Construct Survey name | Survey description | Key information for TAP-Report | Intervention | Control | ||
---|---|---|---|---|---|---|
T0 | T6 | T0 | T6 | |||
Demographic information Custom | Basic demographics | NA | X | Â | X | Â |
Quality of life* EQ 5D-5L [37] | Quality of life with respect to mobility, self-care, usual activities, pain, and anxiety/depression. Five answer options provided from able to/none to extremely difficult/extreme levels (scores ranges 0–1, higher scores = higher quality of life) |  • Severe problems in walking about or unable to walk about  • Severe problems washing or dressing self or unable to wash or dress self  • Severe problems doing usual activities or unable to do usual activities  • Severe pain/discomfort or extreme pain/discomfort  • Severely anxious/depressed or extremely anxious/depressed | X | X | X | X |
Physical activity International Physical Activity Questionnaire (IPAQ) (short) [38]* | Time spent doing physical activity per week | Calculated time in moderate and vigorous physical activity Time spent sitting in one typical day (in hours) | X | X | X | X |
Rapid Assessment of Physical Activity (RAPA) [39] | Quick assessment of physical activity for older adults (score range 1–7, higher scores = higher physical activity) | Suboptimal physical activity (score < 6) | X | X | X | X |
Enablement* Patient Enablement Instrument (PEI) [40] | Client’s ability to cope with, or have Control over their health after visit with health care team | NA | X | X | X | X |
Treatment burden* Multimorbidity Treatment Burden Questionnaire (MTBQ) [41] | Level of difficulty of 10 treatment tasks (e.g., taking many medications) | NA | X | X | X | X |
Disease burden* Disease Burden Morbidity Assessment (DBMA)[42] | Level of limitation chronic diseases have on client’s daily activities | NA | X | X | X | X |
Daily life activities Custom | Description of client’s daily activities, any need of assistance and general thoughts about current activities | Full text responses included | X |  |  | X |
Goals Custom | General life or health based goals | Goals listed | X | X+ | Â | X |
Social life Friendship Scale/Custom [43]* | Client’s relationships with others Added questions about social life (score range 0–24, lower score = higher risk) |  • Social isolation risk score (score < 15)  • Felt isolated from other people most of the time (or almost always)  • Felt alone and friendless most of the time (or almost always)  • Transportation challenges  • Loss of a partner  • Living alone  • Finding it hard to make ends meet | X | X |  | X |
General health Edmonton Frail Scale [44]* | Falls, need of assistance with self-care and household activities, mood, medications, weight, incontinence, fall risk (score range 0–15, higher score = more frail) |  • Edmonton Frail Scale score indicated high risk (score  4-15)  • Uses 5+ prescription medications  • Often feels sad or depressed  • Sometimes loses control of bladder  • More than 20 s on timed up-and-go  • Requires assistance for timed up-and-go  • Has fallen in last year | X | X |  | X |
Nutrition Screen II (8-item) [45] | Indicates if client has a nutritional problem or at risk of developing one (score range 0–64, lower score = higher nutritional risk) |  • High nutritional risk score (score < 38)  • Does not know own weight or if weight changed OR lost more than 10 pounds in the past 6 months OR gained more than 10 pounds in the past 6 months  • Skips meals almost every day  • Poor appetite  • Sometimes/often/always coughs, chokes, or has pain when swallowing food or fluids | X | X |  | X |
Mobility [46] | Level of mobility limitations |  • Preclinical or minor or major limitation in walking 0.5 km  • Preclinical or minor or major limitation in walking 2.0 km  • Preclinical or minor or major limitation in climbing stairs | X | X |  | X |
Sleep 15-D (sleep item) [47] | Sleeping difficulties |  • Great problems with sleep  • Severe problems with sleep | X | X |  | X |
Personal health record Custom | Interest in creating a personal health record | NA | X | X+ | Â | X |
Social context Custom) | Description of client’s context | Descriptive response included | X |  |  | X |
Memory Custom | Memory difficulties | Problems with memory impact daily activities | X | Â | Â | X |
Advance care planning Custom | Client’s interest in discussing advance care planning with physician | Interested in having a discussion with family physician about advance care planning | X |  |  | X |
Oral health¶ Recommended Oral Health Screening Questions [48] | Oral health |  • Problems or pain with dentures  • Oral hygiene risk  • Has diet risk factor for poor oral health  • Family history of tooth decay  • Acid reflux  • Oral dryness  • Symptoms of active dental disease | X |  | X |  |
Smoking and alcohol¥ Custom | Smoking and alcohol behaviors |  • Wants help to address smoking behavior OR wants help to address smoking behavior in the future OR does not want help to address smoking behavior  • Wants help to address drinking behavior OR wants help to address drinking behavior in the future OR does not want help to address drinking behavior | X |  |  |  |
Health TAPESTRY experience* Custom | Feedback on, and impact of Health TAPESTRY program including negative effects | NA | Â | X | Â | Â |
Community program and service use Community Programs and Services (adapted) [49] | Community program and services connected to through Health TAPESTRY | NA | Â | X | Â | Â |