Annals of Behavioral Medicine

, Volume 34, Issue 2, pp 105–114

Applying the RE-AIM framework to assess the public health impact of policy change

  • Stephanie Jilcott
  • Alice Ammerman
  • Janice Sommers
  • Russell E. Glasgow


Background and Purpose: Planning and evaluation models have been developed to assess the public health impact of health promotion interventions. However, few have been applied to health policies. There is an important need for models to help design and evaluate health policies.Methods: This article applies the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) planning and evaluation framework to health policies. We provide definitions and application examples for different policies.Results: As demonstrated by a case study, the RE-AIM dimensions and definitions can also apply to policies. Considerations regarding compliance and enforcement are presented to clarify the complex implementation dimension.Conclusions: The RE-AIM framework can be useful in estimating public health impact, comparing different health policies, planning policies designed for increased likelihood of success, and identifying areas for integration of policies with other health promotion strategies.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. (1).
    Brownson RC, Baker EA, Leet TL, Gillespie KN (eds):Evidence-Based Public Health. New York: Oxford University Press, 2003.Google Scholar
  2. (2).
    Stokols D, Allen J, Bellingham RL: The social ecology of health promotion: Implications for research and practice.American Journal of Health Promotion. 1996,10:247–251.PubMedGoogle Scholar
  3. (3).
    McLeroy KR, Bibeau D, Steckler A, Glanz K: An ecological perspective on health promotion programs.Health Education Quarterly. 1988,15:351–377.PubMedGoogle Scholar
  4. (4).
    McKinlay J: The new public health approach to improving physical activity and autonomy in older populations. In Heinkkine E, Ruoppila I, Krusinen J (eds),Preparation for Aging. London: Plenum, 1995, 87–103.Google Scholar
  5. (5).
    Brownson RC, Gurney JG, Land GH: Evidence-based decision making in public health.Journal of Public Health Management Practice. 1999,5:86–97.Google Scholar
  6. (6).
    Green LW, Kreuter MW:Health Promotion Planning: An Educational and Ecological Approach (4th Ed). Mountain View, CA: Mayfield, 2005.Google Scholar
  7. (7).
    Heller RF, Page J: A population perspective to evidence based medicine: Evidence for population health.Journal of Epidemiology and Community Health. 2002,56:45–47.PubMedCrossRefGoogle Scholar
  8. (8).
    Fuchs VR:The Future of Health Policy. Boston: First Harvard University Press, 1994.Google Scholar
  9. (9).
    Cole BR, Shimkhada R, Fielding JE, Kominski G, Morganstern H: Methodologies for realizing the potential of health impact assessment.American Journal of Preventive Medicine. 2005,28:389.CrossRefGoogle Scholar
  10. (10).
    Schmid TL, Pratt M, Witmer L: A framework for physical activity policy research.Journal of Physical Activity and Health. 2006,3(Suppl. 1):S20-S29.Google Scholar
  11. (11).
    Glasgow RE, Vogt TM, Boles SM: Evaluating the public health impact of health promotion interventions: The RE-AIM framework.American Journal of Public Health. 1999,89:1322–1327.PubMedGoogle Scholar
  12. (12).
    Glasgow RE, Klesges LM, Dzewaltowski DA, Estabrooks PA, Vogt TM: Evaluating the overall impact of health promotion programs: Using the RE-AIM framework to form summary measures for decision making involving complex issues.Health Education & Research. 2006,21:688–694.CrossRefGoogle Scholar
  13. (13).
    Klesges LM, Estabrooks PA, Glasgow RE, Dzewaltowski D: Beginning with the application in mind: Designing and planning health behavior change interventions to enhance dissemination.Annals of Behavioral Medicine. 2005,29:66S-75S.CrossRefGoogle Scholar
  14. (14).
    Glasgow RE, Klesges LM, Dzewaltowski DA, Bull SS, Estabrooks P: The future of health behavior change research: What is needed to improve translation of research into health promotion practice?Annals of Behavioral Medicine. 2004,27:3–12.PubMedCrossRefGoogle Scholar
  15. (15).
    Schmid TL, Pratt M, Howze E: Policy as intervention: Environmental and policy approaches to the prevention of cardiovascular disease.American Journal of Public Health. 1995,85:1207–1211.PubMedGoogle Scholar
  16. (16).
    Wallack L, Dorfman L, Jernigan D, Themba M:Media Advocacy and Public Health. Newbury Park, CA: Sage, 1993.Google Scholar
  17. (17).
    Des Jarlais DC, Lyles C, Crepaz N, TREND Group: Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND statement.American Journal of Public Health. 2004,94:361–366.PubMedGoogle Scholar
  18. (18).
    Glasgow RE: Translating research to practice: Lessons learned, areas for improvement, and future directions.Diabetes Care. 2003,26:2451–2456.PubMedCrossRefGoogle Scholar
  19. (19).
    Dzewaltowski DA, Estabrooks PA, Klesges LM, Glasgow RE: TREND: An important step, but not enough.American Journal of Public Health. 2004,94:1474.PubMedGoogle Scholar
  20. (20).
    Rogers EM:Diffusion of Innovations (5th Ed). New York: Free Press, 2003.Google Scholar
  21. (21).
    Glasgow RE, Lichtenstein E, Marcus AC: Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy to effectiveness transition.American Journal of Public Health. 2003,93:1261–1267.PubMedCrossRefGoogle Scholar
  22. (22).
    Cheadle A, Psaty BM, Curry S, et al.: Community-level comparisons between the grocery store environment and individual dietary practices.Preventive Medicine. 1991,20:250–261.PubMedCrossRefGoogle Scholar
  23. (23).
    Williams AF: Passive and active measures for controlling disease and injury: The role of health psychologists.Health Psychology. 1982,1:399–409.CrossRefGoogle Scholar
  24. (24).
    Sallis JF, Bauman A, Pratt M: Environmental and policy interventions to promote physical activity.American Journal of Preventive Medicine. 1998,15:379–397.PubMedCrossRefGoogle Scholar
  25. (25).
    Sallis JF, Cervero R, Ascher WW, et al.: An ecological approach to creating active living communities.Annual Review of Public Health. 2006,27:297–322.PubMedCrossRefGoogle Scholar
  26. (26).
    Tengs TO, Osgood ND, Lin TH: Public health impact of changes in smoking behavior: Results from the Tobacco Policy Model.Medical Care. 2001,39:1131–1141.PubMedCrossRefGoogle Scholar
  27. (27).
    Joffe M, Mindell J: Complex causal process diagrams for analyzing the health impacts of policy interventions.American Journal of Public Health. 2006,96:473–479.PubMedCrossRefGoogle Scholar
  28. (28).
    Ritzwoller DP, Toobert D, Sukhanova A, Glasgow RE: Economic analysis of the Mediterranean Lifestyle Program for Postmenopausal women with diabetes.Diabetes Educator. 2006,32:761–769.PubMedCrossRefGoogle Scholar
  29. (29).
    Gold MR, Siegel JE, Russell LB, Weinstein MC:Cost-Effectiveness in Health and Medicine. New York: Oxford University Press, 2003.Google Scholar
  30. (30).
    Tengs TO, Ahmad S, Moore R, Gage E: Federal policy mandating safer cigarettes: A hypothetical simulation of the anticipated population health gains or losses.Journal of Policy Analysis and Management. 2004,23:289–290.CrossRefGoogle Scholar
  31. (31).
    Stokols D: Establishing and maintaining healthy environments: Toward a social ecology of health promotion.The American Psychologist. 1992,47:6–22.PubMedCrossRefGoogle Scholar
  32. (32).
    Swinburn B, Gill T, Kumanyika S: Obesity prevention: A Proposed framework for translating evidence into action.Obesity Reviews. 2005,6:23–33.PubMedCrossRefGoogle Scholar
  33. (33).
    Choi BC, Pang T, Lin V, et al.: Can scientists and policy makers work together?Journal of Epidemiology and Community Health. 2005,59:632–637.PubMedCrossRefGoogle Scholar
  34. (34).
    Blamey A, Mutrie N, Aitchison T: Health promotion by encouraged use of stairs.British Medical Journal. 1995,311:289–390.PubMedGoogle Scholar
  35. (35).
    Stokols D: Social ecology and behavioral medicine: Implications for training, practice, and policy.Behavioral Medicine. 2000,26:129–138.PubMedCrossRefGoogle Scholar
  36. (36).
    Dearing JW: Improving the state of health programming by using diffusion theory.Journal of Health Communication. 2004,9(Suppl. 1):21–36.PubMedCrossRefGoogle Scholar
  37. (37).
    Rogers EM: A prospective and retrospective look at the diffusion model.Journal of Health Communication. 2004,9(Suppl. 1):13–19.PubMedCrossRefGoogle Scholar
  38. (38).
    Retting RA, Williams AF, Farmer CM, Feldman AF: Evaluation of red light camera enforcement in Oxnard, California.Accident, Analysis and Prevention. 1999,31:169–174.CrossRefGoogle Scholar
  39. (39).
    Koplan JP, Dietz WH: Caloric imbalance and public health policy.Journal of the American Medical Association. 1999,282:1579–1581.PubMedCrossRefGoogle Scholar
  40. (40).
    Puska P, Pirjo P, Ulla U: Influencing public nutrition for non-communicable disease prevention: From community intervention to national programme—Experiences from Finland.Public Health Nutrition. 2002,5:245–251.CrossRefGoogle Scholar
  41. (41).
    Puska P: Community-based prevention of cardiovascular disease: The North Karelia Project. In Martarazzo JD, Weiss SM, Herd JA, Miller NE (eds),Behavioral Health: A Handbook of Health Enhancement and Disease Prevention. New York: Wiley, 1984, 1140–1147.Google Scholar
  42. (42).
    Glasgow RE, Whitlock EP, Valanis BG, Vogt TM: Barriers to mammography and Pap smear screening among women who recently had neither, one or both types of screening.Annals of Behavioral Medicine. 2000,22:223–228.PubMedGoogle Scholar
  43. (43).
    Glasgow RE, Strycker LA, King D, et al.: Robustness of a computer-assisted diabetes self-management intervention across patient characteristics, healthcare settings, and intervention staff.American Journal of Managed Care. 2006,12:137–145.PubMedGoogle Scholar
  44. (44).
    Estabrooks PA, Dzewaltowski DA, Glasgow RE, Klesges LM: School-based health promotion: Issues related to translating research into practice.Journal of School Health. 2002,73:21–28.CrossRefGoogle Scholar
  45. (45).
    Bull SS, Gillette C, Glasgow RE, Estabrooks P: Worksite health promotion research: To what extent can we generalize the results and what is needed to translate research to practice?Health Education and Behavior. 2002,30:537–549.CrossRefGoogle Scholar
  46. (46).
    Dzewaltowski DA, Estabrooks PA, Klesges LM, Bull S, Glasgow RE: Behavior change intervention research in community settings: How generalizable are the results?Health Promotion International. 2004,19:235–245.PubMedCrossRefGoogle Scholar
  47. (47).
    Besculides M, Zaveri H, Farris R, Will J: Identifying best practices for WISEWOMAN programs using a mixed-methods evaluation.Preventing Chronic Disease. 2006,3:1–9.CrossRefGoogle Scholar
  48. (48).
    Glasgow RE: Evaluation of theory-based interventions: The RE-AIM model. In Glanz K, Lewis FM, Rimer BK (eds),Health Behavior and Health Education (3rd Ed.). San Francisco: Wiley, 2002, 531–544.Google Scholar
  49. (49).
    Kingdon J:Agendas, Alternatives, and Public Policy (2nd Ed.). New York: Harper Collins, 1995.Google Scholar
  50. (50).
    Glasgow RE: eHealth evaluation and dissemination research.American Journal of Preventive Medicine. 2007,32:S119-S126.PubMedCrossRefGoogle Scholar
  51. (51).
    Rotheram-Borus MJ, Flannery D, Duan N: Interventions that are CURRES: Cost-effective, useful, realistic, robust, evolving, and sustainable. In Rehmschmidt H, Belfer M, Goodyear I (eds),Facilitating Pathways: Care, Treatment, and Prevention in Child and Adolescent Health. New York: Springer, 2004, 235–244.Google Scholar

Copyright information

© The Society of Behavioral Medicine 2007

Authors and Affiliations

  • Stephanie Jilcott
    • 1
  • Alice Ammerman
    • 1
  • Janice Sommers
    • 1
  • Russell E. Glasgow
    • 2
  1. 1.University of North CarolinaChapel Hill
  2. 2.Kaiser Permanent ColoradoDenver
  3. 3.Clinical Research UnitKaiser Permanente ColoradoPenrose

Personalised recommendations