Adapting and RE-AIMing a heart disease prevention program for older women with diabetes
First Online: 10 February 2012 DOI:
Cite this article as: Toobert, D.J., Glasgow, R.E., Strycker, L.A. et al. Behav. Med. Pract. Policy Res. (2012) 2: 180. doi:10.1007/s13142-012-0118-7 ABSTRACT
Coronary heart disease is a pervasive public health problem with a heavy burden among older women. There is a need for developing effective interventions for addressing this problem and for evaluating the dissemination potential of such interventions. A multiple-behavior-change program originally designed for men with heart disease was adapted for women at high risk of heart disease in two randomized clinical trials—the Mediterranean Lifestyle Program and ¡Viva Bien!. Results from these two trials, including readiness for dissemination, are evaluated using the RE-AIM framework in terms of Reach, Effectiveness, Adoption, Implementation, and Maintenance. Program adaptations produced relative high reach as well as consistent and replicated effectiveness and maintenance, and were adopted by a high percentage of primary care offices and clinicians approached. We discuss key findings, lessons learned, future directions for related research, and use of RE-AIM for program development, adaptation, scale-up, and evaluation.
KEYWORDS Coronary heart disease Diabetes Latino RE-AIM Evaluation ClinicalTrials.gov Protocol IDs
NCT00142701 (CHDRISK); NCT00680849 (MLP); NCT00233259 (¡Viva Bien!)
Implications Practice: Having a consistent set of criteria or implementation factors against which to judge programs and to guide adaptation can be helpful in balancing fidelity and adaptation, and in planning for dissemination. Policy: Implementation science frameworks such as RE-AIM can be used to help plan, select, and adapt evidence-based interventions for older populations and contexts. Research: Applications such as RE-AIM can be used to create replicable programs that are effective across diverse settings and older populations. References
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