RE-AIM model

Adoption

Is there some group to take ownership of the intervention?

Significance of RE-AIM: what does the model add to science?

Most published research on behavioral change theories have only focused on E: efficacy, etc. --We also need to consider the other dimensions of the model

RE-AIM model (developed by Russell Glasgow)

Reach Efficacy/Effectiveness Adoption Implementation Maintenance

Reach * Effectiveness = Impact

1) Limited reach but v. effective --ex. intensive weight control program 2) Large reach but modestly effective --ex. mass media program **At a population level the impact may be similar

Maintenance: things to consider (3)

1. Are plans in place to make it likely that the program will be continued when public health funding ends? 2. Is continuous support needed? 3. Who will support? **Challenge at state and federal levels

Implementation: things to consider (3)

1. Fidelity of implementation (whaa?) 2. What processes are in place to assure that adopting sites or organizations will deliver the program accurately and effectively? 3. Does the program require staff who have special skills, training, or experience? If so, are those staff available?

Rationale for model: Traditional approaches to treatment can result in: (5)

1. Inequality 2. Limited participation 3. Poor implementation 4. Lack of sustainability 5. Little impact

Maximizing Reach (2)

1. Make the intervention easily accessible --convenient times and accessible places --limit cost/hassle factor --widely promoted 2. Design the program to be applicable to as many individuals as possible --population based rather than high risk

Why is RE-AIM important? (5)

1. Represents a shift away from singular focus on efficacy 2. Moves us toward new questions about whether the intervention is structured in such a way that it can be effectively delivered and maintained in a community 3. Forces program planners to also consider reach and adoption 4. Provides program resources to under-served groups

Adoption: things to consider (4)

1. What agencies or organizations will adopt and deliver the program? 2. What sites will host the program? 3. If many agencies or sites are available for the program, how many of them are willing to become involved? 4. What barriers might exist to the adoption of this program

Implementation

Can the adopting group actually deliver the intervention in a high quality way?

Maintenance

Can the intervention be sustained over time?

Reach

Can this intervention (or program) be delivered to a large percentage of the target population?

Efficacy/Effectiveness/evidence based

What is the evidence that the intervention will produce effective results?

Definitions: Efficacy

Whether the intervention works under ideal/research conditions

Definitions: Effectiveness

Whether the intervention works under real-life conditions

Look in notes for 2 example programs

mm hmm

Definitions: Evidence based

whether there is evidence to suggest the intervention should work --in this community?