Health TAPESTRY Ontario: Protocol for a Randomized Controlled Trial to Test Reproducibility and Implementation

Abstract

Background: Health TAPESTRY (Health Teams Advancing Patient Experience: STRengthening qualitY) aims to help people stay healthier for longer where they live by providing person-focused care through the integration of four key program components: 1) trained volunteers who visit clients in their homes, 2) an interprofessional primary health care team, 3) use of technology to collect and share information, and 4) improved connections to community health and social services. The initial randomized controlled trial of Health TAPESTRY found promising results in terms of health care use and patient outcomes, indicating a shift from reactive to preventive care. The trial was based on one clinical academic centre, thus limiting generalizability. The study objectives are: 1) to test reproducibility of the established effectiveness of Health TAPESTRY on physical activity and hospitalizations, 2) to test the feasibility of, and understand the contributing factors to, the implementation of Health TAPESTRY in six diverse communities across Ontario, Canada, and 3) to determine the value for money of implementing Health TAPESTRY.Methods: This planned study is a pragmatic parallel randomized controlled trial with a delayed intervention for control participants at six months. This trial will simultaneously assess effectiveness and implementation in a real world setting (Type II hybrid) in six diverse communities across Ontario. Participants 70 years of age and older will be randomized into the Health TAPESTRY intervention or the control group (usual care). Intervention clients will receive an individualized plan of care from an interprofessional care team. The plan will be based on a client’s goals and current health risks identified through volunteer visits. The study’s outcomes are mapped onto the RE-AIM framework, with levels of physical activity and number of hospitalizations as the co-primary outcomes. The main analysis will be a comparison at six months.Discussion: It is important to evaluate the effectiveness and implementation of Health TAPESTRY in multiple communities prior to scaling or widespread adoption.Trial registration: ClinicalTrials.gov: NCT03397836 (posted January 12, 2018).

Multimorbidity Treatment Burden Questionnaire (MTBQ): Translation, Cultural Adaptation, and Validation in French-Canadian

“…The Multimorbidity Treatment Burden Questionnaire (MTBQ) is a brief, self-administered 10-item questionnaire (with three additional optional questions), validated in adults with multimorbidity in the United Kingdom (Duncan et al, 2018a). The MTBQ has demonstrated good content validity, construct validity, internal consistency reliability and responsiveness (Duncan et al, 2018a), and has been used in other studies (Friis, Lasgaard, Pedersen, Duncan, & Maindal, 2019;Mangin et al, 2020;McCarthy et al, 2020). This study aimed to translate and adapt the MTBQ to French-Canadians and to assess its validity.…”

Understanding volunteer retention in a complex, community‐centred intervention: A mixed methods study in Ontario, Canada

“…In this study, we included volunteers within Health TAPESTRY, a complex primary care‐based programme aimed at helping older adults stay healthier for longer (Dolovich et al., 2019; Mangin et al., 2020). In Health TAPESTRY, community volunteers visit older adult clients in their homes to conduct health‐related questionnaires and goal setting exercises, help clients connect to community‐based health and social services, provide a social connection, and link clients back to their interprofessional primary care teams for further support and ongoing follow‐up through custom programme technology (Gaber et al., 2020; Oliver et al., 2018).…”