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What's
New – Archives Groups on Aging Feature RE-AIM The National Council on Aging's (NCOA) Center for Healthy Aging and the CDC sponsored Healthy Aging Network recently sponsored a national meeting on how to translate research on effective physical activity programs for older adults into practice. The meeting was held in Seattle on Feb. 14th 2007 and featured use of the RE-AIM model for planning, implementing, and evaluating these programs. Dr. Glasgow gave one of the keynote presentations at the meeting entitled "Laying the Foundation: RE-AIM Overview" A copy of this talk is available by clicking HERE. At the meeting, a related monograph titled "RE-AIM for Program Planning" and sponsored by the NCOA Center o Healthy Aging was released. Click HERE to view or download this monograph.
Dr. Glasgow discussed applying the RE-AIM model for planning and evaluation to health policy and environmental change programs at meeting with CDC staff. CDC division of Physical Activity and Nutrition has recently adopted the RE-AIM model as part of their support and monitoring progress of state health programs on physical activity, nutrition and obesity. DR. DZEWALTOWSKI recently published an article entitled organized community opportunities to promote physical activity during out–of- school time. This was in the new edited book by Alan L. Smith and Stuart H. Biddle, Youth Activity and Inactivity Challenges and Successes (Human Kinetics). Click here to contact Dr. Dzewaltowki for a copy.
In a special issue published by the American Journal of Preventive Medicine in October a series of articles highlights factors and methods associated with disseminating physical activity interventions. In one article the importance of integrating evidence based intervention implementation and testing within clinical settings. The article discusses the importance of understanding the underlying principles of efficacious interventions and the structure of the ultimate delivery system. Translating Effective Clinic-Based Physical Activity Interventions into Practice. Estabrooks & Glasgow. American Journal of Preventive Medicine, 31; 45-56. TRANSLATIONAL RESEARCH IN CHILDHOOD OBESITY PREVENTION EXTERNAL VALIDITY MEETING SUMMARY REPORT AVAILABLE A summary of a meeting held in Chapel Hill, North Carolina this spring on increasing reporting on external validity in journal articles is now available. The meeting was sponsored by the NIH Office of Behavioral and Social Sciences Research, multiple CDC divisions, and the Robert Wood Johnson Foundation. Editors from 13 leading health journals and selected other scientists and NIH representatives discussed the need for and ways to enhance reporting on external validity. The participants agreed that reporting on external validity issues was both important and feasible, and several 'principles' for reporting on these issues were identified. CLICK HERE to go to the full meeting summary. NEW RE-AIM PLANNING TOOL NOW AVAILABLE The RE-AIM framework was developed to serve as a planning and an evaluation tool. Although we are seeing more and more literature demonstrating the utility of the framework for evaluation purposes, its potential as a planning tool hasn’t received the same attention. As a way to support planning procedures using the RE-AIM framework we have added a new Planning Checklist Section to help program, policy, and environmental change planners to develop strategies that best suit the needs of the populations they serve. COLORADO MINIGRANTS USE RE-AIM In order to enable Coloradoans to maintain good health at all stages of their lives Colorado Physical Activity and Nutrition Program(COPAN), which is a part of Colorado Department of Public Health and Environment, has been giving minigrants to get organizations started on healthful eating and active living (HEAL) initiatives for the populations they serve. These minigrants are given under the categories of Breastfeeding, Early Childhood, School Site, Active Community Environment, Older Adult Wellness, Worksite Wellness, 5 a day and School Capacity Building. Led by Dr. Paul Estabrooks, Kaiser Permanente Colorado , at the Clinical Research Unit is currently evaluating these minigrants using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. This framework was chosen as it offers a comprehensive means of measuring interventions both at individual and community levels, with equal emphasis on several outcome dimensions important for large scale impact. For more information on these grants, go to http://www.cdphe.state.co.us/pp/COPAN/grants/index.html RE-AIM METRICS PART OF SYMPOSIUM ON POPULATION IMPACT AT SBM MEETINGS Russ Glasgow presented information on new RE-AIM 'metrics' as part of an The new RE-AIM metrics, that include information on differential WISEWOMAN program utilizes RE-AIM WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation), a Centers for Disease Control and Prevention program, supports 15 states and tribes in reducing the risk of cardiovascular disease among women aged 40-64 who are under- or uninsured. Since program inception in 1995, WISEWOMAN has provided nearly 50,000 women with cardiovascular risk factor screenings and provided more than 100,000 lifestyle intervention sessions. In 2004, the RE-AIM framework was adopted for use in the program and is currently being used for both strategic planning and program evaluation. In developing its long-term strategy, WISEWOMAN has established a long-term goal for each of the five RE-AIM dimensions with the purpose of incrementally increasing its public health impact. As an example, WISEWOMAN has established a goal for Reach which is to ensure that each local site screens minority women in the same proportion as found in the target population which are women participating in the National Breast and Cervical Cancer Early Detection Program. Using RE-AIM for planning continually reminds the program that its responsibility is to design interventions that work for all people and in all settings, even in those settings with few resources. With regard to evaluation, each WISEWOMAN project collects standardized data elements which are then used to measure each of the five RE-AIM dimensions. Summary measures of each dimension are then combined to create a public health impact index for each project and its local sites. This has been particularly helpful in a best practices study completed in 2005 where the results from case studies of high performing sites were compared with results from cases studies of low performing sites. The methods and results from this study are described in a number of articles to be published in peer-reviewed journals in 2006. The ongoing challenge associated with using RE-AIM to measure the public health impact of the WISEWOMAN program is that new systems will need to be established to fully measure each dimension. WISEWOMAN is now in the process of exploring the development of these new systems. Three Presentations Given at Annual Behavioral Coopertative Oncology Group Meeting Three RE-AIM presentations were given by Dr. Glasgow, who was the keynote speaker at the recent annual meeting of the Behavioral Cooperative Oncology Group. To see copies of the Power Point presentations, click on the hot links for each of the titles below. Klesges, L. M., Estabrooks, P. A., Dzewaltowski, D. A., Bull, S. S., & Glasgow, R. E. (2005). Beginning with the application in mind: designing and planning health behavior change interventions to enhance dissemination. Annals of Behavioral Medicine, 29, 66S-75S. ABSTRACT Dissemination of behavior change interventions can be enhanced by considering key elements related to public health impact in the study design and planning phases of research projects. In this article we describe a framework of reach,efficacy/effectiveness, adoption, implementation, and maintenance known as RE-AIM and how it can be used to plan and design studies with features that can strengthen the potential translation of interventions. In describing how RE-AIM concepts were introduced to and adopted by 15 behavior change intervention studies as part of the Behavioral Change Consortium (BCC), we provide an example of practical application of the framework. Recommendations for applying the framework to study planning are based on literature reviews conducted by the RE-AIM workgroup and on discussions with investigators who participated in BCC. Utilizing RE-AIM as a planning framework may have increased attention to issues of external validity among BCC studies and enhanced the potential translation and dissemination of intervention findings into practice. Three RE-AIM presentations were given by Dr. Glasgow, who was the keynote speaker at the recent annual meeting of the Behavioral Cooperative Oncology Group. To see copies of the Power Point presentations, click on the hot links for each of the titles below. ABSTRACT Dissemination of behavior change interventions can be enhanced by considering key elements related to public health impact in the study design and planning phases of research projects. In this article we describe a framework of reach,efficacy/effectiveness, adoption, implementation, and maintenance known as RE-AIM and how it can be used to plan and design studies with features that can strengthen the potential translation of interventions. In describing how RE-AIM concepts were introduced to and adopted by 15 behavior change intervention studies as part of the Behavioral Change Consortium (BCC), we provide an example of practical application of the framework. Recommendations for applying the framework to study planning are based on literature reviews conducted by the RE-AIM workgroup and on discussions with investigators who participated in BCC. Utilizing RE-AIM as a planning framework may have increased attention to issues of external validity among BCC studies and enhanced the potential translation and dissemination of intervention findings into practice. Translating Patient Safety Research David J. Magid, Paul A. Estabrooks, David W. Brand, Marsha A. Raebel, Ted E. Palen, John F. Steiner, Eli J. Korner, David W. Bates, Richard Platt, Russell E. Glasgow There is a pressing need to make patient safety research more relevant to Click here for the paper http://www.ahrq.gov/qual/advances Determining Generalizability and Maintenance of Patient Outcomes from a Quality of Care Improvement Intervention In the April edition of Diabetes Care Jeffery Johnson and his colleagues in Canada described their study that used a cross over design with 12 month follow-up to determine the robustness of their quality of care improvement intervention targeting rural physician's interactions with patients with type 2 diabetes. Although the physicians were the target of the intervention the primary outcomes were patient blood pressure, total cholesterol, and HbA1c. The seldom applied cross over design allowed the researchers to determine the effectiveness of their intervention on the original control group patients following the completion of the original trial. It also allowed the researchers to complete a longer-term follow-up on the original intervention patients to determine if effects were sustained. The results demonstrated that the intervention was equally effective when delivered to control physicians and that most effects were sustained over time.! To read more details of this study check out the paper in Diabetes Care. Johnson, J. A., Eurich, D. T., Toth, E. L., Lewanczuk, R. Z., Lee, T. K., and Majumdar, S. R. Generalizability and Persistence of a Multifaceted Intervention for Improving Quality of Care for Rural Patients With Type 2 Diabetes. Diabetes Care 2005;28:783-8. RE-AIM Perspective and Methods Featured at AAFP Meeting Dr. Glasgow recently presented a keynote address at the annual research CDC Investigators Use RE-AIM to Evaluate Women's Health Program Drs. Rosanne Faerris, Julie Will and colleagues applied the RE-AIM model to the North Carolina WISEWOMAN project, which is one of 15 projects funded by CDC. The WISEWOMAN program aims to remove health disparities by providing uninsured, low-income mid-life women with cardiovascular preventive health services. Data from WISEWOMAN and the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) were used to assess 14 WISEWOMAN sites in RE-AIM Physical Education for Public Health Impact
This article proposed that physical education has failed to deliver the goods when it comes to promoting physical activity in children and adolescents. Since the 1980¹s, school physical education has consistently failed to reach public health objectives related to students¹ daily exposure to physical education and the amount of class time students are engaged in health-enhancing physical activity. RE-AIM is used to illustrate public health impact. Physical Activity Promotion Primary Care
Eakin, E. G., Brown, W. J., Marshall, A. L., Mummery, K., & Larsen, E. (2004). Physical activity promotion in primary care: Bridging the gap between research and practice. Am J Prev Med, 27(4), 297-303. The results of a dissemination trial testing a primary care-based physical activity counseling intervention delivered within the context of a larger, multi-strategy, Australian community-based, physical activity intervention. This dissemination study achieved high rates of adoption, reasonable levels of implementation, and a significant increase in the number of community residents reached with the physical activity counseling intervention. These results suggest that evidence-based primary care physical activity counseling protocols can be translated into practice. Estabrooks Presented with Award
Pau Estabrooks was awarded the new investigator award for his presentation of The Diffusion of an Effective Physical Activity Program: The Sustainability, Adoption, & Reach of “WALK KANSAS” at the Cooper Institute scientific conference Increasing Physical Activity in Populations: Understanding Diffusion and Dissemination. His presentation concluded that Walk Kansas is likely to have a strong public health impact as indicated by rapid diffusion, increasing reach, and strong initial sustainability. These findings are likely related to the compatibility of the program with the KSU-RE mission and ease of program delivery. Dzewaltowski to Discuss Physical Activity Promotion David Dzewaltowski presented "Evidence-Based Physical Activity Two Recent Articles on Dissemination Utilize RE-AIM In a recent issue of the journal Cancer, Glasgow, Marcus, Bull, and Wilson discuss lessons learned from the literature on dissemination of cancer screening interventions. They discuss barriers to dissemination, characteristics of interventions and settings, research evaluations, and the fit among these factors as determinants of the level of dissemination. RE-AIM is used to understand lessons learned and to drive recommendations for future research. Click here to read the abstract in a new window. In a recent special issue of the American Journal of Preventive Medicine devoted to multiple health behaviors, Glasgow, Goldstein, Ockene, and Pronk discuss issues in translating research to practice related to primary care based interventions for multiple health behaviors. They present a series of 5 principles and 15 hypotheses for future translation efforts, several of which are derived from RE-AIM. Click here to read the abstract in a new window. TREND Website is Now Available The TREND Group has established its permanent website at http://www.TREND-statement.org. (Clicking on the preceding URL will open a new window.) The group recommends transparent reporting of evaluations with nonrandomized designs (TREND). TREND Group Promotes Transparent Reporting The American Journal of Public Health's March 2004 issue includes a commentary by Don C. Des Jarlais, PhD, Cynthia Lyles, PhD, Nicole Crepaz, PhD and the TREND Group. The authors recommend transparent reporting of evaluations with nonrandomized designs (TREND) and provide guidelines. Click here to read the abstract in a new window. Conference Agenda Includes RE-AIM RE-AIM was featured in a symposium at the Agency for Health Care Research and Quality Translating Research into Practice conference held July 12-14 in Washington, D.C. The session titled "The RE-AIM Planning and Evaluation Framework as Adapted by Kaiser Permanente Colorado: Applications for TRIP" was presented on Tuesday, July 13. Panelists discussed TRIP-related applications of the RE-AIM framework in reducing patient medication safety errors (Dr. David Magid), enhancing chronic illness guidelines adherence (Dr. Russ Glasgow), and developing community-based prevention programs (Dr. Paul Estabrooks). Click here for citations that are linked to the slide presentations. Health Promotion International Makes Article Available Online The journal article "Behavior change research in community settings: How generalizable are the results?" is available online, courtesy of Health Promotion International. The full citation below is followed by links to the abstract and to the full-text version. Dzewaltowski, D.A., Estabrooks, P.A., Klesges, L.M., Bull, S.S., Glasgow, R.E. (2004). Behavior change research in community settings: How generalizable are the results? Health Promotion International, 19(2), 235-245. Current Diabetes Reports Article Highlights Practical Clinical Trials People have recently proposed clinical trials that address issues central to clinicians, administrative decision makers, and policy makers. An article in this year's Vol. 4 of the Current Diabetes Report provides examples and summarizes design features that will facilitate clinical and policy decision making. Click here to read the abstract in a new window.
The Health Maintenance Consortium is Launched The National Institutes of Health has recently funded
multiple grantees Glasgow Features Diabetes and Using
RE-AIM in Dr. Glasgow presented results from a recent diabetes quality improvement project that reports results using the RE-AIM framework at the Society of Behavioral Medicine Annual Meeting and Scientific Sessions in Baltimore, Md., on March 27, 2004. His talk, entitled "The Diabetes Priority Program: Results from a Randomized Effectiveness Study to Improve Quality of Care," can be viewed in PDF format by clicking here. Click here to download Adobe® Reader® free of charge. Klesges' Presentation to National Chronic Disease Prevention Conference Includes Using RE-AIM for Dissemination Decisions Dr. Klesges featured RE-AIM in a talk, "Planning
and Evaluation Evidence for Dissemination of Prevention Interventions," during
the 18th National Conference on Chronic Disease Prevention and
Control in Washington, D.C., on Feb 18-20, 2004. The presentation
was part of a For more information about the conference, go to
CDC's website at Click here to see slides from the presentation in PDF format. Click here for a list of, and links to, RE-AIM related presentations. Click here to download Adobe® Reader® free of charge. Dzewaltowski Discusses Gap Between Research and Health Promotion During National Health Conference David Dzewaltowski, Kansas Health Foundation Professor of Community Health at Kansas State University and Director, K-State Research and Extension Community Health Institute, presented "Integration of Community Development and Evidence-Based Program Approaches: Closing the Research and Health Promotion Practice Gap" during the 2004 Priester Extension National Health Conference. The 2004 Priester Conference was held April 13-16, 2004, in St. Louis, Mo. The conference theme was “Impacting Health and Wellness: People and Communities Changing Risk Behaviors.” Visit the National Network of Health's website for more information. (This will open a new window.) Click here to see slides from the presentation in PDF format. Publication Uses RE-AIM to Summarize Directions for Future Research The Annals of Behavioral Medicine published an article by members of the RE-AIM work group entitled "The Future of Health Behavior Change Research: What is Needed to Improve Translation of Research into Health Promotion Practice?" in its February 2004 issue (vol. 27, 3-12). After summarizing the consistent results of four recent reviews of the health behavior change literature, the authors conclude that much greater attention to representativeness, moderator variables and the robustness of intervention effects is needed. They provide a specific set of recommendations for researchers, funding agencies, and reviewers and conclude that if significant progress is to be made in translating research into practice, change is needed on the part of all of these stakeholders. Click here to read the abstract. Diabetes and Obesity Translation Conference Includes RE-AIM During a conference "'From Clinical Trials to
Community: The His talk, titled "What Outcomes are Most Important for Translation Research?", was part of a symposium on outcomes measurement. For more information about the conference, go to NIH's website at http://www.niddk.nih.gov/fund/other/conferences. Click here to see slides from the presentation in PDF format. RE-AIM Used to Help RWJF Self-Management Program Grantees Dr. Glasgow presented a session on using RE-AIM
to plan for Dr. Glasgow's presentation was part of the second national learning session held Dec. 7-9, 2003, in New Orleans for the grantee teams working on ways to incorporate self-management support into health care. Click here to view a PDF file containing slides of Dr. Glasgow's presentation. Australian Program Helps Doctors Promote Physical Activity The Victoria Council on Fitness and General Health Inc. (VICFIT) was established through the Ministers for Sport and Recreation and Health to provide advice to government and to coordinate the promotion of fitness in Victoria. One of VICFIT's initiatives, the Active Script Program (ASP), is designed to enable all general practitioners in Victoria to give consistent, effective and appropriate physical activity advice in their particular communities. Phase II of ASP was implemented from July 2000 to June 2001. Click here to open a new window with an excerpt of the report. The PDF file contains the Executive Summary and a section that explains how the RE-AIM framework was used as an evaluation tool. Visit the VICFIT website for more details and for the complete report. Researchers Report on Recruiting Minority Participants In the August 2003 issue of Nicotine and Tobacco
Research, researchers at the University of Kansas School
of Medicine report on the impact of Allegrante Chairs RE-AIM Session at SOPHE 2003 Annual Meeting John P. Allegrante, Ph.D., Professor of Health Education at Columbia University in New York, chaired a session at the 2003 annual meeting of The Society for Public Health Education (SOPHE), on Friday, November 14, in San Francisco, Calif. "Overcoming The Poor External Validity of Health Promotion Research, and What Can Be Done to Facilitate Translation of Research to Practice: Lessons Learned from the NIH Behavior Change Consortium," addresses deficiencies in external validity of health promotion research and offers possible ways to improve the situation. Click here to view the PDF® format presentation without notes or click here to view the PDF® presentation with notes. Visit SOPHE's website. (Will open a new window.) Researchers Report about Determining the Public Health Impact of Community Walking Program Dr. Paul Estabrooks, with Kaiser Permanente - Colorado and Kansas State University (K-State) and Dr. Michael Bradshaw (K-State) were recently invited to the VIIth International Olympic Committee Olympic World Congress on Sport Sciences. Estabrooks presented their work applying the RE-AIM framework to the evaluation of a community walking program. Click the citation below to view the presentation in PDF format. Annals of Behavioral Medicine Slated to Publish RE-AIM Article The following article has been accepted for publication by the Annals of Behavioral Medicine. Dzewaltowski, D.A., Glasgow, R.E., Klesges, L.M., Estabrooks, P.A., and Brock, E. (in press). RE-AIM: evidence based standards and a Web resource to improve translation of research into practice. Annals of Behavioral Medicine. Clinical Research to Clinical Practice — Lost in Translation Dr. Claude Lenfant from the National Heart, Lung,
and Blood Institute at RE-AIM Team Provides Technical Assistance to AFL Grantees The RE-AIM team recently traveled to Colorado Springs
to provide Strategies for Enhancing Adoption and Implementation Available We've listed strategies that can make it easier for organizations and settings to adopt and implement health behavior programs. Maybe you'll find some easy ways to enhance adoption or to make implementation easier that you haven't tried yet. Click on the links below to read the details. Health Care Teams Use RE-AIM to Enhance Self-management The RE-AIM planning and evaluation framework is being incorporated into the recently announced program on "Co-Management Learning Network" for chronic illness funded by the Robert Wood Johnson Foundation. The National Program Office, located in Chicago at the American Hospital Association and directed by Dr. Dorianne Miller, will use RE-AIM to help health care teams. The selected teams will participate in an 8-month-long "learning collaborative network" to improve their design, selection, reach, delivery and sustainability of self-management activities for patients with a variety of chronic illnesses. Glasgow Discusses Integrating Self-management
for Dr. Russell Glasgow presented the 2003 Sparer Distinguished Visiting Professorship lecture at the University of Tennessee Health Science Center in May. He presented research findings and methods to integrate chronic illness self-management and preventive counseling interventions into health-care settings using the RE-AIM framework. Click here to view the slide presentation. JAMA Highlights Physical Activity in Contempo Updates SectionThe June 2003 issue of the Journal of the American Medical Association includes a look at promoting physical activity in primary care practice settings. The article appears in the Contempo Updates Section. Click here to read the Conclusion. Reach and Adoption Calculators are Available for TestingWe've posted a Reach Calculator and an Adoption Calculator
for you to try. We'll add other calculators when they're available. Tools Can be Used to Evaluate Reporting on RE-AIM DimensionsWe recently completed a number of literature reviews to determine how well researchers are reporting issues of internal and external validity based on the RE-AIM framework. We have provided our practical operational coding definitions so that other investigators can use them for future reviews or just to evaluate single articles. (Click here to find the coding sheet and coding definitions on the Tools & Resources page.) Journal of School Health Publishes Review ArticleThe Journal of School Health has just published a review article by authors working on the RE-AIM project (see citation and link to the abstract below). The purpose is to examine what is known about the generalizability of school-based health promotion research.
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Thanks to the Robert Wood Johnson Foundation for providing funding to develop the RE-AIM website and to KSU Research & Extension for hosting it.