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

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.