The RE-AIM framework developed by Glasgow et al. (1999) has 5 analysis parts.
- Attain: share of individuals from a given inhabitants who take part in a program and their traits. As an example, organizational attain with stakeholders might be oblique, supposed or direct. Attain is the variety of members in this system divided by the scale of the goal inhabitants.
- Effectiveness: constructive and damaging program outcomes. These are sometimes measured because the share of members who expertise given constructive and damaging program outcomes. Along with affected person medical outcomes, different kinds of outcomes embody (i) behavioral outcomes for members (e.g., smoking cessation, consuming patterns, bodily exercise), (ii) outcomes for employees who ship an intervention (approaching sufferers, delivering prompts and counseling, making follow-up calls), and (iii) outcomes for the payers and purchasers who assist the intervention (adopting an intervention, altering insurance policies). High quality of life also needs to be thought-about akin to affected person functioning, psychological well being, and client satisfaction.
- Adoption: % of potential settings (e.g., organizations) and workers which have agreed to take part in this system. One may consider this as organizational buy-in. Adoption is normally assessed by direct statement or structured interviews or surveys.
- Implementation: the extent to which this system was delivered as supposed and its value. Implementation could be evaluated on the particular person and group ranges. On the particular person stage, one can measure participant follow-through or “adherence”; on the organizational stage, one can measure the share of workers members who implement this system as supposed.
- Upkeep: upkeep of the first outcomes (>6 months) for people; sustainability of the delivered applications for organizations. For people, relapse or discontinuation is a problem and needs to be evaluated; on the organizational stage, one ought to measure the extent to which a well being promotion follow or coverage turns into routine and a part of the on a regular basis tradition and norms of a corporation.
A abstract of the 5 dimensions in desk type is beneath.
Every of the 5 dimensions listed above is represented on a 0 to 1 (or 0% to 100%) scale. A part of the explanation for the identify is that an intervention’s influence is a perform of it’s attain and effectiveness (Influence = Attain × Efficacy) as outlined by Abrams et al. (1996). Moreover, Effectiveness = Implementation × Efficacy. An intervention could also be efficacious, however it is just efficient if that intervention readily interprets to the real-world. Nonetheless, interventions might have a big influence in short-term research-based environments however is probably not sustainable. The “AIM” element goals to extra utterly characterize the general public well being influence of an intervention based mostly on organizational components. RE-AIM has been used to guage a wide range of interventions akin to:
A key query is whether or not RE-AIM can be utilized not just for particular person interventions, but in addition for multi-faceted interventions that concentrate on plenty of completely different stakeholders (e.g., suppliers, educators, others). A paper by Candy et al. 2014 notice that RE-AIM might be utilized to to multi-faceted intervention in one among 3 ways:
- Exercise particular strategy. Beneath this strategy, every exercise undertaken could be evaluated based mostly on the RE-AIM dimension it focused. “As an example, awareness-raising methods would goal attain or adoption, bodily exercise promotion methods is perhaps used to enhance effectiveness and upkeep, and provider-training methods might be recognized as strategies to enhance adoption and implementation of evidence-based tips.”
- Additive strategy. On this methodology, info could be collected throughout the initiatives after which amalgamated to tell every RE-AIM dimension. As an example, attain might be evaluated based mostly throughout all actions (e.g., mailers, web site visits, participant enrollment). This strategy permits for a great seize of total influence however not how any particular exercise moved the needle on a given RE-AIM dimension.
- Hybrid strategy. On this strategy, researchers resolve pragmatically which methods deserve a extra thorough RE-AIM analysis and that are greatest evaluated utilizing one or two RE-AIM dimensions. The choice is commonly decided ‘pragmatically’ based mostly on the views of the stakeholders. Swett et al. argues that this strategy “can pace the combination of analysis, coverage and follow…[and] additionally scale back burden on members and associate organizations…”
The Candy al. 2014 paper applies the RE-AIM multifaceted framework to the SCI Motion Canada, which was an initiative whose mission was to ‘develop and mobilize methods to tell, train and allow folks dwelling with SCI to provoke and keep a bodily lively life-style’. The precise metrics used as a part of their software of RE-AIM to the SCI Motion Canada intervention are proven beneath.
You may learn extra about how they carried out this strategy within the full paper right here.
