Abstract
Background: The burden of chronic care has been increasing in Singapore with approximately 1 in 4 Singaporeans aged 40 years and above living with at least one chronic condition (diabetes, high blood pressure, high blood cholesterol and stroke) in 2023. To effectively address the growing burden of chronic care in Singapore, a collaborative approach involving key stakeholders is crucial. Public-Private Partnerships (PPPs) play a crucial role in addressing complex healthcare challenges. This study focuses on evaluation of the GetHealthier Programme, a specific PPP initiative aimed at enabling healthy behaviours for the prevention and management of chronic diseases through a phone App and involves key stakeholders from both the public and private sectors. These stakeholders have different roles and responsibilities: Fitbit Health provides wearable technology, ConnectedLife contributes to evidence-based population health solutions, Alexandra Hospital provides health coaches, Starhub provides the digital platform, and General Physicians serve as the first line of care.
Method: We present a case study using a mixed-methods approach, incorporating social network analysis, and stakeholder theory as a theoretical research framework. This framework enables a comprehensive assessment of the co-design process, stakeholder interactions, network structures, and their influence on promoting preventive health behaviour within the PPP ecosystem. Social network analysis enables the mapping and analysis of stakeholder relationships, information flow, and collaboration patterns within the PPP ecosystem. Stakeholder theory provides insights into the roles, interests, power dynamics among stakeholders, and their influence on decision-making processes.
This research incorporates both qualitative and quantitative data collection methods. This approach enables a detailed exploration of the co-design process, stakeholder interactions, and the impact of network structures on promoting healthy behaviours for the prevention and management of chronic diseases.
As a part of data analysis, social network analysis is conducted to map stakeholder relationships, network centrality measures, and the flow of information within the ecosystem. Qualitative data from interviews, and document analysis is analysed using thematic analysis techniques to identify key themes, patterns, and stakeholder perspectives. Quantitative data from surveys is analysed using statistical methods to measure the impact of the PPP ecosystem on promoting preventive health behaviour.
Results: The study generates insights into the co-design process within the GetHealthier Programme as a PPP ecosystem for promoting healthy behaviours for prevention and management of chronic diseases. The findings contribute to understanding the structure, implementation, and operation of the PPP ecosystem, stakeholder roles and interactions, network structures, and their influence on co-creating an intervention. This research also provides recommendations and best practices for future PPPs.
Conclusion: This study focuses on the co-design of the GetHealthier Programme as a PPP ecosystem for prevention and management of chronic diseases. PPPs are crucial in bringing innovations to healthcare faster by engaging different stakeholders outside of the traditional healthcare sector. This study emphasizes the value of co-designing solutions that are fit for purpose, involving diverse stakeholders to avoid poor uptake. The PPP ecosystem seeks to generate novel and effective solutions for improving patient outcomes by integrating wearable technology, population health research, and health coaching.