan

untuk melakukan pelbagai jenis aktiviti fizikal dalam 7 hari yang lepas. Sila imbas
kembali aktiviti dan masa yang dihabiskan untuk kerja (di tempat kerja, rumah
dan kawasan halaman), bergerak dari tempat ke tempat, serta aktiviti rekreasi,
senaman dan sukan.
1. Pada satu (1) minggu yang lepas, berapa hari anda melakukan aktiviti lasak (contoh:
angkat barang yang berat, berlari, bermain bola sepak, senam aerobik) yang
dijalankan selama sekurang-kurangnya 10 minit secara berterusan?
_________ hari seminggu
2. Berapa lamakah anda melakukan aktiviti lasak tersebut dalam sehari?
________ jam _______ minit
3. Pada satu (1) minggu yang lepas, berapa hari anda melakukan aktiviti sederhana
(contoh: kerja-kerja rumah, berbasikal, berenang) yang dijalankan selama sekurangkurangnya 10 minit secara berterusan?
________ hari seminggu
4. Berapakah lama anda melakukan aktiviti sederhana tersebut dalam sehari?
________ jam _______ minit
5. Pada satu (1) minggu yang lepas, berapa hari anda berjalan sekurang-kurangnya 10
minit berterusan dari tempat ke tempat?
82
6. Berapa lamakah anda berjalan kaki dalam sehari?

________ jam _______ minit
7. Berapa lamakah anda duduk atau berbaring (contoh semasa bekerja, membaca,
menonton televisyen) dalam sehari?
________ jam _______ minit
BAHAGIAN F: Sila jawab soalan berikut.
1. Adakah anda merokok?
Ya
Ya, tetapi saya telah berjaya berhenti merokok (Sila susur ke BAHAGIAN E)
Tidak (Sila susur ke BAHAGIAN E)
2. Jika anda merokok, sudah berapa lamakah anda merokok?
__________ tahun ATAU __________ bulan
3. Jika anda merokok, berapa harikah anda merokok dalam seminggu?
__________ hari seminggu
4. Jika anda pernah merokok (sekarang atau masa lalu), berapakah putung rokok yang
anda hisap dalam sehari?
__________ putung sehari
BAHAGIAN G: Sila isi bacaan berat badan dan ketinggian anda yang terkini.
1.
Bilakah kali terakhir anda mengambil bacaan ketinggian dan berat badan anda?
________________________ (Contoh: 3 minggu yang lepas/ 2 bulan yang lepas)
2. Ketinggian: ________ cm
3. Berat badan: ________ kg
BAHAGIAN H: Sila jawap semua soalan berikut dengan memilih pernyataan yang
berkaitan dengan anda. Anda boleh pilih lebih daripada satu pilihan.
1. Adakah anda mengalami masalah kesihatan berikut?
Penyakit jantung
Kolesterol darah tinggi
Strok
Tekanan darah tinggi
Kencing manis
Gula darah tinggi
Tiada masalah kesihatan (Sila susur ke BAHAGIAN G)
2. Antara masalah kesihatan yang anda pilih di Soalan 1, yang manakah telah anda
mendapat rawatan ubat-ubatan?
Penyakit jantung
Kolesterol darah tinggi
Strok
Tekanan darah tinggi
83
Kencing manis
Gula darah tinggi
Tidak mendapat sebarang rawatan
BAHAGIAN I: Sila jawab semua soalan berikut.
1. Berapakah kekerapan anda makan di kafeteria tempat kerja anda?
2. Apakah pandangan anda terhadap makanan di kafeteria tempat kerja anda (contoh:
rasa, pilihan makanan, cara memasak, kebersihan)? Apakah cadangan anda?
Makanan terlalu berminyak
Makanan terlalu masin
Makanan terlalu manis
Kebanyakan makanan adalah makanan bergoreng, saya harap boleh dapat
makanan yang dimasak dengan cara memasak yang lebih sihat
Kekurangan pilihan untuk sayur-sayuran
Kekurangan pilihan untuk buah-buahan
Makanan terdedah
Lain-lain, sila terangkan di ruang yang disediakan:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
3. Adakah anda berpuas hati dengan makanan di kafeteria tempat kerja anda?
Ya
Tidak
4. Apakah topik pemakanan yang anda titikberatkan yang berkaitan dengan penyakit
jantung. Komen dan cadangan anda adalah amat penting untuk kami merancang
program yang akan berlangsung di tempat kerja anda.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
TAMAT SOAL SELIDIK
RIBUAN TERIMA KASIH ATAS PENYERTAAN DAN KERJASAMA ANDA
84

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FACULTY OF MEDICINE AND HEALTH

Mohamad Syazwan b. Hisham

Lim Shin Yeh

Siti Huzaifah bt Mohamed Hussien

Noorshamimi bt Muhammad Rosli

Choo Poh Yee

Yeoh Wei Ching

Nurul Huda bt Abdullah Tauhid

A GRANT PROPOSAL FOR 1HEART:

Figure 1: Framework of PRECEDE-PROCEED Model

Sufficient physical activity

fruits and vegetables, high salt

saturated fats and trans-fatty acids

imbalance (low salary,

lack of social support,

lack of social approval,

understanding and high

social isolation, and

level of health literacy

After implementation of our intervention program, PROCEED portion of this

Figure 2: Prioritization matrix of risk factors of CVDs

GOAL AND OBJECTIVES

Impact Objectives (Behavioural objectives)

Figure 3: Health Belief Model

Table 3: Intervention plan

factors and consequences of CVDs will be

illustrated in info-graphic style on the

mahjong papers, and pasted on wall.

papers in the dark room and the facilitators

its risk factors and

To increase the awareness Health

Second Component: Personal Assessment

BMI and body fat

and recorded in their report card.

understanding on BMI and educate them to

percentage classifications and ask the

participants to determine their body weight

goals for each health status.

such as Pegawai Sains Pemakanan (PSP),

with knowledge and

moderator, and clients in an imaginary

skill of adopting healthy

related to healthy lifestyle that mean to

improve cardiovascular health.

are also free to ask their own questions

regarding to the topic.

to prepare a sandwich/bread sushi roll and a

sandwich/bread sushi roll.

practice the skill of

Different types of foods (meat & fish,

vegetables, fruits, and cereals) with different

cooking methods will be displayed.

according to the food group concept in My

practice skill and

knowledge learnt from

healthy eating changes

such as reduce high fat

foods intake and

increase fruits and

program as compulsory for at least once a

year to ensure the sustainability of the

maintain the healthy

lower in fat and high

MODULES AND EDUCATION DEVELOPMENT PROCESS