Applying the RE-AIM Framework to Evaluate Large-Scale Obesity Prevention Policy, Systems and Environmental Change Efforts in Los Angeles County

Introduction: In 2013, the Los Angeles County Department of Public Health (DPH) began delivering nutrition services through the Nutrition Education and Obesity Prevention (NEOP) program. As part of its scope, NEOP facilitates policy, systems and environmental (PSE) changes to support healthy nutrition and physical activity behaviors among Supplemental Nutrition Assistance Program-eligible residents of Los Angeles County. The RE-AIM Framework was applied to evaluate 164 PSE interventions implemented by DPH and its funded partners. There is limited best-practice information available to guide application of RE-AIM in the context of large-scale, multi-partner efforts. This presentation describes DPH’s roadmap for using RE-AIM to evaluate PSE interventions. Preliminary results and lessons learned are discussed.  

Approach: DPH developed a RE-AIM evaluation protocol to gain buy-in from partners, provide training, ensure consistent data collection, and disseminate findings for the purpose of program planning, continuous improvement, and best practice development. 16 key-informant interviews were conducted with partners to solicit feedback on the PSE evaluation process.

Results: DPH and its 17 funded partners utilize RE-AIM to regularly monitor and evaluate PSE activities. County-level findings have been used to inform PSE implementation. Partners have reported that, while substantial technical assistance and time commitment was required initially, RE-AIM application increased internal capacity to monitor and evaluate programs. Partner feedback was leveraged to refine processes for PSE evaluation and provision of technical assistance.

Discussion: The RE-AIM application strategy employed represents a model of practice that program planners may adopt to support partner and grantee utilization of standardized evaluation methods.