Objectives Amidst the COVID-19 pandemic, healthcare workers (HCWs) may be at greater risk of suffering from psychological distress compared to the general population. This study aimed to investigate the effects of mindfulness practice as delivered using Headspace on psychological and cognitive outcomes among HCWs in Singapore. Methods A total of 80 HCWs were recruited and randomly assigned to engage in either 3 weeks (10 min/day) of mindfulness practice using Headspace or an active control condition (Lumosity; involving playing cognitive games). Participants were administered several self-report measures and two working memory (digit span) tasks at pre- and post-intervention, and one-month follow-up. Results There were no significant between-condition changes on any outcome variables from pre- to post-intervention. From pre-intervention to 1-month follow-up, there were significantly greater improvements among Headspace participants on fear of COVID-19 (p = .005), compassion satisfaction (p = .007), trait mindfulness (p = .002), self-compassion (p = .005), sleep quality (p = .002), and the forward digit span task (p < .001). Several outcomes were mediated by increases in trait mindfulness or self-compassion. Conclusions Use of Headspace may lead to downstream benefits in reducing distress and improving psychological health outcomes among HCWs. The findings have implications for improving psychological support resources for HCWs amidst a pandemic. Trial Registration ClinicalTrials.gov (Identifier: NCT04936893).

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Objective Digital health has recently gained a foothold in monitoring and improving diabetes care. We aim to explore the views of patients, carers and healthcare providers (HCPs) regarding the use of a novel patient-owned wound surveillance application as part of outpatient management of patients with diabetic foot ulcers (DFUs). Methods Semi-structured online interviews were conducted with patients, carers and HCPs in wound care for DFUs. The participants were recruited from a primary care polyclinic network and two tertiary hospitals in Singapore, within the same healthcare cluster. Purposive maximum variation sampling was used to select participants with differing attributes to ensure heterogeneity. Common themes relating to the wound imaging app were captured. Results A total of 20 patients, 5 carers and 20 HCPs participated in the qualitative study. None of the participants have used a wound imaging app before. Regarding a patient-owned wound surveillance app, all were open and receptive to the system and workflow for use in DFU care. Four major themes emerged from patients and carers: (1) technology, (2) application features and usability, (3) feasibility of using the wound imaging application and (4) logistics of care. Four major themes were identified from HCPs: (1) attitudes towards wound imaging app, (2) preferences regarding functionality, (3) perceived challenges for patients/carers and (4) perceived barriers for HCPs. Conclusion Our study highlighted several barriers and facilitators from patients, carers and HCPs regarding the use of a patient-owned wound surveillance app. These findings demonstrate the potential of digital health and areas to improve and tailor a DFU wound app suitable for implementation in the local population.

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BACKGROUND Type 2 diabetes is becoming more prevalent around the world, including in Singapore. Diabetes education programs have been proven to be effective in improving health outcomes and diabetes self-management skills. Several effective approaches to diabetes education in patients with type 2 diabetes have been established, including the use of mobile health applications. Despite strong evidence of their efficacy, these apps are not always well-utilized or accepted by the target population. End-user feedback is essential for designing a feasible and acceptable app that can improve outcomes for chronic disease populations. OBJECTIVE We applied a mixed-methods, end-user-engaged approach to co-design an education app prototype for patients with type 2 diabetes to explore their perceptions, acceptance and usability of the prototype, as well their diabetes experience and perspectives on digital diabetes education. METHODS The study was conducted between August 2021 and January 2022. Participants were eight diabetic patients recruited from diabetes management Facebook groups. A total of six data points were collected: four web-based surveys and two structured interviews via Zoom. Descriptive statistics and thematic analyses of discussion and iterative feedback on the app prototype were used to assess perceptions of living with diabetes, attitudes toward digital diabetes education, and acceptance of the prototype. RESULTS The data collected were grouped into 3 deductive themes: (1) challenges of living with diabetes, (2) validation, acceptability, and usability of diabetes education app prototype, and (3) perspectives on digital diabetes education. The first theme highlighted the importance and burden of solitary accountability, translating knowledge into practice, and developing pragmatic self-consciousness. The second indicated that the diabetes education app prototype is acceptable, with information being the key, power of appearance, ambivalent and polarized opinions toward the chatbot, and potential impact of the app on self-management. The third theme comprised the necessity of utilizing a variety of information seeking strategies and recommendations for desired content and app qualities, including accessibility, adaptability, autonomy, evidence-based, gamification, guidance, integration, personalization, and up-to-date. CONCLUSIONS Our findings could be used for the development of apps to address the health needs of patients with type 2 diabetes. They also add context for understanding type 2 diabetes patients in Singapore, including challenges in self-management and perspectives on diabetes education.