Evaluating the public health impact of health promotion interventions: the RE-AIM framework.

Progress in public health and community-based interventions has been hampered by the lack of a comprehensive evaluation framework appropriate to such programs. Multilevel interventions that incorporate policy- environmental- and individual components should be evaluated with measurements suited to their settings- goals- and purpose. In this commentary- the authors propose a model (termed the RE-AIM model) for evaluating public health interventions that assesses 5 dimensions: reach- efficacy- adoption- implementation- and maintenance. These dimensions occur at multiple levels (e.g.- individual- clinic or organization- community) and interact to determine the public health or population-based impact of a program or policy. The authors discuss issues in evaluating each of these dimensions and combining them to determine overall public health impact. Failure to adequately evaluate programs on all 5 dimensions can lead to a waste of resources- discontinuities between stages of research- and failure to improve publ