AUTHOR=Kwan Bethany M. , McGinnes Hannah L. , Ory Marcia G. , Estabrooks Paul A. , Waxmonsky Jeanette A. , Glasgow Russell E. 

TITLE=RE-AIM in the Real World: Use of the RE-AIM Framework for Program Planning and Evaluation in Clinical and Community Settings

JOURNAL=Frontiers in Public Health

VOLUME=7

YEAR=2019

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2019.00345

DOI=10.3389/fpubh.2019.00345

ISSN=2296-2565

ABSTRACT=<p><bold>Background:</bold> The RE-AIM framework has been widely used in health research but it is unclear the extent to which this framework is also used for planning and evaluating health-related programs in clinical and community settings. Our objective was to evaluate how RE-AIM is used in the “real-world” and identify opportunities for improving use outside of research contexts.</p><p><bold>Methods:</bold> We used purposive and snowball sampling to identify clinical and community health programs that used RE-AIM for planning and/or evaluation. Recruitment methods included surveys with email follow-up to funders, implementers, and RE-AIM working group members. We identified 17 programs and conducted structured in-depth interviews with key informants (<italic>n</italic> = 18). Across RE-AIM dimensions, respondents described motivations, uses, and measures; rated understandability and usefulness; discussed benefits and challenges, strategies to overcome challenges, and resources used. We used descriptive statistics for quantitative ratings, and content analysis for qualitative data.</p><p><bold>Results:</bold> Program content areas included chronic disease management and prevention, healthy aging, mental health, or multiple, often behavioral health-related topics. During planning, most programs considered reach (<italic>n</italic> = 9), adoption (<italic>n</italic> = 11), and implementation (<italic>n</italic> = 12) while effectiveness (<italic>n</italic> = 7) and maintenance (<italic>n</italic> = 6) were considered less frequently. In contrast, most programs evaluated all RE-AIM dimensions, ranging from 13 programs assessing maintenance to 15 programs assessing implementation and effectiveness. On five-point scales, all RE-AIM dimensions were rated as easy to understand (Overall <italic>M</italic> = 4.7 ± 0.5), but obtaining data was rated as somewhat challenging (Overall <italic>M</italic> = 3.4 ± 0.9). Implementation was the most frequently used dimension to inform program design (<italic>M</italic> = 4.7 ± 0.6) relative to the other dimensions (3.0–3.9). All dimensions were considered similarly important for decision-making (average <italic>M</italic> = 4.1 ± 1.4), with the exception of maintenance (<italic>M</italic> = 3.4 ± 1.7). Qualitative corresponded to the quantitative findings in that RE-AIM was reported to be a practical, easy to understand, and well-established implementation science framework. Challenges included understanding differences among RE-AIM dimensions and data acquisition. Valuable resources included the RE-AIM website and collaborating with an expert.</p><p><bold>Discussion:</bold> RE-AIM is an efficient framework for planning and evaluation of clinical and community-based projects. It provides structure to systematically evaluate health program impact. Programs found planning for and assessing maintenance difficult, providing opportunities for further refinement.</p>