Health TAPESTRY Ontario: protocol for a randomized controlled trial to test reproducibility and implementation.

Health care volunteers Implementation Integrated care Interdisciplinary health care teams Older adults Primary health care Randomized controlled trial

Journal

Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253

Informations de publication

Date de publication:
14 Aug 2020
Historique:
received: 27 11 2019
accepted: 12 07 2020
entrez: 16 8 2020
pubmed: 17 8 2020
medline: 28 5 2021
Statut: epublish

Résumé

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 center, 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. This planned study is a pragmatic parallel randomized controlled trial with a delayed intervention for control participants at 6 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 6 months. It is important to evaluate the effectiveness and implementation of Health TAPESTRY in multiple communities prior to scaling or widespread adoption. ClinicalTrials.gov NCT03397836 . Registered on 12 January 2018.

Sections du résumé

BACKGROUND 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 center, 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 METHODS
This planned study is a pragmatic parallel randomized controlled trial with a delayed intervention for control participants at 6 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 6 months.
DISCUSSION CONCLUSIONS
It is important to evaluate the effectiveness and implementation of Health TAPESTRY in multiple communities prior to scaling or widespread adoption.
TRIAL REGISTRATION BACKGROUND
ClinicalTrials.gov NCT03397836 . Registered on 12 January 2018.

Identifiants

pubmed: 32795381
doi: 10.1186/s13063-020-04600-y
pii: 10.1186/s13063-020-04600-y
pmc: PMC7427958
doi:

Banques de données

ClinicalTrials.gov
['NCT03397836']

Types de publication

Clinical Trial Protocol Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

714

Subventions

Organisme : Ontario Ministry of Health and Long-Term Care
ID : NA

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Auteurs

Dee Mangin (D)

Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 5th floor, Hamilton, ON, L8P 1H6, Canada. mangind@mcmaster.ca.

Larkin Lamarche (L)

Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 5th floor, Hamilton, ON, L8P 1H6, Canada.

Doug Oliver (D)

Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 3rd floor, Hamilton, ON, L8P 1H6, Canada.

Sivan Bomze (S)

Canadian Red Cross, 5700 Cancross Court, Mississauga, ON, L5R 3E9, Canada.

Sayem Borhan (S)

Department of Family Medicine, and Department of Health Research Methods, Evidence and Impact McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.

Tracy Browne (T)

Canadian Red Cross, 1460 Fairburn Street, Sudbury, ON, P3A 1N7, Canada.

Tracey Carr (T)

Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 6th floor, Hamilton, ON, L8P 1H6, Canada.

Julie Datta (J)

Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 6th floor, Hamilton, ON, L8P 1H6, Canada.

Lisa Dolovich (L)

Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 5th floor, Hamilton, ON, L8P 1H6, Canada.

Michelle Howard (M)

Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 5th floor, Hamilton, ON, L8P 1H6, Canada.

Sarah Marentette-Brown (S)

Canadian Red Cross, 5700 Cancross Court, Mississauga, ON, L5R 3E9, Canada.

Cathy Risdon (C)

Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 6th floor, Hamilton, ON, L8P 1H6, Canada.

Samina Talat (S)

Canadian Red Cross, 5700 Cancross Court, Mississauga, ON, L5R 3E9, Canada.

Jean-Eric Tarride (JE)

Department of Health Research Methods, Evidence and Impact, McMaster University, Programs for Assessment of Technologies in Health and Center for Health Economics and Policy Analysis, CRL 227, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.

Lehana Thabane (L)

Department of Health Research Methods, Evidence and Impact, McMaster University, Programs for Assessment of Technologist in Health, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.

Ruta Valaitis (R)

School of Nursing, McMaster University, Health Sciences Centre, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.

David Price (D)

Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 6th floor, Hamilton, ON, L8P 1H6, Canada.

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