Sumali Hewage - Academia.edu (original) (raw)
Papers by Sumali Hewage
Clinical Otolaryngology, 2012
Singapore medical journal, 2021
INTRODUCTION To examine how ageing research in medical and social domains in Singapore has transf... more INTRODUCTION To examine how ageing research in medical and social domains in Singapore has transformed over time, this scoping review examined the number, types and characteristics of journal publications on ageing in Singapore from 2008 to 2018. METHODS Using relevant search terms, articles were extracted from multiple databases and then screened and reviewed for eligibility and inclusion by independent reviewers. Data such as title of the study, authors, year of publication, name of journal, type of journal, study design and the kind of data used were charted from the included articles for evidence synthesis. RESULTS Since 2008, there has been a steady increase in the number of publications on ageing in medical and social domains in Singapore. In the medical domain, publications in Ophthalmology formed the largest group of the existing medical literature on ageing in Singapore (22%), followed by Physical Functioning, which involved physiological measurements of physical well-being...
Supplemental material, sj-pdf-1-nmi-10.1177_11786388211016827 for Factors Associated with Intende... more Supplemental material, sj-pdf-1-nmi-10.1177_11786388211016827 for Factors Associated with Intended Postpartum OGTT Uptake and Willingness to Receive Preventive Behavior Support to Reduce Type 2 Diabetes Risk Among Women with Gestational Diabetes in Singapore: An Exploratory Study by Sumali S Hewage, Su Aw, Claudia Chi and Joanne Yoong in Nutrition and Metabolic Insights
Clinical diabetes : a publication of the American Diabetes Association, 2018
Gestational diabetes mellitus (GDM) increases the risk for type 2 diabetes. This qualitative stud... more Gestational diabetes mellitus (GDM) increases the risk for type 2 diabetes. This qualitative study aimed to evaluate health care providers' perceptions of care responsibilities and resources related to reducing type 2 diabetes risk among women with previous GDM in Singapore. Health care providers acknowledged a shared responsibility. They felt that they had less understanding of compliance with long-term maintenance of lifestyle change, exacerbated further by fragmentation of follow-up care. The application of more integrated patient-centered care models, combined with greater health literacy, is urgently required in this area.
Journal of the Academy of Nutrition and Dietetics, 2014
Background: Prince Edward Island is characterized by low household food security (HFS) compared t... more Background: Prince Edward Island is characterized by low household food security (HFS) compared to other Provinces, especially among female lone parents. Low produce intake may be linked to chronic disease and has been associated with household food insecurity. Research Outcome: This study examined differences in produce intake by food security status of adult mothers with young children living on Prince Edward Island and using Family Resource Center services. Methods: Survey of mothers !18 years [USDA HFS module; produce intake and behaviorrelated instrument]. USDA HFS module was scored using Canadian methods. SPSS software was used to tabulate data. Descriptive statistics were used to describe the sample, and ANOVA was used to assess for differences in produce intake among food security groups.
JMIR Formative Research, 2020
Background Gestational diabetes mellitus (GDM) is associated with risks for both the mother and c... more Background Gestational diabetes mellitus (GDM) is associated with risks for both the mother and child. The escalated prevalence of GDM because of obesity and changes in screening criteria demands for greater health care needs than before. Objective This study aimed to understand the perception of patients and health care providers of the barriers to GDM management and preferred interventions to manage GDM in an Asian setting. Methods This mixed methods study used a convergent parallel design. Survey data were collected from 216 women with GDM, and semistructured interviews were conducted with 15 women and with 8 health care providers treating patients with GDM. Participants were recruited from 2 specialized GDM clinics at the National University Hospital, Singapore. Results The patients were predominantly Chinese (102/214, 47.6%), employed (201/272, 73.9%), with higher education (150/216, 69.4%) and prenatal attendance at a private clinic (138/214, 64.2%), already on diet control (2...
Journal of the Academy of Nutrition and Dietetics
Clinical Nutrition ESPEN
OBJECTIVE Lifestyle interventions have been shown to be both effective and cost-effective in redu... more OBJECTIVE Lifestyle interventions have been shown to be both effective and cost-effective in reducing diabetes and metabolic risk in high-risk populations. We systematically reviewed the effectiveness and cost-effectiveness of lifestyle interventions on anthropometric, glycemic and cardiovascular outcomes in women with previous gestational diabetes mellitus (GDM). METHOD Relevant randomized control trials (RCT) were identified by searching multiple electronic databases through 20th June 2018. Data were pooled using random-effects models. The review protocol was registered on the PROSPERO international prospective register of systematic reviews (PROSPERO 2016: CRD42018108870). RESULTS Twenty-one studies met the inclusion criteria and 16 studies with outcome data were analyzed in the meta-analysis. No RCT studies included cost-effectiveness data on lifestyle interventions. The pooled estimate for postpartum weight showed a significant mean reduction in the intervention arm (-1.8 kg [95% CI: -2.9, -0.6; p = 0.002; I2 = 92.2%; p < 0.05]). Further, the effect of lifestyle intervention on weight change was significantly greater in studies of longer duration. Most of the other endpoints had modest improvements but only anthropometric endpoints were statistically significant. However, there was high heterogeneity between the studies. CONCLUSIONS Lifestyle interventions showed statistically and clinically significant improvements in anthropometric outcomes. However, more research is needed to explore lifestyle effects on glycemic and cardiovascular risk factors and to establish cost-effectiveness. Methodologically sound, large scale studies on diverse ethnicities and with longer follow-up would establish the real effect of lifestyle interventions to reduce diabetes risk in women with previous GDM.
HEWAGE, SUMALI S., M.S., May 2014, Food and Nutrition Sciences The Relationship of Food Security,... more HEWAGE, SUMALI S., M.S., May 2014, Food and Nutrition Sciences The Relationship of Food Security, Cervical Health, and Produce Intake in Rural Appalachia Director of Thesis: David H. Holben Food insecurity is associated with lower produce intake. Consumption of produce (vegetables and fruit) high in antioxidants may reduce risk of human papillomavirus (HPV) and cervical dysplasia. This study was designed to examine the differences in HPV status by food security status; differences in risky sexual behaviors by food security status; differences in produce intake/behaviors by food security status; differences in produce intake/behaviors by HPV status; and the association of produce intake/behaviors and food security, adjusted for demographic confounders including the HPV status among women in rural Appalachia who were attending a clinic for gynecological care. Females who were English speaking and writing, 21 years and older, and attending a health clinic for cervical screening/testing...
Nutrition and Metabolic Insights
Aim: To assess and explore the factors affecting willingness to undergo an early postpartum oral ... more Aim: To assess and explore the factors affecting willingness to undergo an early postpartum oral glucose tolerance test (OGTT) and receive postpartum lifestyle modification assistance. Methods: An explanatory sequential mixed-method design was used. A prenatal cross-sectional survey questionnaire (n = 216) was given to women diagnosed with GDM in a tertiary health institution in Singapore and followed up with postpartum semi-structured interviews (n = 30). Multivariate logistic regression and thematic analysis were conducted before merging the findings. Results: Despite universal GDM education, fewer than 75% intended to take the OGTT postpartum, and only 63% felt it was very important. The plan to take the OGTT postpartum was positively associated with a prenatal care provider’s specific recommendation. In contrast, Malay women were less likely to take the test. Most women interpreted a care provider’s recommendation as implying standard practice, which encouraged intended and actu...
The FASEB Journal, 2014
Background Low household food security (HFS) and high cervical cancer rates have been reported in... more Background Low household food security (HFS) and high cervical cancer rates have been reported in Appalachian Ohio. High antioxidant intake may reduce the risk of human papillomavirus (HPV) infection and progression to cervical cancer. Study Objective To examine interrelationship of HFS, produce intake/ behaviors, and cervical health in adult women living in rural Appalachia. Method Survey of females 蠅 21 years [USDA HFS module, produce intake and behavior-related instrument, and Risky Sexual Behavior (RSB) Index questionnaire]. Clinical HPV results were obtained. Results Participants (n=153) [HPV-negative, n=139 (91.4%); HPV-positive, n=13 (8.6%)] were 29.4±7.8 years. For HFS, 113 (75.3%) had high and 37 (24.7%) had marginal, low, or very low HFS. Statistically significant test results showed food insecure group had a higher RSB scores compared to their counterparts (p<0.001). RSB scores were statistically significantly higher in HPV-positive group than HPV-negative group (p=0.0...
Journal of the American Academy of Nutrition and Dietetics
The Faseb Journal, Apr 1, 2014
ABSTRACT Background Low household food security (HFS) and high cervical cancer rates have been re... more ABSTRACT Background Low household food security (HFS) and high cervical cancer rates have been reported in Appalachian Ohio. High antioxidant intake may reduce the risk of human papillomavirus (HPV) infection and progression to cervical cancer. Study Objective To examine interrelationship of HFS, produce intake/ behaviors, and cervical health in adult women living in rural Appalachia. Method Survey of females ≥ 21 years [USDA HFS module, produce intake and behavior-related instrument, and Risky Sexual Behavior (RSB) Index questionnaire]. Clinical HPV results were obtained. Results Participants (n=153) [HPV-negative, n=139 (91.4%); HPV-positive, n=13 (8.6%)] were 29.4±7.8 years. For HFS, 113 (75.3%) had high and 37 (24.7%) had marginal, low, or very low HFS. Statistically significant test results showed food insecure group had a higher RSB scores compared to their counterparts (p<0.001). RSB scores were statistically significantly higher in HPV-positive group than HPV-negative group (p=0.021). Test statistics provided a significant difference between food secure and food insecure groups in median perceived diet quality scores 78.68 and 59.57 respectively, p=0.014. Conclusion Food insecurity was associated with high RSB score and low perceived diet quality. Further studies are required. :
Background Low household food security (HFS) and high cervical cancer rates have been reported in... more Background Low household food security (HFS) and high cervical cancer rates have been reported in Appalachian Ohio. High antioxidant intake may reduce the risk of human papillomavirus (HPV) infection and progression to cervical cancer. Study Objective To examine interrelationship of HFS, produce intake/ behaviors, and cervical health in adult women living in rural Appalachia. Method Survey of females ≥ 21 years [USDA HFS module, produce intake and behavior-related instrument, and Risky Sexual Behavior (RSB) Index questionnaire]. Clinical HPV results were obtained. Results Participants (n=153) [HPV-negative, n=139 (91.4%); HPV-positive, n=13 (8.6%)] were 29.4±7.8 years. For HFS, 113 (75.3%) had high and 37 (24.7%) had marginal, low, or very low HFS. Statistically significant test results showed food insecure group had a higher RSB scores compared to their counterparts (p<0.001). RSB scores were statistically significantly higher in HPV-positive group than HPV-negative group (p=0.0...
BACKGROUND Gestational diabetes mellitus (GDM) is associated with risks for both the mother and c... more BACKGROUND Gestational diabetes mellitus (GDM) is associated with risks for both the mother and child. The escalated prevalence of GDM because of obesity and changes in screening criteria demands for greater health care needs than before. OBJECTIVE This study aimed to understand the perception of patients and health care providers of the barriers to GDM management and preferred interventions to manage GDM in an Asian setting. METHODS This mixed methods study used a convergent parallel design. Survey data were collected from 216 women with GDM, and semistructured interviews were conducted with 15 women and with 8 health care providers treating patients with GDM. Participants were recruited from 2 specialized GDM clinics at the National University Hospital, Singapore. RESULTS The patients were predominantly Chinese (102/214, 47.6%), employed (201/272, 73.9%), with higher education (150/216, 69.4%) and prenatal attendance at a private clinic (138/214, 64.2%), already on diet control (2...
Journal of Hunger & Environmental Nutrition
Nutrients
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Clinical Otolaryngology, 2012
Singapore medical journal, 2021
INTRODUCTION To examine how ageing research in medical and social domains in Singapore has transf... more INTRODUCTION To examine how ageing research in medical and social domains in Singapore has transformed over time, this scoping review examined the number, types and characteristics of journal publications on ageing in Singapore from 2008 to 2018. METHODS Using relevant search terms, articles were extracted from multiple databases and then screened and reviewed for eligibility and inclusion by independent reviewers. Data such as title of the study, authors, year of publication, name of journal, type of journal, study design and the kind of data used were charted from the included articles for evidence synthesis. RESULTS Since 2008, there has been a steady increase in the number of publications on ageing in medical and social domains in Singapore. In the medical domain, publications in Ophthalmology formed the largest group of the existing medical literature on ageing in Singapore (22%), followed by Physical Functioning, which involved physiological measurements of physical well-being...
Supplemental material, sj-pdf-1-nmi-10.1177_11786388211016827 for Factors Associated with Intende... more Supplemental material, sj-pdf-1-nmi-10.1177_11786388211016827 for Factors Associated with Intended Postpartum OGTT Uptake and Willingness to Receive Preventive Behavior Support to Reduce Type 2 Diabetes Risk Among Women with Gestational Diabetes in Singapore: An Exploratory Study by Sumali S Hewage, Su Aw, Claudia Chi and Joanne Yoong in Nutrition and Metabolic Insights
Clinical diabetes : a publication of the American Diabetes Association, 2018
Gestational diabetes mellitus (GDM) increases the risk for type 2 diabetes. This qualitative stud... more Gestational diabetes mellitus (GDM) increases the risk for type 2 diabetes. This qualitative study aimed to evaluate health care providers' perceptions of care responsibilities and resources related to reducing type 2 diabetes risk among women with previous GDM in Singapore. Health care providers acknowledged a shared responsibility. They felt that they had less understanding of compliance with long-term maintenance of lifestyle change, exacerbated further by fragmentation of follow-up care. The application of more integrated patient-centered care models, combined with greater health literacy, is urgently required in this area.
Journal of the Academy of Nutrition and Dietetics, 2014
Background: Prince Edward Island is characterized by low household food security (HFS) compared t... more Background: Prince Edward Island is characterized by low household food security (HFS) compared to other Provinces, especially among female lone parents. Low produce intake may be linked to chronic disease and has been associated with household food insecurity. Research Outcome: This study examined differences in produce intake by food security status of adult mothers with young children living on Prince Edward Island and using Family Resource Center services. Methods: Survey of mothers !18 years [USDA HFS module; produce intake and behaviorrelated instrument]. USDA HFS module was scored using Canadian methods. SPSS software was used to tabulate data. Descriptive statistics were used to describe the sample, and ANOVA was used to assess for differences in produce intake among food security groups.
JMIR Formative Research, 2020
Background Gestational diabetes mellitus (GDM) is associated with risks for both the mother and c... more Background Gestational diabetes mellitus (GDM) is associated with risks for both the mother and child. The escalated prevalence of GDM because of obesity and changes in screening criteria demands for greater health care needs than before. Objective This study aimed to understand the perception of patients and health care providers of the barriers to GDM management and preferred interventions to manage GDM in an Asian setting. Methods This mixed methods study used a convergent parallel design. Survey data were collected from 216 women with GDM, and semistructured interviews were conducted with 15 women and with 8 health care providers treating patients with GDM. Participants were recruited from 2 specialized GDM clinics at the National University Hospital, Singapore. Results The patients were predominantly Chinese (102/214, 47.6%), employed (201/272, 73.9%), with higher education (150/216, 69.4%) and prenatal attendance at a private clinic (138/214, 64.2%), already on diet control (2...
Journal of the Academy of Nutrition and Dietetics
Clinical Nutrition ESPEN
OBJECTIVE Lifestyle interventions have been shown to be both effective and cost-effective in redu... more OBJECTIVE Lifestyle interventions have been shown to be both effective and cost-effective in reducing diabetes and metabolic risk in high-risk populations. We systematically reviewed the effectiveness and cost-effectiveness of lifestyle interventions on anthropometric, glycemic and cardiovascular outcomes in women with previous gestational diabetes mellitus (GDM). METHOD Relevant randomized control trials (RCT) were identified by searching multiple electronic databases through 20th June 2018. Data were pooled using random-effects models. The review protocol was registered on the PROSPERO international prospective register of systematic reviews (PROSPERO 2016: CRD42018108870). RESULTS Twenty-one studies met the inclusion criteria and 16 studies with outcome data were analyzed in the meta-analysis. No RCT studies included cost-effectiveness data on lifestyle interventions. The pooled estimate for postpartum weight showed a significant mean reduction in the intervention arm (-1.8 kg [95% CI: -2.9, -0.6; p = 0.002; I2 = 92.2%; p < 0.05]). Further, the effect of lifestyle intervention on weight change was significantly greater in studies of longer duration. Most of the other endpoints had modest improvements but only anthropometric endpoints were statistically significant. However, there was high heterogeneity between the studies. CONCLUSIONS Lifestyle interventions showed statistically and clinically significant improvements in anthropometric outcomes. However, more research is needed to explore lifestyle effects on glycemic and cardiovascular risk factors and to establish cost-effectiveness. Methodologically sound, large scale studies on diverse ethnicities and with longer follow-up would establish the real effect of lifestyle interventions to reduce diabetes risk in women with previous GDM.
HEWAGE, SUMALI S., M.S., May 2014, Food and Nutrition Sciences The Relationship of Food Security,... more HEWAGE, SUMALI S., M.S., May 2014, Food and Nutrition Sciences The Relationship of Food Security, Cervical Health, and Produce Intake in Rural Appalachia Director of Thesis: David H. Holben Food insecurity is associated with lower produce intake. Consumption of produce (vegetables and fruit) high in antioxidants may reduce risk of human papillomavirus (HPV) and cervical dysplasia. This study was designed to examine the differences in HPV status by food security status; differences in risky sexual behaviors by food security status; differences in produce intake/behaviors by food security status; differences in produce intake/behaviors by HPV status; and the association of produce intake/behaviors and food security, adjusted for demographic confounders including the HPV status among women in rural Appalachia who were attending a clinic for gynecological care. Females who were English speaking and writing, 21 years and older, and attending a health clinic for cervical screening/testing...
Nutrition and Metabolic Insights
Aim: To assess and explore the factors affecting willingness to undergo an early postpartum oral ... more Aim: To assess and explore the factors affecting willingness to undergo an early postpartum oral glucose tolerance test (OGTT) and receive postpartum lifestyle modification assistance. Methods: An explanatory sequential mixed-method design was used. A prenatal cross-sectional survey questionnaire (n = 216) was given to women diagnosed with GDM in a tertiary health institution in Singapore and followed up with postpartum semi-structured interviews (n = 30). Multivariate logistic regression and thematic analysis were conducted before merging the findings. Results: Despite universal GDM education, fewer than 75% intended to take the OGTT postpartum, and only 63% felt it was very important. The plan to take the OGTT postpartum was positively associated with a prenatal care provider’s specific recommendation. In contrast, Malay women were less likely to take the test. Most women interpreted a care provider’s recommendation as implying standard practice, which encouraged intended and actu...
The FASEB Journal, 2014
Background Low household food security (HFS) and high cervical cancer rates have been reported in... more Background Low household food security (HFS) and high cervical cancer rates have been reported in Appalachian Ohio. High antioxidant intake may reduce the risk of human papillomavirus (HPV) infection and progression to cervical cancer. Study Objective To examine interrelationship of HFS, produce intake/ behaviors, and cervical health in adult women living in rural Appalachia. Method Survey of females 蠅 21 years [USDA HFS module, produce intake and behavior-related instrument, and Risky Sexual Behavior (RSB) Index questionnaire]. Clinical HPV results were obtained. Results Participants (n=153) [HPV-negative, n=139 (91.4%); HPV-positive, n=13 (8.6%)] were 29.4±7.8 years. For HFS, 113 (75.3%) had high and 37 (24.7%) had marginal, low, or very low HFS. Statistically significant test results showed food insecure group had a higher RSB scores compared to their counterparts (p<0.001). RSB scores were statistically significantly higher in HPV-positive group than HPV-negative group (p=0.0...
Journal of the American Academy of Nutrition and Dietetics
The Faseb Journal, Apr 1, 2014
ABSTRACT Background Low household food security (HFS) and high cervical cancer rates have been re... more ABSTRACT Background Low household food security (HFS) and high cervical cancer rates have been reported in Appalachian Ohio. High antioxidant intake may reduce the risk of human papillomavirus (HPV) infection and progression to cervical cancer. Study Objective To examine interrelationship of HFS, produce intake/ behaviors, and cervical health in adult women living in rural Appalachia. Method Survey of females ≥ 21 years [USDA HFS module, produce intake and behavior-related instrument, and Risky Sexual Behavior (RSB) Index questionnaire]. Clinical HPV results were obtained. Results Participants (n=153) [HPV-negative, n=139 (91.4%); HPV-positive, n=13 (8.6%)] were 29.4±7.8 years. For HFS, 113 (75.3%) had high and 37 (24.7%) had marginal, low, or very low HFS. Statistically significant test results showed food insecure group had a higher RSB scores compared to their counterparts (p<0.001). RSB scores were statistically significantly higher in HPV-positive group than HPV-negative group (p=0.021). Test statistics provided a significant difference between food secure and food insecure groups in median perceived diet quality scores 78.68 and 59.57 respectively, p=0.014. Conclusion Food insecurity was associated with high RSB score and low perceived diet quality. Further studies are required. :
Background Low household food security (HFS) and high cervical cancer rates have been reported in... more Background Low household food security (HFS) and high cervical cancer rates have been reported in Appalachian Ohio. High antioxidant intake may reduce the risk of human papillomavirus (HPV) infection and progression to cervical cancer. Study Objective To examine interrelationship of HFS, produce intake/ behaviors, and cervical health in adult women living in rural Appalachia. Method Survey of females ≥ 21 years [USDA HFS module, produce intake and behavior-related instrument, and Risky Sexual Behavior (RSB) Index questionnaire]. Clinical HPV results were obtained. Results Participants (n=153) [HPV-negative, n=139 (91.4%); HPV-positive, n=13 (8.6%)] were 29.4±7.8 years. For HFS, 113 (75.3%) had high and 37 (24.7%) had marginal, low, or very low HFS. Statistically significant test results showed food insecure group had a higher RSB scores compared to their counterparts (p<0.001). RSB scores were statistically significantly higher in HPV-positive group than HPV-negative group (p=0.0...
BACKGROUND Gestational diabetes mellitus (GDM) is associated with risks for both the mother and c... more BACKGROUND Gestational diabetes mellitus (GDM) is associated with risks for both the mother and child. The escalated prevalence of GDM because of obesity and changes in screening criteria demands for greater health care needs than before. OBJECTIVE This study aimed to understand the perception of patients and health care providers of the barriers to GDM management and preferred interventions to manage GDM in an Asian setting. METHODS This mixed methods study used a convergent parallel design. Survey data were collected from 216 women with GDM, and semistructured interviews were conducted with 15 women and with 8 health care providers treating patients with GDM. Participants were recruited from 2 specialized GDM clinics at the National University Hospital, Singapore. RESULTS The patients were predominantly Chinese (102/214, 47.6%), employed (201/272, 73.9%), with higher education (150/216, 69.4%) and prenatal attendance at a private clinic (138/214, 64.2%), already on diet control (2...
Journal of Hunger & Environmental Nutrition
Nutrients
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY