PULSES II Research Themes

Interested parties who wish to collaborate with us may contact us at cphri@singhealth.com.sg

Theme 1: Vulnerable Adolescents and Maternal & Child Health

Despite the global prevalence of adolescents with psychosomatic symptoms leading to functional impairment and the high healthcare utilisation in this segment, there are knowledge gaps on local prevalence, underlying risk factors and intervention strategies. These gaps are addressed by a new research theme focusing on vulnerable adolescents, via the following strategies:

• Study the epidemiology and underlying biopsychosocial risk factors to understand and address the needs of adolescents with psychosomatic symptoms;
  
• Study the facilitators and barriers to effective interventions for such conditions;
• Harness AI chatbot technology to facilitate self-management of psychosomatic symptoms in concert with clinical interventions.

Recognising that vulnerability starts early in life, and there is a vicious cycle of increasing obesity and poor mental health in the population, interventions targeting the critical window of developmental plasticity are needed to prevent and address the trajectory of increased health risk across life stages. Interventions during the postpartum period have the potential to confer long-term maternal-child benefits and promote a virtuous cycle of health. Besides, family-based interventions combining dietary, physical activity and behavioural interventions have shown to be best practice in the management of childhood obesity. CPHRI is in collaboration with KK Women's & Children's Hospital and Maternal & Child Health Research Institute to develop research programmes to address these issues.

Theme 2: Diabetes and Hypertension

This theme aims to address the gaps in diabetes and hypertension self-management among high-risk individuals who continue to have poorly controlled diabetes. This theme will address these gaps via the following strategies:

• Design interventions that facilitate patients taking ownership of their diabetes through telehealth and mobile applications;
• Automate and scale a tailored intervention supported by remote care to improve diabetes self-management during Ramadan fasting;
• Elucidate strategies for incorporating annual influenza vaccination as part of routine care and evaluating its effectiveness.

Theme 3: Complex Needs

This theme aims to address the gaps in understanding the mechanisms underlying the functioning of complex integrated programmes in different contexts, the under-studied wider determinants of health, innovative approaches to improve self-management and social connectedness as well as actionable insights for improving long-term caregiving outcomes of complex patient. This theme will address these gaps via the following strategies:

• Evaluate the effectiveness of implementing a novel Empowered Community of Care (ECoC) model in Singapore to improve population health outcomes through a realist implementation science framework;
• Improve social connectedness and care coordination for patients with complex needs through social prescribing;
• Improve the well-being of older caregiver–older care recipient dyads by investigating their longitudinal patterns caregiving-related outcomes, trajectories and predictors of outcomes;
• Develop an AI-enabled digital tool for early detection of cognitive decline among community-dwelling older adults

Theme 4: Pre-frailty & Frailty

This theme aims to address the gaps in the large, pre-frail segment within the ageing population and the medicalisation of frailty assessments, which neglects seniors who do not yet meet arbitrary thresholds but may be amenable to early intervention. This theme will address these gaps via the following strategies:

• Examine intrinsic capacity in the elderly for early detection of frailty;
• Study frailty phenotype and mechanisms in middle-aged adults;
  
• Leverage technology to automate measurements for self-monitoring and routine care

Theme 5: Ageing in the Community

This theme aims to address the gaps in holistic care to support the rapidly ageing population in the community, so that seniors could age in place.  Our research projects seek to improve seniors' health and well-being outcomes via the following three pillars: 1) Built Environment, 2) Technology and 3) Care. These three aspects will be integrated to provide a comprehensive and effective ecosystem to support seniors as they age in place. Comprehensive evaluation of such an ecosystem will be performed through application of appropriate implementation science frameworks to see if it results in delayed frailty, improved health, and health-related quality of life, and if such an ecosystem is cost-effective and scalable.