Advancing Precision Medicine for Cardiovascular Disease and Diabetes in Asian Populations: Digital Intervention Cohort

The overarching aim is to improve cardiometabolic health and promote healthy ageing by supporting adults to adopt favourable lifestyle patterns identified through our observational research. The trial will recruit n=600 to be involved in Phase I (referred to as the "Optimisation Phase") of a two-phase project (Phase II trial registration will be submitted separately). All participants will complete a baseline study visit where, after consent taking, will complete a baseline questionnaire, receive a smartwatch each and additional wearables if applicable, and download the study app for the receiving and testing of interventions and completion of short form surveys. Participants will be involved in the continual evaluation and optimisation of ecological momentary interventions (EMIs) in adaptive, factorial, micro-randomised trials over 12 months. Consenting participants may also be contacted to participate in interviews to be involved in the co-design of interventions, or to provide insights to the feasibility and process evaluation of the trial.

Inclusion Criteria: * are currently enrolled in the Singapore Population Health Studies - Multi-Ethnic Cohort Phase 3 (MEC3) or Second Follow-up (F2), * are of Chinese, Malay, or Indian ethnicity, * are 21 to 69 years old, and * can read and write English, * own or use a smartphone (iOS ≥ 12.4 or Android ≥ 8 with at least 5 GB of free storage, and data plan and internet access), * are able and willing to download and use study smartphone apps, * are able and willing to wear the smartwatch provided throughout the study period, and * can walk independently. Exclusion Criteria: * have a history or current condition of stroke, heart attack, kidney failure, diabetes mellitus, thyroid disease, or cancer, or have had a vascular bypass surgery or angioplasty procedure (either stent or balloon) performed, or * a serious mental health condition including schizophrenia, psychotic depression, or severe dementia, or * are currently pregnant or planning to get pregnant during the study period, or * are participating or planning to participate in other lifestyle intervention studies. * have a known sensitivity to medical-grade adhesives or a bleeding disorder will be \[applicable to continuous glucose monitoring component only\] * with contraindications specified by the blood pressure monitoring device manufacturer \[applicable to continuous blood pressure monitoring component only\] * participated in the pilot study \[applicable to main trial only\].