Skip to main content
Top
Published in: Prevention Science 8/2021

Open Access 01-11-2021

Effectiveness of Community-Delivered Functional Power Training Program for Frail and Pre-frail Community-Dwelling Older Adults: a Randomized Controlled Study

Authors: Nien Xiang Tou, Shiou-Liang Wee, Wei Ting Seah, Daniella Hui Min Ng, Benedict Wei Jun Pang, Lay Khoon Lau, Tze Pin Ng

Published in: Prevention Science | Issue 8/2021

Login to get access

Abstract

Translation of community-based functional training for older adults to reduce frailty is still lacking. We evaluated the effectiveness and implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighborhoods. A two-arm, multicenter assessor-blind stratified randomized controlled trial was conducted at four local senior activity centers in Singapore. Sixty-one community-dwelling older adults with low handgrip strength were randomized to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipment) delivered by a community service provider. The 12-week program comprised 2 × 60 min sessions/week. CG continued usual activities at the centers. Functional performance, muscle strength, and frailty status were assessed at baseline and 3 months. Program implementation was evaluated using RE-AIM framework. The program was halted due to Coronavirus Disease 2019-related suspension of senior center activities. Results are reported from four centers, which completed the program. IG showed significantly greater improvement in the Short Physical Performance Battery test as compared to CG (p = 0.047). No effects were found for timed up and go test performance, muscle strength, and frailty status. The community program exhibited good reach, effectiveness, adoption, and implementation. Our study demonstrated that FPT was associated with greater improvement in physical function in pre-frail/frail participants as compared to exercise activities offered at local senior activity centers. It is a feasible intervention that can be successfully implemented for frail older adults in their neighborhoods.
Trial registration ClinicalTrials.gov, NCT04438876. Registered 19 June 2020–retrospectively registered.
Appendix
Available only for authorised users
Literature
go back to reference Apóstolo, J., Cooke, R., Bobrowicz-Campos, E., Santana, S., Marcucci, M., Cano, A., et al. (2018). Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: A systematic review. JBI Database of Systematic Reviews and Implementation Reports, 16, 140–232.CrossRef Apóstolo, J., Cooke, R., Bobrowicz-Campos, E., Santana, S., Marcucci, M., Cano, A., et al. (2018). Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: A systematic review. JBI Database of Systematic Reviews and Implementation Reports, 16, 140–232.CrossRef
go back to reference Bean, J. F., Kiely, D. K., LaRose, S., O’Neill, E., Goldstein, R., & Frontera, W. R. (2009). Increased velocity exercise specific to task training versus the National Institute on Aging’s strength training program: Changes in limb power and mobility. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 64, 983–991.CrossRef Bean, J. F., Kiely, D. K., LaRose, S., O’Neill, E., Goldstein, R., & Frontera, W. R. (2009). Increased velocity exercise specific to task training versus the National Institute on Aging’s strength training program: Changes in limb power and mobility. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 64, 983–991.CrossRef
go back to reference Cadore, E. L. Casas-Herrero, A., Zambom-Ferraresi, F., Idoate, F., Millor, N., & Gómez, M. (2014) Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age, 36, 773–785.CrossRef Cadore, E. L. Casas-Herrero, A., Zambom-Ferraresi, F., Idoate, F., Millor, N., & Gómez, M. (2014) Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age, 36, 773–785.CrossRef
go back to reference Cadore, E. L., & Izquierdo, M. (2018). Muscle power training: A hallmark for muscle function retaining in frail clinical setting. Journal of the American Medical Directors Association, 19, 190–192.CrossRef Cadore, E. L., & Izquierdo, M. (2018). Muscle power training: A hallmark for muscle function retaining in frail clinical setting. Journal of the American Medical Directors Association, 19, 190–192.CrossRef
go back to reference Cadore, E. L., Rodríguez-Mañas, L., Sinclair, A., & Izquierdo, M. (2013). Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: A systematic review. Rejuvenation Research, 16, 105–114.CrossRef Cadore, E. L., Rodríguez-Mañas, L., Sinclair, A., & Izquierdo, M. (2013). Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: A systematic review. Rejuvenation Research, 16, 105–114.CrossRef
go back to reference Chen, L.-K., Liu, L.-K., Woo, J., Assantachai, P., Auyeung, T.-W., Bahyah, K. S., et al. (2014). Sarcopenia in Asia: Consensus report of the Asian Working Group for Sarcopenia. Journal of the American Medical Directors Association, 15, 95–101.CrossRef Chen, L.-K., Liu, L.-K., Woo, J., Assantachai, P., Auyeung, T.-W., Bahyah, K. S., et al. (2014). Sarcopenia in Asia: Consensus report of the Asian Working Group for Sarcopenia. Journal of the American Medical Directors Association, 15, 95–101.CrossRef
go back to reference Dent, E., Morley, J., Cruz-Jentoft, A., Woodhouse, L., Rodriguez-Manas, L., Fried, L., et al. (2019). Physical frailty: ICFSR international clinical practice guidelines for identification and management. The Journal of Nutrition, Health & Aging, 23, 771–787.CrossRef Dent, E., Morley, J., Cruz-Jentoft, A., Woodhouse, L., Rodriguez-Manas, L., Fried, L., et al. (2019). Physical frailty: ICFSR international clinical practice guidelines for identification and management. The Journal of Nutrition, Health & Aging, 23, 771–787.CrossRef
go back to reference Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRef Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRef
go back to reference Fragala, M. S., Cadore, E. L., Dorgo, S., Izquierdo, M., Kraemer, W. J., Peterson, M. D., et al. (2019). Resistance training for older adults: Position statement from the national strength and conditioning association. The Journal of Strength & Conditioning Research, 33, 2019–2052.CrossRef Fragala, M. S., Cadore, E. L., Dorgo, S., Izquierdo, M., Kraemer, W. J., Peterson, M. D., et al. (2019). Resistance training for older adults: Position statement from the national strength and conditioning association. The Journal of Strength & Conditioning Research, 33, 2019–2052.CrossRef
go back to reference Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., et al. (2001). Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56, M146–M157.CrossRef Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., et al. (2001). Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56, M146–M157.CrossRef
go back to reference Gill, T. M., Baker, D. I., Gottschalk, M., Peduzzi, P. N., Allore, H., & Byers, A. (2002). A program to prevent functional decline in physically frail, elderly persons who live at home. New England Journal of Medicine, 347, 1068–1074.CrossRef Gill, T. M., Baker, D. I., Gottschalk, M., Peduzzi, P. N., Allore, H., & Byers, A. (2002). A program to prevent functional decline in physically frail, elderly persons who live at home. New England Journal of Medicine, 347, 1068–1074.CrossRef
go back to reference Giné-Garriga, M., Guerra, M., Pagès, E., Manini, T. M., Jiménez, R., & Unnithan, V. B. (2010). The effect of functional circuit training on physical frailty in frail older adults: A randomized controlled trial. Journal of Aging and Physical Activity, 18, 401–424.CrossRef Giné-Garriga, M., Guerra, M., Pagès, E., Manini, T. M., Jiménez, R., & Unnithan, V. B. (2010). The effect of functional circuit training on physical frailty in frail older adults: A randomized controlled trial. Journal of Aging and Physical Activity, 18, 401–424.CrossRef
go back to reference Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93, 1261–1267.CrossRef Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93, 1261–1267.CrossRef
go back to reference Glasgow, R. E., Vogt, T. M., & Boles, S. M. (1999). Evaluating the public health impact of health promotion interventions: The RE-AIM framework. American Journal of Public Health, 89, 1322–1327.CrossRef Glasgow, R. E., Vogt, T. M., & Boles, S. M. (1999). Evaluating the public health impact of health promotion interventions: The RE-AIM framework. American Journal of Public Health, 89, 1322–1327.CrossRef
go back to reference Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E., & Wallace, R. B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332, 556–562.CrossRef Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E., & Wallace, R. B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332, 556–562.CrossRef
go back to reference Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., et al. (1994). A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49, M85–M94.CrossRef Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., et al. (1994). A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49, M85–M94.CrossRef
go back to reference Hoogendijk, E. O., Rockwood, K., Theou, O., Armstrong, J. J., Onwuteaka-Philipsen, B. D., Deeg, D. J., et al. (2018). Tracking changes in frailty throughout later life: Results from a 17-year longitudinal study in the Netherlands. Age and Ageing, 47, 727–733.CrossRef Hoogendijk, E. O., Rockwood, K., Theou, O., Armstrong, J. J., Onwuteaka-Philipsen, B. D., Deeg, D. J., et al. (2018). Tracking changes in frailty throughout later life: Results from a 17-year longitudinal study in the Netherlands. Age and Ageing, 47, 727–733.CrossRef
go back to reference Hopkins, W., Marshall, S., Batterham, A., & Hanin, J. (2009). Progressive statistics for studies in sports medicine and exercise science. Medicine & Science in Sports & Exercise, 41, 3–12.CrossRef Hopkins, W., Marshall, S., Batterham, A., & Hanin, J. (2009). Progressive statistics for studies in sports medicine and exercise science. Medicine & Science in Sports & Exercise, 41, 3–12.CrossRef
go back to reference Liu, X., Ng, D.H.-M., Seah, J.W.-T., Munro, Y. L., & Wee, S.-L. (2019). Update on interventions to prevent or reduce frailty in community-dwelling older adults: A scoping review and community translation. Current Geriatrics Reports, 8, 72–86.CrossRef Liu, X., Ng, D.H.-M., Seah, J.W.-T., Munro, Y. L., & Wee, S.-L. (2019). Update on interventions to prevent or reduce frailty in community-dwelling older adults: A scoping review and community translation. Current Geriatrics Reports, 8, 72–86.CrossRef
go back to reference Manini, T., Marko, M., VanArnam, T., Cook, S., Fernhall, B., Burke, J., et al. (2007). Efficacy of resistance and task-specific exercise in older adults who modify tasks of everyday life. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 62, 616–623.CrossRef Manini, T., Marko, M., VanArnam, T., Cook, S., Fernhall, B., Burke, J., et al. (2007). Efficacy of resistance and task-specific exercise in older adults who modify tasks of everyday life. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 62, 616–623.CrossRef
go back to reference Mijnarends, D. M., Meijers, J. M., Halfens, R. J., ter Borg, S., Luiking, Y. C., Verlaan, S., et al. (2013). Validity and reliability of tools to measure muscle mass, strength, and physical performance in community-dwelling older people: A systematic review. Journal of the American Medical Directors Association, 14, 170–178.CrossRef Mijnarends, D. M., Meijers, J. M., Halfens, R. J., ter Borg, S., Luiking, Y. C., Verlaan, S., et al. (2013). Validity and reliability of tools to measure muscle mass, strength, and physical performance in community-dwelling older people: A systematic review. Journal of the American Medical Directors Association, 14, 170–178.CrossRef
go back to reference Moher, D., Schulz, K. F., Altman, D. G., & Group, C. (2001). The CONSORT statement: Revised recommendations for improving the quality of reports of parallel-group randomised trials. The Lancet, 357, 1191-1194. Moher, D., Schulz, K. F., Altman, D. G., & Group, C. (2001). The CONSORT statement: Revised recommendations for improving the quality of reports of parallel-group randomised trials. The Lancet, 357, 1191-1194.
go back to reference Morley, J. E., Vellas, B., Van Kan, G. A., Anker, S. D., Bauer, J. M., Bernabei, R., et al. (2013). Frailty consensus: A call to action. Journal of the American Medical Directors Association, 14, 392–397.CrossRef Morley, J. E., Vellas, B., Van Kan, G. A., Anker, S. D., Bauer, J. M., Bernabei, R., et al. (2013). Frailty consensus: A call to action. Journal of the American Medical Directors Association, 14, 392–397.CrossRef
go back to reference Ofori-Asenso, R., Chin, K. L., Mazidi, M., Zomer, E., Ilomaki, J., Zullo, A. R., et al. (2019). Global incidence of frailty and prefrailty among community-dwelling older adults: A systematic review and meta-analysis. JAMA Network Open, 2, 1–18.CrossRef Ofori-Asenso, R., Chin, K. L., Mazidi, M., Zomer, E., Ilomaki, J., Zullo, A. R., et al. (2019). Global incidence of frailty and prefrailty among community-dwelling older adults: A systematic review and meta-analysis. JAMA Network Open, 2, 1–18.CrossRef
go back to reference Perera, S., Mody, S. H., Woodman, R. C., & Studenski, S. A. (2006). Meaningful change and responsiveness in common physical performance measures in older adults. Journal of the American Geriatrics Society, 54, 743–749.CrossRef Perera, S., Mody, S. H., Woodman, R. C., & Studenski, S. A. (2006). Meaningful change and responsiveness in common physical performance measures in older adults. Journal of the American Geriatrics Society, 54, 743–749.CrossRef
go back to reference Peters, D. H., Adam, T., Alonge, O., Agyepong, I. A., & Tran, N. (2013). Implementation research: What it is and how to do it. The BMJ, 347, f6753.CrossRef Peters, D. H., Adam, T., Alonge, O., Agyepong, I. A., & Tran, N. (2013). Implementation research: What it is and how to do it. The BMJ, 347, f6753.CrossRef
go back to reference Ramírez-Campillo, R., Castillo, A., Carlos, I., Campos-Jara, C., Andrade, D. C., Álvarez, C., et al. (2014). High-speed resistance training is more effective than low-speed resistance training to increase functional capacity and muscle performance in older women. Experimental Gerontology, 58, 51–57.CrossRef Ramírez-Campillo, R., Castillo, A., Carlos, I., Campos-Jara, C., Andrade, D. C., Álvarez, C., et al. (2014). High-speed resistance training is more effective than low-speed resistance training to increase functional capacity and muscle performance in older women. Experimental Gerontology, 58, 51–57.CrossRef
go back to reference Rantanen, T., Guralnik, J. M., Foley, D., Masaki, K., Leveille, S., Curb, J. D., et al. (1999). Midlife hand grip strength as a predictor of old age disability. The Journal of the American Medical Association, 281, 558–560.CrossRef Rantanen, T., Guralnik, J. M., Foley, D., Masaki, K., Leveille, S., Curb, J. D., et al. (1999). Midlife hand grip strength as a predictor of old age disability. The Journal of the American Medical Association, 281, 558–560.CrossRef
go back to reference Roberts, H. C., Denison, H. J., Martin, H. J., Patel, H. P., Syddall, H., Cooper, C., & Sayer, A. A. (2011). A review of the measurement of grip strength in clinical and epidemiological studies: Towards a standardised approach. Age and Ageing, 40, 423–429.CrossRef Roberts, H. C., Denison, H. J., Martin, H. J., Patel, H. P., Syddall, H., Cooper, C., & Sayer, A. A. (2011). A review of the measurement of grip strength in clinical and epidemiological studies: Towards a standardised approach. Age and Ageing, 40, 423–429.CrossRef
go back to reference Shumway-Cook, A., Brauer, S., & Woollacott, M. (2000). Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Physical Therapy, 80, 896–903.CrossRef Shumway-Cook, A., Brauer, S., & Woollacott, M. (2000). Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Physical Therapy, 80, 896–903.CrossRef
go back to reference Steib, S., Schoene, D., & Pfeifer, K. (2010). Dose-response relationship of resistance training in older adults: A meta-analysis. Medicine & Science in Sports & Exercise, 42, 902–914.CrossRef Steib, S., Schoene, D., & Pfeifer, K. (2010). Dose-response relationship of resistance training in older adults: A meta-analysis. Medicine & Science in Sports & Exercise, 42, 902–914.CrossRef
go back to reference Stel, V. S., Smit, J. H., Pluijm, S. M., Visser, M., Deeg, D. J., & Lips, P. (2004). Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer. Journal of Clinical Epidemiology, 57, 252–258.CrossRef Stel, V. S., Smit, J. H., Pluijm, S. M., Visser, M., Deeg, D. J., & Lips, P. (2004). Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer. Journal of Clinical Epidemiology, 57, 252–258.CrossRef
go back to reference Tan, Q. L. L., Chye, L. M. Y., Ng, D. H. M., Chong, M. S., Ng, T. P., & Wee, S. L. (2018). Feasibility of a community-based functional power training program for older adults. Clinical Interventions in Aging, 13, 309–316.CrossRef Tan, Q. L. L., Chye, L. M. Y., Ng, D. H. M., Chong, M. S., Ng, T. P., & Wee, S. L. (2018). Feasibility of a community-based functional power training program for older adults. Clinical Interventions in Aging, 13, 309–316.CrossRef
go back to reference Tarazona-Santabalbina, F. J., Gómez-Cabrera, M. C., Pérez-Ros, P., Martínez-Arnau, F. M., Cabo, H., Tsaparas, K., et al. (2016). A multicomponent exercise intervention that reverses frailty and improves cognition, emotion, and social networking in the community-dwelling frail elderly: A randomized clinical trial. Journal of the American Medical Directors Association, 17, 426–433.CrossRef Tarazona-Santabalbina, F. J., Gómez-Cabrera, M. C., Pérez-Ros, P., Martínez-Arnau, F. M., Cabo, H., Tsaparas, K., et al. (2016). A multicomponent exercise intervention that reverses frailty and improves cognition, emotion, and social networking in the community-dwelling frail elderly: A randomized clinical trial. Journal of the American Medical Directors Association, 17, 426–433.CrossRef
go back to reference Teo, N., Gao, Q., Nyunt, M. S. Z., Wee, S. L., & Ng, T.-P. (2017). Social frailty and functional disability: Findings from the Singapore longitudinal ageing studies. Journal of the American Medical Directors Association, 18, 637. e613–637. e619. Teo, N., Gao, Q., Nyunt, M. S. Z., Wee, S. L., & Ng, T.-P. (2017). Social frailty and functional disability: Findings from the Singapore longitudinal ageing studies. Journal of the American Medical Directors Association, 18, 637. e613–637. e619.
go back to reference Thang, L. L. (2005). Experiencing leisure in later life: A study of retirees and activity in Singapore. Journal of Cross-cultural Gerontology, 20, 307–318.CrossRef Thang, L. L. (2005). Experiencing leisure in later life: A study of retirees and activity in Singapore. Journal of Cross-cultural Gerontology, 20, 307–318.CrossRef
go back to reference Travers, J., Romero-Ortuno, R., Bailey, J., & Cooney, M.-T. (2019). Delaying and reversing frailty: A systematic review of primary care interventions. British Journal of General Practice, 69, e61–e69.CrossRef Travers, J., Romero-Ortuno, R., Bailey, J., & Cooney, M.-T. (2019). Delaying and reversing frailty: A systematic review of primary care interventions. British Journal of General Practice, 69, e61–e69.CrossRef
go back to reference Ware Jr, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 220–233. Ware Jr, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 220–233.
go back to reference Wei, K., Nyunt, M. S. Z., Gao, Q., Wee, S. L., & Ng, T.-P. (2017). Frailty and malnutrition: Related and distinct syndrome prevalence and association among community-dwelling older adults: Singapore longitudinal ageing studies. Journal of the American Medical Directors Association, 18, 1019–1028.CrossRef Wei, K., Nyunt, M. S. Z., Gao, Q., Wee, S. L., & Ng, T.-P. (2017). Frailty and malnutrition: Related and distinct syndrome prevalence and association among community-dwelling older adults: Singapore longitudinal ageing studies. Journal of the American Medical Directors Association, 18, 1019–1028.CrossRef
go back to reference Westhoff, M. H., Stemmerik, L., & Boshuizen, H. C. (2000). Effects of a low-intensity strength-training program on knee-extensor strength and functional ability of frail older people. Journal of Aging and Physical Activity, 8, 325–342.CrossRef Westhoff, M. H., Stemmerik, L., & Boshuizen, H. C. (2000). Effects of a low-intensity strength-training program on knee-extensor strength and functional ability of frail older people. Journal of Aging and Physical Activity, 8, 325–342.CrossRef
go back to reference Wong, E.Y.-S., Lee, A. H., James, A. P., & Jancey, J. (2019). Recreational Centres’ Facilities and Activities to Support Healthy Ageing in Singapore. International Journal of Environmental Research and Public Health, 16, 3343.CrossRef Wong, E.Y.-S., Lee, A. H., James, A. P., & Jancey, J. (2019). Recreational Centres’ Facilities and Activities to Support Healthy Ageing in Singapore. International Journal of Environmental Research and Public Health, 16, 3343.CrossRef
go back to reference Zech, A., Drey, M., Freiberger, E., Hentschke, C., Bauer, J. M., Sieber, C. C., et al. (2012). Residual effects of muscle strength and muscle power training and detraining on physical function in community-dwelling prefrail older adults: A randomized controlled trial. BMC Geriatrics, 12, 68.CrossRef Zech, A., Drey, M., Freiberger, E., Hentschke, C., Bauer, J. M., Sieber, C. C., et al. (2012). Residual effects of muscle strength and muscle power training and detraining on physical function in community-dwelling prefrail older adults: A randomized controlled trial. BMC Geriatrics, 12, 68.CrossRef
Metadata
Title
Effectiveness of Community-Delivered Functional Power Training Program for Frail and Pre-frail Community-Dwelling Older Adults: a Randomized Controlled Study
Authors
Nien Xiang Tou
Shiou-Liang Wee
Wei Ting Seah
Daniella Hui Min Ng
Benedict Wei Jun Pang
Lay Khoon Lau
Tze Pin Ng
Publication date
01-11-2021
Publisher
Springer US
Published in
Prevention Science / Issue 8/2021
Print ISSN: 1389-4986
Electronic ISSN: 1573-6695
DOI
https://doi.org/10.1007/s11121-021-01221-y

Other articles of this Issue 8/2021

Prevention Science 8/2021 Go to the issue