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Related Experiment Videos

Using RE-AIM metrics to evaluate diabetes self-management support interventions.

Russell E Glasgow1, Candace C Nelson, Lisa A Strycker

  • 1Kaiser Permanente Colorado, Clinical Research Unit, Denver, Colorado, USA. russg@ris.net

American Journal of Preventive Medicine
|January 18, 2006
PubMed
Summary

This study compared two diabetes self-management programs using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Both programs showed similar individual impacts, but one demonstrated better reach and effectiveness for population health.

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Area of Science:

  • Public Health
  • Health Services Research
  • Behavioral Science

Background:

  • Healthcare decisions often rely on limited efficacy data.
  • The RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework offers a broader perspective on program impact.
  • Key decision-maker considerations include reach, adoption, and cost.

Purpose of the Study:

  • To compare two diabetes self-management support approaches using composite RE-AIM impact and cost-efficiency indices.
  • To evaluate program impact at both individual participant and setting levels.

Main Methods:

  • Utilized composite RE-AIM indices to assess two distinct diabetes self-management programs: Diabetes Priority (DP) and Diabetes Health Connection (DHC).
  • DP involved 886 patients in 30 primary care offices using clinical staff.

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  • DHC involved 335 patients in HMO and fee-for-service settings using health education staff.

    • Main Results:

    • DP showed greater reach (50% vs. 38%) and initial effectiveness (ES=0.23 vs. 0.17), with better impact consistency across populations.
    • DHC demonstrated higher physician office adoption (20% vs. 6%) and staff adoption (79% vs. 70%).
    • DHC exhibited less variability in protocol implementation among intervention staff (ES=0.0 vs. 0.50).

    Conclusions:

    • Indices focusing on public health and external validity are crucial for identifying impactful and adaptable programs.
    • The RE-AIM framework aids in understanding program success beyond efficacy, informing broader health initiatives.