A Randomized Controlled Trial Using the Health TAPESTRY Approach to Care for Older Adults

NCT ID: NCT02283723

Last Updated: 2018-01-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 316 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2014-12-31
• Study Completion Date: 2016-11-30

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.

Conditions

Aging

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: PREVENTION
• Blinding Strategy: SINGLE

Study Groups

Patient Group 1

This patient group will begin receiving the Health TAPESTRY intervention from time zero.

Group Type: EXPERIMENTAL

Health TAPESTRY Intervention

Intervention Type: OTHER

The patient will receive in-home visits from trained volunteers to assess overall health and wellness and discover any health goals patient might have. This information will be electronically communicated back to interprofessional healthcare team and used to create informed care plan, link to relevant community services and allow the patient to age optimally.

Patient Group 2

Using a step-wedge approach, this patient group will receive the intervention after a six month waiting period where they will be used as a comparable group. In the first six months, they will receive usual care.

Group Type: ACTIVE_COMPARATOR

Usual care

Intervention Type: OTHER

While waiting for the Health TAPESTRY intervention, the control group will receive usual care from their healthcare providers.

Interventions

Health TAPESTRY Intervention

The patient will receive in-home visits from trained volunteers to assess overall health and wellness and discover any health goals patient might have. This information will be electronically communicated back to interprofessional healthcare team and used to create informed care plan, link to relevant community services and allow the patient to age optimally.

Intervention Type: OTHER

Usual care

While waiting for the Health TAPESTRY intervention, the control group will receive usual care from their healthcare providers.

Intervention Type: OTHER

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

• Minimum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Health Canada

OTHER_GOV

Sponsor Role: collaborator

McMaster University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

David Price, MD

Role: STUDY_CHAIR

McMaster University

Locations

McMaster Family Practice

Hamilton, Ontario, Canada

Stonechurch Family Health Centre

Hamilton, Ontario, Canada

Countries

Canada

References

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.

Reference Type: DERIVED

PMID: 32416718 (View on PubMed)

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.

Reference Type: DERIVED

PMID: 32295524 (View on PubMed)

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.

Reference Type: DERIVED

PMID: 31061074 (View on PubMed)

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.

Reference Type: DERIVED

PMID: 27044360 (View on PubMed)

Other Identifiers

14-726

Identifier Type: -

Identifier Source: org_study_id