Original Research
Health Promotion
Perception Towards Health Promotion Activities: Findings From a Community Survey in the State of Penang, Malaysia
Last reviewed: March 2026
Key Findings
- Out of 480 respondents, a response rate of 82.7% was achieved from the district of Jelutong, Penang.
- 43.3% of respondents had never attended a health promotional campaign, citing lack of time and transport as primary barriers.
- The study cohort was dominated by females (63.0%) and was predominantly Malay ethnicity (88.1%).
- Among those who attended health promotion activities, approximately one-third reported satisfaction with the benefits.
Background and Rationale
Health promotion constitutes a cornerstone of public health practice, aiming to enable individuals and communities to increase control over the determinants of their health. In Malaysia, the health promotion landscape has undergone significant transformation since the country’s independence, with the Ministry of Health progressively integrating health education and promotion activities into primary healthcare delivery systems. Despite these efforts, community engagement with health promotion programmes has remained variable across different states and demographic groups.
Penang, one of the most densely populated states in Malaysia with a total population of approximately 1.56 million at the time of this study, presents a unique setting for examining public perceptions of health promotion. As a largely urbanised state with diverse ethnic composition, Penang offers insights into how sociodemographic factors shape attitudes towards preventive health measures. The district of Jelutong, located on Penang Island, served as the study site, offering a representative cross-section of the local population.
Non-communicable diseases (NCDs) have become the leading cause of morbidity and mortality in Malaysia, with diabetes mellitus, hypercholesterolaemia, and hypertension among the most prevalent conditions. Malaysia’s National Health and Morbidity Surveys have consistently demonstrated rising NCD prevalence, making community-level health promotion programmes an essential strategy for disease prevention. However, the effectiveness of these programmes depends significantly on how they are perceived by the target population and the extent to which barriers to participation are addressed.
Study Design and Methods
This study was designed as a questionnaire-based, cross-sectional analysis conducted among the general public in the Jelutong district of Penang. The researchers employed a convenience sampling method to recruit 480 participants. Descriptive statistics were used to characterise the demographic profile of respondents, while inferential statistics measured associations between study variables. The questionnaire assessed knowledge of, attitudes towards, and perceptions about health promotion activities, including barriers to participation and satisfaction levels among those who had attended such programmes.
Ethical approval was obtained from the appropriate institutional review board at Universiti Sains Malaysia. Data collection was carried out through structured face-to-face interviews, ensuring that respondents who had difficulty reading or understanding the questionnaire were not excluded from participation. The statistical analysis was performed using SPSS software, with a significance level of p < 0.05 adopted for all inferential tests.
Principal Findings
The study achieved a response rate of 82.7%, resulting in a final sample of 397 usable questionnaires. The demographic profile of participants reflected the broader Penang population to some degree, though with certain notable characteristics. Females comprised 63.0% of the sample, and the majority of participants (88.1%) were of Malay ethnicity. This ethnic distribution was higher than the overall Penang population distribution, likely reflecting the demographic composition of the Jelutong district specifically.
Attendance at Health Promotion Activities
A substantial proportion of respondents—172 individuals, representing 43.3% of the sample—reported that they had never attended any form of health promotional campaign. This finding is particularly significant given Malaysia’s substantial investment in community health programmes. The primary barriers identified by non-attendees were lack of time and insufficient transport to reach programme venues. These practical obstacles suggest that the scheduling and accessibility of health promotion activities may not align with the daily routines and resource constraints of the population they aim to serve.
| Variable | Frequency | Percentage (%) |
|---|---|---|
| Never attended health promotion campaign | 172 | 43.3 |
| Attended at least one campaign | 225 | 56.7 |
| Female respondents | 250 | 63.0 |
| Malay ethnicity | 350 | 88.1 |
| Satisfied with campaign benefits (among attendees) | ~75 | ~33.3 |
Satisfaction Among Campaign Attendees
Among those who had participated in health promotion activities, roughly one-third expressed satisfaction with the benefits they derived from these campaigns. This relatively modest satisfaction rate indicates considerable room for improvement in how health promotion programmes are designed, delivered, and evaluated. The finding suggests that while people may attend these activities, the content, format, or follow-up may not adequately meet their expectations or address their specific health concerns.
Barriers to Participation
The identification of time constraints and transportation difficulties as the leading barriers to health promotion participation carries important policy implications. Working adults, who form a large segment of the population at highest risk for NCDs, may find it particularly challenging to attend programmes scheduled during conventional working hours. Similarly, individuals living in areas with limited public transportation or those without personal vehicles face additional obstacles in accessing health promotion venues.
These barriers are consistent with findings from other studies in the Southeast Asian context. Research on health promotion among community pharmacists in Penang conducted around the same period similarly identified practical and logistical challenges as significant constraints on the delivery of health promotion services. The Malaysia Ministry of Health’s Komuniti Sihat Pembina Negara (KOSPEN) programme, launched in 2013, later attempted to address some of these barriers by bringing health promotion activities directly into community settings.
Implications for Public Health Policy
The findings of this study have several important implications for the design and delivery of health promotion programmes in Malaysia. First, the high proportion of non-attendees suggests a need for more innovative and accessible delivery modalities. Mobile health promotion units, workplace-based programmes, and digital health education platforms could potentially reach populations that traditional community-based campaigns fail to engage.
Second, the relatively low satisfaction rate among attendees points to a need for more participatory approaches to programme design. Health promotion activities that incorporate community input in their planning stages, address locally relevant health concerns, and provide tangible, practical health information are more likely to generate sustained engagement. The World Health Organisation’s Ottawa Charter for Health Promotion emphasises the importance of enabling and mediating, rather than simply educating, which requires programmes to be responsive to community priorities.
Third, the demographic patterns in the study highlight the importance of culturally tailored health promotion strategies. The predominance of Malay respondents and females in the sample raises questions about whether current programmes are equally accessible and appealing to all ethnic groups and both genders in Malaysia’s multicultural society.
Significance in the Context of Malaysian Public Health
This study, published in 2012, provided a timely baseline assessment of community perceptions of health promotion in Penang. Malaysia was at that point experiencing rapid epidemiological transition, with NCDs overtaking infectious diseases as the primary health burden. The National Health and Morbidity Survey data from subsequent years confirmed that roughly half of Malaysian adults were estimated to be overweight or obese, with sedentary lifestyles and changing dietary preferences identified as major contributing factors.
The research underscored the gap between the availability of health promotion programmes and actual community engagement. This gap has continued to be a focus of Malaysian public health research, with studies examining barriers to healthy behaviours among various population subgroups, including older adults, indigenous communities, and urban low-income populations. The KOSPEN programme and other community-based interventions have since attempted to address many of the barriers identified in this and similar studies.
Limitations
Several limitations should be considered when interpreting these findings. The use of convenience sampling may have introduced selection bias, potentially overrepresenting certain demographic groups while underrepresenting others. The study’s focus on a single district within Penang limits the generalisability of findings to other parts of Malaysia, particularly rural areas where barriers to health promotion participation may differ substantially.
The cross-sectional design captures perceptions at a single point in time and cannot establish causal relationships between demographic factors and health promotion participation. Self-reported data on attendance and satisfaction may be subject to recall bias and social desirability effects. Additionally, the high proportion of Malay respondents relative to other ethnic groups means that the perceptions of Chinese, Indian, and other communities in Penang may be underrepresented.
Hassali MA, Saleem F, Shafie AA, Aljadhey H, Chua GN, Masood I, Goh CT. Perception towards health promotion activities: Findings from a community survey in the state of Penang, Malaysia. Malaysian Journal of Public Health Medicine. 2012;12(2):6–14.
License: Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)