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Table 2 List of all TAP-App surveys

From: Health TAPESTRY Ontario: protocol for a randomized controlled trial to test reproducibility and implementation

Construct

Survey name

Survey description

Key information for TAP-Report

Intervention

Control

T0

T6

T0

T6

Demographic information

Custom

Basic demographics

NA

X

 

X

 

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+

 

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+

 

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

  

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

 

X

  

Community program and service use

Community Programs and Services (adapted) [49]

Community program and services connected to through Health TAPESTRY

NA

 

X

  
  1. NA not applicable
  2. *Survey is used as a research outcome measure
  3. ¶Survey only used at Hamilton FHT site
  4. ¥Survey only used at Dufferin Area FHT site
  5. +Follow-up survey to previous responses