{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:06:46Z","timestamp":1782846406957,"version":"3.54.5"},"reference-count":52,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"\n Background<\/jats:title>\n Overweight and obesity are major risk factors for numerous chronic diseases, requiring effective prevention and intervention strategies. Community-based BMI screening may enhance awareness of weight status, but its effectiveness remains uncertain.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to rigorously evaluate the long-term causal effects of community-based BMI screening with a light-touch intervention in Malaysia using a regression discontinuity design (RDD).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Using data from 2 waves (2013 and 2018) of a Malaysian population-based cohort study (N=6561), we applied a sharp RDD to estimate the causal effects of community-based BMI screening on health outcomes for individuals near the BMI threshold. Participants were aged 35 years or older and completed both follow-ups. The exposure was BMI screening with a light-touch intervention, including height and weight measurement, feedback on results, and referral card distribution. Main outcomes were BMI, blood pressure, and random blood glucose 5 years post intervention, along with health behaviors, health care use, and mental health status.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n BMI screening and intervention showed no significant impact on BMI after 5 years (0.4 kg\/m\u00b2, 95% CI \u20130.2 to 0.9, P=.16). Results remained robust after adjusting for covariates (eg, 0.4 kg\/m\u00b2, 95% CI \u20130.1 to 0.9 with age and sex; 0.5 kg\/m\u00b2, 95% CI \u20130.1 to 1.0 with demographic covariates) and modifying functional forms (0.4 kg\/m\u00b2, 95% CI \u20130.2 to 1.1 with quadratic specification). Robustness was also confirmed across different bandwidths, placebo tests, \u201cdonut\u201d RDD, and when treating age as either a continuous or categorical variable. Interaction analysis revealed almost no substantial heterogeneity effects. Mechanism analysis and secondary outcomes indicated no significant effects on health behaviors (including smoking, physical activity, diet, and sedentary behavior), health care use (screening, diagnosis, and medication treatment of hypertension and diabetes), mental health outcomes (anxiety, depression, and stress levels), or cardiovascular risk factors (systolic blood pressure, diastolic blood pressure, random blood glucose; eg, systolic blood pressure showed a nonsignificant change of 0.2, 95% CI \u20133.5 to 4.0 mm Hg). These findings should be interpreted cautiously, as this study was sufficiently powered to detect larger, clinically meaningful changes but may have lacked power to identify more modest effects.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study is the first to assess the causal effects of population-based BMI screening on long-term health outcomes in a Southeast Asian population. The findings suggest that merely informing individuals of their overweight or obese status and implementing light-touch interventions are insufficient to significantly reduce BMI or drive sustained behavior change. Nonetheless, the results do not exclude the possibility of short-term effects, and more frequent or sustained light-touch interventions may still be effective. Future studies should design more intensive interventions and include larger sample sizes.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/80381","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T19:20:07Z","timestamp":1765999207000},"page":"e80381","source":"Crossref","is-referenced-by-count":0,"title":["Community-Based BMI Screening for Overweight and Obesity in Adults Aged 35 Years and Older in Malaysia: Regression Discontinuity Analysis"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8506-2701","authenticated-orcid":false,"given":"Wenjin","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0872-6523","authenticated-orcid":false,"given":"Zhoutao","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2988-5781","authenticated-orcid":false,"given":"Shiyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0698-7964","authenticated-orcid":false,"given":"Mohd Roshidi","family":"Ismail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8878-5505","authenticated-orcid":false,"given":"Pascal","family":"Geldsetzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4182-4212","authenticated-orcid":false,"given":"Till","family":"B\u00e4rnighausen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7857-5435","authenticated-orcid":false,"given":"Chen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0555-2157","authenticated-orcid":false,"given":"Simiao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0387-6406","authenticated-orcid":false,"given":"Tin Tin","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2008.01922.x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.16.1523"},{"key":"ref3","unstructured":"World Obesity Atlas 202420242025-10-16https:\/\/www.worldobesity.org\/news\/world-obesity-atlas-2024"},{"key":"ref4","unstructured":"RifinHSuiWRatnamKLourdesTKuayLRiyadziMNational health and morbidity survey20232025-10-16https:\/\/iku.nih.gov.my\/images\/nhms2023\/key-findings-nhms-2023.pdf"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2018.05.004"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2013.01.002"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12634"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5868-8-20"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2008.22"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5868-3-40"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016008538.x"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0802293"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1037\/\/1524-9220.2.2.108"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn412"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20361"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1177\/003335491312800617"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1177\/1359105315580223"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1002\/hec.3829"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2023.107520"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1089\/chi.2021.0245"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.4768"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-015-0323-6"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyx113"},{"key":"ref24","unstructured":"Outpatient charges 2024Malaysia MoH20242024-12-11https:\/\/www.moh.gov.my\/index.php\/pages\/view\/160?mid=291"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2014.06.021"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000138"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-072254"},{"key":"ref28","year":"2024","journal-title":"Clinical Practice Guidelines on Management of Obesity"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeconom.2007.05.001"},{"key":"ref30","author":"Cattaneo, MD","year":"2020","journal-title":"A Practical Introduction to Regression Discontinuity Designs: Foundations"},{"key":"ref31","first-page":"16","author":"Matias, D","year":"2016","journal-title":"Handbook of Matching and Weighting Adjustments for Causal Inference"},{"key":"ref32","unstructured":"World Health OrganizationWHO guidelines on physical activity and sedentary behaviourWorld Health Organization20202025-10-17https:\/\/www.who.int\/publications\/i\/item\/9789240015128"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1080\/07350015.2017.1366909"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1401400413"},{"key":"ref35","author":"Lovibond, SH","year":"1995","journal-title":"Manual for the Depression Anxiety Stress Scales"},{"issue":"2","key":"ref36","first-page":"82","volume":"8","author":"Musa, R","year":"2007","journal-title":"ASEAN Journal of Psychiatry"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4064"},{"key":"ref39","first-page":"835","author":"Cattaneo, M","year":"2020","journal-title":"The SAGE Handbook of Research Methods in Political Science and International Relations"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg074"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-21"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4619-z"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.22"},{"key":"ref44","unstructured":"FitchAEverlingLFoxCGoldbergJHeimCJohnsonKPrevention and management of obesity for adultsBloomington: Institute for Clinical Systems Improvement20132025-10-16https:\/\/www.healthpartners.com\/ucm\/groups\/public\/@hp\/@public\/documents\/documents\/cntrb_037112.pdf"},{"key":"ref45","unstructured":"QuekDThe Malaysian healthcare system: a reviewIntensive workshop on health systems in transition20092025-10-16https:\/\/www.academia.edu\/48122928\/The_Malaysian_Health_Care_System_A_Review"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0145074"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afv151"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0803762"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2013.03.019"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437739.71477.ee"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.4249"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2024.100906"}],"container-title":["JMIR Public Health and Surveillance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publichealth.jmir.org\/2025\/1\/e80381","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:13:51Z","timestamp":1782843231000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealth.jmir.org\/2025\/1\/e80381"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,17]]},"references-count":52,"URL":"https:\/\/doi.org\/10.2196\/80381","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.80381","asserted-by":"object"}]},"ISSN":["2369-2960"],"issn-type":[{"value":"2369-2960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,17]]}}}