According to Dr Wong Sweet Fun, senior consultant in KTPH’s Geriatric Medicine department and Clinical Director of Yishun Health’s Population Health and Community Transformation, “Just focusing on addressing medical needs, which constitute 10 per cent of patients' health determinants, is inadequate to keep them well in their homes and community. Sixty per cent of one's health is determined by social, behavioural and environmental factors.”1
An eight-month ethnography research was done to understand how the older residents interacted in community spaces. The research covered a total land area of 1.3km2 and collected 259 hours of interview records conducted with 79 residents, together with 1,796 photographs and videos. To gain a holistic view of the community, interviews were conducted at different times and days to involve different community stakeholders, from the residents to store owners and members of the merchant association.2
The researchers observed the creative ways in which the residents used public spaces. In-depth interviews also distilled some themes that mattered to the older adults: the need for security and freedom, the importance of having meaningful roles and responsibilities, and staying connected while being relevant to the community.
The uncertainty brought about by ageing and the need to seek connection with others just like in the old kampung days in the neighbourhood drew older adults into the public spaces to re-create a sense of community with others. Five archetypes of residents were identified to help the research team understand the community dynamics and roles of respondents to the study.
An exhibition on the ethnography study was then created to inform these insights and solicit ideas from KTPH staff and visitors. Approximately 300 visitors have visited the exhibition. Study trips to Japan and local social service centres helped the design team to learn effective ways to engage the community.
In 2016, KTPH launched an initiative called the Wellness Kampung®, a network of three wellness and care centres at HDB void deck spaces to provide a platform for a suite of health and social programmes.3
This meant empowering residents to exercise choice and control in their daily health and wellness decisions through preventive measures such as healthy cooking and food selection, daily exercise, health screening and coaching.
As part of the Wellness Kampung initiative, residents enjoy a nutritious bowl of soup
to promote healthy eating amongst the community.
The community living room concept was designed to build a stronger support network for residents to inspire each other to adopt healthier lifestyles. Residents who visit the Wellness Kampung were regarded as community assets and strengths; they planned and implemented the programmes, drawing upon talents and experience among themselves. The “stealth health” component was integrated into their daily choices in a natural choice architecture.
A deliberate design to blur the boundaries between interior and exterior space, using see-through folding glass walls, serve as an invitation for residents casually passing by to observe, enquire and eventually use the premises for their enjoyment. The use of positive language to convey the emphasis on wellness and community was key in the design. Technical terms used by healthcare professionals were dropped in favour of commonly used words, for example “food” and not “nutrition” or “diet.”
As part of the Wellness Kampung initiative, the award-winning4,5 Share a Pot® programme was introduced to improve nutrition, fitness and social networks of the residents. Residents get together to exercise and then enjoy a bowl of nutritious soup together. The combination of exercise and protein in the soup stimulates a prolonged increase in muscle synthesis for as long as 24 hours after consumption. Beyond these weekly meet-ups, residents take ownership of their own fitness by tracking their daily steps with pedometers in exchange for reward stamps and tokens of participation. Regular participation gives residents the opportunity to fill their time with meaningful activities and expand their social circles, with many of the residents beginning to look out for each other.
Community nurses regularly hold conversations with residents at the Wellness Kampung on health concerns. These sessions are a welcome resource for simple ailments, hassle-free referrals to community help and advice for the residents. Over time, the nurses have gained the residents’ trust to become “their nurse friend.”