title: A RE-AIM evaluation of evidence-based multi-level interventions to improve obesity-related behaviours in adults: a systematic review (the SPOTLIGHT project).
abstract: BACKGROUND
  This systematic literature review describes the potential public health impact of evidence-based multi-level interventions to improve obesity-related behaviours in adults, using the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework.
  
  
  METHODS
  Electronic databases (PubMed, Embase, and The Cochrane Library) were searched to identify intervention studies published between January 2000 and October 2013. The following inclusion criteria were used: (1) the study included at least one outcome measure assessing obesity-related behaviours (i.e. diet, physical activity or sedentary behaviour), (2) the study collected data over at least one year and (3) the study's intervention targeted adults, was conducted in a specified geographical area or worksite, and was multi-level (i.e. targeting both individual and environmental level). Evidence of RE-AIM of the selected interventions was assessed. Potential public health impact of an intervention was evaluated if information was provided on at least four of the five RE-AIM dimensions.
  
  
  RESULTS
  Thirty-five multi-level interventions met the inclusion criteria. RE-AIM evaluation revealed that the included interventions generally had the potential to: reach a large number of people (on average 58% of the target population was aware of the intervention); achieve the assumed goals (89% found positive outcomes); be broadly adopted (the proportion of intervention deliverers varied from 9% to 92%) and be sustained (sixteen interventions were maintained). The highest potential public health impact was found in multi-level interventions that: 1) focused on all levels at the beginning of the planning process, 2) guided the implementation process using diffusion theory, and 3) used a website to disseminate the intervention.
  
  
  CONCLUSIONS
  Although most studies underreported results within the RE-AIM dimensions, the reported Reach, Effectiveness, Adoption, Implementation and Maintenance were positively evaluated. However, more information on external validity and sustainability is needed in order to take informed decisions on the choice of interventions that should be implemented in real-world settings to accomplish long-term changes in obesity-related behaviours.
authors.affiliation: Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. sofie.compernolle@ugent.be.
authors.forename: Sofie
authors.initials: S
authors.lastname: Compernolle
authors.affiliation: Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. katrien.decocker@ugent.be.|Research Foundation Flanders (FWO), B-1000, Ghent, Belgium. katrien.decocker@ugent.be.
authors.forename: Katrien
authors.initials: K
authors.lastname: De Cocker
authors.affiliation: The EMGO Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. j.lakerveld@vumc.nl.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Lakerveld
authors.affiliation: The EMGO Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. j.mackenbach@vumc.nl.
authors.forename: Joreintje D
authors.initials: JD
authors.lastname: Mackenbach
authors.affiliation: The EMGO Institute for Health and Care Research, Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam, The Netherlands. g.nijpels@vumc.nl.
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
authors.affiliation: Université Paris 13, Sorbonne Paris Cité - UREN (Unité de Recherche en Epidémiologie Nutritionnelle), U557 Inserm; U1125 Inra; Cnam, Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Bobigny, France. jean-michel.oppert@psl.aphp.fr.|Université Pierre et Marie Curie-Paris 6, Department of Nutrition Pitié-Salpêtrière Hospital (AP-HP), (CRNH IdF), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France. jean-michel.oppert@psl.aphp.fr.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
authors.affiliation: European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK. harry.rutter@lshtm.ac.uk.
authors.forename: Harry
authors.initials: H
authors.lastname: Rutter
authors.affiliation: Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal. pteixeira@fmh.ulisboa.pt.
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Teixeira
authors.affiliation: Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. greet.cardon@ugent.be.
authors.forename: Greet
authors.initials: G
authors.lastname: Cardon
authors.affiliation: Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. ilse.debourdeaudhuij@ugent.be.
authors.forename: Ilse
authors.initials: I
authors.lastname: De Bourdeaudhuij
mesh_terms: D004032:Diet; D055317:Evidence-Based Practice; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D009043:Motor Activity; D009765:Obesity / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D057185:Sedentary Behavior