The goal of RE-AIM is to encourage program planners, evaluators, readers of journal articles, funders, and policy-makers to pay more attention to essential program elements including external validity that can improve the sustainable adoption and implementation of effective, generalizable, evidence-based interventions.
The five steps to translate research into action are:
- Reach the target population
- Effectiveness or efficacy
- Adoption by target staff, settings, or institutions
- Implementation consistency, costs and adaptions made during delivery
- Maintenance of intervention effects in individuals and settings over time
Reach – The absolute number, proportion, and representativeness of individuals who are willing to participate in a given initiative, intervention, or program.
Efficacy – The impact of an intervention on important outcomes, including potential negative effects, quality of life, and economic outcomes.
Adoption – The absolute number, proportion, and representativeness of settings and intervention agents (people who deliver the program) who are willing to initiate a program.
Implementation – At the setting level, implementation refers to the intervention agents’ fidelity to the various elements of an intervention’s protocol, including consistency of delivery as intended and the time and cost of the intervention. At the individual level, implementation refers to clients’ use of the intervention strategies.
Maintenance – The extent to which a program or policy becomes institutionalized or part of the routine organizational practices and policies. Within the RE-AIM framework, maintenance also applies at the individual level. At the individual level, maintenance has been defined as the long-term effects of a program on outcomes after 6 or more months after the most recent intervention contact.
Read about Applying the RE-AIM Framework
RE-AIM was originally developed as a framework for consistent reporting of research results and later used to organize reviews of the existing literature on health promotion and disease management in different settings. The acronym stands for Reach, Effectiveness, Adoption, Implementation, and Maintenance which together determine public health impact. Since the original paper in 1999, there have been approximately 100 publications on RE-AIM by a variety of authors in fields as diverse as aging, cancer screening, dietary change, physical activity, medication adherence, health policy, environmental change, chronic illness self-management, well-child care, eHealth, worksite health promotion, women’s health, smoking cessation, quality improvement, weight loss, diabetes prevention, and practice-based research.
More recently, RE-AIM has been used to translate research into practice and to help plan programs and improve their chances of working in “real-world” settings. The framework has also been used to understand the relative strengths and weaknesses of different approaches to health promotion and chronic disease self-management-such as in-person counseling, group education classes, telephone counseling, and internet resources. The overall goal of the RE-AIM framework is to encourage program planners, evaluators, readers of journal articles, funders, and policy-makers to pay more attention to essential program elements including external validity that can improve the sustainable adoption and implementation of effective, generalizable, evidence-based interventions.
See Applying the RE-AIM Framework for answers to some basic questions. You’ll also find ideas to improve your chances at having a positive impact on public health.
Many people have been involved in developing and advancing the RE-AIM model over the years. The list below acknowledges the primary contributors. Any oversights are unintentional and please bring these to our attention by contacting Paul Estabrooks.
Russ Glasgow, Shawn Boles, Tom Vogt
Russell Glasgow, PhD Visiting Professor, Family Medicine Associate Director, Colorado Health Outcomes Program University of Colorado School of Medicine. Dr. Glasgow is one of the original developers of RE-AIM, and has focused on its application in primary care settings and for chronic illness self-management. He is also interested in applications of interactive technologies that have potential for reaching broad audiences and in programs to assist older adults, especially those with multiple chronic conditions. More information here.
Alice Ammerman, DrPH, Director, UNC Center for Health Promotion and Disease Prevention. Dr. Ammerman’s research activities include design and testing of innovative clinical and community-based nutrition and physical activity intervention approaches for chronic disease risk reduction in primarily low income and minority populations.
Borsika A. Rabin, PhD, MPH, PharmD is an Assistant Clinical Professor at the Department of Family Medicine and Colorado Health Outcomes Program at the School of Medicine, University of Colorado. Dr. Rabin’s research focuses on dissemination and implementation of evidence-based interventions, communication and coordination around cancer care with special interest in survivorship related issues, and the evaluation and development of interactive, web-based interventions and tools with a strong emphasis on cancer survival prediction tools and tools that can support planning for dissemination and implementation of interventions (i.e., designing for dissemination and implementation). She designed and developed a number of web-based resources including the Make Research Matter webtool and the Cancer Prognostic Resources website.
Bridget Gaglio, PhD, Program Officer, PCORI. Dr. Gaglio is a behavioral scientist who has a background in working with multiple healthcare settings and conducting health interventions in real-world. Her work is characterized by two main themes: (1) to understand the gaps in the quality of health status and health care that exists among diverse segments of the population and (2) to design interventions that can be implemented and disseminated in a variety of “real world” settings and will benefit their target audiences.
David Dzewaltowski, PhD, Kansas State University, Professor and Head of Kinesiology. Dr. Dzewaltowski is a social and behavioral scientist who has studied the human ecology of community-based interventions promoting physical activity and healthful eating in childcare settings, after-school programs, youth sport, Girl Scouts, middle schools and diverse community organizations. His work has demonstrated that adults can engage children and youth and develop their capacity to influence the environments in which they live, learn and play to promote healthful behavior.
Deborah Toobert, PhD, Oregon Research Institute, Research Scientist. Dr. Toobert has conducted research and published numerous articles related to multiple-health-risk behavior self-management, including healthful eating and weight management, physical activity, smoking cessation, problem solving, stress management, and the challenges of assessing, changing, and maintaining improvements in multiple health-risk behaviors.
Diane King, PhD, Center for Behavioral Health Research & Services, University of Alaska Anchorage, Research Assistant Professor. King’s primary research interests include prevention and self-management of obesity and chronic disease through promotion of healthy eating, healthy communities, and active living. Dr. King’s research emphasizes practical “real world” interventions that have the potential for widespread dissemination and implementation at the individual, environment and policy levels.
Fabio Almeida, PhD, MSW, Virginia Tech, Department of Human Nutrition, Foods and Exercise Assistant Professor. Dr. Almeida’s work focuses on identifying the connections between systems and individuals which can create and sustain positive behavior changes associated with improved health outcomes. In 2014, Dr. Almeida led the team conducting the translation and adaptation of the RE-AIM framework to Portuguese and the Brazilian reality, and is now engaged in many activities to promote the dissemination of RE-AIM throughout Brazil.
Laura Linnan, ScD, University of North Carolina at Chapel Hill, Professor of Health Behavior, Director: Carolina Collaborative for Research on Work & Health. Dr. Linnan has research expertise in the design and evaluation of multi-level interventions to address chronic disease; with a focus on health disparities. Dr. Linnan has worked with a variety of settings including: worksites, schools and other community settings (beauty salons, public libraries, child care facilities).
Lisa Klesges, PhD, Dean, School of Public Health, Professor of Epidemiology & Social and Behavioral Sciences. Dr. Klesges has specialty training in Behavioral Epidemiology and her current work involves family‐based obesity prevention interventions in children, behavioral and environmental risk factor assessment related to childhood obesity, and in translational methods for behavioral interventions.
Marcia Ory, PhD, MPH, Texas A&M Health Science Center, Regents and Distinguished Professor. Dr. Ory’s research expertise is related to: healthy aging, chronic disease management; implementation and dissemination of evidence based programs; recruitment and retention of diverse populations. She has recently become involved in m-health approaches for assessing and changing lifestyle behaviors in clinical and community populations.
Paul A. Estabrooks, PhD, Professor of Human Nutrition, Foods, & Exercise, Virginia Tech, Professor of Family Medicine, Virginia Tech Carilion School of Medicine, Senior Director of Research, Carilion Clinic. Dr. Estabrooks conducts translational research as it relates to physical activity, nutrition, weight control, and population health management. He has designed a number of clinical and community studies using pragmatic approaches and RE-AIM as the basis for determining the potential public health impact of those interventions.
Renae Smith-Ray, PhD, University of Illinois Chicago, Research Scientist. Dr. Smith-Ray has expertise in public health and community- and clinic-based health behavior interventions for older adults. Specifically, Dr. Smith-Ray has extensive experience developing and testing cognitive and physical activity programs for older adults and examining the factors that influence the translation and dissemination of health promotion programs.
Rodger Kessler, PhD ABPP, Assistant Professor of Family Medicine, Fellow, Global Health Economics Unit, University of Vermont College of Medicine, Director, Collaborative Care Research Network. Dr. Kessler implements and evaluates behavioral interventions and models of behavioral care in primary care practices. Kessler focuses on both process engagement and translation of evidence based behavioral care in primary care settings. He works with the full range of primary care patients, with health care systems and insurers to create the opportunity to translate evidence-based interventions into their intended settings. His primary passion is creating alternatives to obstacles that have generated ineffective health care silos.
Samantha Harden, PhD, Assistant Professor of Human Nutrition, Foods, & Exercise, Virginia Tech and Exercise Extension Specialist, Virginia Cooperative Extension. Dr. Harden studies ‘physical activity’ as a mechanism for improved health outcomes and psychological well-being; especially from a group dynamics-based approach. Working with a variety of populations from prenatal women to older adults, Dr. Harden explores intrapersonal, interpersonal, and system-level factors that either speed or impede the rate of translating evidence-based interventions into their intended practice settings (e.g., clinic, community).
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Robert Wood Johnson Foundation (support for website development); Kansas State University (inception to 2007); Kaiser Permanente Colorado Institute for Health Research (2008- 2011); Division of Cancer Control and Population Sciences, National Cancer Institute (2011- 2013); Virginia Tech (August 2013-2016); University of Nebraska Medical Center (2016-present)