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Health TAPESTRY Ontario: A Multi-Site Randomized Controlled Trial Testing Implementation and Reproducibility.

Dee Mangin1, Larkin Lamarche2, Doug Oliver2

  • 1Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada (D. M., L. L., D. O., S. B., T. C., R. C., J. D., L. D., J. G., P. F., M. H., C. R., D. P.) mangind@mcmaster.ca.

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Summary

The Health TAPESTRY program successfully implemented a care model for older adults in primary care. However, it did not reproduce previous findings on reduced hospitalizations or improved physical activity.

Keywords:
agedhealth plan implementationmultimorbidityprimary health carerandomized controlled trial

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Area of Science:

  • Geriatric Medicine
  • Primary Care Innovation
  • Health Services Research

Background:

  • Older adults require tailored primary care to maintain health and independence.
  • The Health TAPESTRY (Health Teams Advancing Patient Experience: Strengthening Quality) program was developed to support this demographic.
  • Previous research indicated positive effects of Health TAPESTRY on health outcomes.

Purpose of the Study:

  • To evaluate the feasibility and implementation of the Health TAPESTRY program across multiple primary care sites.
  • To assess the reproducibility of the program's previously observed effects on health outcomes in older adults.

Main Methods:

  • A pragmatic, unblinded, 6-month parallel group randomized controlled trial was conducted.
  • 599 participants aged 70+ were recruited across 6 urban and rural primary care practices.
  • The intervention involved home visits and interprofessional care team planning; primary outcomes were physical activity and hospitalizations.

Main Results:

  • The Health TAPESTRY program demonstrated widespread reach and adoption according to the RE-AIM framework.
  • No statistically significant differences were found between the intervention and control groups for hospitalizations or physical activity.
  • Serious adverse events were comparable between the intervention and control groups.

Conclusions:

  • Health TAPESTRY was successfully implemented in diverse primary care settings.
  • The program's positive effects on hospitalizations and physical activity from prior studies were not reproduced in this trial.