The RE-AIM framework developed by Glasgow et al. (1999) has 5 analysis elements.
- Attain: share of individuals from a given inhabitants who take part in a program and their traits. As an example, organizational attain with stakeholders could possibly be oblique, meant or direct. Attain is the variety of contributors in this system divided by the dimensions of the goal inhabitants.
- Effectiveness: optimistic and damaging program outcomes. These are sometimes measured because the share of contributors who expertise given optimistic and damaging program outcomes. Along with affected person scientific outcomes, different kinds of outcomes embody (i) behavioral outcomes for contributors (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 help the intervention (adopting an intervention, altering insurance policies). High quality of life also needs to be thought of resembling affected person functioning, psychological well being, and shopper satisfaction.
- Adoption: p.c of doable settings (e.g., organizations) and workers which have agreed to take part in this system. One might consider this as organizational buy-in. Adoption is often assessed by direct commentary or structured interviews or surveys.
- Implementation: the extent to which this system was delivered as meant and its price. Implementation may be evaluated on the particular person and group ranges. On the particular person degree, one can measure participant follow-through or “adherence”; on the organizational degree, one can measure the share of workers members who implement this system as meant.
- Upkeep: upkeep of the first outcomes (>6 months) for people; sustainability of the delivered packages for organizations. For people, relapse or discontinuation is a problem and must be evaluated; on the organizational degree, 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 company.
A abstract of the 5 dimensions in desk kind 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 rationale for the title is that an intervention’s impression is a operate of it’s attain and effectiveness (Affect = Attain × Efficacy) as outlined by Abrams et al. (1996). Moreover, Effectiveness = Implementation × Efficacy. An intervention could also be efficacious, however it’s only efficient if that intervention readily interprets to the real-world. Nonetheless, interventions might have a big impression in short-term research-based environments however will not be sustainable. The “AIM” element goals to extra utterly characterize the general public well being impression of an intervention primarily based on organizational components. RE-AIM has been used to guage quite a lot of interventions resembling:
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 focus on a variety of totally different stakeholders (e.g., suppliers, educators, others). A paper by Candy et al. 2014 word that RE-AIM could possibly be utilized to to multi-faceted intervention in one in all 3 ways:
- Exercise particular strategy. Beneath this strategy, every exercise undertaken could be evaluated primarily based 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 could possibly 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 could possibly be evaluated primarily based throughout all actions (e.g., mailers, web site visits, participant enrollment). This strategy permits for seize of general impression 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 usually decided ‘pragmatically’ primarily based on the views of the stakeholders. Swett et al. argues that this strategy “can velocity the mixing of analysis, coverage and follow…[and] additionally cut back burden on contributors and companion 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 residing with SCI to provoke and preserve 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 possibly can learn extra about how they carried out this strategy within the full paper right here.
