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CompletedNCT05136872COBRAUpdated Sep 19, 2024

Continuous Observations of Behavioural Risk Factors in Asia (COBRA)

An observational study in Health Behavior, Diet, Healthy and Physical Activity, sponsored by National University of Singapore. Completed at 1 site in Singapore. Open to participants aged 21 Years to 69 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-09-19.

Sponsored by National University of Singapore · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
1,361
Ages
21 Years to 69 Years
Sex
All
01

Study summary

The aim of this study is to advance understanding of behavioural risk factors for cardiovascular disease and type 2 diabetes in Singapore.

Read the detailed description

BACKGROUND: Modifiable risk factors for non-communicable diseases, including unhealthy diets and movement behaviours, are influenced by complex and dynamic interactions between people and their social and physical environment. Therefore, understanding patterns and determinants of these risk factors as they occur in real-life is essential to enable the design of precision public health interventions.

AIMS: The aims of this study are to (1) examine patterns of dietary and movement behaviours in real-time as people go about their daily lives, (2) examine how interactions with the social and physical environment influence dietary and movement behaviours, and (3) examine how these patterns differ by ethnicity and other socio-demographic characteristics.

METHOD: This is an observational study in free-living participants over 10 consecutive days, with a 9-day follow-up 6 months later. 1500 participants will be recruited from a large prospective cohort study. Real-time data capture strategies will be used: an ecological momentary assessment (EMA) app with global positioning system (GPS) enabled to collect location data, accelerometers to measure movement, and wearable sensors to monitor blood glucose levels. Participants receive six EMA prompts per day to capture information on diet and movement behaviours (physical activity, sedentary behaviour, sleep), and related contextual factors. A second wave of EMA prompts and GPS monitoring will occur 6 months later. Data will be integrated and analysed using generalised linear models to examine associations between behavioural risk factors and contextual determinants.

02

Conditions studied

  • Health Behavior
  • Diet, Healthy
  • Physical Activity
  • Sedentary Behavior
  • Sleep

Keywords

  • health behavior
  • physical activity
  • sedentary
  • sleep
  • eating behavior
  • GPS
  • glycaemic response
03

In context

Lead sponsor

National University of Singapore is the lead sponsor of 206 studies on the registry; 52 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
21 Years to 69 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Adults in Singapore

Inclusion criteria

  • aged 21 to 69 years of age
  • citizen or permanent resident of Singapore
  • of Chinese, Malay, or Indian ethnicity
  • able to read English
  • own or have continued access to a smartphone with a data plan
  • able to use smartphone apps
  • able to walk independently

Exclusion criteria

Exclusion criteria:

  • history of stroke, heart disease, renal failure, diabetes mellitus, thyroid disease, cancer, or a serious mental health condition (e.g., schizophrenia, depression, or dementia)
  • have had vascular bypass surgery or angioplasty procedure performed
  • known sensitivity to medical-grade adhesives
  • bleeding disorder
05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
1,361 participants (actual)
Patient registry
No
06

What researchers measure

Primary outcomes

  1. Movement behaviours

    Movement behaviours (i.e., physical activity, sedentary behaviour, sleep) are measured using a wrist-worn accelerometer.

    Time frame: continuously for 9 days.

  2. Glucose concentrations

    Glucose concentrations are measured using a continuous glucose monitor sensor.

    Time frame: in 15-minute intervals over 9 days.

  3. Self-reported food intake

    Self-reported food intake measurement through entering of food items and the social and physical environment of eating via an Ecological Momentary Assessment (EMA) smartphone app.

    Time frame: Change in self-reported food intake over time. Data will be collected at 2.5-hour intervals between 8am and 9.30pm over a period of 9 days, and repeated at the 6-month follow-up

  4. Self-reported movement behaviours

    Self-reported movement behaviours (i.e., physical activity, sedentary behaviour, sleep) through entering of the type and social and physical environment context of activity via an Ecological Momentary Assessment (EMA) smartphone app.

    Time frame: Change in self-reported movement behaviours over time. Data will be collected at 2.5-hour intervals between 8am and 9.30pm over a period of 9 days, and repeated at the 6-month follow-up

  5. Self-reported screen time

    Self-reported screen time through entering of the type of screen used and the purpose and the duration of screen time via an Ecological Momentary Assessment (EMA) smartphone app.

    Time frame: Change in self-reported screen time over time. Data will be collected at 2.5-hour intervals between 8am and 9.30pm over a period of 9 days, and repeated at the 6-month follow-up

Secondary outcomes

  1. Self-reported stress levels

    Self-reported stress level will be assessed via an Ecological Momentary Assessment (EMA) smartphone app.

    Time frame: Data will be collected 6 times per day for 9 days, and repeated at the 6-month follow-up.

  2. Self-reported fatigue

    Self-reported fatigue will be assessed via an Ecological Momentary Assessment (EMA) smartphone app.

    Time frame: Data will be collected 6 times per day for 9 days, and repeated at the 6-month follow-up.

  3. Self-reported positive affect

    Self-reported positive affect will be assessed via an Ecological Momentary Assessment (EMA) smartphone app.

    Time frame: Data will be collected 6 times per day for 9 days, and repeated at the 6-month follow-up.

  4. Self-reported hunger

    Self-reported hunger will be assessed via an Ecological Momentary Assessment (EMA) smartphone app.

    Time frame: Data will be collected 6 times per day for 9 days, and repeated at the 6-month follow-up.

07

Study locations

1 site
  • Saw Swee Hock School of Public Health, National University of Singapore
    Singapore, 117549, Singapore
08

References and documents

Publications

  • Edney SM, Park SH, Tan L, Chua XH, Dickens BSL, Rebello SA, Petrunoff N, Muller AM, Tan CS, Muller-Riemenschneider F, van Dam RM. Advancing understanding of dietary and movement behaviours in an Asian population through real-time monitoring: Protocol of the Continuous Observations of Behavioural Risk Factors in Asia study (COBRA). Digit Health. 2022 Jun 30;8:20552076221110534. doi: 10.1177/20552076221110534. eCollection 2022 Jan-Dec. PubMed 35795338 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 19, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05136872
Lead sponsor
National University of Singapore
Collaborators
Ministry of Health, Singapore
Responsible party
Rob M van Dam (Professor, National University of Singapore) — Principal investigator
First posted
Nov 29, 2021
Start date
May 5, 2021
Primary completion
Aug 26, 2024
Completion
Aug 26, 2024
Last update
Sep 19, 2024

Study contacts

Rob M van Dam, PhD
principal investigator · National University of Singapore

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2024. You cannot join it, but the record below documents what was studied.

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