The RE-AIM framework for evaluating interventions: what can it tell us about approaches to chronic illness management?
BACKGROUND
The RE-AIM framework is used as a method of systematically considering the strengths and weaknesses of chronic illness management interventions in order to guide program planning.


METHODS
The RE-AIM dimensions of Reach, Efficacy, Adoption, Implementation, and Maintenance are used to rate one-on-one counseling interventions, group sessions, interactive computer-mediated interventions, telephone calls, mail interventions, and health system policies.


RESULTS
The RE-AIM ratings suggest that, although often efficacious for those participating, traditional face-to-face intervention modalities will have limited impact if they cannot be delivered consistently to large segments of the target population. Interventions using new information technologies may have greater reach, adoption, implementation, and maintenance, and thereby greater public health impact. Policy changes received high ratings across a variety of RE-AIM dimensions.


CONCLUSIONS
Program planners should make decisions regarding implementing and funding health services based on multiple dimensions, rather than only considering efficacy in randomized clinical trials. Doing so may improve the resulting public health impact. Directions for future chronic illness management research related to RE-AIM, and implications for decision making, are described.
Glasgow
R E
RE
AMC Cancer Research Center, Center for Behavioral and Community Studies, 1600 Pierce Street, Denver, CO 80214, USA. russkpf@earthlink.net
McKay
H G
HG
Piette
J D
JD
Reynolds
K D
KD
D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D003376:Counseling / Q000191:economics / Q000379:methods / Q000592:standards*; D019468:Disease Management; D017408:Guidelines as Topic / Q000592:standards*; D006285:Health Planning; D006291:Health Policy; D006292:Health Priorities; D006801:Humans; D008962:Models, Theoretical; D020380:Needs Assessment; D010353:Patient Education as Topic / Q000191:economics / Q000379:methods / Q000592:standards*; D010358:Patient Participation; D015397:Program Evaluation / Q000379:methods*; D012107:Research Design / Q000592:standards