RE-AIM framework
A checklist for judging an intervention's real-world public-health impact across five dimensions, not just whether it works in a trial.
What it means
RE-AIM evaluates programs along five dimensions: Reach (what proportion and which types of people are touched), Effectiveness (impact, including unintended effects), Adoption (uptake by settings and staff), Implementation (fidelity, cost, and consistency of delivery), and Maintenance (sustained effects and continued delivery over time). Its insight is that population impact is roughly Reach multiplied by Effectiveness — a powerful intervention that reaches almost no one, or that no clinic will adopt, achieves little. By forcing attention to adoption and maintenance, it counters the field's bias toward efficacy in tightly controlled studies. Critics note it is an evaluation lens, not a change theory, and that gathering all five dimensions is demanding. It matters because it operationalizes external validity, asking not just 'does it work?' but 'for whom, where, how well, and for how long?'.
Examples
A diabetes-prevention class with stellar outcomes scores poorly on RE-AIM if only motivated volunteers enroll (low reach) and clinics drop it after a year (low maintenance).
A workplace mental-health app with good trial results reaches four percent of staff, and fewer use it as designed. Effective, yes; population impact, close to nothing.
A stop-smoking text service is only modestly effective, yet it reaches every smoker in the region, costs almost nothing to run, and is still going five years later — RE-AIM rates it highly.
First described in Russell Glasgow, Thomas Vogt & Shawn Boles (1999).