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Clustering of lifestyle risk factors and Understanding its association with Stress on health and wellbeing among school Teachers in Malaysia (CLUSTer)

CLUSTer is a longitudinal study among teachers in Malaysia, exploring the clustering of lifestyle risk factors (smoking, overweight/obesity, alcohol use, physical inactivity, and unhealthy diet) with stress; and to follow up on the study population for important health outcomes (hypertension, diabetes mellitus, cardiovascular diseases, cancers, etc).

It was conducted in six states in the Peninsular Malaysia, namely Penang, Kuala Lumpur, Selangor, Melaka, Terengganu and Johor.

Figure 1: Map of Peninsular Malaysia

The baseline study was conducted from 2013 to 2015, where the teachers underwent questionnaire survey and health screening.  Blood samples were taken and stored in Biobank. Follow up study was planned to be conducted to establish health outcomes that happen over time.

This study will enlighten us on the interaction between environment, stress, and clustering of lifestyle risk factors on health and wellbeing, and give us insight into the importance and direction of future preventative actions.

Approval for the study was granted by the Malaysian Ministry of Education, participating state Ministry of Education, principals of participating schools, and the Universiti Malaya.  Ethics clearance was also obtained from the Medical Ethics Committee of the Universiti Malaya Medical Centre (Reference No. 950.1).  All teachers provided written informed consent before data collection. The baseline study was supported by the Ministry of Education High Impact Research Grant (MOE HIR No. E2000069-20001)


Baseline study participation:

A total of 534 public schools participated in the baseline study. The participants were made up of a total of 14,227 teachers with 19% males and 81% females, with 76.2% Malays, 16.2% Chinese and 6.9% Indians, and 0.7% others.

Some of the baseline findings are published and can be accessed here

Follow-up study

The follow-up study will commence in July 2022 where we shall start with Selangor and Kuala Lumpur.  The follow-up of other states will start once we complete these two states.  We shall be contacting the school principals for permission to approach the teachers who participated in the baseline study.

The survey will be online and the participants will be provided with the online survey link.  Upon completion of the survey, participants will be provided with an e-certificate as a token of appreciation. If there is any abnormality based on the questionnaire survey, the participants will be informed and a referral to the health clinic may be provided if necessary.

Confidentiality of data

All survey data and medical results are kept strictly confidential. We will never release individual information about any participant to anyone for any reason.