• Dee Mangin, Larkin Lamarche, Doug Oliver, Gord Blackhouse, Sivan Bomze, Sayem Borhan, Tracey Carr, Rebecca Clark, Julie Datta, Lisa Dolovich, Jessica Gaber, Pamela Forsyth, Michelle Howard, Sarah Marentette-Brown, Cathy Risdon, Samina Talat, Jean-Éric Tarride, Lehana Thabane, Ruta Valaitis, and David Price.
• Department 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.
• Ann Fam Med. 2023 Mar 1; 21 (2): 132142132-142.

PurposeHealth Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) is a complex primary care program aimed at assisting older adults to stay healthier for longer. This study evaluated the feasibility of implementation across multiple sites, and the reproducibility of the effects found in the previous randomized controlled trial.MethodsThis was a pragmatic, unblinded, 6-month parallel group randomized controlled trial. Participants were randomized (intervention or control) using a computer-generated system. Eligible patients, aged 70 years and older, were rostered to 1 of 6 participating interprofessional primary care practices (urban and rural). In total, 599 (301 intervention, 298 control) patients were recruited from March 2018 through August 2019. Intervention participants received a home visit from volunteers to collect information on physical and mental health, and social context. An interprofessional care team created and implemented a plan of care. The primary outcomes were physical activity and number of hospitalizations.ResultsBased on the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, Health TAPESTRY had widespread reach and adoption. In the intention-to-treat analysis (257 intervention, 255 control), there were no statistically significant between-group differences for hospitalizations (incidence rate ratio = 0.79; 95% CI, 0.48-1.30; P = .35) or total physical activity (mean difference = -0.26; 95% CI, -1.18 to 0.67; P = .58). There were 37 non-study related serious adverse events (19 intervention, 18 control).ConclusionsWe found Health TAPESTRY was successfully implemented for patients in diverse primary care practices; however, implementation did not reproduce the effect on hospitalizations and physical activity found in the initial randomized controlled trial.© 2023 Annals of Family Medicine, Inc.

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