PULSES II Research Themes

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Theme 1: Vulnerable Adolescents

Co-leads: A/Prof Tan Ngiap Chuan, Director of Research, SingHealth Polyclinics and A/Prof Helen Chen, Head, Psychological Medicine, KK Women's and Children's Hospital

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.

Theme 2: Diabetes

Co-leads: A/Prof Bee Yong Mong, Head, Endocrinology, Singapore General Hospital; Head of Service, SingHealth Duke-NUS Diabetes Centre, and A/Prof How Choon How, Head of Division, Care & Health Integration, Changi General Hospital

This theme aims to address the gaps in diabetes self-management among high-risk individuals who continue to have poorly controlled diabetes, who are preparing to fast, and who do not have their yearly vaccinations. 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

Co-leads: A/Prof Low Lian Leng, Director, Population Health and Integrated Care Office, Singapore General Hospital and A/Prof Lee Kheng Hock, Director of Education, SingHealth Community Hospital

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

Co-leads: A/Prof Laura Tay, Head, Geriatric Medicine, Sengkang General Hospital; Deputy Head, SingHealth Duke-NUS Centre of Memory and Cognitive Disorders, and A/Prof Ng Yee Sien, Senior Consultant, Rehabilitation Medicine, Sengkang General Hospital and Singapore General Hospital

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