Evaluating the implementation of a hospital work-site obesity prevention intervention: applying the RE-AIM framework

Step Ahead was a randomized controlled trial testing ecologically based weight gain prevention interventions in the hospital workplace. The RE-AIM framework is used to assess the intervention's Reach, Effectiveness, Adoption, Implementation, and Maintenance. Some intervention components reached a large percentage of the workforce. Although the intervention was not effective in changing BMI on a population level, a dose response was observed, in which persons who used more of the intervention components and materials were more likely to prevent weight gain. Adoption of the intervention by sites invited was 100%. Implementation of healthy eating interventions in the hospital setting was especially challenging because close collaboration was necessary with hospital employees and contractors, and their mission and priorities often were at odds with the intervention goals. There are some notable instances of intervention maintenance at the institutional level: Farmers markets have been expanded at both sites since the end of the intervention period, and new wellness programs are being adopted and implemented. Implications for practice include the translation of this research into other workplace settings.