Qualitative approaches to use of the RE-AIM framework: rationale and methods

Jodi Summers Holtrop,Russell E Glasgow,Borsika A Rabin

doi:10.1186/s12913-018-2938-8

Jodi Summers Holtrop, Russell E Glasgow + Show 1 more

Open Access

https://doi.org/10.1186/s12913-018-2938-8

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Abstract

BackgroundThere have been over 430 publications using the RE-AIM model for planning and evaluation of health programs and policies, as well as numerous applications of the model in grant proposals and national programs. Full use of the model includes use of qualitative methods to understand why and how results were obtained on different RE-AIM dimensions, however, recent reviews have revealed that qualitative methods have been used infrequently. Having quantitative and qualitative methods and results iteratively inform each other should enhance understanding and lessons learned.MethodsBecause there have been few published examples of qualitative approaches and methods using RE-AIM for planning or assessment and no guidance on how qualitative approaches can inform these processes, we provide guidance on qualitative methods to address the RE-AIM model and its various dimensions. The intended audience is researchers interested in applying RE-AIM or similar implementation models, but the methods discussed should also be relevant to those in community or clinical settings.ResultsWe present directions for, examples of, and guidance on how qualitative methods can be used to address each of the five RE-AIM dimensions. Formative qualitative methods can be helpful in planning interventions and designing for dissemination. Summative qualitative methods are useful when used in an iterative, mixed methods approach for understanding how and why different patterns of results occur.ConclusionsIn summary, qualitative and mixed methods approaches to RE-AIM help understand complex situations and results, why and how outcomes were obtained, and contextual factors not easily assessed using quantitative measures.

Highlights

There have been over 430 publications using the RE-AIM model for planning and evaluation of health programs and policies, as well as numerous applications of the model in grant proposals and national programs
RE-AIM has been used for both planning [2] and evaluation. [3, 9] the model is somewhat intuitive, full use of it requires in depth information and understanding of multi-level and contextual factors
We provide guidance for researchers and community groups that wish to use qualitative methods in their RE-AIM applications

Summary

Introduction

There have been over 430 publications using the RE-AIM model for planning and evaluation of health programs and policies, as well as numerous applications of the model in grant proposals and national programs. Full use of the model includes use of qualitative methods to understand why and how results were obtained on different RE-AIM dimensions, recent reviews have revealed that qualitative methods have been used infrequently. The RE-AIM model was developed in 1999 in response to a need to have a framework to evaluate potential for, or actual, public health and population impact. [1] RE-AIM includes five dimensions to call attention to the importance of measuring a traditional clinical outcome (i.e. effectiveness), and implementation outcomes that are less frequently assessed, but critical to producing broad impact. There has been significant uptake in the use of RE-AIM as a planning and RE-AIM has been used for both planning [2] and evaluation. [3, 9] the model is somewhat intuitive, full use of it requires in depth information and understanding of multi-level and contextual factors. [10] RE-AIM is one way to approach the “ultimate use” question of what intervention (programs or policies) components, conducted under what conditions and in what settings, conducted by which

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