​Participant Geeta Khandelwal says the Health Insights Singapore study is a good opportunity to be more mindful of some of her bad habits.ST PHOTO: DESMOND FOO

Study, which will include 8,000 more people, will help refine public health efforts

Felicia Choo, The Straits Times

Nearly every day, Ms Geeta Khandelwal wears a smart watch linked to an app that sends the Health Promotion Board (HPB) real-time data about her health such as heart rate, number of steps she walked, sedentary time and sleep.

She also diligently logs her daily meals and drinks into the app, right down to the portion size.

The 38-year-old freelance consultant and editor is one of 2,000 working adults here who are part of a $1.2 million, two-year HPB study that mines their data to personalise health promotion efforts.

The study, called Health Insights Singapore, or hiSG for short, will also serve as a resource for future public health research, according to HPB chief executive officer Zee Yoong Kang.

It could also be used to test policies before they are implemented, he added.

The study marks HPB's foray into precision public health management, generally defined as providing the correct intervention to the right population at the right time.

"Public health (management) struggles because it operates at a high level of generalisation. Therefore, individuals find it very hard to implement a lot of this advice," said Mr Zee. "We now have the opportunity to be much more precise, so we do anticipate that many of our guidelines can be refined and maybe overturned.

HPB recruited participants aged 21 to 40 last August, targeting this age group as it is the period when obesity rates are observed to spike.

To build a comprehensive profile of each participant, the HPB collects details like their age, gender, body mass index (BMI) and fitness level.

Participants also have to meet requirements such as wearing the smart watch for at least eight hours a day, on at least five weekdays and two weekends each month, and recording what they eat on at least three days every three months.

Participants pay a deposit of $50 for the smart watch, a Fitbit Ionic.

As a form of motivation, their deposit is returned if they stick to the study's requirements. If they don't, they forfeit their $50.

Another incentive is the points participants can rack up when they fufil criteria like logging their meals and syncing steps data from watch to app. These can be exchanged for food and shopping vouchers.

Five months in, the study has thrown up some intriguing preliminary findings. For example, researchers found that of the least active participants, who averaged a daily step count of 6,100, more were underweight (15 per cent) than overweight (12 per cent) or obese (7 per cent).

Meanwhile, the exercise enthusiasts, who averaged 13,500 steps a day, had the biggest proportion of overweight (26 per cent) and obese (14 per cent) participants.

The HPB said the overweight participants, who are clocking more steps, may be more muscular or are trying to lose weight.

By next month, a mood scale will be rolled out, so people can log how they feel a few times a day, and short surveys will be introduced in the app within the next six months.

Eventually, participants will receive personalised nudges to improve their health.

The HPB is also scaling up the study and aims to recruit another 8,000 participants from various age groups.

They will comprise students from higher learning institutes, final-year students about to enter the workforce, specific occupation and industry groups with a larger proportion of mature workers, and semi-retired and retired seniors.

The HPB spends on average $400 to $500 on each participant, including the rewards (redeemed with the points), with the smart watches forming the bulk of the cost.

Organisations like Nanyang Polytechnic, the National University of Singapore (NUS) and Duke-NUS Medical School are working with the HPB to conduct studies on participants.
Ms Geeta said: "It was a good opportunity to be more mindful of some of my bad habits like sleeping late and having a sedentary lifestyle. I get a free Fitbit and get to be part of something larger."