Jason Cheah

Demographic and lifestyle characteristics associated with non- willingness to participate in health promotion programmes among adults of a lower socioeconomic status in Singapore

Introduction/Objective Lower socioeconomic groups have been found to have poorer health outcomes and engage in fewer health promoting behaviours. Understanding the reasons behind adverse lifestyle habits and non-willingness to participate in health promotion programmes among lower socioeconomic groups will enable administrators to modify the programmes and increase participation in this population. This study aimed to determine reasons for non-exercise, smoking and non-willingness to participate, and characteristics associated with non-willingness to participate in health promotion programmes among residents in Singapore. Method A cross-sectional survey was conducted on a purposive sample of residents living in four housing developments of one- and two-room households in Singapore from June to October 2009. The patterns of exercise and smoking, receptiveness towards health promotion programmes and the reasons for non-willingness to participate were elicited. Chi-square tests and logistic regression analysis were performed to identify differences between groups. Results Seven hundred and seventy-eight responses were analysed. Only 36.1% of respondents were willing to participate in at least one health promotion programme (health screening, talk or workshop). Older respondents aged 45–64 years and more than 65 years were less likely to participate than their younger counterparts (18–44 years). Malays were more likely than Chinese to participate, and respondents who do not exercise were less likely to participate than respondents who exercise (regularly/occasionally). Reasons for non-willingness to participate were ‘not interested’ and ‘no time’. Conclusion Health promotion messages should adapt to the needs and situation of the disadvantaged, to increase participation.

From Providers to Integrated Systems: A Challenging Journey Ahead for Singapore

Singapore has a population of some 5.5 million people, and is today faced with the triple challenges of a rapidly ageing population, increased chronic disease prevalence, and most importantly, fragmentation of health care delivery. This presents to the policy-makers a “real and present” impetus and call-to-action to redesign and implement new care delivery models, strengthen the governance, incentives and financing for integration; and dramatically transform the Singapore health system to meet the rapidly evolving needs of our population. The vision for healthcare delivery in Singapore for tomorrow is to develop integrated Regional Healthcare Systems: geographically-defined patient-centric healthcare ecosystems comprising partners from the primary, acute and community care sectors, working collaboratively to deliver comprehensive and holistic healthcare services, to improve patient outcomes. Integrated clinical pathways (ICPs) cutting across different providers will ensure continuity of care, and care coordinators will ensure the patient transitions are seamless and coordinated. As such, the “centre of gravity” for health care will be shifted into the community, with increasing emphasis on the development of homeand community-based services to improve the overall patient journey, and promote “ageing in place” in the patient’s home. This presentation will outline the key principles of care integration applied in the transformational journey of Singapore’s health system, and the role of the Agency for Integrated Care in this whole process. The macro and local challenges to integration will be highlighted, and relevant examples of initiatives and technology that have been piloted or deployed, will also be discussed.