• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of amjphAmerican Journal of Public Health Web SiteAmerican Public Health Association Web SiteSubmissionsSubscriptionsAbout Us
Am J Public Health. 1999 September; 89(9): 1322–1327.
PMCID: PMC1508772

Evaluating the public health impact of health promotion interventions: the RE-AIM framework.


Progress in public health and community-based interventions has been hampered by the lack of a comprehensive evaluation framework appropriate to such programs. Multilevel interventions that incorporate policy, environmental, and individual components should be evaluated with measurements suited to their settings, goals, and purpose. In this commentary, the authors propose a model (termed the RE-AIM model) for evaluating public health interventions that assesses 5 dimensions: reach, efficacy, adoption, implementation, and maintenance. These dimensions occur at multiple levels (e.g., individual, clinic or organization, community) and interact to determine the public health or population-based impact of a program or policy. The authors discuss issues in evaluating each of these dimensions and combining them to determine overall public health impact. Failure to adequately evaluate programs on all 5 dimensions can lead to a waste of resources, discontinuities between stages of research, and failure to improve public health to the limits of our capacity. The authors summarize strengths and limitations of the RE-AIM model and recommend areas for future research and application.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.7M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Green LW, Richard L, Potvin L. Ecological foundations of health promotion. Am J Health Promot. 1996 Mar-Apr;10(4):270–281. [PubMed]
  • Glasgow RE, La Chance PA, Toobert DJ, Brown J, Hampson SE, Riddle MC. Long-term effects and costs of brief behavioural dietary intervention for patients with diabetes delivered from the medical office. Patient Educ Couns. 1997 Nov;32(3):175–184. [PubMed]
  • Meenan RT, Stevens VJ, Hornbrook MC, La Chance PA, Glasgow RE, Hollis JF, Lichtenstein E, Vogt TM. Cost-effectiveness of a hospital-based smoking cessation intervention. Med Care. 1998 May;36(5):670–678. [PubMed]
  • Wasson J, Gaudette C, Whaley F, Sauvigne A, Baribeau P, Welch HG. Telephone care as a substitute for routine clinic follow-up. JAMA. 1992 Apr 1;267(13):1788–1793. [PubMed]
  • Shaw KM, Bulpitt CJ, Bloom A. Side effects of therapy in diabetes evaluated by a self-administered questionnaire. J Chronic Dis. 1977 Jan;30(1):39–48. [PubMed]
  • Sorensen G, Emmons K, Hunt MK, Johnston D. Implications of the results of community intervention trials. Annu Rev Public Health. 1998;19:379–416. [PubMed]
  • Starfield B. Quality-of-care research: internal elegance and external relevance. JAMA. 1998 Sep 16;280(11):1006–1008. [PubMed]
  • Stokols D. Establishing and maintaining healthy environments. Toward a social ecology of health promotion. Am Psychol. 1992 Jan;47(1):6–22. [PubMed]
  • Glasgow RE, Eakin EG, Toobert DJ. How generalizable are the results of diabetes self-management research? The impact of participation and attrition. Diabetes Educ. 1996 Nov-Dec;22(6):573–585. [PubMed]
  • Conrad P. Who comes to work-site wellness programs? A preliminary review. J Occup Med. 1987 Apr;29(4):317–320. [PubMed]
  • Goodman RM, McLeroy KR, Steckler AB, Hoyle RH. Development of level of institutionalization scales for health promotion programs. Health Educ Q. 1993 Summer;20(2):161–178. [PubMed]
  • Clarke GN. Improving the transition from basic efficacy research to effectiveness studies: methodological issues and procedures. J Consult Clin Psychol. 1995 Oct;63(5):718–725. [PubMed]
  • Glasgow RE, Fisher EB, Anderson BJ, LaGreca A, Marrero D, Johnson SB, Rubin RR, Cox DJ. Behavioral science in diabetes. Contributions and opportunities. Diabetes Care. 1999 May;22(5):832–843. [PubMed]
  • Cullen JW. Design of cancer prevention studies. Cancer Detect Prev. 1986;9(1-2):125–138. [PubMed]
  • Kristein MM, Arnold CB, Wynder EL. Health economics and preventive care. Science. 1977 Feb 4;195(4277):457–462. [PubMed]
  • Hatziandreu EJ, Sacks JJ, Brown R, Taylor WR, Rosenberg ML, Graham JD. The cost effectiveness of three programs to increase use of bicycle helmets among children. Public Health Rep. 1995 May-Jun;110(3):251–259. [PMC free article] [PubMed]
  • Stokols D. Translating social ecological theory into guidelines for community health promotion. Am J Health Promot. 1996 Mar-Apr;10(4):282–298. [PubMed]
  • Glasgow RE, McCaul KD, Fisher KJ. Participation in worksite health promotion: a critique of the literature and recommendations for future practice. Health Educ Q. 1993 Fall;20(3):391–408. [PubMed]
  • Rind DM, Kohane IS, Szolovits P, Safran C, Chueh HC, Barnett GO. Maintaining the confidentiality of medical records shared over the Internet and the World Wide Web. Ann Intern Med. 1997 Jul 15;127(2):138–141. [PubMed]
  • Emmons KM. Maximizing cancer risk reduction efforts: addressing multiple risk factors simultaneously. Cancer Causes Control. 1997 Nov;8 (Suppl 1):S31–S34. [PubMed]
  • Bradley C. Designing medical and educational intervention studies. A review of some alternatives to conventional randomized controlled trials. Diabetes Care. 1993 Feb;16(2):509–518. [PubMed]
  • Bloom JR, Monterossa S. Hypertension labeling and sense of well-being. Am J Public Health. 1981 Nov;71(11):1228–1232. [PMC free article] [PubMed]
  • Downs WR, Robertson JF, Harrison LR. Control theory, labeling theory, and the delivery of services for drug abuse to adolescents. Adolescence. 1997 Spring;32(125):1–24. [PubMed]
  • Glasgow RE, Osteen VL. Evaluating diabetes education. Are we measuring the most important outcomes? Diabetes Care. 1992 Oct;15(10):1423–1432. [PubMed]
  • Vinicor F. Is diabetes a public-health disorder? Diabetes Care. 1994 Jun;17 (Suppl 1):22–27. [PubMed]
  • Greenlick MR. Educating physicians for population-based clinical practice. JAMA. 1992 Mar 25;267(12):1645–1648. [PubMed]
  • Von Korff M, Gruman J, Schaefer J, Curry SJ, Wagner EH. Collaborative management of chronic illness. Ann Intern Med. 1997 Dec 15;127(12):1097–1102. [PubMed]
  • Sobel DS. Rethinking medicine: improving health outcomes with cost-effective psychosocial interventions. Psychosom Med. 1995 May-Jun;57(3):234–244. [PubMed]
  • McKinlay JB, Marceau LD. A tale of 3 tails. Am J Public Health. 1999 Mar;89(3):295–298. [PMC free article] [PubMed]
  • Stokols D, Pelletier KR, Fielding JE. The ecology of work and health: research and policy directions for the promotion of employee health. Health Educ Q. 1996 May;23(2):137–158. [PubMed]
  • Bradley C. Clinical trials--time for a paradigm shift? Diabet Med. 1988 Mar;5(2):107–109. [PubMed]
  • Fisher EB., Jr The results of the COMMIT trial. Community Intervention Trial for Smoking Cessation. Am J Public Health. 1995 Feb;85(2):159–160. [PMC free article] [PubMed]
  • Smith TJ, Hillner BE, Desch CE. Efficacy and cost-effectiveness of cancer treatment: rational allocation of resources based on decision analysis. J Natl Cancer Inst. 1993 Sep 15;85(18):1460–1474. [PubMed]
  • Aaron H, Schwartz WB. Rationing health care: the choice before us. Science. 1990 Jan 26;247(4941):418–422. [PubMed]
  • Lichtenstein E, Glasgow RE. Smoking cessation: what have we learned over the past decade? J Consult Clin Psychol. 1992 Aug;60(4):518–527. [PubMed]
  • Susser M. The tribulations of trials--intervention in communities. Am J Public Health. 1995 Feb;85(2):156–158. [PMC free article] [PubMed]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...