Clinical trial NCT02283723: A Randomized Controlled Trial Using the Health TAPESTRY Approach to Care for Older Adults
Official title: Health Teams Advancing Patient Experience: Strengthening Quality (TAPESTRY): A Randomized Controlled Trial Using the Health TAPESTRY Approach to Care for Older Adults
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Aging
Keywords: older adults, goal attainment, optimal aging
Lead sponsor: McMaster University
Sponsor class: OTHER
Collaborators: name: Health Canada
First posted: 2014-11-05
Enrollment: 316
Sex: ALL
Minimum age (years): 70
Standard ages: OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: PREVENTION

Brief summary: Health TAPESTRY is a delayed intervention pragmatic randomized control trial promoting interprofessional team collaboration, facilitating connection to the community through system navigation and trained community volunteers, enhancing communication and improving care through the use of technology to better understand and assist older adult patients in achieving their health goals and to enable them to have optimal aging.

Detailed description: The overarching aim of the integrated multicomponent Health TAPESTRY approach is to promote optimal aging. Optimal aging within the Health TAPESTRY program means supporting people to move through life with good health in the best possible way: Being Alive Well. Health TAPESTRY is a health and social care approach that centres on meeting a person's health goals with the support of technology, trained community volunteers, an interprofessional team, system navigation, and better links between primary care and community organizations. The Health TAPESTRY intervention takes a complex, multilevel approach to integration, from both system level and individual level perspectives. The Health TAPESTRY program will provide processes and tools to activate and support individuals to access and use the broad range of available primary health care, social and community services to achieve their personal health goals and strategies to better integrate care at the system level. More specifically Health TAPESTRY will promote optimal aging:

* through intentional, proactive conversations about a person's life, health and care goals within the primary healthcare setting;
* through improved connections between inter-professional primary care teams, community service providers and informal caregivers;
* by training volunteers to serve as a link between the primary care team and a person in their home;
* by using technology from the home to link directly with the primary health care team which includes
* the tablet-based Health TAPESTRY app for volunteers to use;
* the Personal Health Record (PHR) and
* innovative resources (i.e. Optimal Aging Portal).

It is anticipated that together these will enable transformation of how primary healthcare and interprofessional teams provide care to older adults in a manner that provides value for resources used and meets needs and goals of older adults.

Eligibility criteria: Inclusion Criteria:

* Any community-dwelling patient of McMaster Family Health Team over the age of 70

Exclusion Criteria:

* Patient is palliative or receiving end-of-life care
* Patient is deceased
* Has explicitly stated that they do not want to be part of a research project
* Patient resides in long-term care
* Patient has indicated that they do not want to receive a home visit from trained community volunteers.
* Patient or family member does not speak English
* Patient will be out of the country for more than 50% of trial duration

Primary outcomes:
measure: Progress attaining health goals
timeFrame: 12 months
Secondary outcomes:
measure: Quality of life measures (2 tools)
timeFrame: 12 months
measure: Self-efficacy Scale
timeFrame: 12 months
measure: Optimal aging
timeFrame: 12 months
measure: Duke Social Support Index
timeFrame: 12 months
measure: Comprehensiveness
timeFrame: 12 months
measure: Patient Empowerment
timeFrame: 12 months
measure: Patient Centredness
timeFrame: 12 months
measure: Access
timeFrame: 12 months
measure: Satisfaction with Care
timeFrame: 12 months
measure: Hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) for Chronic Disease
timeFrame: 12 months
measure: Caregiver Strain Index
timeFrame: 12 months
measure: Cost-effectiveness
timeFrame: 12 months
Other outcomes:
measure: Patients' Satisfaction with Volunteers
timeFrame: 12 months
measure: Team Functioning
timeFrame: 12 months
measure: Volunteers' Self-efficacy
timeFrame: 12 months
Locations:
city: Hamilton
country: Canada
facility: McMaster Family Practice
state: Ontario
city: Hamilton
country: Canada
facility: Stonechurch Family Health Centre
state: Ontario
Study officials:
affiliation: McMaster University
name: David Price, MD
role: STUDY_CHAIR
References:
citation: Gaber J, Oliver D, Valaitis R, Cleghorn L, Lamarche L, Avilla E, Parascandalo F, Price D, Dolovich L. Experiences of integrating community volunteers as extensions of the primary care team to help support older adults at home: a qualitative study. BMC Fam Pract. 2020 May 16;21(1):92. doi: 10.1186/s12875-020-01165-2.
citation: Valaitis R, Cleghorn L, Dolovich L, Agarwal G, Gaber J, Mangin D, Oliver D, Parascandalo F, Ploeg J, Risdon C. Examining Interprofessional teams structures and processes in the implementation of a primary care intervention (Health TAPESTRY) for older adults using normalization process theory. BMC Fam Pract. 2020 Apr 15;21(1):63. doi: 10.1186/s12875-020-01131-y.
citation: Dolovich L, Oliver D, Lamarche L, Thabane L, Valaitis R, Agarwal G, Carr T, Foster G, Griffith L, Javadi D, Kastner M, Mangin D, Papaioannou A, Ploeg J, Raina P, Richardson J, Risdon C, Santaguida P, Straus S, Price D. Combining volunteers and primary care teamwork to support health goals and needs of older adults: a pragmatic randomized controlled trial. CMAJ. 2019 May 6;191(18):E491-E500. doi: 10.1503/cmaj.181173.
citation: Dolovich L, Oliver D, Lamarche L, Agarwal G, Carr T, Chan D, Cleghorn L, Griffith L, Javadi D, Kastner M, Longaphy J, Mangin D, Papaioannou A, Ploeg J, Raina P, Richardson J, Risdon C, Santaguida PL, Straus S, Thabane L, Valaitis R, Price D. A protocol for a pragmatic randomized controlled trial using the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) platform approach to promote person-focused primary healthcare for older adults. Implement Sci. 2016 Apr 5;11:49. doi: 10.1186/s13012-016-0407-5.