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Research Grants
| Principal Investigator Trevor Yu Kang Yang ([email protected]) We propose investigating the career planning and development behaviours of SFHPs, designing a programme to help increase their proactivity in lifelong career planning that considers their personal needs and life plans too. Subsequently we will construct an assessment tool to evaluate effectiveness of career planning and development initiatives for SFHPs. This mixed-methods study will be conducted in three phases: (1) developing a model describing SFHPs’ career management behaviour from a representative survey and interviews; (2) designing and piloting a programme encouraging proactive career planning and development in SFHPs through six co-design workshops with various stakeholders (healthcare employers, human resources professionals, and professionals); and (3) construct of an assessment tool to evaluate the effectiveness of career planning and development programmes, based on data from the second study phase and a scoping review of existing literature. The assessment tool will be validated using confirmatory factor analysis. |
| Principal Investigator Helen Smith ([email protected]) Funding body NHG-LKCMedicine Centre for Primary Health Care Research & Innovation Amount awarded $60,000 Duration 1.5 years Summary Respiratory diseases constitute a significant health care burden in Singapore, particularly in primary care. In addition to dominating acute presentations, respiratory diseases also contribute significantly the chronic disease burden, which is projected to grow with an ageing population. In older adults, asthma and COPD are often comorbid with other chronic diseases, making primary care and family medicine particularly apt for managing these diseases. In response to the growing chronic disease burden, the Ministry of Health has endeavoured to shift this care burden from tertiary to primary care, and of the latter, from public to private providers. Yet, services and capacities in private general practices are often limited by economies of scale, and they may yet be fully equipped to take on additional care burden of chronic respiratory diseases. The PCN initiative has led to some improvements sharing of resources and expertise, but there is no official data on how much general practices on a whole are benefiting. An appreciation of the gaps in the current capacities can help to identify additional resources needed to implement this policy. Another constraint is the manpower crunch throughout the health care sector. An improved understanding of professional scopes and interprofessional boundaries in primary care and how they can be improved is hence instrumental for improving care and reducing respiratory disease in the community. |
| Principal Investigator Helen Smith Funding body NMRC HSRG Amount awarded $159,692 Duration 1.5 years Summary Gout is a common form of arthritis. It is more prevalent amongst older populations and its incidence is rising. In the Asia Pacific High Income region, it has resulted in a 56% increase in disability adjusted life years (DALYs) over the past two decades and with increasing ageing populations, it is estimated that the number of people living with disability from gout will continue to rise. Gout is very amenable to treatment and early intervention can reduce the burden of the disease dramatically for the individual, society and healthcare systems. Yet there is international, widespread evidence that gout is inadequately treated and that adherence to urate-lowering treatments and dietary modifications is low. Various reasons have been put forward for this, including a lack of expertise in primary care where majority of patients are diagnosed and managed. In addition, studies have shown low health literacy in older adults is a predictor of poor health outcomes, and is a modifiable factor associated with self-management skills and health behaviours related to health status. This study explores the meaning people give to their health experiences like taking into account diversity around age, gender, quality of life, ethnicity and culture25. It will adopt a qualitative research design to enable us to explore the primary research questions and circumstances of patients’ first gout attacks, their responses at the time, types of support and care they used, and use, in managing it, and the implications for health care policy and service organisation. In addition, if the influence of someone else including a caregiver, or a loved one, is highlighted in the face-to-face interview, we will ask seek permission for a further interview with the ‘significant other’ so as to maximise data collection on the topic. |
| Principal Investigator Helen Smith Funding body Primary Health Care Research in Multi-morbidity and Mental Health in a Multi-Ethnic Population (PRIME) Centre Grant Amount awarded $50,000 Duration 18 months Summary Low health literacy (HL) is associated with poorer health outcomes, increased morbidity and higher mortality rates. HL is defined by the World Health Organization as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. The concept of HL is extensive and much more than being able to read information and attend appointments, and incorporates functional, communicative/interactive, and critical domains. It also considers environmental, political and social factors that structure inequalities. Consequently, whilst most studies of HL focus on the individual, there are growing calls to broaden its conceptualisation beyond the individual (micro) to the meso (family) and macro (community and society) levels. In Singapore, the family remains the primary unit of support and therefore it is appropriate to look at HL within a household context rather than as an isolated individual. A second innovative aspect to this work is the involvement of lay community members to recruit households, assist with data collection and inform interpretation of the findings. The aims of our study are threefold: 1. Test the feasibility of using the Health Literacy Test for Singapore (HLTS) to identify ranges of health literacy within households in Singapore 2. Explore the feasibility of training lay people to work as collaborators within the three main ethnic communities in Singapore (Chinese, Malay and Indian) 3. Develop an intervention to improve household HL in a subsequent large-scale study. Feasibility will be assessed by recruitment data and ethnographic field notes from lay collaborators and researchers. Comparisons will be made across different ethnic communities to identify possible cultural dimensions within our findings. |
| Principal Investigator Lorainne Tudor Car Funding body ARISE Amount awarded $50,000 Duration 1 year Summary Singapore has the second-highest proportion of people with diabetes among developed nations. One in three elderly people (aged 60 years and above) have diabetes in Singapore. Prediabetes, a precursor stage to diabetes, affects 22% of those aged 60 and above. Early preclinical changes to the microvasculature are often observable at the prediabetes stage and most people with prediabetes will eventually progress to have diabetes. This transition is preventable with lifestyle modification interventions. Mobile phone-delivered interventions, i.e. mHealth, have been proven to be effective for prevention and management of a range of chronic diseases, and are increasingly used for diabetes. The aim of this study will be to carry out a developmental phase for a randomised trial assessing cost-effectiveness of messaging chatbot app-delivered diabetes prevention intervention compared to usual care in working Singaporeans with prediabetes. The study will also examine the effectiveness of using other mobile messaging platforms (i.e. WhatsApp) for delivery of diabetes prevention, in comparison to Chabot and usual care. |
| Principal Investigator Lorainne Tudor Car Funding body NHG-LKCMedicine Centre for Primary Health Care Research & Innovation Amount awarded $50,000 Duration 1 year Summary This is a collaborative study between National Healthcare Group Polyclinics (NHGP) and Lee Kong Chain School of Medicine (LKCMedicine), NTU. Our aim is to explore and report on information seeking behaviour of primary care physicians and nurses in Singapore. There is a range of healthcare-related information and evidence sources currently available to healthcare professionals encompassing clinical practice guidelines, care guides, journal articles, online webpages, blogs and medical literature databases. However, research shows there is a wide variation in the adoption of evidence across healthcare disciplines, which could lead to poorer primary care outcomes such as patient healthcare quality, satisfaction and adverse outcomes. Besides the difference in evidence adoption, primary care physicians and nurses also differ in their information seeking behaviour. These healthcare professionals differ in their training, working practices and responsibilities, all of which are factors that can influence their information seeking behaviour. There is evidence on information seeking behaviour in primary care settings in various countries but reports of information seeking behaviours in Singapore is limited. The widespread inclination towards evidence-based healthcare, coupled with the constant growth in medical knowledge and increasing complexity of patient care, it is therefore essential to identify relevant information needs, and information seeking behaviour for primary care providers in Singapore. We will recruit physicians and nurses involved in provision of primary care within NHGP. We intend to use surveys and interviews for collection of data. |
| Principal Investigator Julia Zhu FMPC Lead Bernadette Bartlam Funding body LKCMedicine Centre for Primary Health Care Research & Innovation Amount awarded $50,000 Duration 1 year Summary Diabetic foot amputation, affects one’s quality of life, and increases morbidity and mortality. It in turn results in higher healthcare expenses and poorer patient outcomes. Statistics tells us that there is an increase in numbers of such cases, but we know little about those patients’ experiences with diabetic foot amputation in Singaporean context. Therefore, this study aims to explore the lived experiences of patients within 6 months of post operation with a foot or partial foot amputation in primary healthcare. The study adopts qualitative design to enable those patients with amputations to share individual experiences of their daily life in the initial post-discharge period which will contribute to the understanding how an individual copes with life changes related to diabetic foot amputations. Research findings will inform the type and level of assistance and support to be offered to patients during the initial postoperative period by healthcare professionals in primary healthcare setting which will ultimately promote both patients’ wound healing and emotional healing. The findings of this study will also contribute to enhancement of existing services which would better meet the holistic needs of the studied population and build care pathways to treat the “whole” patient considering the bio-psycho-social factors, not just leaving the patients with the “hole” that they have to deal with after their amputation. |