Goh G.,National University of Singapore |
Tan N.C.,National University of Singapore |
Malhotra R.,National University of Singapore |
Malhotra R.,Duke Global Health Institute |
And 5 more authors.
Journal of Medical Internet Research | Year: 2015
Background: Self-management plays an important role in maintaining good control of diabetes mellitus, and mobile phone interventions have been shown to improve such self-management. The Health Promotion Board of Singapore has created a caloric-monitoring mobile health app, the "interactive Diet and Activity Tracker" (iDAT). Objective: The objective was to identify and describe short-term (8-week) trajectories of use of the iDAT app among patients with type 2 diabetes mellitus in a primary care setting in Singapore, and identify patient characteristics associated with each trajectory. Methods: A total of 84 patients with type 2 diabetes mellitus from a public primary care clinic in Singapore who had not previously used the iDAT app were enrolled. The app was demonstrated and patients' weekly use of the app was monitored over 8 weeks. Weekly use was defined as any record in terms of food entry or exercise workout entry in that week. Information on demographics, diet and exercise motivation, diabetes self-efficacy (Diabetes Empowerment Scale-Short Form), and clinical variables (body mass index, blood pressure, and glycosylated hemoglobin/HbA1c) were collected at baseline. iDAT app use trajectories were delineated using latent-class growth modeling (LCGM). Association of patient characteristics with the trajectories was ascertained using logistic regression analysis. Results: Three iDAT app use trajectories were observed: Minimal Users (66 out of 84 patients, 78.6%, with either no iDAT use at all or use only in the first 2 weeks), Intermittent-Waning Users (10 out of 84 patients, 11.9%, with occasional weekly use mainly in the first 4 weeks), and Consistent Users (8 out of 84 patients, 9.5%, with weekly use throughout all or most of the 8 weeks). The adjusted odds ratio of being a Consistent User, relative to a Minimal User, was significantly higher for females (OR 19.55, 95% CI 1.78-215.42) and for those with higher exercise motivation scores at baseline (OR 4.89, 95% CI 1.80-13.28). The adjusted odds ratio of being an Intermittent-Waning User relative to a Minimal User was also significantly higher for those with higher exercise motivation scores at baseline (OR 1.82, 95% CI 1.00-3.32). Conclusions: This study provides insight into the nature and extent of usage of a caloric-monitoring app among patients with type 2 diabetes and managed in primary care. The application of LCGM provides a useful framework for evaluating future app use in other patient populations. ©Glenn Goh, Ngiap Chuan Tan, Rahul Malhotra, Uma Padmanabhan, Sylvaine Barbier, John Carson Allen Jr, Truls Østbye.
Bakshi A.B.,Health Promotion Board |
Wee S.-L.,Agency for Integrated Care |
Tay C.,Agency for Integrated Care |
Wong L.-M.,Agency for Integrated Care |
And 3 more authors.
BMC Health Services Research | Year: 2012
Background: The 15-item Care Transition Measure (CTM-15) is a measure for assessing the quality of care during transition from the patients perspective. The purpose of this study was to test the psychometric properties of the CTM-15 and CTM-3 (a 3-item version of the CTM-15) in Singapore, a multi-ethnic urban state in South-east Asia. Methods. A consecutive sample of patients was recruited from two tertiary hospitals. The subjects or their proxies were interviewed 3weeks after discharge from hospital to home in English or Chinese using the CTM-15 questionnaire. Information about patients visit to emergency department (ED), non-elective rehospitalisation for the condition of index hospitalisation, and care experience after discharge was also collected from respondents. Psychometric properties of CTM-15 and CTM-3 based on the five-point response scale (i.e. strongly disagree, disagree, neutral, agree, and strongly agree) and the three-point response scale (i.e. [strongly] agree, neutral, and [strongly] disagree) were tested for English and Chinese versions separately. Internal consistency reliability was assessed using Cronbachs alpha and construct validity was tested with T-test or Pearsons correlation by examining hypothesised association of CTM scores with ED visit, rehospitalisation, and experience with care after discharge. Exploratory factor analysis was performed to examine latent dimensions of CTM-15. Results: A total of 414 (proxy: 96.1%) and 165 (proxy: 84.8%) subjects completed the interviews in English and Chinese, respectively. Cronbachs alpha values of the different CTM-15 versions ranged from 0.81 to 0.87. In contrast, Cronbachs alpha values of the CTM-3 ranged from 0.42 to 0.63. Both CTM-15 and CTM-3 were correlated with care experience after discharge regardless of survey language or response scale (Pearsons correlation coefficient: 0.36 to 0.46). Among the English-speaking respondents, the CTM-15 and CTM-3 scores based on both the three- and five-point response scales discriminated well between patients with and without ED visits or rehospitalisation for their index condition. Among Chinese-speaking respondents, no difference in CTM scores was observed between patients with and without ED visits or patients with and without rehospitalisation. The English and Chinese versions of the CTM-15 items demonstrated a similar 4-factor structure representing general care plan, medication, agreement on care plan, and specific care instructions. Conclusions: The care transition measure is a valid and reliable measure for quality of care transition in Singapore. Moreover, the care transition measure can be administered to proxies using a simpler response scale. The discriminatory power of the Chinese version of this instrument needs to be further tested in future studies. © 2012 Bakshi et al.; licensee BioMed Central Ltd.
Wong M.L.,National University of Singapore |
Koh T.T.,National University of Singapore |
Tjahjadi S.,National University of Singapore |
Govender M.,Health Promotion Board
Sexually Transmitted Infections | Year: 2014
Objective: To compare the prevalence of condom use and its associated factors within commercial and casual sex relationships between heterosexual men who seek sex online and those who frequent brothels in Singapore. Methods: A survey was conducted between 2011 and 2012 among Singaporean heterosexual men aged 21-70 years who reported engaging in sexual intercourse with commercial or casual partners in the past year. Men seeking sex online (n=304) were recruited from the two most frequented local internet sex forums. Men frequenting brothels (n=297, 97% response rate) were recruited from a stratified cluster random sample of licensed brothels. Results: Compared with men frequenting brothels, men seeking sex online reported significantly higher rates of oral and anal sex and sexually transmitted diseases but lower condom use for oral sex with commercial (16.5% vs 56.6%) and casual partners (21.2% vs 35.3%). In multivariate analyses, the online group showed that partner request for condom use was strongly associated with condom use for vaginal sex (adjusted ORs >3.0) but not with condom use for oral sex with both casual and commercial sex partners. The perceived risk of getting HIV from a partner was also associated with condom use for vaginal sex with commercial and casual partners; and for oral sex with casual partners. In contrast, condom use for oral and vaginal sex with both partners in the brothel group was only associated with partner request for condom use. Conclusions: Men seeking sex online should receive sexually transmitted infection (STI)/HIV prevention interventions that deal with the factors associated with condom use.
PubMed | Health Promotion Board, Singapore Health Services Singhealth, University of Adelaide, National University of Singapore and National Healthcare Group
Type: Journal Article | Journal: Community dentistry and oral epidemiology | Year: 2016
To compare lay peoples perceptions with regard to various levels of dental fluorosis and select dental defects versus normal dentition.Adults rated digitally created photographs made showing lips (without retraction) and teeth depicting the following conditions: no apparent aesthetic defects (normal, Thylstrup- Fejerskov score 0 - TF0), 6 levels of fluorosis (TF1-6), carious lesions (two cavitated and one noncavitated), malocclusions (Class II, Class III, anterior open bite and greater spacing), extrinsic staining and an incisal chip. The photographs were displayed on colour-calibrated iPads() . Participants used a self-administered questionnaire to rate their perceptions on (Item 1) how normal teeth were, (Item 2) how attractive the teeth were, (Item 3) need to seek correction of teeth, (Item 4) how well the person took care of their teeth and (Item 5) whether the person was born like this. Data from Item 5 were excluded due to low reliability.Ratings for Item 1 showed that TF1-4 was similar or significantly better than TF0. For Item 2, TF1 and TF4 were significantly better than TF0, with TF2 and TF3 being similar. For Item 3, there was significantly lower need to seek correction with TF2 and TF4 versus TF0, whereas TF1 and TF3 were similar to TF0. TF5 and TF6 were rated significantly lower than TF0 for Item 1 and Item 2, and significantly higher rating for Item 3 (need to seek correction). Ratings for Item 4 were similar, with TF1, TF2 and TF4 being rated significantly higher than TF0, and TF5 and TF6 being rated lower. Cavitated caries and staining were generally perceived as being significantly less favourable than TF6, with higher need to seek correction as well. Noncavitated carious lesion and incisal chip were rated similar to TF0. Cavitated carious lesions were rated aesthetically similar or significantly worse than TF0 and TF6.Severe fluorosis (TF5 and 6) was perceived to be less aesthetically pleasing and received higher ratings for need to seek correction than normal teeth. Mild-to-moderate fluorosis (TF1-4) showed similar or better aesthetic perceptions and similar or lower need to seek correction, when compared to normal teeth (TF0). Easily visible cavitated dental caries was rated worse than teeth with severe fluorosis (TF6) and normal teeth (TF0).
News Article | October 28, 2016
SINGAPORE, Oct. 28, 2016 /PRNewswire/ -- Actxa is proud to be appointed as one of the official technology partners of the National Steps ChallengeTM (NSC) Season 2 by the Health Promotion Board (HPB). Fueled by the nation's positive response to the physical activity initiative last year, the fitness wearables company has launched three new step tracker models alongside an easy trade-up program, to help Singapore step up and out for NSC Season 2. Launched by HPB on 1 October 2016, Season 2 brings more fun and prizes in motivating the nation to step up and move about every day, anytime and anywhere. Making a welcome return from last year is the immensely popular steps-for-rewards system, where all NSC participants will be rewarded for leading active lifestyles -- the more steps taken each day, the more points earned to redeem sure-win rewards as well as lucky draw chances. The smart gadget tagged to this fun physical activity programme is the steps tracker, a pedometer-based fitness buddy designed to motivate even more Singaporeans to lead active lifestyles. A firm advocate of spurring a nation of physically active people, Actxa came on board last year to supply the wearable technology, and 2015 saw HPB handing out over 156,000 pieces of the specially produced Actxa Stride -- which can still be used for the second season of NSC. In addition, Actxa has produced three enhanced step tracker models: The Stride+, as well as the Swift and Swift+, which NSC Season 2 participants can choose to use if they are not using any of the three official trackers, including the Actxa Stride, that HPB issues. These additional models are available for trade-ups or direct purchase this year. From the Primary One student to the blue-collared worker to the 60-year-old silver-haired grandparent, Actxa's company DNA has always been about incorporating smart technologies into innovative gadgets so consumers are empowered to live healthier, more active lifestyles. As such, Actxa has launched a Trade-In Program for NSC Season 2 -- a fuss-free initiative that takes in all step trackers regardless of condition and brands, for an upgrade to either the Swift or Swift+. The Swift+ in particular packs in plenty of exciting new features to practically assist wearers in their daily dynamic lives. More than just monitoring your daily steps count, the Swift+ functions like a 24/7 fitness buddy thanks to the Activity Tracker which tabulates amount of calories burnt, active duration time and distance travelled on a daily basis. Another powerful addition is in utilising nano-coating technology to deliver Sweat/Rain/Splash/Swim Proof resistance, so users may indulge in water activities without worrying about losing their fitness data. Lifestyle helps aren't forgotten, such as a Silent Alarm for jump-starting the day without waking others, as well as allowing the modern millennial the option of using the Swift+ for receiving call notifications (with Caller ID on screen), text message notifications as well as email notifications while on the go. Find more information on www.actxa.com/sg/swift-plus/. "Actxa is very proud to be a Singaporean company supporting a nationwide initiative that encourages fellow Singaporeans to be active. In support of the National Steps ChallengeTM, we are excited to launch a series of promotions that aim to put our fitness and activity trackers into the hands of everyone, inspiring them to lead active and healthier lives," said Joel Chin, CEO of Actxa. All step trackers can be traded up from 1 Oct 2016 to 31 March 2017 at our list of recognised retail partners, located across 12 locations island wide. Each accepted tracker is entitled to a $15 discount off the Swift or Swift+ (U.P. $49.90 and $69.90). The discounted Swift and Swift+ will cost $34.90 and $54.90 respectively. For more information, log on to www.actxa.com/trade-in. The National Steps Challenge™ (NSC) is a physical activity initiative by the Health Promotion Board (HPB) to encourage Singapore residents to be more physically active every day, anytime and anywhere. After the rousing success of 2015's inaugural launch, Season 2 kickstarted on 1 October 2016 and will end on 30 April 2017. The NSC is open to all Singaporeans, Permanent Residents and foreigners aged 18 and above at the point of registration with a valid NRIC or FIN. The Actxa team was formed in 2015, steered by a team passionate to design, develop and deliver the latest technologies packed into fitness wearables that are not only affordable, but also fun to use and aesthetically right on point. That same year, Actxa became the appointed supplier of the steps tracker for the inaugural National Steps ChallengeTM. Leading up to the anticipated launch of Season 2 on 1 October 2016, Actxa has again been chosen as the appointed supplier of steps tracker, in addition to being the official tech partner of the event. Truly, our company's tagline to 'Mind Your Fitness' speaks of our single motivation to empower customers to embark on healthy lifestyles, through our range of innovative products such as activity trackers and a smart scale that are easily connected via a smart app -- all platforms powered by our experience in technology and biomechanics. For further information, please contact:
Tey H.L.,National Skin Center |
Ee H.L.,National Skin Center |
Tan A.S.,Health Promotion Board |
Theng T.S.,National Skin Center |
And 2 more authors.
Journal of Dermatology | Year: 2010
The aim of this study was to determine if the following characteristics were associated with the presence of psoriatic arthritis in a sample of psoriasis patients: race, family history of psoriasis and psoriatic arthritis, age of onset of psoriasis, smoking, alcohol consumption and the maximum body surface area (BSA) affected by psoriasis. This was a case-control study involving 400 psoriasis patients who attended the Psoriasis and Photo-medicine clinic in the National Skin Center of Singapore over a 1-year period. Cases were psoriasis patients with psoriatic arthritis while controls were psoriasis patients without psoriatic arthritis. The diagnosis of psoriatic arthritis was made by rheumatologists and participants completed a self-administered standardized questionnaire. The maximum BSA involved was determined from the case notes. Psoriatic arthritis was not significantly associated with sex, race, age of onset of psoriasis, a family history of psoriasis, smoking and alcohol consumption but was significantly associated with a family history of psoriatic arthritis (P < 0.001) and the maximum body surface involved (P = 0.05). Using multivariate analysis to control for variables, the presence of psoriatic arthritis was significantly associated with a family history of psoriatic arthritis (odds ratio [OR] = 20.5; 95% confidence interval [CI] = 2.49-169.10) and the maximum BSA involved (OR = 2.52; 95% CI = 1.33-4.75). Indian psoriatic patients were more likely to have psoriatic arthritis compared to the other races. A family history of psoriatic arthritis and a greater maximum body surface involved may be associated with having psoriatic arthritis in this study population of psoriasis patients. © 2010 Japanese Dermatological Association.
Loy E.Y.,Health Promotion Board |
Molinar D.,Health Promotion Board |
Chow K.Y.,Health Promotion Board |
Fock C.,Health Promotion Board
Journal of Medical Screening | Year: 2015
Objective: To evaluate participation rates and performance indicators in the National Breast Cancer Screening Programme, BreastScreen Singapore (BSS). Methods: Data on women aged 40-69 screened in the period 2002-2009 was obtained from BSS and from the Singapore Cancer Registry. Participation rates and performance indicators (including screen detection rates, small tumour detection rates, recall rates, accuracy and interval cancer rates) were examined. Results: BSS participation rate has remained above 10% since 2005. Based on health surveys, national mammography rates have increased from 29.7% before BSS to 39.6% in 2010 after BSS. Performance indicators, with the exception of recall rates, specificity, and interval cancer rate (for first screen), generally improved from 2002-2006 to 2007-2009 and are comparable with organized breast screening programmes in other developed countries. Conclusion: BSS breast cancer screening coverage and rescreen rates in Singapore could be improved. Mechanisms to monitor recall rates are in place, and training opportunities are provided to aid the professional development of radiologists. © The Author(s) 2015.
Tan A.M.,University of Melbourne |
Lamontagne A.D.,University of Melbourne |
Sarmugam R.,Health Promotion Board |
Howard P.,University of Melbourne
BMC Public Health | Year: 2013
Background: Osteoporosis is a debilitating disease and its risk can be reduced through adequate calcium consumption and physical activity. This protocol paper describes a workplace-based intervention targeting behaviour change in premenopausal women working in sedentary occupations. Method/Design. A cluster-randomised design was used, comparing the efficacy of a tailored intervention to standard care. Workplaces were the clusters and units of randomisation and intervention. Sample size calculations incorporated the cluster design. Final number of clusters was determined to be 16, based on a cluster size of 20 and calcium intake parameters (effect size 250 mg, ICC 0.5 and standard deviation 290 mg) as it required the highest number of clusters. Sixteen workplaces were recruited from a pool of 97 workplaces and randomly assigned to intervention and control arms (eight in each). Women meeting specified inclusion criteria were then recruited to participate. Workplaces in the intervention arm received three participatory workshops and organisation wide educational activities. Workplaces in the control/standard care arm received print resources. Intervention workshops were guided by self-efficacy theory and included participatory activities such as goal setting, problem solving, local food sampling, exercise trials, group discussion and behaviour feedback. Outcomes measures were calcium intake (milligrams/day) and physical activity level (duration: minutes/week), measured at baseline, four weeks and six months post intervention. Discussion. This study addresses the current lack of evidence for behaviour change interventions focussing on osteoporosis prevention. It addresses missed opportunities of using workplaces as a platform to target high-risk individuals with sedentary occupations. The intervention was designed to modify behaviour levels to bring about risk reduction. It is the first to address dietary and physical activity components each with unique intervention strategies in the context of osteoporosis prevention. The intervention used locally relevant behavioural strategies previously shown to support good outcomes in other countries. The combination of these elements have not been incorporated in similar studies in the past, supporting the study hypothesis that the intervention will be more efficacious than standard practice in osteoporosis prevention through improvements in calcium intake and physical activity. © 2013 Tan et al.; licensee BioMed Central Ltd.
Sarmugam R.,Health Promotion Board |
Worsley A.,Deakin University
Nutrients | Year: 2014
High salt intake increases the risk of hypertension and cardiovascular diseases. Given the role of knowledge as a determinant of food intake, this paper aims to review the current levels of salt knowledge and the association between salt knowledge and dietary salt intake and salt-related dietary practices in the general population. Twenty two studies were included in the review. In general, the studies showed consumers were able to identify the health risks associated with high salt intake. However, knowledge of recommended daily intakes, understanding of the relationships between salt and sodium and foods that contribute most salt to the diet were poor. Four of the five studies which examined the relationships between salt knowledge and salt-related dietary practices reported significant associations. Two important gaps in the current literature were identified. First, there is a need for a robustly validated tool to examine salt knowledge and its impact on salt intake. Second, a comprehensive salt knowledge assessment should include assessment of procedural, as well as declarative, knowledge. © 2014, by the authors; licensee MDPI, Basel, Switzerland.
Jara-Lazaro A.R.,Singapore General Hospital |
Thilagaratnam S.,Health Promotion Board |
Tan P.H.,Singapore General Hospital
Breast Cancer | Year: 2010
Breast cancer is the commonest malignancy among Singapore women, accounting for 29.7% of all female cancers, with an age-standardized rate of 54.9 per 100,000 per year. It has been the most frequent cancer in Singapore women for the last 30 years, with the highest rates previously reported in those aged between 45 and 49 years, but with a more recent observation of a change in peak age group to women in their late 50s. About 1,100 new cases are diagnosed annually and approximately 270 women die in Singapore each year from breast cancer. In the multiethnic population of Singapore, it has been noted that rising breast cancer incidence is consistent across all three ethnic groups (Chinese, Malays, and Indians). Singapore has among the highest breast cancer incidence in Asia. Possible explanations include rapid urbanization, improvement in socio-economic status, and adoption of a western lifestyle. Our experience with the Singapore breast screening pilot project (1994-1997) and the national breast-screening program (BreastScreen Singapore) has led to increased understanding of this disease in the country. Data from the pilot project showed that breast screening is just as effective in a predominantly Asian population as in the west. Early breast cancer accounted for most breast cancers detected, with pre-invasive ductal carcinoma in situ (DCIS) comprising 26% of all screen-detected cancers in the pilot study. In the currently on-going BreastScreen Singapore, DCIS forms >30% of all breast cancers among pre-menopausal women, a relatively high proportion probably accounted for partially by the greater participation of women aged between 40 and 49 years. Despite the ready availability of subsidized mammographic screening, there are still women in Singapore who present with locally advanced breast cancer. Clinical management of an increasing number of women with breast cancer embraces a multidisciplinary team-based approach, with regular discussions of therapeutic strategies at tumor boards. In order to improve breast cancer diagnostics and therapeutics in our country, it is important that there are continual breast cancer and breast disease-related educational activities for medical professionals engaged in diagnosing and managing breast cancer. The role of public education in raising awareness is also essential. © 2009 The Japanese Breast Cancer Society.