Healthy Eating for Life English as a second language curriculum: applying the RE-AIM framework to evaluate a nutrition education intervention targeting cancer risk reduction

Abstract

Medically underserved US immigrants are at an increased risk for death from preventable or curable cancers due to economic, cultural, and/or linguistic barriers to medical care. The purpose of this study was to describe the evaluation of the pilot study of the Healthy Eating for Life (HE4L) English as a second language curriculum. The Reach, Effectiveness Adoption, Implementation, Maintenance (RE-AIM) model was used to design a mixed-methods approach to the evaluation of the HE4L curriculum. Successful implementation was dependent upon enthusiastic teacher and manager support of the curriculum, teachers' ability to flexibly apply the curriculum to meet student needs, and researcher provision of curriculum workbooks. HE4L can be implemented successfully in various adult education settings to teach healthy eating behaviors and English language principles. Scale-up of HE4L may depend on the development of an online version of the curriculum to avoid the costs associated with printing and distributing curriculum materials.

Implementing a telehealth prehabilitation education session for patients preparing for major cancer surgery

“…Implementation in this paper is defined as the initiation of a health intervention rather than a widespread upscaling and thus this section focused on intervention fidelity. The RE-AIM (reach, efficacy, adoption, implementation and maintenance) framework was chosen as it has been validated as a tool to plan, evaluate and to assess the impact of a variety of health care and health prevention programs [ 35 – 37 ]. Briefly, ‘reach’ refers to participation and representativeness of the target population.…”

Innovations in Mixed Methods Evaluations

“…Another innovation in the assessment of implementation outcomes is the RE-AIM Qualitative Evaluation for Systematic Translation (RE-AIM QuEST), a mixed methods framework developed by Forman and colleagues (31). The RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework is often used to monitor the success of intervention effectiveness, dissemination, and implementation in real-life settings (35), and has been used to guide several mixed method implementation studies (6, 50, 54, 79, 82, 85). The RE-AIM QuEST framework represents an attempt to provide guidelines for the systematic application of quantitative and qualitative data for summative evaluations of each of the five dimensions.…”

Utilizing RE-AIM to scope potential for feasible immigrant cancer literacy education

“…In addition to ways to improve intervention reach , the use of RE-AIM at this scoping phase was helpful in determining factors that could support the implementation and maintenance of a new cancer prevention curriculum. A major implementation challenge reported in the literature has been to cover curriculum content goals while simultaneously building English literacy skills according to course requirements and student level ( Morony et al, 20182018 , Martinez et al, 2017 ). In the current study, results suggested that a health curriculum, with core skills requirements embedded, may be more likely to be adopted by teachers who are looking for materials to meet students’ skills requirements.…”

“…Establishing the ‘real-world’ translation potential of any applied intervention is critical if uptake is the goal. Martinez and colleagues ( Martinez et al, 2017 ) analysed their ESL intervention trial (see ( Duncan et al, 2013 ) and then, using the RE-AIM translational research evaluation framework, retrospectively investigated the curriculum’s translation potential. RE-AIM was developed by Glasgow et al (1999) with the goal of helping researchers establish external validity (i.e., the generalizability of research findings to different populations and settings) in addition to the more common focus on internal validity (i.e., efficacy) when evaluating the impact of community-based and clinical interventions.…”

“…Martinez and colleagues’ ( Martinez et al, 2017 ) retrospective evaluation using RE-AIM highlighted a range of translation barriers. These included time constraints, lack of resources, and misalignment between the language difficulty of the curriculum and students’ capabilities.…”