A Pilot Study of Health Coaching on Older Adults’ Personal Healthcare and Maintenance during the Outbreak of Covid-19 in Singapore

With a rapidly ageing population in Singapore, older adults and their family members face challenges of age-related diseases, caregiver stress, and increasing demand for caregiving services. To address this pressing issue, this pilot study aims to introduce online health coaching for older adults in Singapore and evaluate its effectiveness on maintenance of personal healthcare. In the midst of the COVID-19 outbreak, older adults’ activities were largely restricted by measures on social distancing. The online health coaching provided a solution for older adults to achieve a healthy lifestyle in a contactless manner. In this pilot study, 18 older adults (≥55 years old) who were willing to be coached by trained health coaches (n = 10) for 8 weeks (once a week) were recruited. Pre- and post-surveys with older adults were conducted. Furthermore, health coaching booklet was used to control the quality of coaching and to record diet and exercise plans. The pilot study demonstrated that the health coaching provided older adults with knowledge of nutrition and exercise, raised their awareness of well-being in terms of daily meals and regular exercise, and provided an alternative to maintain a healthy lifestyle amidst global pandemic. Additionally, we also identified that the older adults’ satisfactions with health coaching were positively associated with educational levels (R2 = 0.31). Lastly, this pilot study highlighted that health coaching standardization process for older adults is critical for researchers and healthcare practitioners in the future.

Health Maintenance Restaurant

Arestaurant named "Health Maintenance Restaurant" which serves dishes cooked with traditional Chinese medicine recently opened at Xiyuan Hotel in western Beijing. Entering the restaurant, you’ll see the god of longevity on

Adherence to guideline-directed hepatocellular carcinoma screening:A single-center US experience

BACKGROUND The American Association for the Study of Liver Disease recommends screening patients with cirrhosis for hepatocellular carcinoma(HCC)using imaging with or without alpha-fetoprotein every six months.Unfortunately,screening rates remain inadequate.AIM To assess root causes of screening failure in a subspecialty hepatology clinic.METHODS The authors identified patients with cirrhosis seen in a subspecialty hepatology clinic and determined whether they underwent appropriate screening,defined as two cross-sectional images between five and seven months apart.The authors characterized the primary driver of screening failure.Finally,other hepatologists were surveyed to determine provider perceptions of screening failure causes.RESULTS 1034 patients were identified with an average age of 61 years and a mean MELD of 8.1±3.8.Hepatitis C virus was the most common cirrhosis etiology.489(47%)underwent appropriate screening.No demographic or clinical differences were detected between those who underwent appropriate screening and those who did not.The most common etiologies of screening failure,in descending order,were:radiology unable to schedule timely imaging,provider did not order imaging,patient canceled follow up appointment,appointments scheduled too far apart,lost to follow up,no-show to radiology appointment,and provider canceled appointment.Hepatologists surveyed believed the most common cause of screening failure was no-show to radiology.CONCLUSION Rates of screening were poor even in a subspecialty hepatology clinic.Screening failure was mostly due to systemic factors such as radiology availability and time between hepatology appointments rather than individual error.

Facilitators and barriers to colorectal cancer screening in an outpatient setting

BACKGROUND Colorectal cancer(CRC)is the third most common cancer and the second leading cause of cancer-related deaths in the United States.Still,1 in 3 adults aged 50 years to 75 years have not been screened for CRC.Early detection and management of precancerous or malignant lesions has been shown to improve overall mortality.AIM To determine the most significant facilitators and barriers to CRC screening in an outpatient clinic in rural North Carolina.The results of this study can then be used for quality improvement to increase the rate of patients ages 50 to 75 who are up to date on CRC screening.METHODS This retrospective study examined 2428 patients aged 50 years to 75 years in an outpatient clinic.Patients were up to date on CRC screening if they had fecal occult blood test or fecal immunochemical test in the past one year,Cologuard in the past three years,flexible sigmoidoscopy/virtual colonoscopy in the past five years,or colonoscopy in the past ten years.Data on patient socioeconomic status,comorbid conditions,and other determinants of health compliance were included as covariates.RESULTS Age[odds ratio(OR)=1.058;P=0.017],no-show rate percent(OR=0.962;P<0.05),patient history of obstructive sleep apnea(OR=1.875;P=0.025),compliance with flu vaccinations(OR=1.673;P<0.05),compliance with screening mammograms(OR=2.130;P<0.05),and compliance with screening pap smears(OR=2.708;P<0.05)were important factors in determining whether a patient will receive CRC screening.Race,gender,insurance or employment status,use of blood thinners,family history of CRC,or other comorbid conditions including diabetes,hypertension,congestive heart failure,chronic obstructive pulmonary disease,and end-stage renal disease were not found to have a statistically significant effect on patient adherence to CRC screening.CONCLUSION Patient age,history of sleep apnea,and compliance with other health maintenance tests were significant facilitators to CRC screening,while no-show rate percent was a significant barrier in our patient population.This study will be of benefit to physicians in addressing and improving the CRC screening rates in our community.