Adults In Malaysia Research Articles

Relationship Between Minority Stress Towards Loneliness among LGBT Adults in Malaysia

Relationship Between Minority Stress Towards Loneliness among LGBT Adults in Malaysia

Comparison of eating behaviour by relative weight change status of young adults throughout the COVID-19 pandemic.

The enforcement of nationwide lockdowns has worsened the obesity epidemic in Malaysia. Therefore, this study aims to compare eating behaviour by relative weight change status among young adults in Malaysia throughout the COVID-19 pandemic. Socio-demographics, body height, pre-pandemic body weight, and post-lockdown body weight were self-reported by the young adults. The eating behaviour was assessed using the validated Three-Factor Eating Questionnaire-Revised 18-item (TFEQ-R18). The mean difference in eating behaviour subscales was analysed using MANCOVA with a Bonferroni-adjusted post-hoc test. One-third of the young adults put on body weight due to the lockdowns, with an average relative weight gain of 12.44 ± 9.67%. Conversely, about one-fifth of the young adults reported having lighter body weight in the post-lockdown pandemic phase, with an average relative weight loss of 10.10 ± 4.66%. Young adults in the weight loss category had a significantly higher standardised raw score in cognitive restraints than those in the sustained weight and weight gain categories. In addition, young adults in the weight gain category had statistically higher standardised raw scores in uncontrolled eating and emotional eating compared to those in the sustained weight category. Weight trajectory during the COVID-19 pandemic is linked to disordered eating behaviour among young adults in Malaysia. The findings presented in this study can be potentially valuable in formulating weight management strategies in the post-COVID-19 era.

Age and Sex Differences in LDL Cholesterol Distribution in Adults in Malaysia: A Cross-Sectional Study (2010-2021).

Age and Sex Differences in LDL Cholesterol Distribution in Adults in Malaysia: A Cross-Sectional Study (2010-2021).

Associations between a high ‘calcium, potassium and protein’ dietary pattern, osteopenia and osteoporosis in older adults in Malaysia

Associations between a high ‘calcium, potassium and protein’ dietary pattern, osteopenia and osteoporosis in older adults in Malaysia

The Experience of Overcoming School Bullying Among Young Adults in Malaysia

Past research has supported the notion that school bullying can have a negative and enduring impact, persisting into adulthood. Therefore, this study aims to explore the experiences of young adults in Malaysia who have successfully overcome school bullying. A basic interpretive qualitative research design was employed to understand the experiences of 12 young adults, aged between 19 and 28, who had gone through school bullying and overcome adversity. Through purposive sampling, selected participants were interviewed with the guidance of semi-structured questions. The collected data were analysed using Braun and Clarke's 6-step thematic analysis method. The analysis revealed seven themes: 'Turning point,' 'After-effect,' 'Catalyst,' 'Cognitive reappraisal,''Realization of control,' 'Adaptive coping,' and 'Letting Go and Moving On'. The study's key finding explains that immediate coping strategies during bullying may be maladaptive, emphasising the importance of effective post-bullying cognitive strategies. Furthermore, cognitive reappraisal emerges as critical, with suppressing emotions potentially leading to detrimental consequences. The significance of a catalyst role in addressing cognitive limitations in young adolescents was also discussed. Finally, emphasising the significance of letting go and moving on as adaptive forms of control. In summary, these findings contribute to the existing knowledge, offering a nuanced perspective on overcoming school bullying. The study's implications for mental health care providers and educational institutions were highlighted. Future recommendations and limitations were also addressed.

Explaining Halal Chocolate Purchase Intention Among Muslim Young Adults in Malaysia

Abstract: Chocolate, a timeless household staple, remains a popular guilty pleasure enjoyed by people of all cultures and ages, enduring both good and bad times, and remains a timeless and appealing choice. While everyone loves chocolate, Muslims are only allowed to consume Halal chocolate due to religious obligations. Halal chocolate is becoming increasingly popular as consumers develop a greater awareness of Halal foods and the benefits associated with them. Using the Theory of Planned Behaviour (TPB), this study examines the intention to purchase Halal chocolate among Muslim young adults in Malaysia. A total of 204 Muslims aged 18 to 34 participated in an online survey distributed through various social media platforms using Google Forms. Multiple regression analysis was performed to analyse the data. The results show that attitude, subjective norms, and perceived behavioural control significantly influence the intention to purchase Halal chocolate among Muslim young adults in Malaysia. Theoretically, this study adds to the limited existing literature on Muslim consumers' Halal chocolate purchasing intentions and the robustness of the TPB in explaining purchase intention. Practically, this study assists the Halal chocolate producers, manufacturers, importers, and exporters to engage with their Muslim consumers to promote the consumption of Halal chocolate in the country. Abstrak: Coklat, kudapan seisi rumah, kekal sebagai kudapan yang menyeronokkan tetapi tidak menyihatkan yang popular untuk dinikmati oleh semua lapisan masyarakat dari pelbagai budaya dan peringkat umur. Coklat kekal menjadi pilihan di saat gembira dan sedih. Walaupun coklat digemari oleh semua, tetapi orang Islam hanya dibenarkan mengambil coklat yang Halal disebabkan oleh kewajipan agama. Coklat Halal menjadi semakin popular apabila pengguna meningkatkan kesedaran tentang makanan Halal dan faedah yang berkaitan dengan makanan Halal. Dengan menggunakan Teori Tingkah Laku Terancang (TPB), kajian ini mengkaji hasrat untuk membeli coklat Halal dalam kalangan golongan muda Islam di Malaysia. Seramai 204 orang Islam berumur 18 hingga 34 tahun menyertai tinjauan dalam talian yang diedarkan menerusi pelbagai platform media sosial iaitu Borang Google. Analisis regresi berganda digunakan untuk menganalisis data. Hasil kajian menunjukkan bahawa sikap, norma subjektif, dan kawalan tingkah laku berpengaruh signifikan terhadap niat untuk membeli coklat Halal dalam kalangan golongan muda Islam di Malaysia. Secara teorinya, kajian ini menambah kepada literatur sedia ada yang terhad mengenai niat membeli coklat Halal di kalangan pengguna Muslim dan keteguhan teori TPB dalam menjelaskan niat pembelian. Secara praktikal, kajian ini membantu pengeluar, pengilang, pengimport, dan pengeksport coklat Halal untuk lebih memahami pengguna Muslim dalam mempromosikan pengambilan coklat Halal di negara ini.

CONSUMER PREFERENCE ANALYSIS OF ORGANIC FOOD IN TERENGGANU

The organic food industry is expanding in Malaysia, as demand has risen as consumers become more knowledgeable about the advantages of eating organic food. However, the organic product in Malaysia is still limited in production, as most of the organic products are imported from other countries. This research is to study the factors that influence the consumer preference in buying the organic food in Terengganu. Therefore, this study aims to examine the effect of attitude, subjective norms, and health consciousness towards consumer intention to buy organic food. The study employed the Statistical Package for the Social Sciences (SPSS) and SmartPLS 4.0: PLS-SEM to assess the 397 respondents gathered through an online questionnaire. The analysis revealed causal relationships among the proposed variables, highlighting the quantitative research focus of this study. This study revealed that three independent variables which are subjective norm were not physically affect the customer’s intention to purchase organic food, meanwhile attitude and health consciousness are significant influences towards customer’s intention to purchase. The study is expected to increase knowledge about organic food for future studies in the field of organic food to provide them with a better understanding of consumers' preferences in purchasing organic food. Besides, the findings are beneficial to improve consumer’s quality of life as well as to influence policymakers to execute effective programs to achieve a healthy lifestyle among adults in Malaysia by consuming organic food.

Navigating Love in a Post-Pandemic World: Understanding Young Adults' Views on Short- and Long-Term Romantic Relationships.

The uncertain future due to the COVID-19 pandemic and the technological advancements may have altered young adults' experiences of romantic relationships. It is unclear whether individuals will continue to prefer traditional long-term romantic relationships (LTRR) or opt for short-term ones (STRR). This research describes how young adults in Malaysia perceive LTRR and STRR. Using the structured approach of the theory of social representations, data were collected from 512 participants; 238 (46.48%) male; Mage 21.75; majority were heterosexual and students, and analyzed using prototypical analysis to reveal high consensus elements. Five observations were made: (1) females prioritize "love" in both STRR and LTRR, while males prioritize "love" only in LTRR; (2) females prioritize "marriage" in LTRR, while males prioritize "trust," "comfort," and "stability." Males do not consider "marriage" as part of a LTRR; (3) both males and females view STRR positively, while LTRR are viewed more practically; (4) "sex" is a core element in STRR but is absent in LTRR; (5) males differentiate between STRR and LTRR with no overlapping elements. These findings provide insight into the social representations of romantic relationships among young adults in Malaysia and suggest future directions for research in the field.

Estimating the economic burden of influenza on the older population in Malaysia

Background Influenza is a contagious respiratory illness that can cause life-threatening complications among high-risk groups. Estimating the economic burden of influenza is essential to guide policy‐making on influenza vaccination programmes, especially in resource‐limited settings. This study aimed to estimate the economic burden of influenza on older adults (those aged ≥60 years) in Malaysia from the provider’s perspective. Methods The main data source in this study was the MY-DRG Casemix database of a teaching hospital in Malaysia. Cases with principal and secondary diagnoses coded in the International Classification of Diseases version 10 (ICD-10) as J09, J10.0, J10.1, J10.8, J11.0, J11.1, J11.8, J12.8, and J12.9, which represent influenza and its complications, were included in the study. The direct cost of influenza at all severity levels was calculated from the casemix data and guided by a clinical pathway developed by experts. The effect of the variations in costs and incidence rate of influenza for both the casemix and clinical pathway costing approaches was assessed with sensitivity analysis. Results A total of 1,599 inpatient and 407 outpatient influenza cases were identified from the MY-DRG Casemix database. Most hospitalised cases were aged <18 years (90.6%), while 77 cases (4.8%) involved older people. Mild, moderate, and severe cases comprised 56.5%, 35.1%, and 8.4% of cases, respectively. The estimated average annual direct costs for managing mild, moderate, and severe influenza were RM2,435 (USD579), RM6,504 (USD1,549), and RM13,282 (USD3,163), respectively. The estimated total annual economic burden of influenza on older adults in Malaysia was RM3.28 billion (USD782 million), which was equivalent to 10.7% of the Ministry of Health Malaysia budget for 2020. The sensitivity analysis indicated that the influenza incidence rate and cost of managing severe influenza were the most important factors influencing the total economic burden. Conclusions Overall, our results demonstrated that influenza imposes a substantial economic burden on the older Malaysian population. The high cost of influenza suggested that further efforts are required to implement a preventive programme, such as immunisation for older people, to reduce the disease and economic burdens.

Factor Structure Validation and Measurement Invariance Testing of the Five C’s Model of Positive Youth Development among Emerging Adults in Malaysia

While validation of positive youth development (PYD) measures has increased considerably of late, validation of the Five C’s of PYD among emerging adults in non-WEIRD countries remains limited. The main objective of this study was to examine the factor structure, measurement invariance, and criterion-related validity of the Five C’s model of PYD through the use of the Positive Youth Development Inventory (PYDI). Data were collected from 436 university students in Malaysia, with a mean age of 21.19 ( SD = 1.19). The findings supported a modified bifactor model of the PYDI, which demonstrated strong measurement invariance across gender and race, but not across age categories. Connection showed the strongest latent factor correlations with the other four C’s. Criterion-related validity was supported through its association with psychological hardiness. The findings demonstrate adequate psychometric properties and cultural applicability of a modified bifactor model of the Five C’s model of PYD among emerging adults in Malaysia.

Impact of Coronavirus Disease 2019 Lockdown on Back Pain Intensity, Prevalence and Associated Risk Factor Among Adults in Malaysia

Introduction: Low back pain (LBP) is a common musculoskeletal disorder (MSD) that leads to a variety of negative consequences. The prevalence of LBP was found to be high worldwide. Individuals have been forced to remote studying or working conditions during the coronavirus disease 2019 (COVID-19) pandemic, exposing them to the risk factors of LBP to a greater extent. This is a cross-sectional study conducted among 623 adults and aimed to assess LBP intensity and prevalence among adults in Malaysia before and during the COVID-19 lockdown and to identify the association between demographic, physical and psychological factors with LBP. Methods: A self-administered questionnaire composed of 36 questions regarding demographic characteristics, physical activities and psychological aspects was distributed to the public. Pearson’s Chi-square and Fisher Exact tests were performed using collected data to assess the association between LBP intensity and various risk factors. Results: The prevalence of LBP increased from 64.4% before the lockdown to 83.5% during the lockdown. LBP intensity significantly increased during the lockdown. Before lockdown, factors associated with LBP intensity included gender and stress level. While during the lockdown, age, gender, occupation, time spent on computer use, ergonomics as well as stress level affected the intensity of LBP. Conclusion: The present study showed that the COVID-19 lockdown has contributed to the increase in both the prevalence and intensity of LBP among Malaysians. The identified risk factors include age, gender, occupation, duration of sitting and computer use, adherence to ergonomic recommendations, and stress level.

Disease burden, antimicrobial resistance and molecular characterization of invasive group B Streptococcus among non-pregnant adults in Malaysia: A protocol study

Objective: To determine the prevalence of group B Streptococcus (GBS) isolated from non-pregnant adults from seven major hospitals in Peninsular Malaysia; the incidence, case-fatality ratio, antimicrobial susceptibility patterns, serotype, genotype and distribution of the GBS virulence and pili genes are also investigated. Methods: This multicentre, prospective, observational study is conducted in seven major tertiary hospitals in Malaysia among non-pregnant adults. Simultaneously, a retrospective study is conducted in the selected hospitals with similar approaches. GBS isolates are subjected to phenotyping, serotyping by multiplex PCR, antimicrobial susceptibility testing and PCR-detection of GBS virulence and pilus genes. Seven housekeeping genes are amplified and sequenced for multi-locus sequence typing. Discussion: Findings from the study may contribute to the management of clinical practice to diagnose and prevent GBS related diseases in a timely manner. Prudent use of antibiotics is encouraged by monitoring antimicrobial resistance.

Development and validation of a knowledge, attitude, and practice (KAP) questionnaire for skin cancer in the general public: KAP-SC-Q

BackgroundSkin cancer has emerged as a significant worldwide public health issue, with the global reporting of approximately 1.4 million cases of non-melanoma skin cancer and 287,723 cases of melanoma in 2020. Early detection and prevention are pivotal in battling this disease. However, there is an absence of standardized tools designed to comprehensively gauge these elements. ObjectiveThe study aimed to formulate and examine the validity and reliability of the Knowledge, Attitude, and Practice of Skin Cancer Questionnaire (KAP-SC-Q). MethodsThe research was conducted in two phases. Phase I included the generation and construction of items, content validity, and pilot testing. In Phase II, the questionnaire was distributed to 370 non-health background public adults in Malaysia. The validity and reliability of the questionnaire were ascertained using Item Response Theory (IRT) for the knowledge domain, exploratory factor analysis (EFA) for the attitude and practice segments, and Cronbach's alpha. ResultsThe definitive version of the KAP-SC-Q had 108 items, divided into 17 social demographic, 30 knowledge, 32 attitude, and 29 practice items. Knowledge items had an acceptable range of 0.4–2.0 in the IRT. The EFA revealed that attitude and practice sections contributed to 34.25% and 52.94% of the total observed variance, respectively. The Cronbach's α coefficient was 0.85, signifying good internal consistency. ConclusionThe study validated that KAP-SC-Q exhibits commendable psychometric attributes, marking it as a trustworthy instrument to assess the public's knowledge, attitude, and practices concerning skin cancer.

Effectiveness of a Theory-Based Digital Animated Video Intervention to Reduce Intention and Willingness to Sext Among Diploma Students: Cluster Randomized Controlled Trial.

Sexting refers to the exchange of sexually explicit digital content in the form of texts, photos, or videos. In recent years, sexting has become a public health concern. Surveys in Malaysia show a high prevalence of young adults engaged in sexting. Given that sexting is associated with sexual risk behavior, cyberbullying, and mental health issues, this behavior needs intervention to alleviate the resulting public health burden. However, there is a scarcity of theory-based intervention programs on the prevention of intention and willingness to sext among young adults. This study aimed to develop and implement a sexting intervention module guided by the prototype willingness model (PWM), delivered using web-based animated video, and evaluate its effectiveness among diploma students from a public higher educational institution. The primary outcomes were intention and willingness to sext, while the secondary outcomes were knowledge, attitude, perceived norms, and prototype perceptions of sexting. This 2-armed, parallel, single-blinded cluster randomized controlled trial was conducted in a public higher educational institution in the state of Melaka, Malaysia. Diploma students from 12 programs were randomly allocated into intervention and control groups. Both groups answered a self-administered web-based questionnaire assessing the outcomes at the baseline. The intervention group received a newly developed intervention module based on the PWM in the form of 5 animated videos posted on a private YouTube platform, while the control group was put on the waitlist. The intervention group was encouraged to discuss any issues raised with the researchers via WhatsApp private chat after viewing the videos. All participants were observed immediately and 3 months postintervention. Data analysis was performed with SPSS (version 26; IBM Corp). A generalized linear mixed model was used to determine the effectiveness of the intervention. There were a total of 300 participants with an attrition rate of 8.3% (n=25). After adjusting for age, sex, relationship status, and the amount of time spent on the web, there were significant differences in the intention to sext (β=-.12; P=.002; Cohen d=0.23), willingness to sext (β=-.16; P<.001; Cohen d=0.40), knowledge (β=.12; P<.001; Cohen d=0.39), attitude (β=-.11; P=.001; Cohen d=0.31), perceived norms (β=-.06; P=.04; Cohen d=0.18), and prototype perceptions (β=-.11; P<.001; Cohen d=0.35) between the intervention and control groups over 3 months. In this study, the sexting intervention module using the PWM that was delivered via web-based animated videos was effective in reducing intention and willingness to sext as well as in improving knowledge of sexting, attitudes, perceived norms, and prototype perceptions. Therefore, relevant agencies involved in the promotion of sexual and reproductive health among young adults in Malaysia can consider the implementation of this module. Thai Clinical Trial Registry TCTR20201010002; https://www.thaiclinicaltrials.org/show/TCTR20201002001.

Social determinants of food choice motives among young adults in Malaysia during the transition to the endemic phase of COVID-19

Changes in socioeconomic status due to the pandemic-led economic crisis could profoundly impact an individual’s food choice motives. Therefore, this study aims to evaluate the food choice motives of young adults residing in Malaysia during the transition to the endemic phase of COVID-19 and to investigate the differences in food choice motives by referring to their socio-demographic characteristics. This cross-sectional web-based study recruited 630 young adults aged 15-30 through a combination of convenience and snowball sampling approaches. They were required to self-report their socio-demographic information, while the food choice motives were assessed using a validated 36-item Food Choice Questionnaire (FCQ). Emerging findings demonstrated that sensory appeal, price, and mood were the top three rated food choice motives by young adults residing in Malaysia during the transition to the endemic phase of COVID-19. Gender, age, marital status, monthly earned income, and educational attainment were the predominant determinants of food choice motives among young adults. Government and non-governmental organisations should collaborate on intervention programs that educate the younger generation on healthy eating and help them make informed food choices.

Association between frequency of processed and ultraprocessed food consumption with lifestyle habits score for cancer prevention among adults in Malaysia

Introduction: Cancer is the second leading cause of mortality globally. Processed and ultra-processed foods are reported to be high in energy, sugar, and unhealthy fats, while low in fibre, vitamins and minerals, that can increase the risk of cancer. Methods: A cross-sectional study involving adults aged 18-59 years was conducted in Peninsular Malaysia (n=122). Sociodemographic data were obtained through a questionnaire and lifestyle habits score for cancer prevention was assessed using MyGenomSihat©. The food frequency questionnaire used had four groups (i.e., unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods) containing 53 food items to evaluate the frequency of food consumption. All data obtained were self-reported by the participants. Results: Mean age was 27.6±8.1 years with a majority (76.2%) having household income of less than &lt;RM4,850. The results from MyGenomSihat© demonstrated that majority (53.3%) of subjects had average scores between 41-85, which is considered to be satisfactory lifestyle habits. Most Malaysian adults ate ultra-processed foods (32.9%) compared to processed foods (4.9%). However, there were no significant correlations between consumption of both processed and ultraprocessed food groups and lifestyle habits score for cancer prevention (r=-0.072, p=0.089 and r=-0.008, p=0.992, respectively). Conclusion: Most subjects had satisfactory lifestyle habits scores for cancer prevention. Interventions are needed to improve lifestyle habits among the targeted population for cancer prevention.

Oral healthcare seeking behavior of Malaysian adults in urban and rural areas: findings from the National Health and Morbidity Survey 2019

BackgroundThe development and implementation of appropriate strategies to enhance oral health in the community can be aided by an understanding of oral healthcare seeking behavior among urban and rural populations. The purpose of this study was to identify the factors associated with oral healthcare seeking behavior of the Malaysians in urban and rural locations who self-reported dental problems.MethodsThe National Health and Morbidity Survey 2019, a cross-sectional nationwide household survey that focused on non-institutionalised Malaysians, provided the data for this study on adults in Malaysia who were 18 years of age and older. A two-stage stratified random sampling technique was employed to ensure national representativeness. Data was collected using a multilingual (Malay and English), structured, and validated questionnaire via face-to-face interviews from July to October 2019. The dependent variable was oral healthcare seeking behavior (sought oral healthcare and self-medication). Independent variables were predisposing, enabling and health needs factor based on Andersen’s Behavioral Model. Descriptive statistics were used to describe the characteristics and oral healthcare seeking behavior of the respondents. The relationship between the independent and dependent variables were investigated using multivariable logistic regression analysis.ResultsThe analysis comprised a total of 10,134 respondents, representing about 18.2 million Malaysian adults aged 18 and above. The overall prevalence of Malaysian adults who self-reported dental problems was low (5.5%) and was slightly higher in the rural than urban population. Almost half sought treatment from healthcare practitioners, and almost a quarter self-medicated. Ethnicity was associated with seeking healthcare and self-medication among urban dwellers. Among the rural population, income level was associated with seeking healthcare while education level was associated with self-medication.ConclusionDisparities in oral healthcare seeking behaviors exist between Malaysians living in urban and rural areas. Future policies should adopt focused strategies that concentrate on oral healthcare accessibility and health literacy of the vulnerable and rural populations to achieve the best oral healthcare for this population group.

Impact of deprescribing intervention on potentially inappropriate medications and clinical outcomes among hospitalized older adults in Malaysia: a randomized controlled trial (REVMED RCT) protocol

BackgroundPolypharmacy and the use of potentially inappropriate medications (PIMs) are prevalent among older patients admitted to hospitals, posing a heightened risk of adverse drug events. This trial aims to evaluate the effectiveness of a pharmacist-led deprescribing intervention in reducing medications, PIM and improving clinical outcomes, using the locally developed Malaysian Potentially Inappropriate Prescribing Screening tool in Older Adults (MALPIP).MethodsThis is an 18-month cluster-randomized, open-label, parallel-arm controlled trial conducted at 14 public hospitals in the Perak state of Malaysia. Patients aged 60 and above, who have at least one medication and one comorbidity are eligible. A stratified-cluster randomization design is employed, with 7 hospitals assigned to the control arm and 7 hospitals assigned to the intervention arm. The MALPIP screening tool will be used in the intervention group to review the medications. If PIM is detected, the pharmacists will discuss with doctors and decide whether to stop or reduce the dose. The primary outcomes of this trial are the total number of medications and number of PIM. The secondary outcomes include fall, emergency department visits, readmissions, quality of life and mortality. Outcomes will be measured during enrolment, discharge, 6, 12, and 18 months.DiscussionThis REVMED trial aims to test the hypothesis that a pharmacist-led deprescribing intervention initiated in the hospital will reduce the total number of medications and PIM 18 months after hospital discharge, reducing fall, emergency department visits, readmissions, mortality and lead to improvement in quality of life. Trial findings will quantify the clinical outcomes associated with reducing medications and PIM for hospitalized older adults with polypharmacy.Trial registration number: This trial was prospectively registered at clinicaltrials.gov (NCT05875623) on the 25th of May 2023. NCT05875623 Clinicaltrials.gov URL: NCT05875623 registered on 25th July 2023.

KNOWLEDGE, ATTITUDE AND PRACTICE ON COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) ASSOCIATED WITH COVID-19

People are more likely to seek information on Complementary and Alternative Medicine (CAM) for self-treatment to reduce COVID-19 symptoms or for prevention. The present study aims to assess the Knowledge, Attitude, and Practices (KAP) of CAM- associated with COVID-19 among adults in Malaysia. A cross-sectional study was carried out on 503 respondents using an online questionnaire. The data was analysed using SPSS version 20 and descriptive statistics were applied. A Chi-squared test was used to determine the association between KAP status and socio-demographic factors. The findings indicated that the majority of respondents had moderate knowledge score (60%) and practice (55.9%), but a high attitude (80%) towards CAM related to COVID-19. There is a significant association between age, ethnicity, employment status and knowledge level on CAM (p &lt; 0.05) and also between educational level and attitude level on CAM associated with COVID-19 (p &lt; 0.05). Furthermore, there is a significant association between practice level and age, race, educational level, and employment status on CAM associated with COVID-19. The present findings indicated that 73.4% of the respondents used CAM in the past 6 months to reduce or prevent symptoms of COVID-19, with most of them (51.3%) taking more than two types. In conclusion, adults in Malaysia have moderate knowledge and practice, but a high attitude towards CAM associated with COVID-19. We also postulate that respondents are more open to evidence regarding the CAM associated with COVID-19 and ready to adopt the modalities as part of integrated medicine.

Fluency trumps working memory capacity in the truth effect

ABSTRACT The truth effect, wherein repeated information gains perceived truthfulness, has been extensively studied in participants’ primary languages, showing robustness. However, individual differences in the truth effect due to working memory capacity (WMC) remain less explored. This study tested the truth effect and its relation to WMC amongst 130 young adults in Malaysia via Zoom. They were first exposed to 45 semantically meaningless statements (exposure phase). Then, participants completed a series of working memory tasks, including Backward Digit Span, Operation Span and Symmetry Span, before being exposed to the same 45 statements and 15 new statements. In the second exposure (rating phase), participants rated each statement on a 6-point Likert scale on its fluency and truth value. Results indicated fluency's significant association with the truth effect, consistent with prior research, while WMC showed no significant relationship. The truth effect persisted even when presented in a non-native language, highlighting its cross-linguistic significance.