Increasing Uptake of TP-HPB Medical Assessment

Year Submitted: 2025
Published Date: 06 November 2025

Tags: Physical Health, Preventive Care, Community Health, Health Promotion, Public Awareness, Primary Care, Care Continuum, Population Health

About this Content

Aims

A TP-HPB Medical Assessment was offered to 1,559 full-time TP students with a Body Mass Index (BMI) of more than 27.5. According to the World Health Organisation
(WHO), these students fall in the severely overweight category for Asians. The previous Medical Assessment held in 2016 was offered to severely overweight year 1
and 2 students, and saw an uptake of only 81 attendees (9.7%). This study, conducted in 2018, aimed to find out whether making minor cost-free changes to the invitation letters and the timing of a Medical Assessment in Temasek Polytechnic (TP) would result in a change in uptake rates. In 2018, the uptake was more than double with 164 attendees (15.4%) for the same group of students or 199 (12.8%) including severely overweight students in other years of study. Furthermore, the attrition rates of those who registered but did not attend was fell to 11% in 2018 from 23% in 2016. The study found that reducing barriers to attendance such as timing of the MA and a default option in registration forms could have explained the higher uptake in 2018. Additionally, enhanced invitation letters which: i) dispelled commonly used excuses; ii) included a reminder slip; and iii) used direct language, did not increase attendance at a Medical Assessment.

Methods

The interventions used in this study were informed by earlier studies which showed
the effectiveness in increasing uptake rates through the following: opportunistic health
checks, indicating a default, use of direct language, implementation intentions to
bridge the gap between intention and behaviour, and dispelling common
misconceptions. The participants in these earlier studies were mainly Caucasian
adults from 40-74 years of age. This study aimed to add to the existing research by
looking at the effectiveness of these interventions in the context of an educational
institution where participants comprised of mainly Asian youths. The following
paragraph details the interventions that were employed. In 2018, the MA was timed
for students to be able to take the MA opportunistically when they are on campus and
also reduces the barriers to attendance by avoiding busy periods such as during
project submission, test or exam periods. In contrast, in 2016, the MA was held during
the study week during which students are not required to be on campus for lessons
and is the week before the start of exams. Furthermore, in 2018, the registration form
was redesigned to make the default choice of attending the MA more salient by using
a larger and bold font, which could result in higher attendance rates. Students were
also randomised into three groups, receiving one of the three different invitation letters:
i) standard letter (no change); ii) enhanced letter with reminder slip and addresses
commonly used excuses; iii) enhanced letter with reminder slip only. This study employed a pre-post design, which compared the attendance rates and key
differences between the uptake of the MA in 2016, and 2018 which was when the
various interventions were put in place.

Results

199 students attended the MA in 2018, an increase from 81 in 2016 (Figure 1).
Although the MA in 2016 only included Year 1 and 2 students, a similar comparison of
uptake by Year 1 and 2 students in 2018 still registered a significant increase of 102%
to 164 students. This higher attendance rate could be explained through the timing of
the MA in 2018, which allowed students to take the MA opportunistically when they
were already on campus and before the start of lessons. In addition, it could be a result
of the default choice on the registration forms. However, contrary to other studies, the
results here suggested that students were not more likely to attend the MA if they
received an enhanced letter that included a reminder slip and dispelled commonly used excuses.

Lessons Learnt

Enhanced invitation letters which included a reminder slip and dispelled commonlyused excuses (I dont want to skip lessons and Im still so young, I dont think I have
any health problems) were not effective at increasing attendance at the MA. Year of
study was a statistically significant factor affecting attendance. Future studies in an
educational institution setting should ensure that this characteristic is block
randomised and balanced across the groups.

Keywords

medical checkup, health assessment, behaviour

Innovators' Details

Connect with this contributor!

Tan Wah Pheow - TAN_Wah_Pheow@tp.edu.sg

Project Attachment

175_TP-TPCABS_Increasing_Uptake_of_TP-HPB_Medical_Assessment.pdf