Key Considerations and Recommended Strategies for Conducting a School-Based Longitudinal RE-AIM Evaluation: Insights From a 28-School Cluster Randomized Trial

RE-AIM is an implementation science framework that provides a structure to promote data collection and analysis in the domains of Reach, Efficacy/ Effectiveness, Adoption, Implementation, and Maintenance. The RE-AIM approach promotes more data collection and reporting than typical evaluations so potential adopters can determine the potential program fit for their setting. RE-AIM has been used to evaluate a variety of programs; however, there are few resources that provide strategies for conducting a RE-AIM evaluation in the school setting. The purpose of this article is to inform future studies by elucidating experiences conducting a large, complex, multisite, longitudinal RE-AIM evaluation in schools in partnership with the state’s Departments of Education and Health, and to share strategies for overcoming obstacles. With the long-term goal of facilitating the translation of school-based intervention research into practice, we provide key considerations and recommend strategies for school-based RE-AIM evaluation success.

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Process Evaluation of a Medical Student–Delivered Smoking Prevention Program for Secondary Schools: Protocol for the Education Against Tobacco Cluster Randomized Trial (Preprint)

10.2196/preprints.13508 ◽

2019 ◽

Author(s):

Titus Josef Brinker ◽

Fabian Buslaff ◽

Janina Leonie Suhre ◽

Marc Philipp Silchmüller ◽

Evgenia Divizieva ◽

...

Keyword(s):

Medical Student ◽

Randomized Trial ◽

Process Evaluation ◽

Smoking Prevalence ◽

Cluster Randomized Trial ◽

Smoking Prevention ◽

School Based ◽

Cluster Randomized ◽

And Control

BACKGROUND Most smokers start smoking during their early adolescence under the impression that smoking entails positive attributes. Given the addictive nature of cigarettes, however, many of them might end up as long-term smokers and suffering from tobacco-related diseases. To prevent tobacco use among adolescents, the large international medical students’ network Education Against Tobacco (EAT) educates more than 40,000 secondary school students per year in the classroom setting, using evidence-based self-developed apps and strategies. OBJECTIVE This study aimed to evaluate the long-term effectiveness of the school-based EAT intervention in reducing smoking prevalence among seventh-grade students in Germany. Additionally, we aimed to improve the intervention by drawing conclusions from our process evaluation. METHODS We conduct a cluster-randomized controlled trial with measurements at baseline and 9, 16, and 24 months postintervention via paper-and-pencil questionnaires administered by teachers. The study groups consist of randomized schools receiving the 2016 EAT curriculum and control schools with comparable baseline data (no intervention). The primary outcome is the difference of change in smoking prevalence between the intervention and control groups at the 24-month follow-up. Secondary outcomes are between-group differences of changes in smoking-related attitudes and the number of new smokers, quitters, and never-smokers. RESULTS A total of 11,268 students of both sexes, with an average age of 12.32 years, in seventh grade of 144 secondary schools in Germany were included at baseline. The prevalence of cigarette smoking in our sample was 2.6%. The process evaluation surveys were filled out by 324 medical student volunteers, 63 medical student supervisors, 4896 students, and 141 teachers. CONCLUSIONS The EAT cluster randomized trial is the largest school-based tobacco-prevention study in Germany conducted to date. Its results will provide important insights with regards to the effectiveness of medical student–delivered smoking prevention programs at school. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13508

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A School-Based Sleep Education Program for Adolescents: A Cluster Randomized Trial

PEDIATRICS ◽

10.1542/peds.2014-2419d ◽

2015 ◽

Vol 135 (3) ◽

pp. X23-X23

Keyword(s):

Randomized Trial ◽

Education Program ◽

Cluster Randomized Trial ◽

Sleep Education ◽

School Based ◽

Cluster Randomized

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School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial

BMC Medicine ◽

10.1186/1741-7015-12-56 ◽

2014 ◽

Vol 12 (1) ◽

Cited By ~ 74

Author(s):

Wietse A Tol ◽

Ivan H Komproe ◽

Mark JD Jordans ◽

Aline Ndayisaba ◽

Prudence Ntamutumba ◽

...

Keyword(s):

Mental Health ◽

Randomized Trial ◽

Cluster Randomized Trial ◽

Health Intervention ◽

Mental Health Intervention ◽

School Based ◽

Cluster Randomized

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Assessing the impact of a school-based latrine cleaning and handwashing program on pupil absence in Nyanza Province, Kenya: a cluster-randomized trial

Tropical Medicine & International Health ◽

10.1111/tmi.12360 ◽

2014 ◽

Vol 19 (10) ◽

pp. 1185-1197 ◽

Cited By ~ 22

Author(s):

Bethany A. Caruso ◽

Matthew C. Freeman ◽

Joshua V. Garn ◽

Robert Dreibelbis ◽

Shadi Saboori ◽

...

Keyword(s):

Randomized Trial ◽

Cluster Randomized Trial ◽

Nyanza Province ◽

School Based ◽

Cluster Randomized ◽

The Impact

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Spread and scale of an electronic deprescribing software to improve health outcomes of older adults living in nursing homes: study protocol for a stepped wedge cluster randomized trial

Trials ◽

10.1186/s13063-021-05729-0 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Marc-Eric Nadeau ◽

Justine L. Henry ◽

Todd C. Lee ◽

Émilie Bortolussi-Courval ◽

Carole Goodine ◽

...

Keyword(s):

Older Adults ◽

Randomized Trial ◽

Study Design ◽

Long Term Care ◽

Cluster Randomized Trial ◽

Stepped Wedge ◽

Term Care ◽

Medication Reviews ◽

Cluster Randomized

Abstract Background Medication overload or problematic polypharmacy is a major problem causing widespread harm, particularly to older adults. Taking multiple medications increases the risk of potentially inappropriate medications (PIMs), and residents in long-term care (LTC) are frequently prescribed 10 or more medications at once. One strategy to address this problem is for the physician and/or pharmacist to perform regular medication reviews; however, this process can be complicated and time-consuming. With a prescription review, medications may be decreased, changed, or stopped altogether. MedReviewRx is a software that runs an analysis using deprescribing rules to produce a report to guide medication reviews addressing medication overload for residents in LTC. Methods This study will employ a mixed methods effectiveness-implementation hybrid type 2 study design. To measure effectiveness, a stepped wedge cluster randomized trial design is planned, which allows us to approximate a randomized clinical trial. Approximately 1000 residents living in LTC will be recruited from five facilities in New Brunswick. The study will begin with 3 months of baseline data on rates of deprescribing. Thereafter, every 3 months a new cluster will enter the intervention mode. The intervention consists of medication reviews augmented with the MedReviewRx software, which will be used by staff and clinicians in the facilities. The estimated study duration is 18 months and the main outcome will be the proportion of patients with one or more PIMs deprescribed (reduced/stopped or changed to a safer alternative) in the 90 days following a prescription review. The goal is to study the impact of MedReviewRx on medication overload among older adults living in LTC. In typical fashion of a stepped wedge cluster randomized trial, each cluster acts as an internal control (before and after) as well as a control for the other clusters (external control). Qualitative data collected will include resident/caregiver attitudes towards deprescribing and semi-structured interviews with staff working in the long-term care homes. Discussion This study design addresses issues with seasonality and allows all clusters to participate in the intervention, which is an advantage when the intervention is related to quality improvement. This study will provide valuable information on PIM use, cost savings, and facilitators and challenges associated with medication reviews and deprescribing. This study represents an important step towards understanding and promoting tools to guide safe and rational reduction of PIM use among older adults. Trial registration NCT04762303, Registered February 21, 2021.

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