Applying The RE-AIM Framework To The Health Promotion Policy In Toyooka City.

Abstract

PURPOSE: Toyooka city, located on the western frontier of Japan, is regarded as harboring a typical Japanese super-aging society. The rapid aging of the population is placing a hefty financial burden and has led to an increased focus on strategies that help the elderly maintain physical activity. In 2012, the health promotion policy of “Walking as a way of life” was formulated to enforce the municipal office to play a more significant role in promoting physical activity at the population level in Toyooka city. This study aimed to evaluate the implementation and impact of this policy based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation) framework. METHODS: A sample comprising 2,500 randomly selected residents were mailed a questionnaire. The data were analyzed using the RE-AIM framework. The use of the RE-AIM framework can enhance the generalizability of results when implementing the enforcement of the policy. Reach was defined as the proportion of eligible citizens that reported being aware of this program. Effectiveness of physical activity and social capital factors (i.e., networks in the neighborhood, trust for the community, social participation) was compared between citizens who were aware of the policy against those who were not aware of it. Independent sample t tests were used to compare groups for differences. Adoption was evaluated according to the proportion of organizations that had delivered results. Implementation governed how the results would be publicized. RESULTS: In total, 873 response questionnaires were completed and returned. There were 340 citizens (38.9%) who were aware of this policy. The group that was aware had significantly higher social capital than the group that was not (p < .01). However, no significant differences were found in adherence to physical activity. Of all organizations, 30.9% reported adoption. When considering the most cited information sources, the print media from the municipal office was distributed to 100% of homes. CONCLUSIONS: The use of the RE-AIM framework revealed that the health promotion policy of “Walking as a way of life” in Toyooka-city could reach residents with high social capital, but could not increase their physical activity. The authors have no conflicts of interest.