How Singapore is using wearables to design health campaigns

By Shirley Tay and Tian Jiao Lim

Terence Ng, Director of the Policy & Technology Innovation Office at Singapore’s Health Promotion Board, discusses his team’s efforts to personalise health promotion.

The Oura ring, a wearable device that tracks body temperature, heart rate, and respiratory rate, has been all the rage. NBA players, Prince Harry, and Twitter CEO Jack Dorsey have donned it - because some believe the data it collects makes it a useful detection tool for signs of Covid-19.

We are indeed in the midst of the “Wearable Revolution”. Singapore’s Health Promotion Board has jumped on the bandwagon too, and is using data from wearables to “shift away from a ‘one-size-fits-all’ approach towards a future of personalised health promotion,” says Terence Ng, Director of HPB’s Policy & Technology Innovation Office.

Together with mobile applications, wearables help HPB “better tailor our programmes and messages,” says Ng. GovInsider spoke to Ng to find out how HPB is using the two to collect data and design health campaigns.

Smart data collection

Nearly 3,000 Singaporeans wear a smartwatch linked to an app that sends HPB real-time data about their heart rate, sleep patterns, and physical activity. This is part of the Health Insights Singapore study (hiSG). The study uses FitBit Ionic smartwatches and the hiSG mobile application to collect lifestyle data from participants aged 17-74, says Ng.

Participants are required to commit to the study for two years and fulfill requirements such as wearing the device for at least eight hours a day, seven days a month. In return, participants get to keep the smartwatch and redeem shopping or dining vouchers using points accumulated from completing questionnaires and recording meals.

Data collected from hiSG is analysed to allow HPB to better understand the health behaviour of Singaporeans, says Ng. It helps HPB understand how individual preferences, together with motivators, are important when designing health messages, interventions, or programmes, says Ng. “This is to help us build a knowledge base and support more tailored delivery of nudges to help individuals improve their lifestyle.”

hiSG has also paved the way for HPB to bring a “scalable digital-enabled protocol” to collaborations with healthcare, academic and industry partners, says Ng. This helps to facilitate data collection and help HPB understand the complexity of behavioural change, he adds. Some collaborations include the study of wearable-enabled rehabilitative care as patients transit back into the community, and relationship patterns across activity, mood and sleep.

National Steps Challenge

Through the National Steps Challenge, HPB aims to make it "simple and attractive” for Singaporeans to track their steps with wearables and mobile applications, says Ng. “The use of a steps tracker (wearable technology) and a mobile application empowers participants to track their own progress anytime and anywhere, as they work towards their personal goals.”

HPB has distributed new fitness trackers with a heart rate monitoring function to allow participants to be more aware of the intensity of their physical exercise, says Ng. The new trackers can also nudge participants when they have been sedentary for a long time.

To motivate Singaporeans to participate in the challenge, gamification and incentives are pushed out. The challenge is enhanced across multiple “seasons” to pique and sustain participant interest, says Ng. For example, a new category of physical activity was added for those physically ready to engage in higher-intensity exercise.

According to Ng, sign-ups for the National Steps Challenge have grown from 156,000 in the first season to 800,000 in the fourth season.

Collaboration with FitBit

Beyond using technology on HPB’s own platforms, the organisation also partners with industry players to develop programmes for personalised health promotion, says Ng.

In October 2019, HPB collaborated with Fitbit to use algorithms and personalised messages to test the effectiveness of customised reminders, says Ng. Together with behavioural insights and analytics, the programme aims to encourage sustained behavioural change such as increased physical activity, better sleep quality, and improved nutrition. HPB aims to enrol 10,000 participants by the end of 2020, says Ng.

As HPB uses digital platforms to push out personalised health promotion initiatives, it has to ensure users’ data are kept private and secure, says Ng. While data is collected to identify improvements that can be made to the programme, height, weight and gender data is anonymised.

HPB also makes the consent process clear for all programme participants to ensure they give explicit and informed consent before sharing any personal information and health data, Ng says.

It also has to ensure that the less tech-savvy are not left out of these digital initiatives. For hiSG, HPB ensured participants understood the study requirements by conducting hour-long briefing sessions. Additional sessions were conducted in smaller groups for the senior participants, says Ng, and customer care support is provided for all hiSG users as well.

Moving forward, HPB aims to use deep data and health insights to “move to a future of even more personalised health promotion,” says Ng. “The priority will therefore be on leveraging emerging technologies and developing a suite of digital platforms for our health promoting programmes.”

Gone are the days of generalised health promotion. Riding on the waves of wearables and other emerging technologies, HPB is set to create a tailored and personalised future of health campaigns.