Examining spousal and family support as predictors of long-term weight loss and remission of type 2 diabetes following bariatric surgery in Singapore: a retrospective cohort study.

OBJECTIVES: Postoperative outcomes vary considerably across bariatric patients and may be related to psychosocial factors. In this study, we examined whether a patient's family support predicts postsurgical weight loss and the remission of type 2 diabetes mellitus (T2DM). DESIGN: Retrospective cohort study in Singapore. SETTING: Participants were recruited from a public hospital in Singapore. PARTICIPANTS: Between 2008 and 2018, 359 patients completed a presurgical questionnaire before undergoing gastric bypass or sleeve gastrectomy. OUTCOME MEASURES: As part of the questionnaire, patients described their family support in terms of structure (marital status, number of family members in the household) and function (marriage satisfaction, family emotional support, family practical support). Linear mixed-effects and Cox proportional-hazard models were used to examine whether these family support variables predicted percent total weight loss or T2DM remission up to 5 years postsurgery. T2DM remission was defined as glycated haemoglobin (HbA1c) <6.0% without medications. RESULTS: Participants had a mean preoperative body mass index of 42.6±7.7 kg/m2 and HbA1c (%) of 6.82±1.67. Marital satisfaction was found to be a significant predictor of postsurgical weight trajectories. Namely, patients who reported higher marital satisfaction were more likely to sustain weight loss than patients who reported lower marital satisfaction (ß=0.92, SE=0.37, p=0.02). Family support did not significantly predict T2DM remission. CONCLUSIONS: Given the link between marital support and long-term weight outcomes, providers could consider asking patients about their spousal relationships during presurgical counselling. TRIAL REGISTRATION NUMBER: NCT04303611.

Predicting Public Uptake of Digital Contact Tracing During the COVID-19 Pandemic: Results From a Nationwide Survey in Singapore.

BACKGROUND: During the COVID-19 pandemic, new digital solutions have been developed for infection control. In particular, contact tracing mobile apps provide a means for governments to manage both health and economic concerns. However, public reception of these apps is paramount to their success, and global uptake rates have been low. OBJECTIVE: In this study, we sought to identify the characteristics of individuals or factors potentially associated with voluntary downloads of a contact tracing mobile app in Singapore. METHODS: A cohort of 505 adults from the general community completed an online survey. As the primary outcome measure, participants were asked to indicate whether they had downloaded the contact tracing app TraceTogether introduced at the national level. The following were assessed as predictor variables: (1) participant demographics, (2) behavioral modifications on account of the pandemic, and (3) pandemic severity (the number of cases and lockdown status). RESULTS: Within our data set, the strongest predictor of the uptake of TraceTogether was the extent to which individuals had already adjusted their lifestyles because of the pandemic (z=13.56; P<.001). Network analyses revealed that uptake was most related to the following: using hand sanitizers, avoiding public transport, and preferring outdoor over indoor venues during the pandemic. However, demographic and situational characteristics were not significantly associated with app downloads. CONCLUSIONS: Efforts to introduce contact tracing apps could capitalize on pandemic-related behavioral adjustments among individuals. Given that a large number of individuals is required to download contact tracing apps for contact tracing to be effective, further studies are required to understand how citizens respond to contact tracing apps. TRIAL REGISTRATION: ClinicalTrials.gov NCT04468581, https://clinicaltrials.gov/ct2/show/NCT04468581.