In recent years, Singapore’s Ministry of Health has urged members of the public to adopt healthier lifestyles given the rising rate of obesity. According to a report from Channel NewsAsia in 2021, the country’s obesity rate was at the highest level in more than a decade.
More people have begun turning to mobile phone apps for assistance to lose weight due to their convenience, and the ease of self-monitoring and self-regulation, especially in light of the COVID-19 pandemic.
However, commercially available weight management apps are effective only to a small extent and are often unsustainable due to low engagement or adherence to recommendations, says NUS Nursing research fellow Dr Jocelyn Chew.
The solution? Artificial Intelligence, commonly known as Al.
In her earlier research explorations into heart failure self-care, Dr Chew noted how heart failure patients adjusted their lifestyles, adopting healthier behaviours and practices such as better diets and exercise. She then developed an interest in the concept of adherence.
“The more I dealt with that, the more I realised that the problem lies upstream. A lot of these chronic diseases actually stem from an upstream problem of weight management,” says Dr Chew.
Her focus then shifted from heart failure self-care to weight management, which Dr Chew says essentially still boils down to the same thing—adherence to a healthy lifestyle.
During her PhD study in Hong Kong, Dr Chew realised that requiring someone to attend repeated counselling sessions or consultations in person was inconveniencing patients, which may not be the best way to encourage behaviour change.
Furthermore, in the realm of patient education, educators would find themselves repeating the same pieces of advice to patients.
It was then that Dr Chew developed an interest in tapping Al for weight management.
“When you want to change a behaviour, you need a program to be very convenient—something that’s attractive and easy to follow,” says Dr Chew.
In addition to supporting the more mundane tasks of patient education, Al could also craft a more intuitive experience that is tailored to each user—essentially creating an app fueled by users, for users, instead of current weight loss apps and programs often prescribed by healthcare professionals or commercial companies.
Al can also imitate human intelligence and communication, performing human tasks in a faster, more accurate and intuitive way.
“With an increasing trend of digital transformation in our daily lives, it is timely to assess Singaporean users’ needs and preferences in weight management apps, be it Al or non-Al,” says Dr Chew.
From her previous work, Dr Chew notes that potential barriers to adopting Al-based healthcare programs include a “lack of trust in human-like autonomous machines in terms of efficacy, credibility and data privacy”.
ADOPTION OF PROGRAMS
Although weight loss apps have been shown to aid in significant weight loss, the first hurdle towards success would be the adoption of such programs by the general public, especially those with a high Body Mass Index (BMI).
“Common reasons for the non-adoption of such programs include depleting motivation, the lack of satisfactory results, dietary constraints, logistical constraints, low level of supervision and low provision of social support,” says Dr Chew.
“Evidently, motivation, commitment, frequent progress tracking and coaching are essential for the adoption of and engagement in weight loss programmes.”
Dr Chew’s study, Acceptability and user perceptions of smartphone-based weight management applications, is funded by the NUHS Family Medicine/Primary Care/Health Services Research (FM/PC/H5R) Seed Grant, which supports innovative ideas in the area of Family Medicine, primary care, and health services.
The research examines the perceptions of Singaporeans towards the use of smartphone-based mobile apps for weight management and the incorporation of Al, and seeks to understand what members of the public with a high BMI need and would want in a weight management app.
Dr Chew opts for a sequential explanatory study design, which allows for more rigorous analyses across the one-and-a-half-year study.
The study comprises two phases. The first, a quantitative study, will collect survey data for a general overview, while the second qualitative phase will see participants divided into low, medium and high stratifications according to selected metrics.
Participants will then be picked for extensive interviews to explore their perceptions, needs and views.
“Although mobile apps have been in the market for years, their uptake and sustained user engagement remain unclear, especially in a developed multi-ethnic Southeast Asian population like Singapore,” says Dr Chew.
“It would be impractical to develop an app if no one is going to use it.”
IDENTIFYING GAPS IN APPS
According to Dr Chew, uncovering the acceptability and needs of the users would then allow researchers to identify the current gaps in weight loss mobile apps, and identify context-specific solutions to optimise resource allocation and weight management outcomes.
Following this, there are three main findings that would make a difference in future research, practice and policy:
- Researchers can gauge whether the general
- public is ready for such technology, and facilitate planning and implementation of such programmes in clinical and community settings.
- User experiences of current weight loss apps can be analysed to highlight redundancies of certain app components, which can then be either improved on or phased out to enhance resource allocation and outcome efficacies.
- Participants’ considerations, needs, preferences and suggestions on how to improve current weight loss mobile apps would serve as a needs-based evaluation for more personalised and population-specific intervention developments and research in the future.
Dr Chew is also currently working with various stakeholders to develop an Al-based weight management app, called the eating Trigger-Response Inhibition Program (eTRIP), specifically for people with high BMI.
