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Spectrum of Prevention


RE-AIM is an acronym for Reach, Effectiveness, Adoption, Implementation, and Maintenance. If all five principles of the acronym are incorporated into planning and evaluation, public health impact can be identified.

While the Spectrum of Prevention helps to identify the different levels that we can do our work, RE-AIM helps us to identify our impact at each level. RE-AIM is an outcome model designed by Virginia Tech that can be applied to program development, program evaluation, policy-making, and research interpretation for the purpose of improving upon and making evidence-based initiatives sustainable in identified communities.

Click on each of the tabs below to find out more about the five principles.

Whose lives have been impacted?

  • Who are the participants?
  • Does the pool of participants accurately represent the targeted community?
  • Who opted to participate vs. who opted to not participate at recruitment?
  • Number of messages disseminated in the program?

Effectiveness (also referred to as Efficacy) captures change in primary outcomes including quality of life, economic outcomes, and adverse consequences.

How have people been affected?

  • Are materials appropriate to the participants (culture, literacy-level, language, SES)?
  • Has the program/change imparted a shift in knowledge, attitude and behavior in the
  • targeted community?
  • Are participants able to articulate key take away messages?
  • What are the positive and negative outcomes?

Adoption explores program adoption by staff and community settings and representativeness of those participating.

How was the change done?

  • Who is doing the change?
  • Who opted to participate vs. who opted not to participate?
  • How is the change being done?

Implementation captures the interventionist's expertise and fidelity to the program, consistency and cost of delivery, and adaptation of an approach to local circumstances.

How was the change applied?

  • Fidelity to program/change?
  • Were the targeted goals met?
  • What worked and what didn't work?

Maintenance captures sustainability at the individual and setting levels; long-term follow-up of individuals (6+ months) and whether components are institutionalized or modified over time.

What were the long-term effects?

  • Did the change happen? Is it infused in the targeted community?
  • Has the change morphed over time?
  • What are the longterm consequences of the change?
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