Co-Creating a Synchronous Tele-Education Program With Community-Dwelling Older Adults Using a Participatory Approach: A Mixed-Methods Study.

There is a pressing need to include older individuals in health education and uncover their specific needs. Leveraging the advantages of digitized health education, this study employed a participatory approach to engage community-dwelling older adults in co-creating a synchronous tele-education program, with dementia as the focus due to its rising prevalence and associated stigma in Singapore. Our findings demonstrate the preliminary effectiveness and feasibility of tele-education. Participants' feedback and recommendations provided valuable insights and could guide the future development of a comprehensive tele-education program. Participants' satisfaction with the co-design workshops also indicates the potential of involving older generations in the design process of user-centered digital health interventions in online environments. Moving forward, the study advocates collaboration among health institutes, government and social agencies, and community organizations, alongside systematic evaluation of the long-term impacts of tele-education, with the aim of improving health outcomes and reducing health inequalities among the older population.

A pilot randomised controlled trial exploring the feasibility and efficacy of a human-AI sleep coaching model for improving sleep among university students.

Objective: Sleep quality is a crucial concern, particularly among youth. The integration of health coaching with question-answering (QA) systems presents the potential to foster behavioural changes and enhance health outcomes. This study proposes a novel human-AI sleep coaching model, combining health coaching by peers and a QA system, and assesses its feasibility and efficacy in improving university students' sleep quality. Methods: In a four-week unblinded pilot randomised controlled trial, 59 university students (mean age: 21.9; 64% males) were randomly assigned to the intervention (health coaching and QA system; n = 30) or the control conditions (QA system; n = 29). Outcomes included efficacy of the intervention on sleep quality (Pittsburgh Sleep Quality Index; PSQI), objective and self-reported sleep measures (obtained from Fitbit and sleep diaries) and feasibility of the study procedures and the intervention. Results: Analysis revealed no significant differences in sleep quality (PSQI) between intervention and control groups (adjusted mean difference = -0.51, 95% CI: [-1.55-0.77], p = 0.40). The intervention group demonstrated significant improvements in Fitbit measures of total sleep time (adjusted mean difference = 32.5, 95% CI: [5.9-59.1], p = 0.02) and time in bed (adjusted mean difference = 32.3, 95% CI: [2.7-61.9], p = 0.03) compared to the control group, although other sleep measures were insignificant. Adherence was high, with the majority of the intervention group attending all health coaching sessions. Most participants completed baseline and post-intervention self-report measures, all diary entries, and consistently wore Fitbits during sleep. Conclusions: The proposed model showed improvements in specific sleep measures for university students and the feasibility of the study procedures and intervention. Future research may extend the intervention period to see substantive sleep quality improvements.

Addressing Data Absenteeism and Technology Chauvinism in the Use of Gamified Wearable Gloves Among Older Adults: Moderated Usability Study.

BACKGROUND: Digital health technologies have the potential to improve health outcomes for older adults, especially for those recovering from stroke. However, there are challenges to developing these technologies, such as data absenteeism (where older adults' views are often underrepresented in research and development) and technology chauvinism (the belief that sophisticated technology alone is the panacea to addressing health problems), which hinder their effectiveness. OBJECTIVE: In this study, we aimed to address these challenges by developing a wearable glove integrated with culturally relevant exergames to motivate older adults to exercise and, for those recovering from stroke, to adhere to rehabilitation. METHODS: We conducted a moderated usability study with 19 older adults, of which 11 (58%) had a history of stroke. Our participants engaged in a 30-minute gameplay session with the wearable glove integrated with exergames, followed by a quantitative survey and an in-depth interview. We used descriptive analysis to compare responses to the System Usability Scale between those who had a history of stroke and those who did not. In addition, we analyzed the qualitative interviews using a bottom-up thematic analysis to identify key themes related to the motivations and barriers regarding the use of wearable gloves for rehabilitation and exercise. RESULTS: Our study generated several key insights. First, making the exergames exciting and challenging could improve exercise and rehabilitation motivation, but it could also have a boomerang effect, where participants may become demotivated if the games were very challenging. Second, the comfort and ease of use of the wearable gloves were important for older adults, regardless of their stroke history. Third, for older adults with a history of stroke, the functionality and purpose of the wearable glove were important in helping them with specific exercise movements. CONCLUSIONS: Our findings highlight the importance of providing contextual support for the effective use of digital technologies, particularly for older adults recovering from stroke. In addition to technology and usability factors, other contextual factors such as gamification and social support (from occupational therapists or caregivers) should be considered to provide a comprehensive approach to addressing health problems. To overcome data absenteeism and technology chauvinism, it is important to develop digital health technologies that are tailored to the needs of underserved communities. Our study provides valuable insights for the development of digital health technologies that can motivate older adults recovering from stroke to exercise and adhere to rehabilitation.

Attrition in Conversational Agent-Delivered Mental Health Interventions: Systematic Review and Meta-Analysis.

BACKGROUND: Conversational agents (CAs) or chatbots are computer programs that mimic human conversation. They have the potential to improve access to mental health interventions through automated, scalable, and personalized delivery of psychotherapeutic content. However, digital health interventions, including those delivered by CAs, often have high attrition rates. Identifying the factors associated with attrition is critical to improving future clinical trials. OBJECTIVE: This review aims to estimate the overall and differential rates of attrition in CA-delivered mental health interventions (CA interventions), evaluate the impact of study design and intervention-related aspects on attrition, and describe study design features aimed at reducing or mitigating study attrition. METHODS: We searched PubMed, Embase (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials, and Web of Science, and conducted a gray literature search on Google Scholar in June 2022. We included randomized controlled trials that compared CA interventions against control groups and excluded studies that lasted for 1 session only and used Wizard of Oz interventions. We also assessed the risk of bias in the included studies using the Cochrane Risk of Bias Tool 2.0. Random-effects proportional meta-analysis was applied to calculate the pooled dropout rates in the intervention groups. Random-effects meta-analysis was used to compare the attrition rate in the intervention groups with that in the control groups. We used a narrative review to summarize the findings. RESULTS: The systematic search retrieved 4566 records from peer-reviewed databases and citation searches, of which 41 (0.90%) randomized controlled trials met the inclusion criteria. The meta-analytic overall attrition rate in the intervention group was 21.84% (95% CI 16.74%-27.36%; I2=94%). Short-term studies that lasted ≤8 weeks showed a lower attrition rate (18.05%, 95% CI 9.91%- 27.76%; I2=94.6%) than long-term studies that lasted >8 weeks (26.59%, 95% CI 20.09%-33.63%; I2=93.89%). Intervention group participants were more likely to attrit than control group participants for short-term (log odds ratio 1.22, 95% CI 0.99-1.50; I2=21.89%) and long-term studies (log odds ratio 1.33, 95% CI 1.08-1.65; I2=49.43%). Intervention-related characteristics associated with higher attrition include stand-alone CA interventions without human support, not having a symptom tracker feature, no visual representation of the CA, and comparing CA interventions with waitlist controls. No participant-level factor reliably predicted attrition. CONCLUSIONS: Our results indicated that approximately one-fifth of the participants will drop out from CA interventions in short-term studies. High heterogeneities made it difficult to generalize the findings. Our results suggested that future CA interventions should adopt a blended design with human support, use symptom tracking, compare CA intervention groups against active controls rather than waitlist controls, and include a visual representation of the CA to reduce the attrition rate. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42022341415; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341415.

Examining COVID-19 Tweet Diffusion Using an Integrated Social Amplification of Risk and Issue-Attention Cycle Framework.

Drawing upon the social amplification of risk (SARF) and the issue-attention cycle framework, we examined the amplification of COVID-19 risk-related tweets through (a) topics: key interests of discussion; (b) temperament: emotions of tweets; (c) topography (i.e., location); and (d) temporality (i.e., over time). We computationally analyzed 1,641,273 tweets, and conducted manual content analysis on a subset of 6,000 tweets to identify how topics, temperament, and topography of COVID-19 tweets were associated with risk amplification - retweet and favorite count - using negative binomial regression. We found 11 dominant COVID-19 topics-health impact, economic impact, reports of lockdowns, report of new cases, the need to stay home, coping with COVID-19, news about President Trump, government support, fight with COVID-19 by non-government entities, origins, and preventive measure in our corpus of tweets across the issue-attention cycle. The negative binomial regression results showed that at the pre-problem stage, topics on President Trump, speculation of origins, and initiatives to fight COVID-19 by non-government entities were most likely to be amplified, underscoring the inherent politicization of COVID-19 and erosion of trust in governments from the start of the pandemic. We also found that while tweets with negative emotions were consistently amplified throughout the issue-attention cycle, surprisingly tweets with positive emotions were amplified during the height of the pandemic - this counter-intuitive finding indicated signs of premature and misplaced optimism. Finally, our results showed that the locations of COVID-19 tweet amplification corresponded to the shifting COVID-19 hotspots across different continents across the issue-attention cycle. Theoretical and practical implications of risk amplification on social media are discussed.

Decision-making Factors Toward the Adoption of Smart Home Sensors by Older Adults in Singapore: Mixed Methods Study.

BACKGROUND: An increasing aging population has become a pressing problem in many countries. Smart systems and intelligent technologies support aging in place, thereby alleviating the strain on health care systems. OBJECTIVE: This study aims to identify decision-making factors involved in the adoption of smart home sensors (SHS) by older adults in Singapore. METHODS: The study involved 3 phases: as an intervention, SHS were installed in older adults' homes (N=42) for 4 to 5 weeks; in-depth semistructured interviews were conducted with 18 older adults, 2 center managers, 1 family caregiver, and 1 volunteer to understand the factors involved in the decision-making process toward adoption of SHS; and follow-up feedback was collected from 42 older adult participants to understand the reasons for adopting or not adopting SHS. RESULTS: Of the 42 participants, 31 (74%) adopted SHS after the intervention, whereas 11 (26%) did not adopt SHS. The reasons for not adopting SHS ranged from privacy concerns to a lack of family support. Some participants did not fully understand SHS functionality and did not perceive the benefits of using SHS. From the interviews, we found that the decision-making process toward the adoption of SHS technology involved intrinsic factors, such as understanding the technology and perceiving its usefulness and benefits, and more extrinsic factors, such as considering affordability and care support from the community. CONCLUSIONS: We found that training and a strong support ecosystem could empower older adults in their decision to adopt technology. We advise the consideration of human values and involvement of older adults in the design process to build user-centric assistive technology.

Understanding the effects of message cues on COVID-19 information sharing on Twitter.

Analyzing and documenting human information behaviors in the context of global public health crises such as the COVID-19 pandemic are critical to informing crisis management. Drawing on the Elaboration Likelihood Model, this study investigates how three types of peripheral cues-content richness, emotional valence, and communication topic-are associated with COVID-19 information sharing on Twitter. We used computational methods, combining Latent Dirichlet Allocation topic modeling with psycholinguistic indicators obtained from the Linguistic Inquiry and Word Count dictionary to measure these concepts and built a research model to assess their effects on information sharing. Results showed that content richness was negatively associated with information sharing. Tweets with negative emotions received more user engagement, whereas tweets with positive emotions were less likely to be disseminated. Further, tweets mentioning advisories tended to receive more retweets than those mentioning support and news updates. More importantly, emotional valence moderated the relationship between communication topics and information sharing-tweets discussing news updates and support conveying positive sentiments led to more information sharing; tweets mentioning the impact of COVID-19 with negative emotions triggered more sharing. Finally, theoretical and practical implications of this study are discussed in the context of global public health communication.

COVID-19 Tweet Links: A Preliminary Investigation of Type and Relevance.

We conducted an exploratory study of the links found in Twitter tweets. Our results showed that the largest category of tweet links was social media platforms followed by alternative news sites. Government agencies and educational institutions were under-represented. In terms of relevance, about 75% of the links were related to COVID-19 but disappointingly, only 40% of the links were directly related to their respective tweets' topics.

Conversational Agent for Healthy Lifestyle Behavior Change: Web-Based Feasibility Study.

BACKGROUND: The rising incidence of chronic diseases is a growing concern, especially in Singapore, which is one of the high-income countries with the highest prevalence of diabetes. Interventions that promote healthy lifestyle behavior changes have been proven to be effective in reducing the progression of prediabetes to diabetes, but their in-person delivery may not be feasible on a large scale. Novel technologies such as conversational agents are a potential alternative for delivering behavioral interventions that promote healthy lifestyle behavior changes to the public. OBJECTIVE: The aim of this study is to assess the feasibility and acceptability of using a conversational agent promoting healthy lifestyle behavior changes in the general population in Singapore. METHODS: We performed a web-based, single-arm feasibility study. The participants were recruited through Facebook over 4 weeks. The Facebook Messenger conversational agent was used to deliver the intervention. The conversations focused on diet, exercise, sleep, and stress and aimed to promote healthy lifestyle behavior changes and improve the participants' knowledge of diabetes. Messages were sent to the participants four times a week (once for each of the 4 topics of focus) for 4 weeks. We assessed the feasibility of recruitment, defined as at least 75% (150/200) of our target sample of 200 participants in 4 weeks, as well as retention, defined as 33% (66/200) of the recruited sample completing the study. We also assessed the participants' satisfaction with, and usability of, the conversational agent. In addition, we performed baseline and follow-up assessments of quality of life, diabetes knowledge and risk perception, diet, exercise, sleep, and stress. RESULTS: We recruited 37.5% (75/200) of the target sample size in 1 month. Of the 75 eligible participants, 60 (80%) provided digital informed consent and completed baseline assessments. Of these 60 participants, 56 (93%) followed the study through till completion. Retention was high at 93% (56/60), along with engagement, denoted by 50% (30/60) of the participants communicating with the conversational agent at each interaction. Acceptability, usability, and satisfaction were generally high. Preliminary efficacy of the intervention showed no definitive improvements in health-related behavior. CONCLUSIONS: The delivery of a conversational agent for healthy lifestyle behavior change through Facebook Messenger was feasible and acceptable. We were unable to recruit our planned sample solely using the free options in Facebook. However, participant retention and conversational agent engagement rates were high. Our findings provide important insights to inform the design of a future randomized controlled trial.

Understanding the Temporal Effects on Tweetcussion of COVID-19 Vaccine.

In the fight against COVID-19, the Pfizer and BioNTech vaccine announcement marked a significant turning point. Analysing the topics discussed surrounding the announcement is critical to shed light on how people respond to the vaccination against COVID-19. Specifically, since the COVID-19 vaccine was developed at unprecedented speed, different segments of the public with a different understanding of the issues may react and respond differently. We analysed Twitter tweets to uncover the issues surrounding people's discussion of the vaccination against COVID-19. Through the use of Latent Dirichlet Allocation (LDA), nine topics were identified pertaining to vaccine-related tweets. We analysed the temporal differences in the nine topics, prior and after the official vaccine announcement.

Wii or Kinect? A Pilot Study of the Exergame Effects on Older Adults' Physical Fitness and Psychological Perception.

Exergames are now often implemented among older adults for health purposes. This study aimed to investigate whether playing Kinect and Wii exergames has effects on older adults' physical fitness and psychological perceptions towards exergames. A total of 23 older participants aged above 60 years were recruited and randomly assigned into two groups, in which they played either Kinect or Wii Bowling exergames for three sessions in one week. Physiological and psychological measures were collected including heart rate, blood pressure, shoulder flexibility, as well as perceived benefits and intentions for future use. Findings indicated that exergames are equivalent to light-intensity exercises, and hence pose no or minimal risk to older adults. Older adults had a positive attitude towards exergames and have a strong willingness to engage in exergaming on a regular basis. Although no significant platform difference was identified, observation and qualitative findings suggested that Wii might provide a more intense physical activity than Kinect, while Kinect might obtain a higher perception among older adults than Wii. The study has several practical implications for both health professionals and exergame designers targeting the ageing population.

Effectiveness of eHealth Nutritional Interventions for Middle-Aged and Older Adults: Systematic Review and Meta-analysis.

BACKGROUND: The risk of development of chronic diseases related to poor nutrition increases with age. In the face of an aging population, it is important for health care sectors to find solutions in delivering health services efficiently and effectively to middle-aged and older adults. OBJECTIVE: The aim of this systematic review and meta-analysis was to consolidate the literature that reported the effectiveness of eHealth apps in delivering nutritional interventions for middle-aged and older adults. METHODS: A literature search from five databases (PubMed, CINAHL, Cochrane, Web of Science, and Global Health) from the past 5 years was performed. Studies were selected for inclusion that used eHealth to deliver nutritional interventions to adults aged 40 years and above, and reported health and behavioral outcomes. Two independent reviewers searched for research articles and assessed the eligibility of studies to be included in the review. A third reviewer resolved disagreements on study inclusion. We also assessed the quality of the included studies using the CONSORT 2010 checklist. RESULTS: A total of 70 studies were included for analysis. The study quality ranged from 44% to 85%. The most commonly used eHealth intervention type was mobile apps (22/70, 31%). The majority of studies (62/70, 89%) provided multicomponent health interventions, which aimed to improve nutrition and other health behaviors (eg, exercise, smoking cessation, medication adherence). Meta-analysis results indicated high and significant heterogeneity; hence, conclusions based on these results should be considered with caution. Nonetheless, the results generally showed that eHealth interventions improved anthropometric and clinical outcomes, but not behavioral outcomes such as fruit and vegetable consumption. CONCLUSIONS: The use of eHealth apps to deliver health interventions has been increasing in recent years, and these apps have the potential to deliver health services to a larger group of people. Our findings showed that the effectiveness of eHealth apps to deliver health interventions for middle-aged to older adults was supported by the improvement of anthropometric and clinical outcomes. Future work could aim to develop research frameworks in administering eHealth interventions to address heterogeneity in this field of research.

Examining Organizational, Cultural, and Individual-Level Factors Related to Workplace Safety and Health: A Systematic Review and Metric Analysis.

One major gap in existing health communication research is that few studies have synthesized findings from the literature to map out what are the key factors related to workplace (a) safety awareness, (b) safety risks, (c) health awareness, and (d) health risks. This study bridges the gap by systematically reviewing what these organizational, cultural, and individual-level factors are, and examine the impact of workplace safety and health publications using traditional and alternative metrics in academic and non-academic settings. Through an iterative process of coding, the results revealed six categories of organizational (management commitment, management support, organizational safety communication, safety management systems, physical work environment, and organizational environment), two cultural (interpersonal support and organizational culture), and four individual-level (perception, motivation, attitude, and behavior) factors. In terms of impact, articles that were most impactful in academia (e.g., high citation count) may not necessarily receive the same amount of online attention from the public. Theoretical and practical implications for health communication were discussed.

Exergaming as a Community Program for Older Adults: The Effects of Social Interaction and Competitive Information.

This study examined how different types of social interaction and competitive information in exergaming affect older adults' motivation and attitude toward playing exergames. A 2 (time: pre- vs. posttest) × 3 (social interaction: play alone vs. play with peer vs. play with youth) × 2 (competition: competition informed vs. noncompetition informed) mixed experiment was conducted with 319 Singaporean older adults over 6 weeks through a three-way analysis of variance. Social interaction was found to significantly affect the changes of extrinsic motivation over time, while competitive information affected intrinsic motivation significantly. The results showed significant three-way interaction effects between time, social interaction, and competitive information on older adults' extrinsic and intrinsic motivations. The changes of attitude over time were not affected by either social interaction or competitive information. The findings contribute to aging research and advance the knowledge of potential factors that promote the effective implementation of exergames for community older adults.

Play Mode Effect of Exergames on Subthreshold Depression Older Adults: A Randomized Pilot Trial.

BACKGROUND: Subthreshold depression is a common mental disorder in late life. Increasing studies have supported the positive effects of exergames to subthreshold depression. The current study aims to investigate how play mode potentially affects exergames' effects on subthreshold depression among older adults. METHOD: A between-group experiment was carried out to compare the effect of exergames with different play modes. Fifty-two Singaporean older adults with subthreshold depression were randomly assigned into two conditions, and performed either single-player or multiple-player Nintendo Wii Tennis exergames for 6 weeks, while the key variables of depression, social support and loneliness were measured at both pre- and post-study period. RESULTS: Findings from path analysis suggested that older adults in multiple-player exergames experienced lower levels of loneliness, and further more reduction on subthreshold depression, when compared to those in single-player exergames. Although social support was not affected by play mode, the significant relationship among social support, loneliness, and depression was found in the context of exergaming. CONCLUSION: This study not only provides additional insight into a possible causal association lining play mode and health outcomes of exergames, but also opens the discussion of how to optimize antidepressive effect of exergames for older adults.

Health information seeking behaviour using mobile devices among people with diabetes: A comparison between Middle and high income country.

OBJECTIVE: The internet has become a primary source of information for many individuals especially those with chronic diseases. This study aims to understand and compare the health seeking behaviour using mobile devices among individuals with diabetes and between a high (Singapore) and middle (Malaysia) income country. METHODS: A cross sectional survey was conducted among people with diabetes in Malaysia and Singapore. Participants attending the primary health clinic for the treatment of diabetes were approached to participate in this survey. Data on demographics, health status and beliefs to health were collected and compared. RESULTS: A total of 673 respondents were included in the study. Most of the respondents reported to have access to the Internet, with a high ownership of mobile phones (99.3%). However, only one in every three respondents sought information online. Younger individuals (≤50 years) and those with higher education more likely to seek information using mobile devices. Respondents in Singapore reported to be more likely to use mobile devices to monitor their health as compared to respondents in Malaysia. However, most respondents would seek health information from their healthcare professionals' especially physicians. CONCLUSION: There was limited differences in the health-seeking behaviour among the respondents from both countries, suggesting for a need to identify for more effective means of distribution of health related information.

Conversational Agents in Health Care: Scoping Review and Conceptual Analysis.

BACKGROUND: Conversational agents, also known as chatbots, are computer programs designed to simulate human text or verbal conversations. They are increasingly used in a range of fields, including health care. By enabling better accessibility, personalization, and efficiency, conversational agents have the potential to improve patient care. OBJECTIVE: This study aimed to review the current applications, gaps, and challenges in the literature on conversational agents in health care and provide recommendations for their future research, design, and application. METHODS: We performed a scoping review. A broad literature search was performed in MEDLINE (Medical Literature Analysis and Retrieval System Online; Ovid), EMBASE (Excerpta Medica database; Ovid), PubMed, Scopus, and Cochrane Central with the search terms "conversational agents," "conversational AI," "chatbots," and associated synonyms. We also searched the gray literature using sources such as the OCLC (Online Computer Library Center) WorldCat database and ResearchGate in April 2019. Reference lists of relevant articles were checked for further articles. Screening and data extraction were performed in parallel by 2 reviewers. The included evidence was analyzed narratively by employing the principles of thematic analysis. RESULTS: The literature search yielded 47 study reports (45 articles and 2 ongoing clinical trials) that matched the inclusion criteria. The identified conversational agents were largely delivered via smartphone apps (n=23) and used free text only as the main input (n=19) and output (n=30) modality. Case studies describing chatbot development (n=18) were the most prevalent, and only 11 randomized controlled trials were identified. The 3 most commonly reported conversational agent applications in the literature were treatment and monitoring, health care service support, and patient education. CONCLUSIONS: The literature on conversational agents in health care is largely descriptive and aimed at treatment and monitoring and health service support. It mostly reports on text-based, artificial intelligence-driven, and smartphone app-delivered conversational agents. There is an urgent need for a robust evaluation of diverse health care conversational agents' formats, focusing on their acceptability, safety, and effectiveness.

Information needs and information seeking behaviour of people with dementia and their non-professional caregivers: a scoping review.

BACKGROUND: People with dementia often require full-time caregivers especially in the later stages of their condition. People with dementia and caregivers' access to reliable information on dementia is essential as it may have an important impact on patient care and quality of life. This study aims to provide an overview of the information needs and information seeking behaviour of people with dementia and their non-professional caregivers. METHODS: We conducted a scoping review of the literature and searched four electronic databases for eligible studies published up to August 2018. Two reviewers independently screened studies and extracted data. Information needs were classified according to emerging themes in the literature, and information seeking behaviour was categorized using Wilson's model of information behaviour. RESULTS: Twenty studies with a total of 4140 participants, were included in this review. Reported information needs focused on: (i) disease; (ii) patient care provision; (iii) healthcare services; and (iv) caregiver self-care. The most commonly reported information need was on healthcare service-related information. Characteristics found to influence information needs were the severity of dementia as well as patient and caregiver status. People with dementia and non-professional caregivers mainly displayed active searching, information seeking behaviour and preferred using electronic sources to obtain health information. CONCLUSION: Current dementia information sources available in English are extensive in the information they offer, but more emphasis needs to be placed on healthcare service-related information. All studies originated from high income countries and focused on information needs of non-professional caregivers only. The only variables found to be associated to information needs were severity of dementia condition as well as patient/caregiver status. The information needs identified in this review can be used to inform development and design of future dementia resources for people with dementia and their non-professional caregivers.

Influence of Organizational Issues on Nurse Administrators' Support to Staff Nurses' Use of Smartphones for Work Purposes in the Philippines: Focus Group Study.

BACKGROUND: Studies show that nurses use their own smartphones for work purposes, and there are several organizational issues related to this. However, it is unclear what these organizational issues are in the Philippines and the influence they have on nurse administrators' (ie, superiors) support to staff nurses' (ie, subordinates) use of smartphones for work purposes. OBJECTIVE: Drawing from the Organizational Support Theory (OST), this study aimed to identify organizational issues that influence nurse administrators' support to staff nurses' use of smartphones for work purposes. METHODS: Between June and July 2017, 9 focus groups with 43 nurse administrators (ie, head nurses, nurse supervisors, and nurse managers) were conducted in 9 tertiary-level general hospitals in Metro Manila, the Philippines. Drawing from OST, issues were classified as those that encouraged or inhibited nurse administrators to support nurses' use of smartphones for work purposes. RESULTS: Nurse administrators were encouraged to support nurses' use of smartphones for work purposes when (1) personal smartphones are superior to workplace technologies, (2) personal smartphones resolve unit phone problems, and (3) policy is unrealistic to implement. Conversely, issues that inhibited nurse administrators to support nurses' use of smartphones for work purposes include (1) smartphone use for nonwork purposes and (2) misinterpretation by patients. CONCLUSIONS: Nurse administrators in the Philippines faced several organizational issues that encouraged or inhibited support to staff nurses' use of smartphones for work purposes. Following OST, the extent of their support can influence staff nurses' perceived organizational support on the use of smartphones for work purposes, Overall, the findings highlight the role and implication of organizational support in the context of smartphone consumerization in hospital settings, especially in developing countries.

The Aging of a Young Nation: Population Aging in Singapore.

The juxtaposition of a young city-state showing relative maturity as a rapidly aging society suffuses the population aging narrative in Singapore and places the "little red dot" on the spotlight of international aging. We first describe population aging in Singapore, including the characteristic events that shaped this demographic transition. We then detail the health care and socioeconomic ramifications of the rapid and significant shift to an aging society, followed by an overview of the main aging research areas in Singapore, including selected population-based data sets and the main thrust of leading aging research centers/institutes. After presenting established aging policies and programs, we also discuss current and emerging policy issues surrounding population aging in Singapore. We aim to contribute to the international aging literature by describing Singapore's position and extensive experience in managing the challenges and maximizing the potential of an aging population. We hope that similar graying populations in the region will find the material as a rich source of information and learning opportunities. Ultimately, we aspire to encourage transformative collaborations-locally, regionally, and internationally-and provide valuable insights for policy and practice.