Assessing Falls Efficacy in Seniors: Important Insights in Hospital and Community Settings.

Falls efficacy is an important psychological construct in falls prevention and management. It refers to an individual's perceived physical ability to prevent and manage falls. Despite its significance, falls efficacy remains under-researched.

Models of community hospitals and state of research in high-income countries: a scoping review.

Introduction: Existing literature have not reviewed the growing spectrum of care models in Community Hospitals (CH) along with the scope of research. We fill this gap by reviewing CHs models in high-income countries.

Methods: We conducted a scoping review according to Arksey & O'Malley's framework.

Expanding the role of community hospitals to promote population health in Singapore.

Population health encompasses health outcomes, their determinants, and the distribution within the group of individuals. A life course approach, involving residents regardless of health status and disease complexity, and addressing their needs holistically and contextually is a key policy for improving population health. Healthier SG represents Singapore's transformation towards population health.

Validation of the advance care planning engagement survey in Singapore.

Background: Singapore has an ageing population. End-of-life care and advance care planning are becoming increasingly important. To assess advance care planning engagement, valid tools are required.

Association of Novel Clinical and Behavioural Markers with HbA1c Improvement: A Latent Class Analysis of 912 Patients with Type 2 Diabetes Mellitus.

Objective: The escalating prevalence of Type 2 Diabetes Mellitus (T2DM) overwhelms healthcare systems. Lifestyle interventions enhancing patient monitoring and adherence vary in efficacy, emphasizing the need to understand differential response across patient subgroups. This study aimed to segment patients with T2DM into distinct latent classes and identify characteristics associated with optimal 12-month glycated haemoglobin (HbA1c) reduction.

Exploring the Determinants of Age-Friendly Neighbourhoods Among Seniors Residing in a Low-Income Urban Community in Singapore: A Participatory Study.

The growing interest regarding the role of the living environment in healthy ageing highlights the need to investigate place-related urban features contributing to health and socio-emotional wellbeing. This study aimed to use a participatory methodology to explore the determinants of an age-friendly neighbourhood built environment that promotes or limits healthy ageing in place among seniors residing in a low-income urban community in Singapore. The study utilised photovoice and semi-structured interviews with 25 community-dwelling seniors aged 65 and above, residing in government-built public housing.

Advancing social prescribing in Singapore: an update on progress.

In 2019, SingHealth Community Hospitals (SCH) introduced Social Prescribing (SP) program to support patients in transitioning back to the community after hospitalization, which involves personalized care plans developed by Wellbeing Coordinators (WBCs) to connect patients with relevant community resources. With the recent launch of the nation-wide 'Healthier SG' initiative, a population health strategy in Singapore aimed at enabling individuals to prevent and manage chronic diseases, it is important to provide an update on our program's recent developments. This includes creating a living asset map, updating outcome assessment tools, organizing training sessions to enhance the skills SP practitioners, and establishing the Singapore Community of Practice in Social Prescribing (SCOMP).

Psychological Resilience in Post-acute Care: A Cross-Sectional Study of Health Care Workers in Singapore Community Hospitals.

Objectives: Psychological resilience is a crucial component of mental health and well-being for health care workers. It is positively linked to compassion satisfaction and inversely associated with burnout. The current literature on health care worker resilience has mainly focused on primary care and tertiary hospitals, but there is a lack of studies in post-acute and transitional care settings.

How family physicians in Singapore recognise complexity during consultations: a qualitative study.

Background: The prevalence of persons with complex needs in Singapore is rising. Poor understanding of what constitutes complexity impedes the identification of care gaps and development of interventions to improve care for these individuals. We aim to identify the characteristics contributing to complexity in primary care, from the Family Physicians' (FP) perspectives.

Experiences of a Community-Based Digital Intervention Among Older People Living in a Low-Income Neighborhood: Qualitative Study.

Background: Older adults worldwide experienced heightened risks of depression, anxiety, loneliness, and poor mental well-being during the COVID-19 pandemic. During this period, digital technology emerged as a means to mitigate social isolation and enhance social connectedness among older adults. However, older adults' behaviors and attitudes toward the adoption and use of digital technology are heterogeneous and shaped by factors such as age, income, and education.

Exploring the Implementation of Shared Decision-Making Involving Health Coaches for Diabetes and Hypertension Self-Management: Qualitative Study.

Background: An emerging focus on person-centered care has prompted the need to understand how shared decision-making (SDM) and health coaching could support self-management of diabetes and hypertension.

Objective: This study aims to explore preferences for the scope of involvement of health coaches and health care professionals (HCPs) in SDM and the factors that may influence optimal implementation of SDM from the perspectives of patients and HCPs.

Methods: We conducted focus group discussions with 39 patients with diabetes and hypertension and 45 HCPs involved in their care.

Acceptability of Mobile App-Based Motivational Interviewing and Preferences for App Features to Support Self-Management in Patients With Type 2 Diabetes: Qualitative Study.

Background: Patients with type 2 diabetes mellitus (T2DM) experience multiple barriers to improving self-management. Evidence suggests that motivational interviewing (MI), a patient-centered communication method, can address patient barriers and promote healthy behavior. Despite the value of MI, existing MI studies predominantly used face-to-face or phone-based interventions.

Empowering patients with comorbid diabetes and hypertension through a multi-component intervention of mobile app, health coaching and shared decision-making: Protocol for an effectiveness-implementation of randomised controlled trial.

Introduction: Diabetes and hypertension are prevalent and costly to the health system. We have developed a mobile app (EMPOWER app) which enables remote monitoring and education through personalised nudges. We aim to study the effectiveness of a multi-component intervention comprising the EMPOWER mobile app with health coaching and shared decision-making for diabetes and hypertension.

Frameworks for measuring population health: A scoping review.

Introduction: Many regions in the world are using the population health approach and require a means to measure the health of their population of interest. Population health frameworks provide a theoretical grounding for conceptualization of population health and therefore a logical basis for selection of indicators. The aim of this scoping review was to provide an overview and summary of the characteristics of existing population health frameworks that have been used to conceptualize the measurement of population health.

Prevalence and factors associated with sarcopenia among older adults in a post-acute hospital in Singapore.

Background: Sarcopenia is common in older adults worldwide, but its prevalence varies widely owing to differences in diagnostic criteria, population sampled, and care setting. We aimed to determine the prevalence and factors associated with sarcopenia in patients aged 65 and above admitted to a post-acute hospital in Singapore.

Methods: This was a cross-sectional study of 400 patients recruited from a community hospital in Singapore.

Artificial intelligence, ChatGPT, and other large language models for social determinants of health: Current state and future directions.

This perspective highlights the importance of addressing social determinants of health (SDOH) in patient health outcomes and health inequity, a global problem exacerbated by the COVID-19 pandemic. We provide a broad discussion on current developments in digital health and artificial intelligence (AI), including large language models (LLMs), as transformative tools in addressing SDOH factors, offering new capabilities for disease surveillance and patient care. Simultaneously, we bring attention to challenges, such as data standardization, infrastructure limitations, digital literacy, and algorithmic bias, that could hinder equitable access to AI benefits.

Socioeconomic and behavioral determinants of non-compliance with physician referrals following community screening for diabetes, hypertension and hyperlipidemia: a mixed-methods study.

Early detection of undiagnosed diabetes, hypertension or hyperlipidemia through screening could reduce healthcare costs resulting from disease complications. To date, despite ample research on the factors linked to the uptake of community health screening programs, little attention has been directed at delayed or incomplete follow-up after positive outcomes are identified in community screening tests. This study aimed to investigate the socioeconomic and behavioral factors that influence non-compliance with recommendations for primary care physician referrals, following community-based screening for diabetes, hypertension and hyperlipidemia.

A policy ethnography study of a Singapore regional health system on its governance adaptations and associated challenges as a project organisation to implement Healthier Singapore.

Objectives: Project organisations reflect a modern and non-bureaucratic form of organising public-sector activities, which promises innovation, entrepreneurship, and order and control to bring about change. This study seeks to investigate the project organisation Singapore Health Services (SingHealth) Region Health System (RHS)'s approach to implementing the Healthier Singapore (HSG) strategy, including models of governance and perceptions of RHS leads, identify the challenges facing the RHS, and to draw insights into the conditions necessary for using project organisation as a policy tool in policy implementation.

Study Design: We adopted a policy ethnography approach to answering the research question.

Evaluating the association of COVID-19 restrictions on discharge planning and post-discharge outcomes in the community hospital and Singapore regional health system.

Objectives: The COVID-19 is a global health issue with widespread impact around the world, and many countries initiated lockdowns as part of their preventive measures. We aim to quantify the duration of delay in discharge to community from Community Hospitals, as well as quantify adverse patient outcomes post discharge pre and during lockdown period.

Design And Methods: We conducted a before-after study comparing the length of stay in Community Hospitals, unscheduled readmissions or Emergency Department attendance, patients' quality of life using EQ5D-5l, number and severity of falls, in patients admitted and discharged before and during lockdown period.

Role of Caregivers in Remote Management of Patients With Type 2 Diabetes Mellitus: Systematic Review of Literature.

Background: With the growing use of remote monitoring technologies in the management of patients with type 2 diabetes mellitus (T2DM), caregivers are becoming important resources that can be tapped into to improve patient care.

Objective: This review aims to summarize the role of caregivers in the remote monitoring of patients with T2DM.

Methods: We performed a systematic review in MEDLINE, Embase, Scopus, PsycINFO, and Web of Science up to 2022.

Smartphone ownership, digital literacy, and the mediating role of social connectedness and loneliness in improving the wellbeing of community-dwelling older adults of low socio-economic status in Singapore.

Introduction: During the COVID-19 pandemic, safe-distancing measures resulted in many community-dwelling older adults being socially isolated and lonely, with its attending negative impact on wellbeing and quality of life. While digital technology may have mitigated this, older adults of low socioeconomic status (SES) are more likely to be digitally excluded and hence susceptible to the adverse effects of social isolation and loneliness. This study aims to understand the factors that affect digital literacy, smartphone ownership, and willingness to participate in a digital literacy program (DLP), and to test the hypothesized relations between digital literacy, social connectedness, loneliness, wellbeing, and quality of life amongst community dwelling older adults of low SES.

Pandemic-related health literacy: a systematic review of literature in COVID-19, SARS and MERS pandemics.

Introduction: Health literacy plays an essential role in one's ability to acquire and understand critical medical information in the coronavirus disease 2019 (COVID-19) infodemic and in other pandemics. We aimed to summarise the assessment, levels and determinants of pandemic-related health literacy and its associated clinical outcomes.

Methods: A systematic review was performed in Medline, Embase, PsycINFO, CINAHL and four major preprint servers.

Implementation of social prescribing: lessons learnt from contextualising an intervention in a community hospital in Singapore.

The need to develop holistic public health approaches that go beyond treating the biological causes of ill health, to addressing the social determinants of health, have been highlighted in the global health agenda. Social prescribing, where care professionals link individuals to community resources that tackle social needs have gained increasing traction worldwide. In Singapore, SingHealth Community Hospitals introduced social prescribing in July 2019 to manage the complex health and social needs of the aging populace.