Table 2.

Implementation Outcome Traditional Definitions, Health Equity Focused Definitions, and Example Assessment Tools or Methods

Implementation Outcome	Traditional Definition (Glasgow et al., 1999; Proctor et al., 2011)	Health Equity Focused Definition (Eslava-Schmalbach et al., 2019; Shelton et al., 2020)	Example Assessment Tool or Method
RE-AIM (Glasgow et al., 1999)
Reach	Proportion of eligible young adult patients or clients who receive a BI	Proportion of eligible young adults who receive a BI, as well as evaluation of the degree to which young adults are being equitably reached by the BI	Number of young adults who receive BI divided by total number of eligible young adults
Effectiveness	Success rate of the implemented BI with respect to decreased alcohol use and alcohol-related problems among young adults	Evaluation of potential differences in success rate of the implemented BI across young adults as a function of social determinants of health	Pre-post implementation assessment with an alcohol use scale or clinical interview
Adoption	Degree to which providers initiate BI at least once with young adults	Degree to which providers initiate BI with at least one young adult, and whether BI uptake is equitable across treatment settings (e.g. organizations with different resources) and disadvantaged populations	Number of providers who initiate BI with at least one young adult divided by the total number of eligible providers
Implementation/Fidelity	Degree to which providers are delivering BI as intended with respect to both adherence and skill	Degree to which providers are delivering BI as intended equitably across settings and populations (e.g. as potentially influenced by resources or social determinants of health)	Fidelity checklists assessing BI core components
Sustainability/Maintenance	Degree to which BI becomes an established part of clinical practice and continues to be used once implementation supports are removed	Degree to which BI becomes an established part of clinical practice equitably across settings, with attention to whether resources are equitably maintained among disadvantaged populations	Measure of reach 6 or more months after removal of active implementation support
Classic Implementation Outcomes (Proctor et al., 2011)
Acceptability	Degree to which treatment providers and/or patients/clients are satisfied with the BI intervention and approve of BI implementation in the treatment setting	Degree to which treatment providers, patients/clients from disadvantaged populations, members of the broader community, and other key stakeholders are satisfied with the BI intervention and approve of BI implementation in the treatment setting	Acceptability of Intervention Measure (Weiner et al., 2017)
Appropriateness	Provider or organizational perceptions about whether BI is compatible or fits well with current provider/organizational practice.	Provider or organizational perceptions about whether BI is compatible or fits well with disadvantaged populations that they serve	Intervention Appropriateness Measure (Weiner et al., 2017)
Costs	Total costs and resources needed to scale up BI in a specific organization or system	Total costs and resources needed to scale up BI in an organization/system for both disadvantaged and non-disadvantaged populations	Calculation of total dollars and resources mapped to observerable activities required to implement BI (Saldana et al., 2014)
Feasibility	Utility or ease with which providers can use the BI intervention with patients or clients	Utility or ease with which providers can use BI to reduce barriers to treatment and the degree to which BI can be used across settings for disadvantaged populations	Feasibility of Intervention Measure (Weiner et al., 2017)
Penetration/Coverage	Extent to which a BI becomes integrated within a specific organization or system	Extent to which BI can be accessed by disadvantaged populations who may benefit from BI receipt	Number of providers who routinely deliver BI divided by the total number of providers trained in BI

Note: Three of the classic implementation outcomes - adoption, sustainability, and fidelity - overlap with the RE-AIM outcomes and are listed in the RE-AIM section of the table.