Use When Planning a Project
When planning a project, we recommend that you take specific steps to plan for success, especially by considering ideas from the Practical Robust Implementation and Sustainability Model (PRISM) that are relevant to your context and stakeholders. If you are unfamiliar with PRISM or would like more information on it, click HERE.
What tools does this website have about using RE-AIM for planning?
- Click here to use our interactive tool that will guide you through considerations of
RE-AIM for planning, and that saves these questions and your answers as a PDF file. - Review key questions to consider for each RE-AIM domain below, including specific PRISM concepts that are relevant.
We recommend considering all RE-AIM dimensions during the planning phase of a project, even if it is unlikely that you will focus on some of the dimensions when you implement the program. When considering the RE-AIM dimensions, it is important to also consider the related PRISM contextual domains that can help frame questions that will lead to improvements in your most important RE-AIM outcomes. Below you will find questions to help you in project planning.
Don’t worry if you can’t answer all of these questions, or that some don’t apply to your specific project. Decide which are most important for your project and get started. We’ve presented this in a sequential order for someone that is focused on the adoption of a new program or policy in their setting, but you may want to start with the RE-AIM dimensions that are most important to your situation and stakeholders. Thinking through these issues will help you increase the chances that your project will be successful.
You can use our interactive tool that will guide you through the planning process and then save these questions and your answers as a PDF file. It might be helpful to go through these questions as a team, with your stakeholders, or just for self-reflection.
Navigate each dimension:
Reach
Key Planning Questions to Address Reach:
- Who will experience a health benefit from your project?
- How many people could possibly benefit and how many do you estimate will engage with your program or be impacted by your policy? What will be the participation rate in your program?
- How will you know if those that participated in your project are representative of the intended audience?
- Are there groups that experience disparities that you would like to engage in your program or expose to your policy? If so, how will you be sure that people experiencing disparities participate?
Key PRISM Considerations:
Program Characteristics
- How user-centered is the program or policy?
- How do potential participants rate its usability, burden, and relative advantage over existing offerings?
- How compatible is the program or policy with potential participants’ lifestyle?
- What are some cost issues that could influence reach?
- What are the most likely reasons that intended users may not participate? How can you proactively address these issues?
Characteristics and Perspectives of Potential Participants (e.g., those that will hopefully have a health benefit resulting from your program and policy)
- What are the characteristics of potential participants that could be barriers or facilitators of participation?
- What are the competing demands that potential participants may experience?
- What do you know about the knowledge, beliefs, and perceptions of the potential participants as it relates to your program and policy?
- What history will your intended beneficiaries likely have with similar program and policy or in dealing with this health issue
- Have you engaged potential participants to get their perspectives on the program?
Implementation and Sustainability Infrastructure
- What facilitation processes exist to support recruitment AND retention of participants?
- Can tasks related to monitoring and increasing the reach be part of key staff job
descriptions? - Is there an existing audit and feedback system that can support reach?
- Are there any financial incentives to participate…or that will likely limit participation?
External Environment (e.g., things outside of your settings that could influence adoption)
- Are there external/community resources and partners that could support the reach of
the program or policy? - Are there external factors that could reduce reach?
- Are there any related policies or programs that can help with recruitment
Adoption
Key Planning Questions to Address Adoption:
- What settings or types of organizations are able to implement this program or policy?
- How many settings/organizations are there and how many do you estimate will use your program or policy?
- Who are the staff that will deliver the program or policy? How many are there? How many will agree to deliver it?
- How will you be sure that the participating staff and organizations have the skills and capacity to adopt the program or policy?
- How will you be sure that staff and organizations that provide services to clients with the most need (e.g., under-represented populations) participate?
Key PRISM Considerations:
Program/Policy Characteristics
- How do the staff and organizational personnel perceive the strength of evidence of your program or policy?
- How do the staff and other stakeholders responsible for adoption, rate the usability, burden, and relative advantage of the program or policy?
- Characteristics and Perspectives of Organizational Staff Adopting and Implementing the Program or Policy
- How much support does the program or policy have from key managers, operational leaders, and other stakeholders? Are there local opinion leaders that will champion the program or policy?
- Are there any financial or cultural barriers to adopting the program or policy? Are staff incentives aligned with adoption?
- Are systems available to support needed training, system-change, and assessment of the program and policy to support decision-making for adoption?
- What is the history of our organization or community in dealing with similar issues?
Implementation and Sustainability Infrastructure
- What facilitation processes exist to support implementation of a new program or policy?
- Can tasks related to the adoption of the program or policy be part of key staff job descriptions?
- Is there an existing infrastructure that can support adoption?
- Are there systems that can easily track progress on adoption of the program and policy?
External Environment (e.g., things outside of your settings that could influence adoption)
- Are there external/community resources and partners that could support adoption of the program or policy?
- Are there external factors that could be barriers to adoption?
- What are the reimbursement or coverage issues that affect staff adoption?
- What are the policy, regulatory or competitive factors that could influence adoption of the program or policy?
Implementation
Key Planning Questions to enhance Implementation:
- Who, where, when, how, and to what degree will the program and policy be implemented?
- To what extent will the program and policy be implemented as intended?
- Will it be implemented consistently across types of recipients, staff and settings?
- What are the essential elements of the program or policy that should not be adapted?
- What adaptations are necessary to improve the fit of the program with the setting and intended participants?
- What are the costs of implementation? To whom? At what points in the program?
Key PRISM Considerations:
Program Characteristics
- How will you pilot the program implementation and implementation strategies to determine usability?
- How will you determine adaptations needed and how you will track adaptations; and guide adaptations when needed?
- How will you assess staff and other stakeholder ratings and perceptions of the program and policy’s usability, burden, and relative advantage over existing offerings?
- How will you report on the results of program and policy implementation to staff and stakeholders?
- How will you track costs of implementation? Be sure to consider whose costs for what, and at what point in the program?
Characteristics and Perspectives of Participant Recipients (e.g., those that will have a health benefit resulting from your project)
- How will you assess and understand the program or policy related knowledge, beliefs, and perceptions of participants?
- How will you document the integration of the project with other services to make it easy for participants to maintain engagement?
- How will you engage recipients to address the problem if implementation is not going well?
Characteristics and Perspectives of Organizational Recipients (e.g., staff implementing your program and policy)
- How will you assess support for the project from key managers, operational leaders, and other stakeholders? How will you engage local opinion leaders to champion the program and policy?
- How will you assess financial or cultural barriers to implementation? How will you assess staff incentive alignment with implementation of the program or policy?
- Are systems available to support ongoing training, system-change, and assessment of the program or policy to support decision-making for adoption?
- How will you help staff to integrate new activities into their existing workflow (consider process mapping)?
Implementation and Sustainability Infrastructure
- How will facilitation processes be used to support implementation?
- How will you update job descriptions with tasks related to implementation?
- How will you apply new or existing infrastructure to support implementation?
- How will implementation progress be assessed and reported back to relevant stakeholders?
External Environment (e.g., things outside of your settings that could influence adoption)
- Are there external/community resources and partners that could support implementation?
- Are there external factors that could be a barrier to implementation?
- Have new challenges or competing priorities emerged?
Effectiveness
Key Planning Questions to Enhance Effectiveness:
- What are the most important outcomes that you and your stakeholders would like to learn about?
- How likely is it that your program will achieve its key outcomes?
- How robust will the effectiveness be across subgroups of the intended audience?
- What are potential negative outcomes?
- Have you considered systems issues and that t is unusual for a policy to have strong effects on all outcomes? For example participation, equity, magnitude of change, cost.
Key PRISM Considerations:
Program Characteristics
- How will you report on the results to staff and stakeholders?
- What outcomes are these stakeholders most interested in- which will determine if they will continue the program?
- What does the evidence say about the robustness of effects for the program and policy?
Characteristics and Perspectives of Participant Recipients (e.g., those that will have a health benefit resulting from your program and policy)
- How will you assess participant changes resulting from the program and policy?
- How will you track potential unintended consequences for program and policy participants?
- How can you engage recipients to review and enhance the effectiveness of the program and policy?
Characteristics and Perspectives of Organizational Recipients (e.g., staff implementing your program and policy)
- How will you share effectiveness outcomes to support decision-making for ongoing implementation?
- How will you engage staff and other stakeholders in enhancing effectiveness?
Implementation and Sustainability Infrastructure
- How will performance data be used?
- How will best practices related to effectiveness be gathered?
- Whose job responsibility will it be to see that the program and policy is effective?
- What incentives are there for recipients and different staff to produce positive outcomes?
External Environment (e.g., things outside of your settings that could influence adoption)
- Are there external/community resources and partners that could improve the effectiveness of the program and policy?
- Are there external factors that could be a barrier to effectiveness?
- Can this program and policy effort be integrated with other organizational or community priorities?
Maintenance
Key Planning Questions to Enhance Maintenance and Sustainability:
- How likely is your program and policy to produce lasting effects for the individual participants?
- How will the decision to maintain program and policy implementation be made by the implementation sites?
- How will you plan for program and policy sustainability?
- How will you determine if (and guide) adaptations that may be needed?
Key PRISM Considerations:
Program Characteristics
- How will you report on the robustness of sustained effects for the program and policy (i.e., consistent maintenance across subgroups of participants)?
- What adaptations are necessary to improve the fit of the intervention for sustainability? How will you track adaptations and subsequent outcomes?
- What are the costs of sustained implementation? To whom? When? Do you need to consider different staff, automating procedures, etc?
- How will you track time, burden and costs of sustained implementation?
Characteristics and Perspectives of Participant Recipients (e.g., those that will have a health benefit resulting from your program and policy)
- How will you assess longer-term participant changes resulting from the program and policy?
- How will you assess the program and policy knowledge, beliefs, and perceptions of participants over the long-term?
- How will you engage participants in planning for long term maintenance after the initial intensive phase of adoption is completed?
Characteristics and Perspectives of Organizational Recipients (e.g., both decision makers and staff implementing your program and policy)
- How will you assess support for sustaining the program and policy from key managers, operational leaders, and other stakeholders? How will you engage local opinion leaders to champion sustaining the program and policy?
- How will you assess ongoing staff incentive alignment with implementation of the program and policy?
- Are systems available to support ongoing training, system-change, and assessment of the program and policy to support decision-making for sustainability?
Implementation and Sustainability Infrastructure
- Should the sustainability infrastructure be the same as that used for implementation?
- How will facilitation processes be used to support sustainability of the program and policy?
- How will you ensure continued priority, funding and reporting on progress of the program and policy?
External Environment (e.g., things outside of your settings that could influence adoption)
- Are there external/community resources and partners that could support the sustainability of the program and policy?
- Are there external factors that could be a barrier to sustainability (e.g, lack of reimbursement)?
- Are there new or upcoming policies, community state or national programs or incentives that will either support or detract from maintenance of this program and policy
Putting it All Together…after working through the above issues:
-What RE-AIM outcomes are most appropriate to emphasize in your settings?
-What are likely to be the greatest challenges- at each level?
-What are the likely supports, champions, and strategies to enhance success?
-What are the key PRISM factors in your context that need to be addressed
A final word: As your program and policy is being implemented, be sure to review the material in the DURING section of this website, and especially the Iterative RE-AIM activities