School of Health & Exercise Sciences, University of British Columbia, 1147 Research Rd, Kelowna, British Columbia, V1V 1V7, Canada.
International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, British Columbia, V5Z 1M9, Canada.
BMC Public Health. 2019 Jun 24;19(1):803. doi: 10.1186/s12889-019-7131-4.
The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is a useful tool for evaluating the impact of programs in community settings. RE-AIM has been applied to evaluate individual programs but seldom used to evaluate the collective impact of community-based, public health programming developed and delivered by multiple autonomous organizations. The purposes of this paper were to (a) demonstrate how RE-AIM can be operationalized and applied to evaluate the collective impact of similar autonomous programs that promote health and well-being and (b) provide preliminary data on the collective impact of Canadian spinal cord injury (SCI) peer mentorship programs on the delivery of peer mentorship services.
Criteria from all five RE-AIM dimensions were operationalized to evaluate multiple similar community-based programs. For this study, nine provincial organizations that serve people with SCI were recruited from across Canada. Organizations completed a structured self-report questionnaire and participated in a qualitative telephone interview to examine different elements of their peer mentorship program. Data were analyzed using summary statistics.
Having multiple indicators to assess RE-AIM dimensions provided a broad evaluation of the impact of Canadian SCI peer mentorship programs. Peer mentorship programs reached 1.63% of the estimated Canadian SCI population. The majority (67%) of organizations tracked the effectiveness of peer mentorship through testimonials and reports. Setting-level adoption rates were high with 100% of organizations offering peer mentorship in community and hospital settings. On average, organizations allocated 10.4% of their operating budget and 9.8% of their staff to implement peer mentorship and 89% had maintained their programming for over 10 years. Full interpretation of the collective impact of peer mentorship programs was limited as complete data were only collected for 52% of survey questions.
The lack of available organizational data highlights a significant challenge when using RE-AIM to evaluate the collective impact of multiple programs that promote health and well-being. Although researchers are encouraged to use RE-AIM to evaluate the collective impact of programs delivered by different organizations, documenting limitations and providing recommendations should be done to further the understanding of how best to operationalize RE-AIM in these contexts.
RE-AIM（Reach、Effectiveness、Adoption、Implementation 和 Maintenance）框架是评估社区环境中项目影响的有用工具。RE-AIM 已被用于评估单个项目，但很少用于评估由多个自治组织开发和提供的基于社区的公共卫生编程的集体影响。本文的目的是：(a) 展示如何操作化 RE-AIM 并将其应用于评估促进健康和福祉的类似自治计划的集体影响；(b) 提供关于加拿大脊髓损伤 (SCI) 同伴指导计划在同伴指导服务提供方面的集体影响的初步数据。
使用所有五个 RE-AIM 维度的标准来评估多个类似的基于社区的项目。在这项研究中，从加拿大各地招募了 9 个为 SCI 患者服务的省级组织。组织完成了一份结构化的自我报告问卷，并参加了一次定性电话访谈，以检查其同伴指导计划的不同要素。使用汇总统计数据进行数据分析。
使用多个指标来评估 RE-AIM 维度，广泛评估了加拿大 SCI 同伴指导计划的影响。同伴指导计划覆盖了估计的加拿大 SCI 人群的 1.63%。大多数组织（67%）通过证词和报告跟踪同伴指导的效果。设定层面的采用率很高，100%的组织在社区和医院环境中提供同伴指导。平均而言，组织将其运营预算的 10.4%和员工的 9.8%用于实施同伴指导，89%的组织已经将其编程维持了 10 年以上。由于仅收集了 52%的调查问题的完整数据，因此对同伴指导计划的集体影响的全面解释受到限制。
缺乏可用的组织数据突出表明，当使用 RE-AIM 评估促进健康和福祉的多个计划的集体影响时，这是一个重大挑战。尽管鼓励研究人员使用 RE-AIM 评估由不同组织提供的计划的集体影响，但应记录局限性并提供建议，以进一步了解如何在这些情况下最好地操作化 RE-AIM。
