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A 3-month jump-landing training program: a feasibility study using the RE-AIM framework.

ABSTRACT: CONTEXT: Evaluating the translatability and feasibility of an intervention program has become as important as determining the effectiveness of the intervention. OBJECTIVE: To evaluate the applicability of a 3-month jump-landing training program in basketball players, using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. DESIGN: Randomized controlled trial. SETTING: National and regional basketball teams. PATIENTS OR OTHER PARTICIPANTS: Twenty-four teams of the second highest national division and regional basketball divisions in Flanders, Belgium, were randomly assigned (1:1) to a control group and intervention group. A total of 243 athletes (control group = 129, intervention group = 114), ages 15 to 41 years, volunteered. INTERVENTION(S): All exercises in the intervention program followed a progressive development, emphasizing lower extremity alignment during jump-landing activities. MAIN OUTCOME MEASURE(S): The results of the process evaluation of the intervention program were based on the 5 dimensions of the RE-AIM framework. The injury incidence density, hazard ratios, and 95% confidence intervals were determined. RESULTS: The participation rate of the total sample was 100% (reach). The hazard ratio was different between the intervention group and the control group (0.40 [95% confidence interval = 0.16, 0.99]; effectiveness). Of the 12 teams in the intervention group, 8 teams (66.7%) agreed to participate in the study (adoption). Eight of the participating coaches (66.7%) felt positively about the intervention program and stated that they had implemented the training sessions of the program as intended (implementation). All coaches except 1 (87.5%) intended to continue the intervention program the next season (maintenance). CONCLUSIONS: Compliance of the coaches in this coach-supervised jump-landing training program was high. In addition, the program was effective in preventing lower extremity injuries.

SUBMITTER: Aerts I

PROVIDER: S-EPMC3655742 | biostudies-other | 2013 May-Jun

REPOSITORIES: biostudies-other

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A 3-month jump-landing training program: a feasibility study using the RE-AIM framework.

Aerts Inne I Cumps Elke E Verhagen Evert E Mathieu Niels N Van Schuerbeeck Sander S Meeusen Romain R

Journal of athletic training 20130403 3

<h4>Context</h4>Evaluating the translatability and feasibility of an intervention program has become as important as determining the effectiveness of the intervention.<h4>Objective</h4>To evaluate the applicability of a 3-month jump-landing training program in basketball players, using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework.<h4>Design</h4>Randomized controlled trial.<h4>Setting</h4>National and regional basketball teams.<h4>Patients or other partic ...[more]

PMID: 23675788

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Project description:BackgroundThe National Diabetes Prevention Program (National DPP) is rapidly expanding in an effort to help those at high risk of type 2 diabetes prevent or delay the disease. In 2012, the Centers for Disease Control and Prevention funded six national organizations to scale and sustain multistate delivery of the National DPP lifestyle change intervention (LCI). This study aims to describe reach, adoption, and maintenance during the 4-year funding period and to assess associations between site-level factors and program effectiveness regarding participant attendance and participation duration.MethodsThe Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide the evaluation from October 2012 to September 2016. Multilevel linear regressions were used to examine associations between participant-level demographics and site-level strategies and number of sessions attended, attendance in months 7-12, and duration of participation.ResultsThe six funded national organizations increased the number of participating sites from 68 in 2012 to 164 by 2016 across 38 states and enrolled 14,876 eligible participants. By September 2016, coverage for the National DPP LCI was secured for 42 private insurers and 7 public payers. Nearly 200 employers were recruited to offer the LCI on site to their employees. Site-level strategies significantly associated with higher overall attendance, attendance in months 7-12, and longer participation duration included using self-referral or word of mouth as a recruitment strategy, providing non-monetary incentives for participation, and using cultural adaptations to address participants' needs. Sites receiving referrals from healthcare providers or health systems also had higher attendance in months 7-12 and longer participation duration. At the participant level, better outcomes were achieved among those aged 65+ (vs. 18-44 or 45-64), those who were overweight (vs. obesity), those who were non-Hispanic white (vs. non-Hispanic black or multiracial/other races), and those eligible based on a blood test or history of gestational diabetes mellitus (vs. screening positive on a risk test).ConclusionsIn a time of rapid dissemination of the National DPP LCI the findings of this evaluation can be used to enhance program implementation and translate lessons learned to similar organizations and settings.

Project description:Background: The RE-AIM framework has been widely used in health research but it is unclear the extent to which this framework is also used for planning and evaluating health-related programs in clinical and community settings. Our objective was to evaluate how RE-AIM is used in the "real-world" and identify opportunities for improving use outside of research contexts. Methods: We used purposive and snowball sampling to identify clinical and community health programs that used RE-AIM for planning and/or evaluation. Recruitment methods included surveys with email follow-up to funders, implementers, and RE-AIM working group members. We identified 17 programs and conducted structured in-depth interviews with key informants (n = 18). Across RE-AIM dimensions, respondents described motivations, uses, and measures; rated understandability and usefulness; discussed benefits and challenges, strategies to overcome challenges, and resources used. We used descriptive statistics for quantitative ratings, and content analysis for qualitative data. Results: Program content areas included chronic disease management and prevention, healthy aging, mental health, or multiple, often behavioral health-related topics. During planning, most programs considered reach (n = 9), adoption (n = 11), and implementation (n = 12) while effectiveness (n = 7) and maintenance (n = 6) were considered less frequently. In contrast, most programs evaluated all RE-AIM dimensions, ranging from 13 programs assessing maintenance to 15 programs assessing implementation and effectiveness. On five-point scales, all RE-AIM dimensions were rated as easy to understand (Overall M = 4.7 ± 0.5), but obtaining data was rated as somewhat challenging (Overall M = 3.4 ± 0.9). Implementation was the most frequently used dimension to inform program design (M = 4.7 ± 0.6) relative to the other dimensions (3.0-3.9). All dimensions were considered similarly important for decision-making (average M = 4.1 ± 1.4), with the exception of maintenance (M = 3.4 ± 1.7). Qualitative corresponded to the quantitative findings in that RE-AIM was reported to be a practical, easy to understand, and well-established implementation science framework. Challenges included understanding differences among RE-AIM dimensions and data acquisition. Valuable resources included the RE-AIM website and collaborating with an expert. Discussion: RE-AIM is an efficient framework for planning and evaluation of clinical and community-based projects. It provides structure to systematically evaluate health program impact. Programs found planning for and assessing maintenance difficult, providing opportunities for further refinement.

Project description:Introduction: Veterans frequently seek chronic pain care from their primary care providers (PCPs) who may not be adequately trained to provide pain management. To address this issue the Veterans Health Administration (VHA) Office of Specialty Care adopted the Specialty Care Access Network Extension for Community Healthcare Outcomes (VA-ECHO née SCAN-ECHO). The VA-ECHO program offered training and mentoring by specialists to PCPs and their staff. VA-ECHO included virtual sessions where expertise was shared in two formats: (1) didactics on common pain conditions, relevant psychological disorders, and treatment options and (2) real-time consultation on patient cases. Materials and methods: VA-ECHO participants' perspectives were obtained using a semi-structured interview guide designed to elicit responses based on the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. A convenience sampling was used to recruit PCPs and non-physician support staff participants. Non-physicians from rural VHA sites were purposively sampled to gain diverse perspectives. Findings: This qualitative study yielded data on each RE-AIM domain except reach. Program reach was not measured as it is outside the scope of this study. Respondents reported program effectiveness as gains in knowledge and skills to improve pain care delivery. Effective incorporation of learning into practice was reflected in respondents' perceptions of improvements in: patient engagement, evidenced-based approaches, appropriate referrals, and opioid use. Program adoption included how participating health care systems selected trainees from a range of sites and roles to achieve a wide reach of pain expertise. Participation was limited by time to attend and facilitated by institutional support. Differences and similarities were noted in implementation between hub sites. Maintenance was revealed when respondents noted the importance of the lasting relationships formed between fellow participants. Discussion: This study highlights VA-ECHO program attributes and unintended consequences. These findings are expected to inform future use of VA-ECHO as a means to establish a supportive consultation network between primary and specialty care providers to promote the delivery evidence-based pain management practices.

Project description:BackgroundThe positive health impact of physical activity (PA) is well known, yet a large proportion of the world's population remains sedentary. General PA programs are common as health promotion initiatives. However, effectiveness evaluations of such PA programs on individual and organizational aspects, which could inform the decision-making process of public health bodies are still lacking, particularly in the most socially disadvantaged areas, where health promotion schemes are particularly needed. The aim of this study was to assess the effectiveness of a Guided Walking Program in a high social vulnerability context.MethodsA quasi-experimental, mixed methods study was conducted. The program had a duration of 6 months and a 6-month follow-up period after the intervention. Session frequency was five times a week, where sessions consisted of supervised PA combined with educational sessions. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework was followed to assess the program. The International Physical Activity Questionnaire (IPAQ) and accelerometers were used to measure levels of PA. Focus groups were conducted to gain a comprehensive insight on the implementation domain.ResultsMost subjects in the intervention (IG) (n = 74) and control (CG) (n = 74) groups were female (IG:90.5%; CG:95.9%), aged 18-49 years (IG:44.6%; CG:43.2%), received less than 1 minimum wage (IG:74.3%; CG:83.7%) and had 0-4 years of formal education (IG:52.1%; CG:46.1%). The reach of the intervention was 0.3%. The IG showed increased levels of PA at post-intervention and 6-month follow-up. However, the difference between groups was not statistically significant. Adoption data revealed that 89.5% of the professionals in the Primary Health Care Center (health center) team perceived the benefits of the program for the population. The program was independently promoted by the health center team for a further 4 months post-intervention. The qualitative data revealed that the program was discontinued due to participants' low adherence and human resource limitations in the unit's operational dynamics.ConclusionsA health promotion intervention in a socially deprived setting faces challenges but can be effective and feasible to implement. The present study informs the development of future health promotion initiatives in this context.Trial registrationNCT02857127 . Registered: 30 July 2016 (retrospectively registered).

Project description:IntroductionDespite recommendation that all women receive an ultrasound in pregnancy prior to 24 weeks', this remains unavailable to many women in low-income countries where trained practitioners are scarce. Although many programmes have demonstrated efficacy, few have achieved longterm sustainability, with a lack of information about how best to implement such programmes. This mixed-methods study aimed to evaluate the implementation of a novel education package to teach ultrasound-naive midwives in Malawi basic obstetric ultrasound, assessing its impact in the context of the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.MethodsThe study ran across six sites in Malawi between October 2020 and June 2021, encompassing three phases; pre-implementation, implementation and post-implementation. Twenty nine midwives underwent a bespoke education package with matched pre and post course surveys assessed their knowledge, attitudes and confidence and "hands on" assessments evaluating practical skills. Training evaluation forms and in-depth interviews explored their satisfaction with the package, with repeat assessment and remote image review evaluating maintenance of skills.Results28/29 midwives completed the training, with significant increases in knowledge, confidence and practical skills. Adherence to the education package varied, however many changes to the proposed methodology were adaptive and appeared to facilitate the efficacy of the programme. Unfortunately, despite reporting approval regarding the training itself, satisfaction regarding supervision and follow up was mixed, reflecting the difficulties encountered with providing ongoing in-person and remote support.ConclusionThis programme was successful in improving trainees' knowledge, confidence and skill in performing basic obstetric ultrasound, largely on account of an adaptive approach to implementation. The maintenance of ongoing support was challenging, reflected by trainee dissatisfaction. By evaluating the success of this education package based on its implementation and not just its efficacy, we have generated new insights into the barriers to sustainable upscale, specifically those surrounding maintenance.

Project description:ObjectiveMost formats of currently used community-based health education for cognitive impairment prevention are limited to one-way communication, such as distributing leaflets, pasting posters, or holding a lecture, and they lack comprehensive evaluation. Here we aim to design, test, and evaluate a novel pilot cognitive health education program combined with psychosocial interventions (CHECPI).MethodsWe designed the CHECPI program and tested it among adults aged 60 and over in an aging-friendly community in 2018. Multidimensional cognitive functions were measured by the Montreal Cognitive Assessment (MoCA) before and three months after the CHECPI program. Quantitative and qualitative analyses were performed based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. Wilcoxon signed-rank tests were used to assess changes in multidimensional cognitive functions.ResultsThe CHECPI program was comprised of 12 courses and introduced 5 kinds of psychosocial interventions. Reach: 28 older adults participated in the program, of whom most were female (n = 22) and younger elderly with an average age of 65.32 years. Effectiveness: 19 participants finished≥6 courses as well as the follow-up survey. Although their MoCA scores did not improve significantly, they had increased their visuospatial ability significantly (with the average score increasing by 0.42). Adoption: the community officers, lecturers, and participants highly recommended the program, but they agreed that the lack of professional instructors may hinder its popularization. Implementation: the program was implemented in full accordance with the pre-program design. Maintenance: three months after the program, 17 participants had maintained at least one of the seven healthy behaviors that were introduced in the program.ConclusionsYounger female elderly were more willing to participate in the program. It enhanced participants' visuospatial ability, but a sufficient number of professional instructors are crucial for large-scale promotion.

Project description:BackgroundChildhood overweight and obesity is a major public health concern. Community-based interventions have the potential to reach caregivers and children. However, the overall health impact of these programs is rarely comprehensively assessed. This study evaluated a physical activity and healthy eating family program (Healthy Together; HT) using the RE-AIM framework.MethodsTen sites implemented the 5-week program. Thirty-nine staff members and 277 program participants (126 caregivers [M age ?=?35.6] and 151 children [M age ?=?13]) participated in the evaluation. Each RE-AIM dimension was assessed independently using a mixed-methods approach. Sources of data included archival records, interviews and surveys. Effectiveness outcome variables were assessed at pre- and post-intervention and 6-month follow-up.ResultsReach: HT participants were almost entirely recruited from existing programs within sites. Effectiveness: Caregivers' nutrition related efficacy beliefs increased following HT (ps?<?.03). Participation in HT was not associated with significant changes in physical activity or nutrition behaviour or perceived social support (ps?>?.05). Knowledge surrounding healthy diets and physical activity increased in children and caregivers (ps?<?.05). Adoption: Thirty-five percent of sites approached to implement HT expressed interest. The 10 sites selected recruited existing staff members to implement HT.ImplementationProgram objectives were met 72.8% of the time and 71 adaptations were made. HT was finance- and time-dependent. Maintenance: Two sites fully implemented HT in the follow-up year and 5 sites incorporated aspects of HT into other programs.ConclusionsWorking alongside organizations that develop community programs to conduct comprehensive, arms-length evaluations can systematically highlight areas of success and challenges. Overall HT represents a feasible community-based intervention; however further support is required in order to ensure the program is effective at positively targeting the desired outcomes. As a result of this evaluation, modifications are currently being implemented to HT.

Project description:Promoting walking for the journey to/from work and during the working day is one potential approach to increase physical activity in adults. Walking Works was a practice-led, whole-workplace walking programme delivered by employees (walking champions). This study aimed to evaluate the implementation of Walking Works using the RE-AIM framework and provide recommendations for future delivery of whole-workplace walking programmes.Two cross sectional surveys were conducted; 1544 (28%) employees completed the baseline survey and 918 employees (21%) completed the follow-up survey. Effectiveness was assessed using baseline and follow-up data; reach, implementation and maintenance were assessed using follow-up data only. For categorical data, Chi square tests were conducted to assess differences between surveys or groups. Continuous data were analysed to test for significant differences using a Mann-Whitney U test. Telephone interviews were conducted with the lead organisation co-ordinator, eight walking champions and three business representatives at follow-up. Interviews were transcribed verbatim and analysed to identify key themes related to adoption, implementation and maintenance.Adoption: Five workplaces participated in Walking Works. Reach: 480 (52.3%) employees were aware of activities and 221 (24.1%) participated.A variety of walking activities were delivered. Some programme components were not delivered as planned which was partly due to barriers in using walking champions to deliver activities. These included the walking champions' capacity, skills, support needs, ability to engage senior management, and the number and type of activities they could deliver. Other barriers included lack of management support, difficulties communicating information about activities and challenges embedding the programme into normal business activities. Effectiveness: No significant changes in walking to/from work or walking during the working day were observed. Maintenance: Plans to continue activities were mainly dependent on identifying continued funding.RE-AIM provided a useful framework for evaluating Walking Works. No changes in walking behaviour were observed. This may have been due to barriers in using walking champions to deliver activities, programme components not being delivered as intended, the types of activities delivered, or lack of awareness and participation by employees. Recommendations are provided for researchers and practitioners implementing future whole-workplace walking programmes.

Project description:BackgroundCommunity testing for HIV can reach previously untested populations but is rarely offered in workplaces. Targeting the construction sector could reach workers from high risk populations.MethodsThe RE-AIM framework was used to evaluate Test@Work, a workplace HIV testing intervention for construction workers implemented at 21 events (10 companies) in the UK. Test@Work had three components: 1) an online health toolkit to inform managers about health screening and HIV testing; 2) general health checks; and 3) opt-in HIV consultation and testing. Quantitative data were collected using registration and exit questionnaires with workers (n = 426) and pre/post-event questionnaires with managers (n = 15), with qualitative analysis of free text responses.ResultsReach 426 individuals had health checks. Participants were broadly representative of the UK construction workforce, but with a higher proportion of permanent workers. Most workers reported being in good health but also believed their work had an adverse impact on their health. Effectiveness: 97% of health check participants opted to have a consultation about sexual health (n = 413) and 82% had an HIV test (n = 348), of whom 78% had not previously been tested. All HIV tests were non-reactive. HIV testing at work was considered acceptable by most participants. Participants reported learning new things about their health (74%), said they would make changes as a result (70%) and felt confident of success (median score 8/10). Adoption: Recruitment of companies was challenging and time consuming. Seven of the participating companies were very large, employing over 1000 workers, which is atypical of construction generally.ImplementationAll events were completed as planned and were considered successful by all parties. Maintenance: All managers would arrange further events if they were offered them. Six managers incorporated sexual health awareness into their health programmes, but this was not possible for many as health agendas were set centrally by their organisations.ConclusionsOpt-in HIV testing, when embedded within a general health check, has high uptake and acceptability in the UK construction sector, and reaches individuals at risk for HIV who may not otherwise attend for testing. Cost-effectiveness of this approach is yet to be determined.Trial registrationClinicalTrials.gov Identifier: NCT04292002 .

Dataset Information

A 3-month jump-landing training program: a feasibility study using the RE-AIM framework.

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A 3-month jump-landing training program: a feasibility study using the RE-AIM framework.

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