Background
Aims
Methods
Materials and general procedures
Peer-reviewed documents: search strategy, inclusion, and exclusion criteria
Stakeholders’ documents (other than peer-reviewed): search strategy, inclusion criteria, exclusion criteria, and quality evaluation
Data extraction, coding, and synthesis
Results
Description of analyzed material
Implementation conditions
RE-AIM domain | Systematic reviews, stakeholders’ documents, and position reviews endorsing respective characteristics | ||
---|---|---|---|
Characteristics category
| |||
Implementation characteristics | Policies only | Interventions only | Policies and interventions |
Domain: Reach | |||
(a) Strategies facilitating recruitment processes | |||
Resources/strategies for implementers helping them to invite and follow-up participants | Systematic reviews [5]. | ||
Awareness raising (strategies to raise awareness of dietary behavior, physical activity, sedentary behaviors, as well as interventions and policies) to help implementers to invite participants | |||
Incentives to participate | Position reviews [28]. | ||
(b) Issues in participation processes and their effects on implementation | |||
General attrition ratesa | |||
Participation levels, i.e., percent of those agreeing among eligible participantsa | |||
Representativeness of attrition and dropouta | |||
Differential attrition across the program conditions/typesa | |||
(c) Cultural and social issues in reaching target populations | |||
Enhancing cultural competences of intervention/policy (creating culturally sensitive versions of materials) | Systematic reviews [67]. | ||
Domain: Efficacy | |||
(d) Satisfaction with implementation | |||
Participants’ satisfaction with implementationa | |||
(e) Feasibility and acceptability | |||
Feasibility of implementation and acceptability of implementation among providers, stakeholders, and participantsa | |||
Acceptability of the program among participants (e.g., acceptability of: the group size, the type of participants, interventionists’ skills)a | |||
(f) Evaluation of implementation/adoption processes (excluding evaluation of the outcomes of the program) | |||
Evaluation and monitoring results are disseminated to communities, stakeholders, and nationally | Stakeholders’ documents [69]. | ||
Difficulty/a lack of opportunity to assess the impact of one policy separately from ancillary policies/interventions due to the increasing complexity of policies/legislationsa | |||
Domain: Adoption | |||
(g) Training for implementation | |||
Training for implementers and disseminators (e.g., training, certifıcates, workshops, training instructions, skill development) | |||
Training instructions/materials for implementers | Position reviews [35]. | ||
Regular meetings or supervision for staff to secure implementation | Position reviews [28]. | ||
(h) Staff expertise for implementation | |||
No additional expertise required for staff involved in implementation | |||
Implementers’ skill, knowledge, and competence to implement the program correctly | Position reviews [35]. | ||
(i) Collaboration and communication for implementation | |||
Collaboration between implementers; the use of methods to increase communication between implementers | |||
Key political and stakeholders’ support for implementation (stakeholders identified and involved) | |||
Cross-sectorial collaboration: collaboration between sectors of health, sports, food, transportation, planning and housing, green spaces, education, healthcare, and social services | Position reviews [91]. | ||
Involvement of multiple stakeholders at multiple levels | Stakeholders’ documents [97]. | ||
Collaboration with professionals and organizations for program implementation | |||
Effective leadership to secure collaboration (between facilitators, institutions, and organizations involved) | Stakeholders’ documents [97]. | ||
Synergy with other existing or operating programs | Position reviews [114]. | Position reviews [41]. | |
Securing food industry involvement/preventing and counteracting food industry resistance | |||
(j) Community support for implementation | |||
Securing the involvement of local community in implementation | |||
Community organizations support adoption | |||
Building relationships/networks for implementation (between implementing organizations and community organizations) | Systematic reviews [100]. | Systematic reviews [26]. | |
(k) Adoption in physical environment facilitating implementation | |||
Maintenance or development of built and natural environment to enable policies implementation | Systematic reviews [67]. | ||
Supportive physical environment in the community promotes implementation and adoption | Systematic reviews [72]. | Stakeholders’ documents [40]. | |
(l) Governmental and legislative involvement | |||
Federal (national) government co-issues the program or is involved in program issuing | Position reviews [41]. | ||
Legal basis/secured legal support for implementation and maintenance (e.g., fiscal, liability instruments, market environment laws) | |||
Accounting for legal instruments to support implementation (existing legal instruments supporting implementation, changes in law, and legal burden for businesses) | |||
Politicians’ collaboration (negotiation with and influencing politicians and policy makers) | |||
Involvement of a local government and accounting for regional regulations | |||
Accounting for conflicting policies in adoption processa | |||
Domain: consistency, cost, and adaptations in Implementation | |||
(m) Simplicity as a factor facilitating implementation | |||
Simplicity of communicating and implementing the program (not too complex, not too difficult to follow) | Stakeholders’ documents [66]. | ||
Complexities of existing policies and their interrelations as barriers to implementationa | |||
(n) Accessibility for participants | |||
Increasing accessibility to environmental structures | Stakeholders’ documents [40]. | ||
Financially accessible programs (low-cost, high affordability) | Systematic reviews [44]. | ||
Barriers for accessibility in physical environment (e.g., architectural solutions as barriers to exercise; a lack of stairs)a | Stakeholders’ documents [63]. | ||
(o) Evaluating and solving time-related issues in implementation | |||
Lack of time in the community involved in implementationa | Position reviews [33]. | Stakeholders’ documents [69]. | |
Time for implementation: assessment of time needed for implementation conducted and adequate time secured | Systematic reviews [44]. | Stakeholders’ documents [69]. | |
Limited time in curriculum to add new program in respective settings (e.g., schools) | Position reviews [115]. | Position reviews [70]. | |
(p) Fidelity | |||
Fidelity of the program (in reference to the content and the dose of the program) | Stakeholders’ documents [64]. | Position reviews [56]. | |
Degree to which intervention is delivered as intended (compared to the protocol) | |||
Assessment of fidelity of deliverya | |||
(q) Use of implementation theory/framework | |||
Use of implementation theory for implementation practice | |||
Use of RE-AIM framework for identification, appraisal, and synthesis of material | |||
(r) Cultural context in implementation | |||
Culture-sensitive implementation, addressing the needs of diverse population in their community context (social, cultural, economic, and political) | |||
(s) Costs and funding of implementation | |||
Costs of implementation analyzed (e.g., analysis of costs to deliver per person) | Position reviews [33]. | ||
Funding/resources for implementation secured and provided | |||
Lack of/limited funding for implementationa | Position reviews [41]. | ||
Cost targets: low (feasible) costs of implementation, cheap resources, and affordable across settings | |||
Securing funds for long-term maintenance (e.g., through national government funds) | Position reviews [33]. | Stakeholders’ documents [40]. | |
(t) Other resources needed for delivery | |||
Lack of resources for implementation in organizations involved in deliverya | Systematic reviews [71]. | ||
Lack of resources for implementation (from sources other than involved organizations)a | Position reviews [41]. | ||
(u) Delivery characteristics | |||
Extent to which protocol was delivered as intended/protocol adherence | Systematic reviews [71]. | ||
Consistency of delivery and evaluation/monitoring of consistency | Position reviews [35]. | ||
Identifying the essential amount of time/number of sessions required to deliver the program | Position reviews [107]. | Systematic reviews: [60]. | |
Mass media involved in delivery and dissemination | Stakeholders’ documents [93]. | ||
Involving any available staff into the program delivery | |||
Clear identification of roles and responsibilities in implementation processes | Stakeholders’ documents [93] | ||
Delivery through various professional groups, lay health advisors, and users | |||
Pilots: testing new and existing materials before delivering to the target population | Position reviews [82]. | Position reviews [101]. | |
(v) Settings’ characteristics affecting delivery and implementation | |||
Organizational practices supporting implementation, management participation in implementation | Stakeholders’ documents [30]. | ||
Aims and existing polices within the organization are accounted for (how does the program fit into organizational aims and existing policies?) | Systematic reviews [44]. | ||
(w) Adjustments and customizations in implementation | |||
Deep-structure adaptations (deep cultural and ethnic adaptations to participants, consultations with community advisors on cultural adaptations, consultation with participants) | |||
Customization of the program (to target population and local conditions) | |||
Potential adaptations to enhance the fıt within community contexts | Stakeholders’ documents [64] | ||
Assessment of adaptations of the intervention/policy made during deliverya | Systematic reviews [72]. | ||
Adoption to settingsa | |||
(x) Planning and monitoring of implementation processes | |||
Plans for implementation | |||
Plans for monitoring and plans for evaluation (how to increase data availability and of high quality?) | Position reviews [92]. | ||
Process monitoring and evaluation | |||
Monitoring and assessment of adherence to implementation protocol/protocol fidelity | |||
(y) Implementers’ characteristics affecting implementation | |||
Implementers’ expectations regarding the program and perceived control of the programa | |||
Levels of engagement/involvement and awareness of implementers | Position reviews [106]. | Stakeholders’ documents [40]. | |
Support needed (perceived by implementers)a | |||
Domain: Maintenance | |||
(z) Sustainability | |||
Institutionalization of the content of the program and its implementation (e.g., the integration into existing institutional programs) | |||
Strategies to promote long-term participation (maintenance) included | |||
Building capacity to secure maintenance (training and support in organization, aiming at promotion of maintenance) | Stakeholders’ documents [130]. |
No. | Implementation domain | Page no. (in a report or protocol of evaluated intervention/policy) |
---|---|---|
Implementation condition | ||
Implementation domain: Reach | ||
1a | Resources/strategies for implementers helping them to invite and follow-up participants | |
2a | Awareness raising (strategies to raise awareness of dietary behavior, physical activity, sedentary behaviors, as well as interventions and policies) to help implementers to invite participants | |
3a | Incentives to participate | |
4b | General attrition ratesa | |
5b | Participation levels, i.e., percent of those agreeing among eligible participantsa | |
6b | Representativeness of attrition and dropouta | |
7b | Differential attrition across the program conditions/typesa | |
8c | Enhancing cultural competences of intervention/policy (creating culturally sensitive versions of materials) | |
Implementation domain: Efficacy | ||
9d | Participants’ satisfaction with implementationa | |
10e | Feasibility of implementation and acceptability of implementation among providers, stakeholders, and participantsa | |
11e | Acceptability of the program among participants (e.g., acceptability of the group size, the type of participants, interventionists’ skills)a | |
12f | Evaluation and monitoring results are disseminated to communities, stakeholders, and nationally | |
13f | Difficulty/a lack of opportunity to assess the impact of one policy separately from ancillary policies/interventions due to the increasing complexity of policies/legislationsc,a | |
Implementation domain: Adoption | ||
14g | Training for implementers and disseminators (e.g. training, certifıcates, workshops, training instructions) | |
15g | Training instructions/materials for implementers | |
16g | Regular meetings or supervision for staff to secure implementation | |
17h | No additional expertise required for staff involved in implementation | |
18h | Implementers’ skill, knowledge, and competence to implement the program correctly | |
19i | Collaboration between implementers; the use of methods to increase communication between implementers | |
20i | Key political and stakeholders’ support for implementation (stakeholders identified and involved) | |
21i | Cross-sectorial collaboration: collaboration between sectors of health, sports, food, transportation, planning and housing, green spaces, education, healthcare, and social services | |
22i | Involvement of multiple stakeholders at multiple levels | |
23i | Collaboration with professionals and organizations for program implementation | |
24i | Effective leadership to secure collaboration (between facilitators, institutions, and organizations involved) | |
25i | Synergy with other existing or operating programs | |
26i | Securing food industry involvement/preventing and counteracting food industry resistancec | |
27j | Securing the involvement of local community in implementation | |
28j | Community organizations support adoption | |
29j | Building relationships/networks for implementation (between implementing organizations and community organizations) | |
30k | Maintenance or development of built and natural environment to enable policies implementation | |
31k | Supportive physical environment in the community promotes implementation and adoption | |
32l | Federal (national) government co-issues the program or is involved in program issuing | |
33l | Legal basis/secured legal support for implementation and maintenance (e.g. fiscal, liability instruments, market environment laws)c | |
34l | Accounting for legal instruments to support implementation (existing legal instruments supporting implementation, changes in law, and legal burden for businesses)c | |
35l | Politicians’ collaboration (negotiation with and influencing politicians and policy makers)c | |
36l | Involvement of a local government and accounting for regional regulations | |
37l | Accounting for conflicting policies in adoption processc,a | |
Implementation domain: Consistency, cost, and adaptations in implementation | ||
38m | Simplicity of communicating the program (not too complex, not too difficult to follow) | |
39m | Complexities of existing policies and their interrelations as barriers to implementationc,a | |
40n | Increasing accessibility to environmental structures | |
41n | Financially accessible programs (low-cost, high affordability) | |
42n | Barriers for accessibility in physical environment (e.g., architectural solutions as barriers to exercise; a lack of stairs)a | |
43o | Lack of time in the community involved in implementationa | |
44o | Time for implementation: assessment of time needed for implementation conducted and adequate time secured | |
45o | Limited time in curriculum to add new program in respective setting (e.g., schools) | |
46p | Fidelity of the program (in reference to the content and the dose of the program) | |
47p | Degree to which intervention is delivered as intended (compared to the protocol)b | |
48p | Assessment of fidelity of deliveryb,a | |
49q | Use of implementation theory for implementation practice | |
50q | Use of RE-AIM framework for identification, appraisal, and synthesis of material | |
51r | Culture-sensitive implementation, addressing the needs of diverse population in their community context (social, cultural, economic, and political) | |
52s | Costs of implementation analyzed (e.g., analysis of costs to deliver per person) | |
53s | Funding/resources for implementation secured and provided | |
54s | Lack of/limited funding for implementationa | |
55s | Cost targets: low (feasible) costs of implementation, cheap resources, and affordable across settings | |
56s | Securing funds for long-term maintenance (e.g., through national government funds) | |
57t | Lack of resources for implementation in organizations involved in deliverya | |
58t | Lack of resources for implementation (from sources other than organizations involved)a | |
59u | Extent to which protocol was delivered as intended/protocol adherence | |
60u | Consistency of delivery and evaluation/monitoring of consistency | |
61u | Identifying the essential amount of time/number of sessions required to deliver the program | |
62u | Mass media involved in delivery and dissemination | |
63u | Involving any available staff into the program deliveryb | |
64u | Clear identification of roles and responsibilities in implementation processes | |
65u | Delivery through various professional groups, lay health advisors, and users | |
66u | Pilots: testing new and existing materials before delivering to the target population | |
67v | Organizational practices supporting implementation, management participation in implementation | |
68v | Aims and existing polices within the organization are accounted for (does the program fit into organizational aims and existing policies?) | |
69w | Deep-structure adaptations (e.g., deep cultural and ethnic adaptations to participants, consultations with community advisors on cultural adaptations, consultation with participants) | |
70w | Customization of the program (to target population and local conditions) | |
71w | Potential adaptations to enhance the fıt within community contexts | |
72w | Assessment of adaptations of the intervention/policy made during deliverya | |
73w | Adoption to settingsa | |
74w | Plans for implementation | |
75w | Plans for monitoring and plans for evaluation (how to increase data availability and of high quality?) | |
76w | Process monitoring and evaluation | |
77w | Monitoring and assessment of adherence to implementation protocol/protocol fidelity | |
78x | Implementers’ expectations regarding the program and perceived control of the programa | |
79x | Levels of engagement/involvement and awareness of implementers | |
80x | Support needed (perceived by implementers)a | |
Implementation domain: Maintenance | ||
81z | Institutionalization of the program content and its implementation (e.g., the integration into existing institutional programs) | |
82z | Strategies to promote long-term participation (maintenance) included | |
83z | Building capacity to secure maintenance (training and support in organization, aiming at promotion of maintenance) |