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Title: Using the RE-AIM framework to evaluate physical activity public health programs in Mexico

Author
item JAUREGUI, EDTNA - University Of Guadalajara
item PACHECO, ANN - University Of Houston
item SOLTERO, ERICA - University Of Houston
item O'CONNOR, TERESIA - Children'S Nutrition Research Center (CNRC)
item CASTRO, CYNTHIA - Stanford University School Of Medicine
item ESTABROOKS, PAUL - Virginia Tech
item MCNEILL, LORNA - Md Anderson Cancer Center
item LEE, REBECCA - Arizona State University

Submitted to: BioMed Central(BMC) Public Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/27/2015
Publication Date: 2/19/2015
Citation: Jauregui, E., Pacheco, A.M., Soltero, E.G., O'Connor, T.M., Castro, C.M., Estabrooks, P.A., Mcneill, L.H., Lee, R.E. 2015. Using the RE-AIM framework to evaluate physical activity public health programs in Mexico. BioMed Central(BMC) Public Health. 15:162.

Interpretive Summary: In Mexico, physical inactivity is a significant public health problem and public health programs and initiatives are trying to increase physical activity among populations. While such programs are generally well received and relatively widely implemented, few systematic assessments of the public health impact of such programs have been conducted. Programs that can be shown to have important public health impact should be more broadly disseminated and sustained. This study assessed existing physical activity programs in Mexico using an framework for individual and organizational factors of health promotion programs, called RE-AIM (stands for: reach, efficacy/effectiveness, adoption, implementation, and maintenance). In general, many of the Mexican programs did not report on the five important public health indicators identified in RE-AIM. Only 45% reported reach indicators, 34% reported efficacy/effectiveness indicators, 60% reported adoption indicators, 40% reported implementation indicators, and 35% reported maintenance indicators. While reach and adoption of these programs were most commonly reported, there is a need for stronger evaluation of behavioral and health outcomes of Mexican physical activity programs before the public health impact of these programs can be established.

Technical Abstract: Physical activity (PA) public health programming has been widely used in Mexico; however, few studies have documented individual and organizational factors that might be used to evaluate their public health impact. The RE-AIM framework is an evaluation tool that examines individual and organizational factors of public health programs. The purpose of this study was to use the RE-AIM framework to determine the degree to which PA programs in Mexico reported individual and organizational factors and to investigate whether reporting differed by the program's funding source. Public health programs promoting PA were systematically identified during 2008–2013 and had to have an active program website. Initial searches produced 23 possible programs with 12 meeting inclusion criteria. A coding sheet was developed to capture behavioral, outcome and RE-AIM indicators from program websites. In addition to targeting PA, five (42%) programs also targeted dietary habits and the most commonly reported outcome was change in body composition (58%). Programs reported an average of 11.1 (+/-3.9) RE-AIM indicator items (out of 27 total). On average, 45% reported reach indicators, 34% reported efficacy/effectiveness indicators, 60% reported adoption indicators, 40% reported implementation indicators, and 35% reported maintenance indicators. The proportion of RE-AIM indicators reported did not differ significantly for programs that were government supported (M=10, SD=3.1) and programs that were partially or wholly privately or corporately supported (M=12.0, SD=4.4). While reach and adoption of these programs were most commonly reported, there is a need for stronger evaluation of behavioral and health outcomes before the public health impact of these programs can be established.