Assessing PRISM context domains and RE-AIM outcomes: Data from use of the Iterative PRISM Webtool

Area of Science:

• Implementation Science
• Health Services Research
• Program Evaluation

Background:

• Implementation science theories, models, and frameworks (TMFs) are crucial for well-executed studies but are rarely evaluated.
• Understanding construct relationships within TMFs can refine them, advance the field, and aid practitioners.

Purpose of the Study:

• To evaluate hypotheses related to the Practical, Robust Implementation and Sustainability Framework (PRISM) context domains and Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) outcomes.
• To assess the utility of the Iterative PRISM (iPRISM) webtool for operationalizing PRISM constructs and to explore potential refinements.

Main Methods:

• Utilized the Iterative PRISM (iPRISM) webtool, comprising 21 assessment questions, to operationalize PRISM constructs.
• Tested 11 a priori hypotheses concerning relationships within and between PRISM context and RE-AIM outcome constructs.
• Collected data from 348 respondents across clinical, community, and public health settings.

Main Results:

• Seven of 11 hypotheses were supported, including lower Maintenance ratings compared to other RE-AIM outcomes.
• Equity scores within RE-AIM dimensions were consistently lower than general ratings.
• Fewer hypotheses regarding PRISM context items were supported, potentially due to single-item operationalization.

Conclusions:

• The iPRISM webtool provides a standardized method for operationalizing PRISM constructs and offers initial norms.
• Further research, including qualitative evaluations, is necessary to fully understand the complex relationships within RE-AIM outcomes, PRISM context domains, and their interrelations.