Skip to main content
Top
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

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

Authors: Jodi Summers Holtrop, Borsika A. Rabin, Russell E. Glasgow

Published in: BMC Health Services Research | Issue 1/2018

Login to get access

Abstract

Background

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, 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.

Methods

Because 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.

Results

We 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.

Conclusions

In 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.
Literature
1.
go back to reference Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89(9):1322–7. PMID: 10474547CrossRefPubMedPubMedCentral Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89(9):1322–7. PMID: 10474547CrossRefPubMedPubMedCentral
2.
go back to reference Klesges LM, Estabrooks PA, Dzewaltowski DA, et al. Beginning with the application in mind: designing and planning health behavior change interventions to enhance dissemination. Ann Beh Med. 2005;29(Suppl):66–75. PMID: 15921491CrossRef Klesges LM, Estabrooks PA, Dzewaltowski DA, et al. Beginning with the application in mind: designing and planning health behavior change interventions to enhance dissemination. Ann Beh Med. 2005;29(Suppl):66–75. PMID: 15921491CrossRef
8.
go back to reference Vinson CA, Stamatakis KA, Kerner JF. Dissemination and implementation research in community and public health settings. In: Brownson RC, Colditz GA, Proctor EK, editors. Dissemination and implementation research in health: translating science to practice. 2nd ed. New York, NY: Oxford University Press; 2017. p. 355–70. Vinson CA, Stamatakis KA, Kerner JF. Dissemination and implementation research in community and public health settings. In: Brownson RC, Colditz GA, Proctor EK, editors. Dissemination and implementation research in health: translating science to practice. 2nd ed. New York, NY: Oxford University Press; 2017. p. 355–70.
13.
go back to reference Crabtree BF, Miller WL. Doing qualitative research. 2nd ed. Thousand Oaks, CA: Sage Publications; 1999. Crabtree BF, Miller WL. Doing qualitative research. 2nd ed. Thousand Oaks, CA: Sage Publications; 1999.
14.
go back to reference Green J, Thorogood N. Qualitative methods for health research. Thousand Oaks, CA: Sage Publications; 2014. Green J, Thorogood N. Qualitative methods for health research. Thousand Oaks, CA: Sage Publications; 2014.
15.
go back to reference Creswell J. Qualitative inquiry and research design: choosing among five approaches. 3rd ed. Thousand Oaks, CA: Sage Publications; 2013. Creswell J. Qualitative inquiry and research design: choosing among five approaches. 3rd ed. Thousand Oaks, CA: Sage Publications; 2013.
16.
go back to reference Silverman D. Qualitative research. 3rd ed. Thousand Oaks, CA: Sage Publications; 2010. Silverman D. Qualitative research. 3rd ed. Thousand Oaks, CA: Sage Publications; 2010.
18.
go back to reference Potworowski G, Green LA. Cognitive task analysis: methods to improve patient-centered medical home models by understanding and leveraging its knowledge work. Rockville, MD: Agency for Healthcare Research and Quality; 2013. Potworowski G, Green LA. Cognitive task analysis: methods to improve patient-centered medical home models by understanding and leveraging its knowledge work. Rockville, MD: Agency for Healthcare Research and Quality; 2013.
19.
go back to reference Crandall B, Klein G, Hoffman RR. Working minds: a practitioner's guide to cognitive task analysis. Cambridge, MA: MIT Press; 2006. Crandall B, Klein G, Hoffman RR. Working minds: a practitioner's guide to cognitive task analysis. Cambridge, MA: MIT Press; 2006.
20.
go back to reference Ritzwoller DP, Glasgow RE, Sukhanova AY, et al. Economic analyses of the be fit be well program: a weight loss program for community health centers. J Gen Intern Med. 2013;28(12):1581–8. PMID: 23733374CrossRefPubMedPubMedCentral Ritzwoller DP, Glasgow RE, Sukhanova AY, et al. Economic analyses of the be fit be well program: a weight loss program for community health centers. J Gen Intern Med. 2013;28(12):1581–8. PMID: 23733374CrossRefPubMedPubMedCentral
22.
go back to reference Bellg AJ, Borrelli B, Resnick B, et al. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH behavior change consortium. Health Psychol. 2004;23(5):443–51. PMID: 15367063CrossRefPubMed Bellg AJ, Borrelli B, Resnick B, et al. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH behavior change consortium. Health Psychol. 2004;23(5):443–51. PMID: 15367063CrossRefPubMed
23.
go back to reference Allen J, Linnan LA, Emmons KM. Fidelity and its relationship to implementation effectiveness, adaptations, and dissemination. In: Brownson R, Colditz GA, Proctor EK, editors. Dissemination and implementation research in health. Oxford: New York, NY; 2012. Allen J, Linnan LA, Emmons KM. Fidelity and its relationship to implementation effectiveness, adaptations, and dissemination. In: Brownson R, Colditz GA, Proctor EK, editors. Dissemination and implementation research in health. Oxford: New York, NY; 2012.
27.
go back to reference Castro FG, Barrera M Jr, Martinez CR Jr. The cultural adaptation of prevention interventions: resolving tensions between fidelity and fit. Prev Sci. 2004;5(1):41–5. PMID: 15058911CrossRefPubMed Castro FG, Barrera M Jr, Martinez CR Jr. The cultural adaptation of prevention interventions: resolving tensions between fidelity and fit. Prev Sci. 2004;5(1):41–5. PMID: 15058911CrossRefPubMed
28.
go back to reference Bauman AE, Cabassa LJ, Wiltsey SS. Adaptation in dissemination and implementation science. In: Brownson RC, Colditz G, Proctor EK, editors. Dissemination and implementation research in health. New York: Oxford University Press; 2017. Bauman AE, Cabassa LJ, Wiltsey SS. Adaptation in dissemination and implementation science. In: Brownson RC, Colditz G, Proctor EK, editors. Dissemination and implementation research in health. New York: Oxford University Press; 2017.
29.
go back to reference Rhodes W, Ritzwoller DP, Glasgow RE. Stakeholder perspectives on costs and resource expenditures: addressing economic issues most relevant to patients, providers and clinics. 2018. In Press. Rhodes W, Ritzwoller DP, Glasgow RE. Stakeholder perspectives on costs and resource expenditures: addressing economic issues most relevant to patients, providers and clinics. 2018. In Press.
34.
go back to reference Feldstein A, Glasgow RE. A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Jt Comm J Qual Patient Saf. 2008;34(4):228–43. PMID: 18468362CrossRefPubMed Feldstein A, Glasgow RE. A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Jt Comm J Qual Patient Saf. 2008;34(4):228–43. PMID: 18468362CrossRefPubMed
41.
go back to reference Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q. 1996;74(4):511–44. PMID: 8941260CrossRefPubMed Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q. 1996;74(4):511–44. PMID: 8941260CrossRefPubMed
42.
go back to reference Donabedian A. Evaluating the quality of medical care. Millbank Q. 1966;44:Suppl 166–206. PMID: 16279964. Donabedian A. Evaluating the quality of medical care. Millbank Q. 1966;44:Suppl 166–206. PMID: 16279964.
48.
go back to reference Minkler M, Salvatore AL. Participatory approaches for study design and analysis in dissemination and implementation research. In: Brownson R, Colditz G, Proctor E, editors. Dissemination and implementation research in health: translating science into practice. New York, NY: Oxford University Press; 2012. Minkler M, Salvatore AL. Participatory approaches for study design and analysis in dissemination and implementation research. In: Brownson R, Colditz G, Proctor E, editors. Dissemination and implementation research in health: translating science into practice. New York, NY: Oxford University Press; 2012.
52.
go back to reference Creswell JW, Klassen AC, Plano C, et al. Best practices for mixed methods research in the health sciences. Bethesda, MD: Office of the Behavioral and Social Sciences Research, National Institutes of Health; 2011.CrossRef Creswell JW, Klassen AC, Plano C, et al. Best practices for mixed methods research in the health sciences. Bethesda, MD: Office of the Behavioral and Social Sciences Research, National Institutes of Health; 2011.CrossRef
54.
go back to reference Plano Clark VL. The adoption and practice of mixed methods: U.S. trends in federally funded health-related research. Qual Inq. 2010;16:428–40.CrossRef Plano Clark VL. The adoption and practice of mixed methods: U.S. trends in federally funded health-related research. Qual Inq. 2010;16:428–40.CrossRef
56.
go back to reference Palinkas LA, Cooper BR. Mixed methods evaluation in dissemination and implementation science. In: Brownson RC, Colditz G, Proctor EK, editors. Dissemination and implementation research in health. New York: Oxford University Press; 2017. Palinkas LA, Cooper BR. Mixed methods evaluation in dissemination and implementation science. In: Brownson RC, Colditz G, Proctor EK, editors. Dissemination and implementation research in health. New York: Oxford University Press; 2017.
Metadata
Title
Qualitative approaches to use of the RE-AIM framework: rationale and methods
Authors
Jodi Summers Holtrop
Borsika A. Rabin
Russell E. Glasgow
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-2938-8

Other articles of this Issue 1/2018

BMC Health Services Research 1/2018 Go to the issue