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| Name | Class |
|---|---|
| Canadian Red Cross | OTHER |
| Ontario Ministry of Health and Long Term Care | OTHER_GOV |
| David Braley | UNKNOWN |
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The Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) is a community-based program led by primary care teams, that creates connections between trained community volunteers, interprofessional health care teams, novel technology and community engagement through improved system navigation. The overall vision is to help people stay healthier for longer in the places where they live.
The Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) involves recording a person's life and health goals, screening for health risks and needs, and then initiating a plan that supports achievement of those goals and address risks and needs. It includes four parts:
Initial findings from Implementation Phase I: 6-month unblinded delayed intervention pragmatic randomized controlled trial that took place in Hamilton, ON (HiREB File #14-726, Clinical Trials.gov NCT02283723) showed significant differences between the intervention and control group. Specifically, at 6-months the it was found:
Understanding the feasibility of implementing Health TAPESTRY in other primary care sites is important to evaluate its potential as an approach. Replication of these initial findings are critical in terms of empirical support for the approach as well as spread and scalability in the wider primary health care system.
Six sites have been identified as Health TAPESTRY-Ontario implementation sites. It should be noted that all appropriate site approvals will be obtained prior to implementation.
A broad alliance between Canadian Red Cross and the Department of Family Medicine has been made, with Health TAPESTRY being a part of that alliance. As part of this partnership, the Canadian Red Cross partner will recruit, train, schedule, and retain community volunteers to operate in the 6 sites.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Health TAPESTRY Intervention | Experimental | This patient group will begin receiving the TAPESTRY interventions from time zero |
|
| Usual Care | Active Comparator | This patient group will receive the intervention after a 6 month waiting period. In the first 6 months they will receive usual care and they will be used as a comparison group. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Health TAPESTRY Intervention | Other | The patient will receive in-home visits from trained volunteers who will collect information electronically using a tablet computer. The volunteers will collect information about the client's health goals, health risks, and needs using a specifically designed application (TAP-App). Once the data is gathered, it is summarized into a report (TAP-report) which is securely and electronically sent to the health care clinic (TAP huddle). The team can leverage clinic supports and/or community supports as they deem appropriate to help clients reach their health goals and address any needs and risks which were reported during the volunteer visits. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Hospitalizations | Number of hospitalizations in the past 6 months. | Change of number of hospitalizations from baseline to 6 months |
| Change in Physical activity | Physical activity will be measured by the Short version of the International Physical Activity Questionnaire. Respondents indicate how many days in the past seven days and for how many minutes they have engaged in vigorous and moderate intensity activity and walking activity. Scores are calculated by multiplying the days by the number of minutes on one day, by the metabolic equivalent of task (8.0,4.0 and 3.3 for vigorous, moderate, walking activity respectively). Minimum score is of the scale is zero, with higher scores representing higher levels of physical activity. | Change in physical activity from baseline measurement to 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Emergency department and urgent care visits | Number of emergency department and urgent care visits in the past 6 months. Reasons for each visit will also be extracted in order to describe the nature of visits. | Baseline, 6 months |
| Falls |
| Measure | Description | Time Frame |
|---|---|---|
| Best and worst parts of intervention | Open-ended list of the five best and five worst parts of Health TAPESTRY for patients and health care providers. | 12 months |
| Recommend to others | Patients and health care providers asked whether or not they would recommend Health TAPESTRY to others. |
Participant Inclusion Criteria:
Participant Exclusion Criteria:
Site Inclusion Criteria:
A Health TAPESTRY site must have the commitment and capacity to implement and sustain the full Health TAPESTRY Program (all four parts). As such, the following success factors are essential:
Site Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dee Mangin, MBChB,DPH,FR | McMaster University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Family Medicine | Hamilton | Ontario | L8P 1H6 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36973055 | Derived | Mangin D, Lamarche L, Oliver D, Blackhouse G, Bomze S, Borhan S, Carr T, Clark R, Datta J, Dolovich L, Gaber J, Forsyth P, Howard M, Marentette-Brown S, Risdon C, Talat S, Tarride JE, Thabane L, Valaitis R, Price D. Health TAPESTRY Ontario: A Multi-Site Randomized Controlled Trial Testing Implementation and Reproducibility. Ann Fam Med. 2023 Mar-Apr;21(2):132-142. doi: 10.1370/afm.2944. | |
| 35718763 |
| Label | URL |
|---|---|
| Health TAPESTRY website | View source |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Jul 4, 2023 | |
| Reset | Feb 21, 2024 | |
| Release | Mar 17, 2026 | |
| Reset | Apr 3, 2026 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jul 4, 2023 | Feb 21, 2024 | |||
| Mar 17, 2026 |
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| Usual Care | Other | Usual care while waiting for the Health TAPESTRY intervention, the control group will receive usual care from their healthcare providers. |
|
Number of falls in the past 6 months (those resulting in medical treatment).
| Baseline, 6 months |
| Hours sitting | Hours sitting will be measured by the sitting item on the Short version of the International Physical Activity Questionnaire. Respondents indicate for how many hours they sit in a typical day. Scale ranges from 0 hours to 24 hours, higher scores indicate higher hours sitting. | Baseline, 6 months |
| Patient enablement | A modified version of the Patient Enablement Instrument will be used as a measure of patient empowerment in their own care. Specifically, the stem "as a result of your visit to the doctor today…" was deleted and instead, "after a usual visit with your family health care team, do you feel that you are…" was used. | Baseline, 6 months |
| Quality of life | The EuroQol five dimension (EQ-5D-5L) will be used to measure quality of life. This survey asks respondents to rate their ability in five different domains: mobility, self-care, usual activities, pain, and anxiety/depression. In addition, respondents are asked to rate their current health state on a scale from 0 ('worst health you can imagine') to 100 ('best health you can imagine'). A score from the five domains is calculated using a macro program and ranges from 0 to 1. | Baseline, 6 months |
| Treatment burden | Treatment burden will be measured by the Brief Treatment Burden Scale. Respondents are asked to rate their level of difficulty they have with ten different treatment-related tasks on a scale from "not difficult" to "extremely difficult". | Baseline, 6 months |
| Disease burden | Disease burden will be measured using the Disease Burden survey. Respondents are asked to indicate which conditions they have, and for those conditions present, the degree to which the condition hurts their daily activity from "not at all" to "a lot". The list contains common chronic conditions. | Baseline, 6 months |
| Medications | Number of long-term prescription medications (defined as use of a medication for 3 or more months). | Baseline, 6 months |
| Negative effects (unmet expectations) | A measure of unmet expectations specifically developed for this trial. Participants will be asked to rate the level of their expectation with the question: 'In thinking about the kind and amount of care you received as a result of Health TAPESTRY, to what extent did it meet your expectations?' Answer option include: exceeded expectations, met expectations, no real difference in kind or amount of care received, or kind and amount of care received was worse than before Health TAPESTRY. | Baseline, 6 months |
| Negative effects (effects of labeling) | The negative effects of labeling will be measured using a survey developed for this trial. For those identifying that Health TAPESTRY made them aware of health conditions or risks they were unaware of before, an open-ended question to describe the impact of this awareness will be asked. | 6 months |
| Negative effects (serious adverse events) | Serious adverse events will be recorded using retrospective chart audit. | 6 months |
| Primary care visits | Number of primary care visits. | Baseline, 6 months |
| Reason for hospitalization | Reason for each hospitalization will be categorized into ambulatory care sensitive conditions or acute care conditions. | Baseline, 6 months |
| 6-months post intervention (patients), 12-months (healthcare providers) |
| Satisfaction with volunteer | Satisfaction with interpersonal relationships with volunteer survey completed by patients. | 6 months |
| Type of primary care visit | Recorded profession of the clinician holding the visit with the patient. | 6 months |
| Length of hospital stay | Number of days spent in the hospital. Same-day hospitalizations will reflect zero days spent in the hospital for that particular hospitalization. | 6 months |
| Critical incidents | Number and type of critical incidents will be tracked electronically. | 12 months |
| Implementation processes | NoMAD survey | 1 months, 2 months, 3 months, 6 months, 9 months, 12 months |
| Derived |
| Lamarche L, Clark RE, Parascandalo F, Mangin D. The implementation and validation of the NoMAD during a complex primary care intervention. BMC Med Res Methodol. 2022 Jun 19;22(1):175. doi: 10.1186/s12874-022-01655-0. |
| 35177040 | Derived | Gaber J, Datta J, Clark R, Lamarche L, Parascandalo F, Di Pelino S, Forsyth P, Oliver D, Mangin D, Price D. Understanding how context and culture in six communities can shape implementation of a complex intervention: a comparative case study. BMC Health Serv Res. 2022 Feb 17;22(1):221. doi: 10.1186/s12913-022-07615-0. |
| 32795381 | Derived | Mangin D, Lamarche L, Oliver D, Bomze S, Borhan S, Browne T, Carr T, Datta J, Dolovich L, Howard M, Marentette-Brown S, Risdon C, Talat S, Tarride JE, Thabane L, Valaitis R, Price D. Health TAPESTRY Ontario: protocol for a randomized controlled trial to test reproducibility and implementation. Trials. 2020 Aug 14;21(1):714. doi: 10.1186/s13063-020-04600-y. |
| Apr 3, 2026 |