RE-AIM Model Research Articles

A nurse practitioner-led deprescribing bundled intervention to reduce rates of polypharmacy in the post-acute care setting.

In post-acute care (PAC) settings, residents face elevated risks of adverse drug reactions and emergency department visits because of polypharmacy. With over 90% of PAC residents nationally taking five or more medications, targeted deprescribing of inappropriate or unnecessary medications emerges as a critical strategy. The project site faces high rates of polypharmacy with a root cause analysis revealing a deficiency in evidence-based practices (EBP) for deprescribing potentially inappropriate or unnecessary medications. To address this issue, a bundled deprescribing intervention was implemented as part of a quality improvement project aimed at reducing polypharmacy rates. This project, conducted at a PAC setting in the midwestern United States, used the RE-AIM Model. Data collection involved tracking prescribing rates before and after the intervention for residents admitted to the practice setting over a 5-month period. A bundled EBP intervention comprising a deprescribing framework, pharmacist collaboration, and the utilization of an EBP guideline, established a systematic process guiding deprescribing efforts for each resident on admission to the PAC setting. Fourty-nine patients received a deprescribing bundle, resulting in a 26.67% reduction in prescribed medications. On average, patients had 5.55 medications deprescribed, with reductions noted across 85 distinct therapeutic drug categories. Nurse practitioners play a pivotal role initiating successful deprescribing interventions within the PAC setting. Using a comprehensive approach, integrating pharmacist collaboration and EBP leads to reductions in prescribing rates among PAC residents. This model demonstrates potential for sustainable improvements in patient outcomes within the PAC environment.

Improving Cancer Treatment Communication between Secondary and Primary Care: A New Format for Written Communication

In decision making for cancer treatment, information is crucial for patients and health care professionals. Although conversations about treatment decisions take place in hospitals, many patients also appreciate the insights of their general practitioner (GP). GPs indicated that, in order to have meaningful conversations about treatment decisions with their patients, they need additional information about treatment options and considerations, such as expected benefits and side effects.In this practice innovation, we developed and implemented a new written communication format from medical specialists to GPs, aimed at providing accurate treatment information to facilitate GPs in supporting patients with cancer in decision-making. The new format added 3 specific headings to standard letters in the electronic patient files (EPFs): (1) treatment options, (2) treatment considerations, and (3) treatment intent.This innovation was implemented in a large university hospital in the Netherlands between 2020 and 2021. We performed a process evaluation of the implementation using the RE-AIM model, based on assessment of written communication obtained from patients’ EPFs, and telephonic interviews with specialists and GPs.In the Netherlands, all inhabitants are registered with a GP, who acts as a gatekeeper to specialist care, and has a comprehensive overview of a patient’s history, based on digital communication with hospitals after referral for specialist care. EPFs are used to generate digital letters to communicate between medical specialists in a hospital and GPs outside the hospital. Incorporating new headings in the communication format in the EPF successfully encouraged medical specialists to share such information when used appropriately. Treatment options, considerations, and treatment intent were stated more often in the new format compared with the old format. GPs appreciated the new format, highlighting the value of including treatment considerations, which enhanced their comprehension of the medical specialist's thought processes.Recognition of the problem and motivation for improvement facilitated the implementation. Specialists stated the format to be time-efficient compared with the old format; however, technical improvements could make it easier to use. Automaticity to use of the old format, inadequate information, and technical issues were a barrier for implementation.In summary, a straightforward innovation can improve communication between medical specialists and GPs and promote the role of the GPs in decision making for cancer treatment.

Indoor environment sensor systems for healthier homes: a feasibility study in social housing

ABSTRACT This study examines the feasibility of using an indoor environment sensor system to improve property management and health in social housing. Over a 6-year period, sensors were installed and maintained in 280 homes to monitor temperature, humidity, and air quality, with the sensor data provided to residents and the Housing Association (HA) through co-designed dashboards. Employing a mixed method sequential research design, feasibility was evaluated using the RE-AIM model. From the residents’ perspective, monitoring the indoor environment was acceptable, but adoption rates of the dashboard were low and there was minimal evidence of its effectiveness in prompting changes in behavior. From the HA perspective, the system proved effective in identifying high-risk homes, prompting the HA to reach out to vulnerable residents, and provide more timely support and maintenance. The system also facilitated long-term monitoring, planning, and helped the HA achieve its social objectives and legislative responsibilities. Despite initial technical challenges, HA staff expressed a desire to continue using the system, integrate it with existing infrastructure, and expand its deployment to more homes. However, scaling the intervention would require careful planning. In conclusion, sensor systems are a feasible intervention that holds promise in helping to address health risks in underserved communities.

Analysis Research Public Health Trends with the RE-AIM Model and VOSviewer : A Literature Review

Abstract This study uses the VOSviewer tool to conduct research mapping analysis in order to examine public health research using the RE-AIM Framework. Descriptive analysis is used with a quantitative bibliometric approach in this research strategy. Based on Web of Science search results, the research data was acquired with the keywords "sanitation, public health, RE-AIM". From the data produced in the last five years (2017–2022), A total of 279 scholarly articles were acquired. The findings demonstrated that each year, more study has been conducted on public health and RE-AIM, and the topic of sanitation and RE-AIM has never been conducted. In conclusion, Currently, research on the subject of public health and RE-AIM is worthwhile, and it involves research that is still infrequently done. It is therefore anticipated that this research will serve as a guide for selecting the research topic Keywords : Bibliometrics, VOSviewer, Public Health, RE-AIM

Revisiting the opioid and naloxone education (ONE) program: Program evaluation using the RE-AIM model four years later

ObjectiveThe Opioid and Naloxone Education (ONE) Program focuses on community pharmacy-based patient screening and interventions to improve population health with regard to opioid use. The purpose of this paper is to reevaluate the ONE Program performance using the RE-AIM model, in comparison to the review performed in 2019. MethodsThe program performance of the ONE Program was evaluated from January 1, 2021 to December 31, 2022 was evaluated using the five domains of the RE-AIM model. Reach was defined as the proportion of patients receiving opioid prescriptions who completed the screening. Efficacy was defined as the proportion of individuals identified as at risk who received a pharmacist intervention. Adoption was defined as the proportion of community pharmacies who enrolled in the ONE Program. Implementation was defined as the proportion of pharmacies that enrolled that provided at least five patient screenings. Maintenance was defined as the proportion of pharmacies that completed at least one screening three months. These results were compared against evaluation of the program from October 12, 2018 to June 1, 2019. ResultsApproximately 7.28 % of patients receiving opioid prescriptions were screened for risk of opioid misuse and accidental overdose (Reach). Of the patients screened, 97.4 % of patients at risk for opioid misuse or accidental overdose received a pharmacist-led intervention (Efficacy). Additionally, 49.6 % of the pharmacist that enrolled in the ONE Program completed at least five screenings (79 %) and of those, 86.4 % maintained the program three months later. ConclusionsIn years four and five of implementation, the ONE Program demonstrated improvement in four of the five domains of the RE-AIM model compared to years one and two. However, Reach declined over time. This reevaluation has demonstrated the importance of longitudinal program assessment, and the possibility of improved program performance over time.

Dissemination and implementation of an evidence-based voluntary medical male circumcision program: The Spear & Shield program.

Despite compelling evidence linking voluntary medical male circumcision (VMMC) with 60-70% HIV risk reduction in sub-Saharan Africa, Zambian men have been especially reluctant to undergo VMMC. The Government of Zambia set targets for VMMC uptake and promoted community-level interventions. Spear & Shield (S&S) is an innovative, evidence-based, service program promoting VMMC uptake while ensuring both VMMC supply and demand. This study assessed the large-scale provincial rollout of the program (S&S2) utilizing the RE-AIM model for translating interventions into the community. The S&S2 study was conducted between November 2015 and December 2020, and sequentially rolled out over four Zambian provinces in 96 clinics; 24 observation clinics received VMMC training only. Local clinic healthcare workers were trained to conduct the VMMC procedure and HIV counselors were trained to lead S&S group sessions. Using the RE-AIM model, primary outcomes were: Reach, the number, proportion, and representativeness of S&S attendees; Effectiveness, the impact of S&S2 on VMMC uptake; Adoption, the number, proportion, and representativeness of clinics implementing S&S2; Implementation, fidelity to the S&S intervention manual; and Maintenance, the extent to which S&S2 became an element of standard care within community clinics. Initially, n = 109 clinics were recruited; 96 were sustained and randomized for activation (Adoption). A total of 45,630 clinic patients (n = 23,236 men and n = 22,394 women) volunteered to attend the S&S sessions (Reach). The S&S2 program ran over 2,866 clinic-months (Implementation). Although the study did not target individual-level VMMCs, ~58,301 additional VMMCs were conducted at the clinic level (Effectiveness). Fidelity to the S&S intervention by group leaders ranged from 42%-95%. Sustainability of the program was operationalized as the number of CHCs initially activated that sustained the program. Intervention delivery ended, however, when study funding ceased (Maintenance). The S&S2 program successfully utilized the RE-AIM model to achieve study goals for implementation and dissemination in four Zambian provinces. Innovative VMMC programs such as S&S2 can improve the uptake of VMMC, one of the most effective strategies in the HIV prevention arsenal.

Outcomes and Feasibility of an Occupational Care Programme (TERRA) to Support Work Ability of Rare and Advanced Cancer Patients: A Report of 7 Cases

Introduction: Advancements in the field of oncology are allowing patients to live longer, with enhanced quality of life (QoL). Accordingly, more patients with cancer are expressing the desire to return to work (RTW). Previous research has indicated that patients with a rare or advanced cancer can experience unique problems in the RTW process. Methods: This pilot study evaluated the outcomes and feasibility of the occupational care programme TERRA (i.e., recalibraTe lifE and woRk with and afteR cAncer) for patients with a rare or advanced cancer. Four rare cancer patients and 3 advanced cancer patients completed TERRA; a supportive occupational care programme consisting of five online group sessions over a two-month period. Pre- and post-intervention outcomes were collected using validated self-report questionnaires. The primary outcome was work ability. Secondary outcomes included QoL, anxiety and depression, fatigue, unmet needs, self-efficacy, readiness for RTW, work intention, work involvement, and work-life conflict. Feasibility was assessed using the RE-AIM model. Results: Changes in work ability scores were inconsistent across participants. Well-being outcomes generally improved following the intervention. Feasibility was evaluated positively by both participants and trainers. Conclusion: A multidisciplinary approach may further improve outcomes of occupational interventions supporting rare and advanced cancer patients. An effectiveness study to evaluate the outcomes and feasibility of the programme is deemed necessary.

Older Adult Mental Health: A Student-Led Project to Reduce Stigma Among Residents Living in a Publicly Supported Housing

Twenty percent of older adults report having a concern about their mental health. Mental health concerns lead to impairments in physical, mental, and social functioning and complicate the management of chronic illness. These concerns are widely underrecognized and often untreated or under-treated in community-dwelling older adults. A 6-week student-led mental health promotion initiative for older adults living in publicly supported housing was developed. The initiative included student-led weekly “mood” screenings which aimed to destigmatize mental illness and educational sessions teaching the older adults how to use iPads and access the internet and Wi-Fi. The goal of the project was to have residents engage in telehealth visits that promote mental health and improve quality of life. Ungirded by the RE-AIM framework, the initiative focused on achieving Reach by ensuring participants had sufficient knowledge and skill in using the telehealth technology and were not encumbered by mental illness stigma. The project sample of older adults living in publicly supported housing self-reported minimal depressive symptoms and demonstrated stigma toward seeking help for mental illness. Cultural implications contribute to these findings. To have a program with good Reach as delineated in the RE-AIM model, it must recognize facilitators and barriers. Integrating affordability, cultural congruency, and a social connection to community in its design together with the utilization of students during implementation may promote mental health and mitigate some of the negative health consequences.

Evaluation of the Spanish-Language Cancer Educational Webinar Series "Vamos a educarnos contra el cáncer" with the RE-AIM Framework.

The COVID-19 pandemic disrupted healthcare for patients with chronic diseases, including cancer. Barriers to healthcare increased, especially for racial and ethnic minorities. While many institutions developed webinars to educate community members, few webinars used a community-based participatory approach, employed a theory-based engagement design, and were evaluated. This manuscript reports the outcomes of "Vamos a educarnos contra el cáncer," a 2021 webinar series. Monthly educational webinars were conducted in Spanish on cancer-related topics. The presentations were delivered by Spanish-speaking content experts from different organizations. Webinars were conducted using the video conferencing platform Zoom. Polls were launched during the webinar to collect data and evaluate each webinar. The RE-AIM model of reach, effectiveness, adoption, implementation, and maintenance was used to evaluate the series. The SAS Analytics Software was used for analysis and data management. Two hundred ninety-seven people participated with over 3000 views of the webinar recordings (Reach); 90% rated the sessions as good or excellent (Effectiveness); 86% agreed to adopt or improve a cancer-related behavior, and 90% reported willingness to adopt or improve a cancer-related action for someone else (Adoption); 92% reported feeling engaged (Implementation). The series has produced a resource library, manual of operations, and agreement of the Hispanic/Latino Cancer Community Advisory Board (CAB) to continue the webinar series in the future (Maintenance). Overall, these results highlight the impact of this webinar series and provide a standard approach to planning, delivering, and evaluating webinars as a strategy for cancer prevention and control in a culturally appropriate manner.

Process evaluation of Dulce Digital-Me: an adaptive mobile health (mHealth) intervention for underserved Hispanics with diabetes.

Type 2 diabetes disproportionately impacts ethnic minorities and individuals from low socioeconomic status. Diabetes self-management education and support has been shown to improve clinical outcomes in these populations, and mobile health (mHealth) interventions can reduce barriers to access. Dulce Digital-Me (DD-Me) was developed to integrate adaptive mHealth technologies to enhance self-management and reduce disparities in the high-risk, underserved Hispanic population. The objective of the present study was to evaluate reach, adoption, and implementation of an mHealth diabetes self-management education and support intervention in this underrepresented population. The present analysis is a multimethod process evaluation using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. The study was effective in reaching a sample that was representative of the intended population; only modest but significant differences were observed in sex and age. The DD-Me health coach (HC) cited several important facilitators of intervention adoption, including outreach frequency and personalization, and the automated HC report. Implementation fidelity was high, with participants receiving >90% of intended interventions. Participants who received DD-Me with support from a HC were most engaged, suggesting utility and acceptability of integrating HCs with mHealth interventions. Perceptions of implementation among study participants were positive and consistent across study arms. This evaluation revealed the target population was successfully reached and engaged in the digital health interventions, which was implemented with high fidelity. Further studies should evaluate the efficacy and maintenance of the study following the RE-AIM model to determine whether this intervention warrants expansion to additional settings and populations.

Assessing the Implementation of an LGBTQ+ Mental Health Services Training Program to Determine Feasibility and Acceptability During the COVID-19 Pandemic.

Despite significant social and legal progress, LGBTQ+ (lesbian, gay, bisexual, transgender, and other sexual and gender minority) populations continue to experience higher rates of mental health and substance use disorders than their heterosexual and cisgender counterparts. Effective LGBTQ+ affirmative mental health care is essential for addressing these disparities but is often limited and difficult to access. The shortage of LGBTQ+ affirmative mental health care providers results from the absence of required and accessible LGBTQ+-focused training and technical assistance opportunities for mental health care professionals. This study evaluates the implementation of our COVID-19 adapted, completely virtual, organization- and therapist-focused training program to improve the mental health workforce's cultural competence in working with the LGBTQ+ community: the Sexual and Gender Diversity Learning Community (SGDLC). Guided by an expanded RE-AIM model, we used administrator and therapist feedback to assess SGDLC implementation factors to understand how it may be best translated for scaled-up promotion and widespread adoption. Assessment of the initial reach, adoption, and implementation of the SGDLC indicated that it had strong feasibility; reports on satisfaction and relevance support the SGDLC's acceptability. Maintenance could not be fully assessed from the short study follow-up period. Still, administrators and therapists expressed an intent to continue their newfound practices, a desire for continued training and technical assistance in this area, but also concerns about finding additional opportunities for this education.

A proposal for a set of attributes relevant for Web portal data quality: The Brazilian Rare Disease Network case

Despite widespread growth in the use and complexity of web portals, insufficient attention is paid to their quality. Thus, this paper aims to describe the validation process of the Brazilian Network of Rare Diseases Portal and identify a set of data quality attributes required for psychometric evaluations that will support the portal implementation. This protocol describes a cross- sectional study of mixed nature divided into three steps: A usability evaluation, a Delphi consensus, and an electronic service quality assessment. Also, the RE-AIM model will be applied at various stages of evaluative research. We hope the improvement carried out during the validation of RARAS can contribute to the dissemination of knowledge in the area and include, based on scientific knowledge and clinical experts, offering clear, attractive, and accessible information for the population. A research gap exists in determining components of integrated e-service quality, usability, and user experience evaluation model in general, and for rare disease web portals, in particular. Users of the RARAS Portal need to get validated content and the required reliable online services without doing exhaustive searches or visiting multiple sources, with the main focus on e-service quality.

The RE-AIM Evaluation of the Evidence-Based Multiple Drug Treatment Program in Taiwan District

This study employs the RE-AIM based 360-degree feedback analysis to examine the scientific evidence-based drug treatment program implemented by the Agency of Corrections, Ministry of Justice, in Taiwan to ensure the program quality and effective resource allocation and to help improve the effectiveness of the treatment. Also, the study results were expected to strengthen the possibility of drug addicts successfully returning to society, achieving the goal of preventing recidivism and reshaping the meaningful life for drug offenders. Based on the outcomes of qualitative interviews, focus groups, pre- and post-measurement scores, case manager's work survey questionnaires, and official statistics analysis for the year 2020-2021, this study attempts to complete the goal through the RE-AIM model analysis. In terms of Reach dimension, the study finds that the proportion of drug-administering cases that completed professional treatment before release from prison has been increasing year by year; in terms of Effectiveness dimension, regardless of the scale scores, the subjective feelings of the clients encountered or the official statistics, we find that the positive impacts on the case (behavior change and self-understanding), and there is still room for improvement in reducing impulsive of drug offenders, curriculum design and recidivism rate; in terms of Adoption dimension, besides to practical workers, colleagues in other departments in the organization also intervened in the plan to some extent, but there is still room for improvement in the horizontal connection and integration of various units; in terms of Implementation dimension, the service and investment time of the first-line practitioners are in agreement with the core values of the Evidence-Based Drug Treatment Program; in terms of Maintenance dimension, data on recidivism out of prison shows that the treatment courses have continuous effects for the case intervention. Besides, it also indicates that the Agency of Corrections and Ministry of Justice will not only keep promoting this treatment program but also continue to improve it and see the "Scientific Evidence-based Drug Treatment program" as the organization's regular service. Finally, the research findings provided suggestions for curriculum planning, resource allocation, treatment execution, and practical work aids.

Implementing and Evaluating Community Health Worker-Led Cardiovascular Disease Risk Screening Intervention in Sub-Saharan Africa Communities: A Participatory Implementation Research Protocol.

The increasing burden of non-communicable diseases (NCDs), particularly cardiovascular diseases (CVD) in low- and middle-income countries (LMICs) poses a considerable threat to public health. Community-driven CVD risk screening, referral and follow-up of those at high CVDs risk is essential to supporting early identification, treatment and secondary prevention of cardiovascular events such as stroke and myocardial infarction. This protocol describes a multi-country study that aims to implement and evaluate a community health worker (CHW)-led CVD risk screening programme to enhance referral linkages within the local primary care systems in sub-Saharan Africa (SSA), using a participatory implementation science approach. The study builds upon a prior community-driven multicentre study conducted by the Collaboration for Evidence-based Health Care and Public Health in Africa (CEBHA+). This is a participatory implementation research. The study will leverage on the CVD risk citizen science pilot studies conducted in the four selected CEBHA+ project countries (viz. Ethiopia, Rwanda, Malawi, and South Africa). Through planned engagements with communities and health system stakeholders, CHWs and lay health worker volunteers will be recruited and trained to screen and identify persons that are at high risk of CVD, provide referral services, and follow-up at designated community health clinics. In each country, we will use a multi-stage random sampling to select and then screen 1000 study participants aged 35-70 years from two communities (one rural and one urban). Screening will be done using a simple validated non-laboratory-based CVD risk assessment mobile application. The RE-AIM model will be used in evaluating the project implementation outcomes, including reach, fidelity, adoption and perceived effectiveness. Developing the capacities of CHWs and lay health worker volunteers in SSA to support population-based, non-invasive population-based CVD risk prevention has the potential to impact on early identification, treatment and secondary prevention of CVDs in often under-resourced communities. Using a participatory research approach to implementing mobile phone-based CHW-led CVD risk screening, referral and follow-up in SSA will provide the evidence needed to determine the effectiveness of CVD risk screening and the potential for scaling up in the wider region.

Project UPLIFT: Adoption and implementation experiences of an epilepsy self-management program

RationaleProject UPLIFT is an evidence-based epilepsy self-management program shown to prevent and treat depression through an 8-session, group telehealth intervention. Since 2012, the program has been disseminated by training community-based providers to deliver UPLIFT to people with epilepsy (PWE). Limited research has described the adoption, implementation, and practice-based maintenance of self-management programs like UPLIFT. We sought to gain a better understanding of this process from trained program adopters. MethodsA cross-sectional evaluation of adoption and implementation experiences was conducted. An online survey with closed- and open-ended questions was distributed to 120 UPLIFT program adopters to collect information about reasons for being trained and experiences implementing the program. Survey items were developed based on the RE-AIM model to assess program reach, effectiveness, adoption, implementation, and maintenance. For closed-ended responses, frequencies and cross-tabs were calculated. Open-ended responses were reviewed and grouped by theme. Results41 respondents completed the survey (34% response rate). Respondents were from a variety of organizations including clinical (39%, n = 16), educational/research (17%, n = 7), and Epilepsy Foundation affiliates/chapters (12%, n = 5), among others. The most frequently endorsed reason for training in UPLIFT was an interest in supporting PWE (73%, n = 30). Most respondents rated delivering UPLIFT as very important (49%, n = 20) or important (32%, n = 13) to the organization. Sixty-one percent (n = 25) of respondents reported implementing (implementors) UPLIFT. Of those who had not yet implemented UPLIFT, 50% (n = 8) planned on implementing it at some point. Among program implementors, the most frequently reported implementation facilitators included participant interest (68%, n = 17), training (68%, n = 17), and organizational support (64%, n = 16). Program implementors indicated having program champions (80%, n = 20). The most frequently reported implementation challenge reported was recruitment (72%, n = 18). In open-ended responses, funding was a key theme that would facilitate continued implementation, but 48% (n = 12) responded that did not have access to resources and/or funding to help continue offering UPLIFT. Developing partnerships was recommended to improve the reach and maintenance of the program. Despite challenges, implementors agreed (44%, n = 11) or strongly agreed (36%, n = 9) that UPLIFT was effective in addressing mental health problems among program participants, and 76% (n = 19) plan on continuing to offer UPLIFT. ConclusionImplementation surveys increase understanding of program adoption and impact for dissemination trainees. Implementation benefits from program champions, strong partnerships, and sustained funding. Continued refinement of implementation support, such as developing a sustained referral system, maintaining relationships with trainees, supporting evaluation activities, and exploring opportunities for program updates to further enhance adoption, implementation, and maintenance.

Five years’ experience with value-based quality improvement teams: the key factors to a successful implementation in hospital care

BackgroundIn recent years, value-based healthcare (VBHC) has become one of the most accepted concepts for fixing the ‘broken’ healthcare systems. Numerous hospitals have embraced VBHC and are trying to implement value-based quality improvement (VBQI) into their practice. However, there is a lack of knowledge on how to practically implement VBHC and organizations differ in their approach. The aim of this study was to explore the main factors that were experienced as hindering and/or supporting in the implementation of VBQI teams in hospital care.MethodsA qualitative study was performed with semi-structured interviews with 43 members of eight VBQI teams in a large Dutch top-clinical teaching hospital. Participants included physicians, physician assistants, nurses, VBHC project leaders, managers, social workers, researchers and paramedics. Interview grids were structured according to the RE-AIM model (reach, effectiveness, adoption, implementation and maintenance). A thematic content analysis with open coding was used to identify emerging (sub)themes.ResultsWe identified nine main factors divided over three domains (organization, culture and practice) that determined whether the implementation of VBQI teams was successful or not: 1). Practical organization of value-based quality improvement teams, 2). Organizational structure 3). Integration of VBHC with existing quality improvement approaches and research 4). Adoption and knowledge of the VBHC concept in the hospital 5). Multidisciplinary engagement 6). Medical leadership 7). Goal setting and selecting quality improvement initiatives 8). Long-cycle benchmarking and short-cycle feedback 9). Availability of outcome data.ConclusionsOverall, this study goes beyond the general VBHC theory and provides healthcare providers with more detailed knowledge on how to practically implement value-based quality improvement in a hospital care setting. Factors in the ‘organization’ and ‘practice’ domain were mentioned in the strategic value agenda of Porter and Lee. Though, this study provides more practical insight in these two domains. Factors in the ‘culture’ domain were not mentioned in the strategic value agenda and have not yet been thoroughly researched before.

P10-05 Evaluation of a MOOC on Heath Promotion in sports club

BackgroundThe acquisition of health promotion (HP) skills and knowledge is essential for interventions development [1,2]. Considering the increasing recognition of the potential of HP in sports clubs (SC) [3] and the number of HP interventions [4,5], the development of training to optimize their implementation is important. To this end, the MOOC (Massive Open Online Course) PROSCeSS (PROmotion de la Santé dans les Clubs de SportS) was developed. The objective of this work was to evaluate the learning process of the MOOC, its acceptability and its effectiveness on the HP knowledge and on the abilities to implement the learning.MethodsQuestionnaires were sent to participants before and after the training between November and February 2022. The RE-AIM model, measuring reach (affected audience) of the training, effectiveness (knowledge gained), adoption (motivations to participate in the course), implementation (use of learning), and maintenance (long-term use of learning) was used to structure the study. Descriptive and multivariate statistics were performed using SPSS 23.0 software.Preliminary ResultsOf the 2000 learners, 21% completed the pre-MOOC questionnaire and 5% completed the post-MOOC questionnaire. Among non-exclusive categories, 32% of learners were SC coaches, 26% were managers, 43% were practitioners (on average for 10 years) and 46% were HP or sport professionals. A paired sample t-test showed an 11% increase in the post-MOOC knowledge questionnaire score compared to the pre-MOOC questionnaire, as well as a 10% increase in confidence in implementing HP actions. 48% of learners were “completely satisfied” with the MOOC and 47% “quite satisfied”. The strategies of participatory approach, communication and objective were considered as the most important and feasible while the lack of time, financial and human resources were considered the main barriers to learning's implementation.ConclusionsSC actors seem to be interested in HP and want to be trained. This MOOC appears to be an effective solution for acquiring knowledge in HP. The results provide indications for the development of strategic tools and inform on strategies recognized as effective and feasible to implement HP projects and face the problems encountered by the SC.

Evaluation of the intervention “Bom Dia”, in Recife- Pernambuco-Brazil in the control of childhood obesity

Childhood obesity has been increased sharply in Brazil and worldwide, becoming a major public health problem. This study aims to evaluate the “Bom Dia” program (a multidisciplinary program to care of obese children) in Recife, Pernambuco, Brazil, according to the reach, effectiveness, adoption, implementation, and maintenance using the RE-AIM model. In this study, mixed methods were used to collect data, with triangulation of methods, documentation research, directed observation, field journal, questionnaire, and semi-structured interviews, conducted from February to December 2020. This program had a 0.95% reach at community level. Some barriers such as: inflexibility of the program schedule, poor economic conditions, access difficulties, and weak integration in Health Care Network, made in difficult to reach the target population. The program presented "adoption" by all members of the multi professional team. The intervention was successfully implemented, although some adjustments to of the logic model were required over time. “Bom Dia” has been maintained at the organizational level over the years, due to the performance of the intervention team and the support from the health organizations. Finally, despite the "reach" to the target audience had not achieved expressive results, this study is unpublished, and the intervention can promote improvements in the quality of life of obese children and adolescents. Therefore, the results of this study are important for practice and could support the implementation of similar intervention programs to control obesity in children.

The Wellness Center in Public Hospitals in Thailand: A Qualitative Assessment Using RE-AIM Model.

Non-communicable diseases (NCDs) become one of serious health issues globally including Thailand. The Wellness Center was introduced by the Ministry of Public Health (MOPH) in public hospitals since 2018 for both healthy people and people who at risk for NCDs. It incorporates risk evaluation, health assessment, health behaviors changing, health promotion and prevention, and health record system to follow participant's health status. This study aimed to evaluate the Wellness Centers in three public hospitals in Thailand using RE-AIM framework. Findings indicated that the Wellness Centers successful reached its target groups. Although sample size was small, the findings provided a positive outcome. Besides, the average weight and Body Mass Index (BMI) had reduced significantly after participants attending both services of Wellness Centers. However, there were some challenges from this program such as financial sustainability, performance indicator, and data system.

Evaluating a Memory Clinic Using the RE-AIM Model. The Experience of the "Memory and Neuropsychiatry Clinic" in Hospital Del Salvador, Chile.

The development of healthcare services for dementia is key to improving access to care and post-diagnostic support for people living with dementia. Memory Units have emerged as a new healthcare service composed of multidisciplinary teams with the goal of improving diagnosis and/or management of dementia patients. The main objective of this study was to describe and evaluate the Reach and Effectiveness of a Memory Unit in a public hospital in Chile, using the RE-AIM model, a multi-component model that allows for the evaluation of the implementation of ongoing healthcare programs. Regarding “R” (Reach): from March 2018 up to June 2019, a total of 510 patients were referred and assessed. Most patients came from primary care (51.9%) and from outpatient services at the Hospital Salvador (39.2%), particularly from the Neurology (63.3%) and Psychiatry (16.0%) departments. We estimated that our Memory Unit assessed 5.39% of all of the dementia patients living in the area of referral. With respect to “E” (Effectiveness): 419 patients are still being followed up at the Memory Unit. Ninety-one patients (18%) were discharged. Of these, 55 (66%) were referred to primary healthcare, 28 (31%) to other outpatient services, 9 (10%) to a specialized mental healthcare center, and 9 (10%) to a daycare center. Due to the short period of time that the Memory Unit has been operating, no other RE-AIM dimensions could be evaluated at this juncture. To our knowledge, this is the first implementation study of a Memory Unit in Latin America, and the first using the RE-AIM model. Although cultural differences worldwide might play a role in the lack of international guidelines, the publication of the experience of the first year of this unit in Chile could inform new countries about this process. Ongoing challenges include continuing to collect data to complement the RE-AIM evaluation and developing a protocol that can be adopted elsewhere in Chile and Latin America. Further studies are needed to assess the benefits of a Memory Unit in comparison to regular care and to develop a model that assures continuity and coordination of care for people with dementia.