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Translating Clinical Informatics Interventions into Routine Clinical Care: How Can the RE-AIM Framework Help?
Bakken S, Ruland CM.
J Am Med Inform Assoc. 2009 Aug 28. [Epub ahead of print]
School of Nursing, College of Physicians and Surgeons, Columbia University, New York, NY; Department of Biomedical Informatics, College of Physicians and Surgeons, Columbia University, New York, NY.
OBJECTIVE Clinical informatics intervention research suffers from a lack of attention to external validity in study design, implementation, evaluation, and reporting. This lack of attention to external validity hampers the ability of others to assess the fit of a clinical informatics intervention with demonstrated efficacy in one setting for implementation in their setting. The objective of this model formulation paper is to demonstrate the applicability of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework with proposed extensions to clinical informatics intervention research and describe the framework's role in facilitating the translation of evidence into practice and generation of evidence from practice. Both aspects are essential to reap the clinical and public health benefits of clinical informatics research. DESIGN We expanded the RE-AIM framework through the addition of assessment questions relevant to clinical ! informatics intervention research including those related to predisposing, enabling, and reinforcing factors. We used two case studies to validate the expanded RE-AIM framework. RESULTS The first case study supported the applicability of the RE-AIM framework to inform the real world implementation of a clinical informatics intervention with demonstrated efficacy in randomized controlled trials (RCTs) - the Choice (Creating better Health Outcomes by Improving Communication about Patients' Experiences) intervention. The second case study, an RCT of a personal digital assistant (PDA)-based decision support system (DSS) for guideline-based screening and management, illustrated how the RE-AIM framework can be used to inform the design of an efficacy RCT that will generate evidence from practice through capture of essential contextual details typically lacking in RCT design and reporting. CONCLUSION The case studies validate, through example, the applicability of the RE-AIM frame! work to inform the design, implementation, evaluation, and reporting of clinical informatics intervention studies.
The delivery of public health interventions via the Internet: actualizing their potential.
Bennett GG, Glasgow RE.
Annu Rev Public Health. 2009 Apr 29;30:273-92
Center for Community Based Research, Dana Farber Cancer Institute, Boston, Massachusetts 02115, USA. gbennett@hsph.harvard.edu
The Internet increasingly serves as a platform for the delivery of public health interventions. The efficacy of Internet interventions has been demonstrated across a wide range of conditions. Much more work remains, however, to enhance the potential for broad population dissemination of Internet interventions. In this article, we examine the effectiveness of Internet interventions, with particular attention to their dissemination potential. We discuss several considerations (characterizing reach rates, minimizing attrition, promoting Web site utilization, use of tailored messaging and social networking) that may improve the implementation of Internet interventions and their associated outcomes. We review factors that may influence the adoption of Internet interventions in a range of potential dissemination settings. Finally, we present several recommendations for future research that highlight the potential importance of better understanding intervention reach, developing consensus regarding Web site usage metrics, and more broadly integrating Web 2.0 functionality.
Genevieve F. Dunton, Renee Lagloire, Trina Robertson
Using the RE-AIM Framework to Evaluate the Statewide Dissemination of a School-Based Physical Activity and Nutrition Curriculum: “Exercise Your Options”
American Journal of Health Promotion, March/April 2009, V23, I4, 229
Glasgow RE, Gaglio B, Estabrooks PA, Marcus AC, Ritzwoller DP, Smith TL, Levinson AH, Sukhanova A, O'donnell C, France EK. Comprehensive Long-Term Results of Smoking Harm Reduction Program. Medical Care 2009 47(1):115-120. Abstract CLICK HERE
Klesges LM, Dzewaltowski DA, Glasgow RE. Review of External Validity Reporting in Childhood Obesity Prevention Research. American Journal of Preventive Medicine 2008;34(3):216-223 Abstract CLICK HERE
Jilcott, Ammerman, Sommers, & Glasgow. Applying the RE-AIM framework to assess the public health impact of policy change. Annals Behavioral Medicine, 2007, 34: 105-114. Abstract CLICK HERE
Glasgow RE. eHealth Evaluation and Dissemination Research. American Journal of Preventive Medicine 2007;32(5S):S119-S126. Abstract CLICK HERE
Translating Effective Clinic-Based Physical Activity Interventions into Practice.
Estabrooks & Glasgow. American Journal of Preventive Medicine 2006 , 31; 45-56.
Meeting Summary and Recommendations from the Meeting of Health Journal Editors on External Valdity Reporting Issues, Chapel Hill, North Carolina, April 17-18 2006.
Using RE-AIM Metrics to Evaluate Diabetes Self-Management Support Interventions. AJPM 2006;30(1):67-73.
Practical Behavioral Trials to Advance Evidence-Based Behavioral Medicine. Ann Behav Med 2006; 31(1):5-13.
Do Behavioral HARM Reduction Approaches Reach More or Different Smokers. Addictive Behaviors 2006; 31(3):509-518
RE-AIMing Research for application: Ways to Improve Evidence for Family Practice. J Am Board Fam Pract 2006;19(1):11-19.
Evaluating the Relevance, Generalization, and Applicability of Research: Issues in Translation Methodology and External Validity. Eval Health Prof 2006;29(1):126-153
Robustness of a Computer-Assisted Diabetes Self-management Intervention across patient characteristics, healthcare Settings, and Intervention Staff. Am J Managed Care 2006; 12:137-145.
An Initiative for Nutrition Education in Children: Program Description and Evaluation. Gesundheitswesen. 2006; 68(3):165-70.
Practice-based research in primary care: facilitator of, or barrier to, practice improvement? Ann Fam Med. 2005 Suppl 2:S28-32.
Translational research principles of an effectiveness trial for diabetes care in an urban African American population. Diabetes Educ.2005; 31(6):880-9.
A randomized effectiveness trial to improve
diabetes care. Diabetes Care 28(1):33-39.
A practical randomized trial to improve
diabetes care. J Gen Int Med 19(12):1167-1174.
Physical activity promotion in primary care: Bridging the gap
between research and practice. Am J Prev Med, 27(4), 297-303.
School physical education in the post-report eara: An
analysis from public health. Journal of Teaching in Physical Education, 23,
318-337.
RE-AIM: Evidence based standards and a Web resource to improve
translation of research Into practice. Annals of Behavioral Medicine, 28, 75-80.
Beginning with the application in mind: designing
and planning health behavior change interventions to enhance translation
and dissemination. Annals of Behavioral Medicine, 29, S66-75.
TREND: An important step, but not enough.
American Journal of Public Health, 94: 1474.
The future of physical
activity behavior change research: what is needed to improve translation
of research into health promotion practice? Exercise and Sport
Sciences Review. 32(2):57-63.
Behavior change research in community settings: how
generalizable are the results? Health Promotion International,
19(2), 235-245.
NOTE:
Health Promotion International has made the preceding article available
online. Choose from
these
options:
- Click here to read the abstract, courtesy of the publisher
(in a new window).
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here to access the full text, courtesy of the publisher (in a new window).
Practical, practice and policy relevant trials. Current
Diabetes Reports. 4:111-112.
The future of health behavior change research: what
is needed to improve translation of research into health promotion
practice? Annals of Behavioral Medicine. 27:3-12.
Translating What We
Have Learned into Practice: Principles and Hyptheses for Addressing
Multiple Behaviors in Primary Care. Am J Prev Med 27:(25):88-101.
Disseminating effective
cancer screening interventions. Cancer 101 (Suppl 5):1239-1250.
Patient
recruitment strategies and lessons learned during a diabetes self-management
program conducted in a primary care setting. The Diabetes Educator.
29(4), 673-681.
Worksite
health promotion research: to what extent can we generalize the results
and what is needed to translate research to practice? Health Education & Behavior,
30, 537-549.
Reporting
of validity from school health promotion studies published in 12
leading journals, 1996-2000. Journal of School Health, 73(1):
21-28.
Physical activity
promotion through primary care. Journal of the American Medical
Association, 289(22): 2913-2916.
Evaluating the impact of behavioral
interventions that target physical activity: Issues of generalizability
and public health. Psychology of Sport and Exercise, 4(1):
41-55.
Translating Research to Practice: Lessons learned, areas
for improvement, and future directions. Diabetes Care, 26:
2451-2456.
The D-Net Diabetes Self-Management Program: long-term implementation,
outcomes, and generalization results. Preventive Medicine 36(4):
410-419.
Why don't we see more translation
of health promotion research to practice? Rethinking the efficacy
to effectiveness transition. American Journal of Public Health,
93(8): 1261-1267.
Successful recruitment of minorities into clinical trials:
The Kick It at Swope project. Nicotine Tobacco Research.
5(4):575-84. [NOTE: The source of this abstract is PubMed.
For more information, contact the lead author: University of Kansas
School of Medicine, Department of Preventive Medicine, Kansas City,
KS 66160, USA. kharris2@kumc.edu]
Using pedometers to increase physical activity
in a family planning clinic: a feasibility study. Health Promotion
Journal of Australia. 14(3), 165-170. (Contact corresponding
author to obtain a copy of this publication – Elizabeth Eakin
[EEakin@qldcancer.com.au]).
Reaching
those most in need: A review of diabetes self-management interventions
in disadvantaged populations. Diabetes Metab Res Rev, 18 (1):
26-35.
Evaluation of Theory-Based Interventions: The RE-AIM Model.
In: Health Behavior and Health Education: Theory, Research, and
Practice. K. Glanz, F.M. Lewis, & B.K. Rimer (Eds) 3rd Edition.
San Francisco, John Wiley & Sons. Pages 531-544.
Behavior change intervention research in health care
settings: A review of recent reports, with emphasis on external validity. American
Journal of Preventive Medicine, 23(1): 62-69.
Response to Connelly from the BCC Representativeness and
Translation Work Group: the issue is one of impact, not of world view
or preferred approach. Health Education Research, 17(6): 696-699.
Implementation, generalization, and long-term results of the "Choosing
Well" diabetes self-management intervention. Patient
Education and Counseling, 48(2): 115-122.
If
you build It, will they come? Reach and adoption associated with
a comprehensive lifestyle management program for women with type
2 diabetes. Patient Education and Counseling, 48(2): 99-105.
Enhancing support for health behavior change among women at
risk for heart disease: The Mediterranean Lifestyle Trial. Health
Education Research. 17, 574-585.
Smoking cessation interventions
among hospitalized patients: What have we learned? Preventive
Medicine, 32(4):376-388.
Making a difference with interactive
technology: Considerations in using and evaluating computerized aids
for diabetes self-management education. Diabetes Spectrum,
14(2): 99-106.
The
RE-AIM framework for evaluating interventions: What can it tell us
about approaches to chronic illness management? Patient Education
and Counseling, 44: 119-127.
Promoting
smoking abstinence in pregnant and postpartum patients: A comparison
of 2 approaches. American Journal of Managed Care, 7, 685-693.
Review of primary care-based
physical activity intervention studies: Effectiveness and implications
for practice and future research. Journal of Family Practice,
49(2):158-168.
Medical office-based interventions.
In F.J. Snoek and T.C. Skinner (Eds.) Psychology in diabetes care.
New York: John Wiley & Sons, pages 141-168.
Brief, computer-assisted diabetes
self-management counseling: Effects on behavioral, physiological
and quality of life outcomes. Medical Care, 38: 1062-1073.
A brief
smoking cessation intervention for women in low-income Planned Parenthood
Clinics. American Journal of Public Health, 90(5): 786-789.
Outcomes of and for diabetes education research. Diabetes
Educator, 25(6) Suppl: 74-88.
Evaluating the public
health impact of health promotion interventions: The RE-AIM framework. American
Journal of Public Health, 89:1323-1327.
Interactive technology applications for
behavioral counseling: Issues and opportunities for health care. American
Journal of Preventive Medicine, 17:269-274.
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