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. 2019 Apr 1;3(3):e10192. doi: 10.1002/lrh2.10192

Table 2.

Operational definitions and description of domains using the RE‐AIM framework

Axes Operational Definition Domains and Description
Reach Reach refers to the representation of the population targeted. The current patients who participate compared with the population catchment for this intervention. Population need—review government documentation and internal reports about rates
Patient characteristics—compare the sociodemographic characteristics of the patients and families that accessed care compared with the population
Efficacy Efficacy refers to the impact the intervention has on key outcomes: Patient health outcomes, caregiver burden and distress, and patient and caregiver satisfaction with the services provided. Service access—track how patient's access to other community service and supports change over time
Caregiver factors—track how caregiver burden, enablement, depression, stress symptoms change over time
Health status—as a long‐term outcome, EMR data will be used to track the health outcomes of patients over time
Patient satisfaction—track how caregiver satisfaction with services provided change over time
Adoption Adoption refers to how feasible the program is in practice. It is a measure of how well the service providers have used the intervention as planned and address issues such as adherence, usability, and acceptability. Additional measures of provider professional development and contributions to this field of work are included. Usability—continual feedback from staff about their satisfaction with the current model and how to improve the model
Professional development and contributions—examining the professional development of staff and their contributions to the field (eg, research, service committees, teaching, and training)
Implementation Implementation refers to process fidelity, process evolution, costs for effectiveness, and interactions with the extant health care system over time. Adherence to best practices—fidelity to guidelines in clinical operations
System reach and acceptability—an evaluation of consultation services process by other service providers
Time expenditure—clinic flow obtained and analyzed using Salesforce, a platform with the ability to capture operations metrics
Cost‐benefit analysis—understand the synergies between medical and dental care, team‐based care approaches and nurse‐only clinic days
Maintenance Maintenance refers to the sustainability of the program, comprising factors such as capacity, public sector response, and embeddedness in system and ecosystem evolution that this intervention produces. Ecosystem evolution—documentation, interviews that elicit the narrative of how things have changed, and public reports will be analyzed to gain insight into the impact the clinic has made over time
Capacity building—examine the staff training opportunities and the exposure and perceptions of trainees to the service and population, assess the extent other providers gain interest and/or confidence to treat this population
Embeddedness in system—examine how the program is incorporated into the public system through tracking referrals, and consultation requests over time, partnerships with academic faculties for research and training
Clinic process map—track how the theory of change and logic model evolves with the environment in the complexity of the public health system