Evaluation Toolkit for Breastfeeding Programs and Projects

June 2012

Appendix C - RE-AIM evaluation framework template

Page last updated: 04 November 2013

(These instructions can be deleted once you have finalised your document.)
This template provides a structure for designing an evaluation based on the RE-AIM model. RE-AIM stands for:

Diagram showing the RE-AIM evaluation framework, with the acronym described in full as: "Reach", "Effectiveness", "Adoption", "Implementation", "Maintenance".

This is a good framework to use when you are implementing a service which provides a point in time intervention, rather than a program which has a longitudinal focus. It was first developed to evaluate public health interventions so is well suited to short-term clinical engagements with consumers.

Complete the sections below, and then use these to fill in the table on the next page. It’s helpful to involve others who will have an informed view about what you are trying to accomplish.

1. Program being evaluated
Type your answer here

2. Evaluators
(internal, external, team or individual)
Type your answer here

3. Resources required
(financial, time, staff, etc)
Type your answer here

4. Reach - Who are you trying to reach? Be as specific as possible, e.g. women within the first month post-partum, pregnant women in the 3rd trimester, young pregnant women, first-time mothers
Type your answer here

5. Effectiveness - What services are you providing? How will you know if they are effective? Be as specific as possible.
Type your answer here

6. Adoption - How will your service be advertised? What place does it have in the local network of health services? How will you ensure it is adopted by both the health system and by consumers?
Type your answer here

7. Implementation - What will you do to implement the service? What needs to happen to make it work – financial resources, staffing, management, clinical protocols or pathways, referral processes?
Type your answer here

8. Maintenance - What is required for the service to be maintained? For instance, is funding secure? Will your service have a natural ‘use-by’ date or could it run forever? What needs to happen for it to continue to operate in the long term?
Type your answer here

9. Now that you have considered all those things, sit back and reflect for a bit. What questions do you need to ask to discover what you have achieved in each domain? It can be helpful to consider the framework in two sections:

  • ‘RE’ focuses on the consumer; who are you trying to reach? How will you know you are effective?
  • ‘AIM’ focuses on the organisation; how does your service fit into the broader system? Does your service compete or complement other services? How well has it been implemented? What needs to be done to maintain the quality of the service?
10. In the table below, enter the questions which you have identified for each domain in the second column (evaluation questions).

11. When your questions have all been agreed, you need to identify the indicators which will help you answer the questions. Are they measures of personal experience such as satisfaction, or are they indicators which will be clinically measured? Write these down next to each evaluation question. There may be more than one indicator for some questions.

12. Now, where will you find the data? Will it be in the clinical records or other documentation, or do you need to create a new way to collect the information? Do you need to talk to people – staff or clients – to find out about their experiences? Write your data sources in that column next to each indicator.

13. After all of this, you should have a completed table which identifies the following:
  • what you expect to happen if your program is working as you intend
  • what questions you can ask to find out if your program is achieving its outcomes
  • what indicators will provide answers to those questions
  • where you will find the data you need.
14. Once your framework is completed, it can be useful to share it with others to get their perspective. Sometimes explaining things to others can help make it clearer to ourselves, and also allow others to ask questions we may not have thought of.

15. Now you have a plan to evaluate your program. Go for it!

Framework componentEvaluation questions (samples below)Indicators (samples below)Data sources (samples below)
ReachWho is using the service? How often? What services are women accessing? Is the service targeting the needs of women in the local area? Are there eligibility criteria? If so, what are they and are they appropriate? Which particular ‘ages and stages’ of the breastfeeding experience are being targeted?Number of women accessing service and comparison to expected local population need; demographic characteristics and comparison to local population Service records

Local demographics

Interviews with local women

EffectivenessHow effective is the service in supporting women to breastfeed?Number of service users who continue to breastfeed at points in timeService records

Survey of service users

AdoptionHow is the service linked to other relevant services? How well do services collaborate or cross-refer? To what extent is the service fully embedded in the larger organisation or network?Number and type of collaborative agreements

Evidence of cross-referral or collaboration

Perceptions of staff/stakeholders

Organisational records

Service documentation or clinical referral records

Interviews with key staff/stakeholders

ImplementationHow was the service implemented? What were the barriers or enablers in establishing the service?Documentation regarding implementation

Perceptions of staff/stakeholders

Organisational records

Interviews with key staff/stakeholders

MaintenanceHow is the service funded? How sustainable is the funding? How is the service governed? What challenges face the service in meeting future community needs?Documentation regarding maintenance

Perceptions of staff/stakeholders

Organisational records

Interviews with key staff/stakeholders