Table 2 Implementation evaluation
RE-AIM/ PRISM dimension | Patient level | Healthcare provider (HCP) level | System level |
|---|---|---|---|
Reach | Number of participants per health district Representativeness of target population | ||
Effectiveness | See Fig. 3 | ||
Adoption | Number of HCPs who participate in training sessions/total HCPs Representativeness of HCPs who participate in training sessions | Number of health districts, health centers and posts that participate in training sessions/total Representativeness of health districts that participate in training sessions | |
Implementation (fidelity, adaptation) | Documentation of home-based BP measurement on patient’s card Number of health coaching sessions received | Characteristics of training workshops for HCPs Application of HTN algorithm by HCP Extent to which implementation strategies (patient lists, audit and feedback, collaborative team meetings, supervision, and coaching sessions) are implemented Specific modes of implementation by different providers Types and frequency of delivery adaptation made | Availability of intervention inputs: medications, monitors, materials, staff Specific modes of implementation in different sites |
Maintenance (sustainability) | Sustained BP control, medication adherence, lifestyle changes, quality of life, stages of behavior change at 18 months | Sustained HTN knowledge over time Intention to continue implementation beyond study period Adaptations needed in order to continue implementation | Intention to continue beyond study period Adaptations needed in order to continue implementation |
Fit | Adaptations by healthcare providers to make the intervention and implementation strategies fit to their context | Changes at the national, state and health district level to be able to implement the intervention and implementation strategies | |
Sustainability infrastructure | Policies or programs related to HCP hiring, training or retention Supervision infrastructure Audit and feedback | Support and resources from MOH leadership to implement intervention Medication availability Information system BP monitors Staffing |