Alexandra Hospital and Google partner to trial digital health trackers for healthier lifestyles

Alexandra Hospital and Google partner to trial digital health trackers for healthier lifestyles

Alexandra Hospital (AH) and Google have launched the ACTIVATION research initiative, to see if leveraging digital technology and personalised coaching can lead to sustained behavioural changes and improved health outcomes.

The ACTIVATION research initiative aims to engage 1,700 participants aged 21 to 75 who are at risk of developing hypertension, diabetes, hyperlipidaemia and obesity. To-date, it has 275 individuals on board that were recruited through family doctors and GP referrals at its various polyclinics in the west. But the team is confident that they will hit the number of participants without needing to open the initiative up further. According to Dr Alexander Yip, Head of AH Healthcare Redesign, “We will hit 1700 participants in the west. There are no ifs or buts. We can only recruit in the West for now because our recruitment points are National University Polyclinics (NUPs) and AH. In the future, we hope this becomes a National Programme.”

Once enrolled in the ACTIVATION programme, participants will receive a complimentary smartwatch (a Google Fitbit) and will be required to download the Healthier SG app to get updates from the smartwatch with their activity-tracking data and lifestyle information.

To test the effectiveness of digital interventions, participants are divided into three groups, each receiving different levels of intervention:

• A smartwatch only
• A smartwatch with access to a dedicated application to monitor their lifestyle choices and nudging system
• A smartwatch with a dashboard, nudging system, and digital health coaching in the form of human digital health coaches, of which AH has since employed three such coaches, to guide participants using the ConnectedLife dashboard

When asked if other health trackers would be used for the trial, Dr Yip said the for now it’s only open to Fitbits to ensure consistency and control during the evaluation phase. However, he didn’t rule out onboarding other devices at a later stage.

The research team at AH is keen to explore if a more personalised approach is more likely to engage and motivate individuals compared to generic nudges from a device, and if it is more effective in facilitating long-term behavioural change compared to the limited capabilities of a smartwatch. As Dr Yip put it:

An important nuance of what we are doing is that we are not just slapping a wearable on patients and/or setting automated nudges and then sending off on their way. We are recognising the importance of understanding participants’ intrinsic motivations, personalities, and readiness for change together, whilst leveraging digital markers from the watch to drive health-related behaviour change.

The ConnectedLife app will combine patients’ clinical data such as BMI and blood pressure, and lifestyle data such as the level of physical activity collected through their trackers. Alexandra Hospital’s Digital Health Coach (DHC) will then develop personalised lifestyle goals for each participant and provide digital interventions if they fall under the “Watch + Dashboard + DHC” arm of the initiative.

During the trial There will be three physical study follow-ups, involving waist circumference measurement, blood taking (if needed) and survey administration at baseline (time of recruitment), 6-month and 12-month follow-up. Participants will also be contacted at 3rd and 9th month for a brief survey on their healthcare utilisation.