Relative Impact of Preventative Primary Care: A Longitudinal Evaluation of COVID-19 (RIPPLE-C)

A strong primary care system is essential for effective chronic disease management and prevention, but the COVID-19 pandemic resulted in dramatic changes across the healthcare system. The RIPPLE-C project identifies areas of primary care that were, and continue to be, affected by the pandemic to help focus support and attention for recovery.

RIPPLE-C is investigating:

  • Changes in indicators of primary care performances across three domains:
    • Access to care
    • Comprehensiveness of care
    • Appropriateness of care
  • Patient perspectives on how the pandemic affected their medical care and the decisions they made when seeking out care
  • Whether the ongoing treatment and monitoring of patients with chronic and risk factor conditions was maintained over the course of the pandemic

RIPPLE-C is a mixed methods study conducted in two concurrent phases. Results from each phase are used to help interpret results and discussion points of both studies.

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Phase 1: Retrospective Cohort Study

In this phase, we use de-identified electronic medical data from a primary care research database (CPCSSN) that includes data from nearly 2 million participants nationwide. This phase compares chronic disease management before and during the pandemic.

Phase 2: Qualitative Study

For this phase, we explore patient perspectives on how the COVID-19 pandemic affected their experiences with primary care. We recruited participants with the following characteristics:

  • Aged 50+
  • With type 2 diabetes

We interviewed participants to learn about their experiences navigating care for chronic conditions and whether there are any challenges or changes to their healthcare.

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RIPPLE-C Team Members

  • Michelle Howard, Co-Principal Investigator
  • Dee Mangin, Co-Principal Investigator
  • Meredith Vanstone
  • Shuaib Hafid
  • Karla Freeman
  • Andrea Carruthers
  • Jennifer Lawson
  • Rebecca Clark
  • Kris Aubrey-Bassler, Memorial University
  • Marie-Therese Lussier, University of Montreal
  • Kathryn Nicholson, Western University
  • Neil Drummond, University of Alberta
  • John Queenan, Queen’s University
  • Amanda Ramdyal, McMaster University