Health services data indicate that under present conditions evidence-based medical and preventive practices are not consistently implemented in clinical practice and affect the quality of care provided to patients. Operating with similar conditions and resources, it is unlikely that evidence-based behavioral medicine (EBBM) practices will be more successfully implemented.
In this article we propose ways to help improve the implementation of EBBM practice.
This article describes the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework that is available on a free-use Web site (http://www.re-aim.org), which offers practical research translation tools, resources, and support for program planners, community leaders, and researchers. The material located at www.re-aim.org can be used to help anticipate and overcome likely barriers to dissemination and to estimate eventual public health impact.
Data on Web site utilization and lessons learned thus far in its implementation are presented.
Scientists and public health leaders should devote greater attention to reporting practice-oriented issues such as generalizability, breadth of application, and pragmatic and setting or contextual issues in addition to the current focus on internal validity issues. We hope that this and similar efforts will assist EBBM interventions to have broader applications, be consistently implemented, and be sustained.
"In order to systematically evaluate the process of implementation at the schools, eight process indicators were assessed: recruitment, context, reach, dosage, fidelity, satisfaction, effectiveness and continuation. These process indicators were derived from the Diffusion of Innovation Theory of Rogers , the model developed by Steckler and Linnan , the Process Evaluation Plan of Saunders  and the RE-AIM framework [4,18]. Table 3 presents the process indicators and their definition stratified for the dissemination phases. "
[Show abstract][Hide abstract] ABSTRACT: The evidence-based Dutch Obesity Intervention in Teenagers (DOiT) program is a school-based obesity prevention program for 12 to 14-year olds attending the first two years of prevocational education. This paper describes the study protocol applied to evaluate (a) the nationwide dissemination process of DOiT in the Netherlands, and (b) the relationship between quality of implementation and effectiveness during nationwide dissemination of the program in the Netherlands.
In order to explore facilitating factors and barriers for dissemination of DOiT, we monitored the process of adoption, implementation and continuation of the DOiT program among 20 prevocational schools in the Netherlands. The study was an education observational study using qualitative (i.e. semi-structured interviews) and quantitative methods (i.e. questionnaires and logbooks). Eight process indicators were assessed: recruitment, context, reach, dosage, fidelity, satisfaction, effectiveness and continuation. All teachers, students and parents involved in the implementation of the program were invited to participate in the study. As part of the process evaluation, a cluster-controlled trial with ten control schools was conducted to evaluate the effectiveness of the program on students' anthropometry and energy balance-related behaviours and its association with quality of implementation.
The identified impeding and facilitating factors will contribute to an adjusted strategy promoting adoption, implementation and continuation of the DOiT program to ensure optimal use and, thereby, prevention of obesity in Dutch adolescents.Trial registration: Current Controlled Trials ISRCTN92755979.
BMC Public Health 12/2013; 13(1):1201. DOI:10.1186/1471-2458-13-1201 · 2.26 Impact Factor
"These factors were derived from empirical reflections, transfer and adaptation processes, and process evaluations . Some authors have attempted to list these criteria , while others have examined external validity criteria [12,15,24,25] or the adaptation process . However, few of the criteria emerging from the literature are structured operationally in a tool that can easily be used by stakeholders wanting to transfer an intervention. "
[Show abstract][Hide abstract] ABSTRACT: Health promotion interventions are often complex and not easily transferable from one setting to another. The objective of this article is to present the development of a tool to analyze the transferability of these interventions and to support their development and adaptation to new settings.
The concept mapping (CM) method was used. CM is helpful for generating a list of ideas associated with a concept and grouping them statistically. Researchers and stakeholders in the health promotion field were mobilized to participate in CM and generated a first list of transferability criteria. Duplicates were eliminated, and the shortened list was returned to the experts, scored for relevance and grouped into categories. Concept maps were created, then the project team selected the definitive map. From the final list of criteria thus structured, a tool to analyze transferability was created. This tool was subsequently tested by 15 project leaders and nine experts.
In all, 18 experts participated in CM. After testing, a tool, named ASTAIRE, contained 23 criteria structured into four categories: population, environment, implementation, and support for transfer. It consists of two tools--one for reporting data from primary interventions and one for analyzing interventions' transferability and supporting their adaptation to new settings.
The tool is helpful for selecting the intervention to transfer into the setting being considered and for supporting its adaptation. It also facilitates new interventions to be produced with more explicit transferability criteria.
BMC Public Health 12/2013; 13(1):1184. DOI:10.1186/1471-2458-13-1184 · 2.26 Impact Factor
"The RE-AIM -model is an evaluative framework focusing on multiple criteria associated with health related behavior change research . It helps to translate research findings into practice and it contributes to a balanced emphasis on both internal and external validity . The framework conceptualizes the public health impact of an intervention as a function of five factors including reach, efficacy, adoption, implementation and maintenance . "
[Show abstract][Hide abstract] ABSTRACT: Background:
Originating from the interdisciplinary collaboration between public health and the transportation field a workplace intervention to promote commuter cycling, 'Bike to Work: cyclists are rewarded', was implemented. The intervention consisted of two cycling contests, an online loyalty program based on earning 'cycling points' and the dissemination of information through folders, newsletters, posters and a website. The study purpose was to evaluate the dissemination efforts of the program and to gain insights in whether free participation could persuade small and middle-sized companies to sign up.
The RE-AIM framework was used to guide the evaluation. Two months after the start of the intervention a questionnaire was send to 4880 employees. At the end of the intervention each company contact person (n = 12) was interviewed to obtain information on adoption, implementation and maintenance.Comparison analyses between employees aware and unaware of the program were conducted using independent-samples t-tests for quantitative data and chi-square tests for qualitative data. Difference in commuter cycling frequency was assessed using an ANOVA test. Non-parametric tests were used for the comparison analyses between the adopting and non-adopting companies.
In total seven of the twelve participating companies adopted the program and all adopting companies implemented all intervention components. No significant differences were found in the mean number of employees (p = 0.15) or in the type of business sector (p = 0.92) between adopting and non-adopting companies. Five out of seven companies had the intention to continue the program. At the individual level, a project awareness of 65% was found. Employees aware of the program had a significantly more positive attitude towards cycling and reported significantly more commuter cycling than those unaware of the program (both p < 0.001). Participation was mainly because of health and environmental considerations.
The results of the dissemination study are promising. The adoption and implementation rates indicate that the 'Bike to Work: cyclists are rewarded' program seems to be a feasible workplace intervention. At the individual level, a higher score of commuter cycling was found among the employees aware of the program. Nevertheless, more evidence regarding long term effectiveness and sustainability of the intervention is needed.
BMC Public Health 06/2013; 13(1):587. DOI:10.1186/1471-2458-13-587 · 2.26 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.