Type 2 Diabetes MellitusTAP-HC-DMNCT02715791
TAPESTRY With Health Connnectors for Diabetes Management
A study testing TAP-HC-DM in people with Type 2 Diabetes Mellitus and Hypertension, run by McMaster University at 3 sites in Canada.
Trial summary
The TAPESTRY-HC-DM approach is designed to support self-management of chronic disease by strengthening connections between patients and the primary healthcare system through "health connectors" -both volunteers and technology including the TAPESTRY Healthy Lifestyle App and McMaster Personal Health Record (PHR). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Type 2 Diabetes Mellitus, Hypertension
- What is being tested?
- TAP-HC-DM
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 3 sitesCanada
- Study dates
- Feb 2016to 26 Sep 2017
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Active patient at McMaster Family Health Team
- Aged 18+
- Diagnosis of Diabetes
- Diagnosis of Hypertension
- Regular access to a computer
- And at least ONE of:
Show all 11Show fewer
- Uncontrolled HbA1C measures (in the past 6 months, or most recent) - 10
- Uncontrolled recent blood pressure (in the past 3 months, or most recent) - 140/90 or higher (either number higher)
- Newly diagnosed with diabetes (diagnosed within 6 months)
- End-stage organ damage/other complications of diabetes [e.g. renal dysfunction, diabetic neuropathy]
- Doctor Recommendation
Who cannot join
- identified as deceased
- explicitly stated they do not want to be part of a research project
- reside in long-term care
- are receiving end-of-life care
- directly related to anyone from the McMaster University Department of Family Medicine
- not a participant in another TAPESTRY project
Trial locations and contacts
3 sites in 1 country.
Canada3 sites
McMaster Family Health Practice
Hamilton, Ontario, L8P 1H6
McMaster University Department of Family Medicine
Hamilton, Ontario, L8P 1H6
Stonechurch Family Health Centre
Hamilton, Ontario, L8W 3J6
About this study
Official title: Teams Advancing Patient Experience: Strengthening Quality for People Through Health Connectors for Diabetes Management (TAPESTRY-HC-DM): A Feasibility RCT
The TAPESTRY-HC-DM approach is designed to support self-management of chronic disease by strengthening connections between patients and the primary healthcare system through "health connectors" -both volunteers and technology including the TAPESTRY Healthy Lifestyle App and McMaster Personal Health Record (PHR). It will explore whether strengthening primary care connections across patients, providers, and community organizations through TAPESTRY-HC-DM - i.e., the deployment of volunteer health connectors coordinated by a community organization, the use of the TAPESTRY Healthy Lifestyle e-Application by patients, and care coordination processes by the interprofessional primary healthcare team - can increase self-efficacy in managing chronic conditions.
Read the detailed description
TAP-HC-DM is a feasibility randomized controlled trial (RCT) involving various pieces of intervention and their interactions to form a complex adaptive system. The purpose of the trial is to assess the effectiveness of the intervention not only through evaluating patient outcomes, but also through understanding the process of implementation and its fidelity to core elements.
The trial will be conducted within the McMaster Family Health Team (MFHT) in Hamilton, Ontario. The MFHT consists of two sites, with approximately 30,000 patients, as well as 30 family physicians, 70 family medicine residents, 10 nurse practitioners and other healthcare professionals.
Initial lists of potential participants will be created using an algorithm based on the inclusion criteria that will be run on the clinics' electronic medical records systems, with manual chart audits completed afterwards on an as-needed basis. The family physicians will then be asked to vet this list for further exclusion criteria. Patients from the list will then be sent a package including an invite letter from their family physician and a consent form.
Participants who have consented, will receive a welcome call from volunteers who will then provide detailed description of the program and expectations. The clients will then be invited to sign up for McMaster Personal Health Record (PHR) and asked to complete the modules (Diabetes, Hypertension, Sleep, Exercise, Nutrition, Medications, PHR) on the Healthy Lifestyle app. After completion of the modules, participants will receive a report and suggested tip sheets based on their responses. Volunteers as health connectors will connect with clients weekly, providing motivation, education, tech support, and community connections. The healthcare teams at the clinics will also receive the report and will triage it in their weekly huddles. Any follow-up recommended by the clinics will be communicated to volunteers who will then work with clients on the given recommendations, or directly to patients.
- Conditions
- Type 2 Diabetes Mellitus, Hypertension
- Being tested
- TAP-HC-DM, Usual Care
- Keywords
- Self-Management, Health Connectors, Volunteers, Technology, Interprofessional team, Chronic disease, Self-efficacy, Patient-centredness, Community Engagement
- Medical subject headings
- Diabetes Mellitus, Type 2, Hypertension, Chronic Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TAP-HC-DMBehavioural
Patients randomized to the intervention group will complete the Healthy Lifestyle App modules. Their results will create a report with a suggested list of tip sheets that patients, volunteers, and clinics will see.
Patients will also be encouraged to access the McMaster PHR in order to track their health, and communicate with volunteers or the clinic.
Volunteer health connectors will connect with patients at least weekly, by phone, McMaster PHR message, or in person (depending on patient preference). They will be motivating, providing tip sheets or other education, doing tech support, providing community resources, and building a volunteer-patient relationship with the client.
Clinicians will see and triage the reports, and may follow up on various aspects identified.
Usual CareOther
Patients randomized to the control group will receive usual care and upon the end of the intervention arm of the study will receive the TAPESTRY-HC-DM intervention as detailed in the intervention group.
| Study group | Role | What they receive |
|---|---|---|
| Usual Care | Other | Patients randomized to the control group will receive usual care and upon the end of study will receive access to the Healthy Lifestyle App and the McMaster PHR Receives: Other: Usual Care |
| TAP-HC-DM | Other | Patients randomized to the intervention group will get TAP-HC-DM intervention from time zero Receives: Behavioral: TAP-HC-DM |
What is being measured
The primary outcome is the main question the study is designed to answer.
Diabetes self-efficacy
This is the primary outcome which will be measured by Stanford Diabetes Self-Efficacy Scale, an 8-item scale.
Measured: 4-month
Secondary outcomes (9)
Self-efficacy in Managing General Chronic Conditions
The outcome will be measured by a 6-item Stanford Self-Efficacy Scale for Managing Chronic Disease. It covers several domains that are common across many chronic diseases, symptom control, role function, emotional functioning and communicating with physicians.
Measured: 4-month
Attainment of Health Goals
The outcome will be assessed using a Goal Attainment Scale (GAS) Questionnaire
Measured: 4-month
Assessment of Care for Chronic Conditions
The outcome will be assessed using Assessment of Care for Chronic Conditions survey having 20 items
Measured: 4-month
Patient Empowerment
The outcome will be assessed using Patient Empowerment questionnaire, a 5-item survey questionnaire and Canadian Institutes of Health Research (CIHR) Common Indicator for the Community- Based Primary Health Care (CBPHC)
Measured: 4-month
Patient Centredness
The outcome will be assessed using Patient Centeredness questionnaire, a 6-item questionnaire and CIHR Common Indicator for the Community- Based Primary Health Care (CBPHC)
Measured: 4-month
Satisfaction with Healthcare
This will be measured using a one item questionnaire that inquires how clients would like to rate the quality of healthcare they received on a scale of 0-100 (0=not satisfied, 100=completely satisfied)
Measured: 4-month
Patient Activation
This will be assessed by a 13-item Patient Activation Measure (PAM) questionnaire.
Measured: 4-month
Patient Readiness for Change
Readiness-for-Change Questionnaire (RCQ) for Diabetes Self-Management will be used to examine the clients' stage of readiness for diabetes management behaviour change (pre-contemplation, contemplation, action, maintenance), developed based on the Cardiovascular Risk Reduction Program Readiness-to-Change Lifestyle Behavior
Measured: 4-month
Physical Activity
This will be assessed using the Rapid Assessment of Physical Activity (RAPA).
Measured: 4-month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Mar 2016 (estimated)
- Study startFeb 2016
- Primary completionDec 2016
- Study completion26 Sep 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Type 2 Diabetes MellitusStudies of the same condition, open and under way.
- More trials run by McMaster UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 50 participants (actual)
Sponsor and investigators
- Lead sponsor
- McMaster University
- Sponsor type
- University, hospital or other
- Collaborators
- Ontario Ministry of Health and Long Term Care, Health Canada, McMaster Family Health Team, Volunteer Hamilton, INSPIRE-PHC
- Responsible party
- Principal investigator, Gina Agarwal, McMaster University
- Investigators
- David Price, MD, CCFP, Study chair, Professor and Chair, McMaster Department of Family MedicineLisa Dolovich, PharmD, MSc, Principal investigator, Co-Principal Investigator, McMaster Department of Family Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02715791
- Sponsor's protocol ID
- 0744
- Acronym
- TAP-HC-DM
- Status last verified
- Oct 2017
- First submitted
- 3 Nov 2015
- Last updated
- 4 Oct 2017
- Results posted
- No
- Data monitoring committee
- No
- Individual data sharing
- No
Publications
Agarwal G, Gaber J, Richardson J, Mangin D, Ploeg J, Valaitis R, Reid GJ, Lamarche L, Parascandalo F, Javadi D, O'Reilly D, Dolovich L. Pilot randomized controlled trial of a complex intervention for diabetes self-management supported by volunteers, technology, and interprofessional primary health care teams. Pilot Feasibility Stud. 2019 Oct 27;5:118. doi: 10.1186/s40814-019-0504-8. eCollection 2019.
PubMed 31673398
Study at a glance
From the registry record, last updated by the sponsor on 4 Oct 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Teams Advancing Patient Experience: Strengthening Quality for People Through Health Connectors for Diabetes Management (TAPESTRY-HC-DM): A Feasibility RCT
- ClinicalTrials.gov ID
- NCT02715791
- Acronym / sponsor ID
- TAP-HC-DM / 0744
- Conditions
- Type 2 Diabetes Mellitus, Hypertension
- Keywords
- Self-Management, Health Connectors, Volunteers, Technology, Interprofessional team, Chronic disease, Self-efficacy, Patient-centredness
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 50 participants (actual)
- Lead sponsor
- McMaster UniversityUniversity, hospital or other
- Collaborators
- Ontario Ministry of Health and Long Term Care, Health Canada, McMaster Family Health Team, Volunteer Hamilton, INSPIRE-PHC
- Study start
- Feb 2016
- Primary completion
- Dec 2016 (actual)
- Study completion
- 26 Sep 2017 (actual)
- First posted
- 22 Mar 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The TAPESTRY-HC-DM approach is designed to support self-management of chronic disease by strengthening connections between patients and the primary healthcare system through "health connectors" -both volunteers and technology including the TAPESTRY Healthy Lifestyle App and McMaster Personal Health Record (PHR). It will explore whether strengthening primary care connections across patients, providers, and community organizations through TAPESTRY-HC-DM - i.e., the deployment of volunteer health connectors coordinated by a community organization, the use of the TAPESTRY Healthy Lifestyle e-Application by patients, and care coordination processes by the interprofessional primary healthcare team - can increase self-efficacy in managing chronic conditions.
Detailed description
TAP-HC-DM is a feasibility randomized controlled trial (RCT) involving various pieces of intervention and their interactions to form a complex adaptive system. The purpose of the trial is to assess the effectiveness of the intervention not only through evaluating patient outcomes, but also through understanding the process of implementation and its fidelity to core elements.
The trial will be conducted within the McMaster Family Health Team (MFHT) in Hamilton, Ontario. The MFHT consists of two sites, with approximately 30,000 patients, as well as 30 family physicians, 70 family medicine residents, 10 nurse practitioners and other healthcare professionals.
Initial lists of potential participants will be created using an algorithm based on the inclusion criteria that will be run on the clinics' electronic medical records systems, with manual chart audits completed afterwards on an as-needed basis. The family physicians will then be asked to vet this list for further exclusion criteria. Patients from the list will then be sent a package including an invite letter from their family physician and a consent form.
Participants who have consented, will receive a welcome call from volunteers who will then provide detailed description of the program and expectations. The clients will then be invited to sign up for McMaster Personal Health Record (PHR) and asked to complete the modules (Diabetes, Hypertension, Sleep, Exercise, Nutrition, Medications, PHR) on the Healthy Lifestyle app. After completion of the modules, participants will receive a report and suggested tip sheets based on their responses. Volunteers as health connectors will connect with clients weekly, providing motivation, education, tech support, and community connections. The healthcare teams at the clinics will also receive the report and will triage it in their weekly huddles. Any follow-up recommended by the clinics will be communicated to volunteers who will then work with clients on the given recommendations, or directly to patients.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Usual Care | Other | Other: Usual CarePatients randomized to the control group will receive usual care and upon the end of study will receive access to the Healthy Lifestyle App and the McMaster PHR |
| TAP-HC-DM | Other | Behavioral: TAP-HC-DMPatients randomized to the intervention group will get TAP-HC-DM intervention from time zero |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Active patient at McMaster Family Health Team
- Aged 18+
- Diagnosis of Diabetes
- Diagnosis of Hypertension
- Regular access to a computer
Key exclusion criteria (6 listed)
- identified as deceased
- explicitly stated they do not want to be part of a research project
- reside in long-term care
- are receiving end-of-life care
- directly related to anyone from the McMaster University Department of Family Medicine
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TAP-HC-DMPatients randomized to the intervention group will complete the Healthy Lifestyle App modules. Their results will create a report with a suggested list of tip sheets that patients, volunteers, and clinics will see. Patients will also be encouraged to access the McMaster PHR in order to track their health, and communicate with volunteers or the clinic. Volunteer health connectors will connect with patients at least weekly, by phone, McMaster PHR message, or in person (depending on patient preference). They will be motivating, providing tip sheets or other education, doing tech support, providing community resources, and building a volunteer-patient relationship with the client. Clinicians will see and triage the reports, and may follow up on various aspects identified. | Behavioural | TAP-HC-DM |
| Usual CarePatients randomized to the control group will receive usual care and upon the end of the intervention arm of the study will receive the TAPESTRY-HC-DM intervention as detailed in the intervention group. | Other | Usual Care |
Primary outcome
Diabetes self-efficacy
Time frame: 4-month
This is the primary outcome which will be measured by Stanford Diabetes Self-Efficacy Scale, an 8-item scale.
9 secondary outcomes
Self-efficacy in Managing General Chronic Conditions
Time frame: 4-month
Attainment of Health Goals
Time frame: 4-month
Assessment of Care for Chronic Conditions
Time frame: 4-month
Patient Empowerment
Time frame: 4-month
Patient Centredness
Time frame: 4-month
Satisfaction with Healthcare
Time frame: 4-month
Patient Activation
Time frame: 4-month
Patient Readiness for Change
Time frame: 4-month
Physical Activity
Time frame: 4-month
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Oct 2017.
- Derived from this study: PubMed 31673398Agarwal G, Gaber J, Richardson J, Mangin D, Ploeg J, Valaitis R, Reid GJ, Lamarche L, Parascandalo F, Javadi D, O'Reilly D, Dolovich L. Pilot randomized controlled trial of a complex intervention for diabetes self-management supported by volunteers, technology, and interprofessional primary health care teams. Pilot Feasibility Stud. 2019 Oct 27;5:118. doi: 10.1186/s40814-019-0504-8. eCollection 2019.
- Individual participant dataSharing planned: No
Related trials for Type 2 Diabetes Mellitus
Not yet recruitingPhase 3
Efficacy and Safety of Once-Weekly SHR-3167 Compared With Once-Daily Insulin Glargine in Adults With Insulin-Naive Type 2 Diabetes
Type 2 Diabetes
Active, not recruiting
Digital Reinforcement of Motivational Interviewing Micro-Skills Among Primary Care Healthcare Professionals
Hypertension (Without Type 2 Diabetes Mellitus)
Recruiting
Investigating Vascular Properties of HEMI and SPG Signals in Individuals With or at Risk for Chronic Kidney Disease
Chronic Kidney Disease, Hypertension (HTN)
Not yet recruitingPhase 3
A Study to Evaluate the Effectiveness and Safety of the Drug AZD6234 for Managing Weight in Adults Who Are Obese or Overweight. These Participants May or May Not Also Have Type 2 Diabetes
Obesity, Overweight
Not yet recruiting
Impact of Endoscopic Sleeve Gastroplasty (ESG) in Obese Adults With Type 2 Diabetes (T2D)
Type 2 Diabetes Mellitus (T2D), Obesity (BMI>30)
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
David Price, MD, CCFP study chair
Professor and Chair, McMaster Department of Family Medicine
Lisa Dolovich, PharmD, MSc principal investigator
Co-Principal Investigator, McMaster Department of Family Medicine
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing TAP-HC-DM in people with Type 2 Diabetes Mellitus and Hypertension, run by McMaster University at 3 sites in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 11 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Oct 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Diabetes self-efficacy (time frame: 4-month). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02715791, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Oct 2017.