"Replanning" a Statewide Walking Program Through the Iterative Use of the Reach, Effectiveness, Adoption,...

Area of Science:

• Public Health
• Health Promotion
• Behavioral Science

Background:

• Interventions adapt during efficacy and effectiveness trials, but post-research implementation quality and impact are often underreported.
• Community entities may undervalue data on long-term implementation quality and impact.
• Iterative evaluation is crucial for ensuring sustained, robust public health outcomes over time.

Purpose of the Study:

• To detail the replanning process of a community-based physical activity intervention.
• To assess public health impact and inform future iterations of the program.
• To evaluate the utility of the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework within a continuous improvement cycle.

Main Methods:

• Utilized the RE-AIM framework within an assess, plan, do, evaluate, report (APDER) process.
• Assessed alignment with evidence-based core components of a statewide physical activity program.
• Evaluated program reach, effectiveness on physical activity behaviors, and maintenance of effects.

Main Results:

• The Walk Across Arkansas program was adopted by most delivery agents and increased physical activity post-intervention.
• Program effects on physical activity levels were not maintained six months after completion.
• Future iterations will focus on recruitment for diverse populations and a blueprint to minimize program drift.

Conclusions:

• Replanning a community-based physical activity intervention is key to understanding and improving public health impact.
• The RE-AIM framework, applied through the APDER process, effectively guided decision-making for program sustainability.
• Continuous evaluation and adaptation are essential for maintaining intervention effectiveness beyond initial research phases.