A RE-AIM evaluation of evidence-based multi-level interventions to prevent obesity in adults: a systematic review

Purpose: This systematic literature review describes the potential public health impact of evidence-based multi-level interventions to prevent obesity, using the RE-AIM framework. Method: Electronic databases (Pubmed, Embase, and The Cochrane Library) were searched to identify relevant intervention studies published between January 2000 and April 2012. The following inclusion criteria were used: (1) aiming to influence overweight/obesity-related behaviors, (2) targeting adults, (3) being conducted in a geographical area/worksite, (4) being multi-level (combining both individual and environmental changes), and (5) collecting data over at least one year. Reach, Efficacy, Adoption, Implementation and Maintenance of the selected interventions were assessed. Results: Thirty-three interventions were identified. In terms of ‘Reach’, targeted geographical area/ worksite and population sample were well reported, in contrast to participation rate and representativeness of participants. In terms of ‘Efficacy’, 97% of the studies reported information on positive outcomes, while less than 5% reported on negative outcomes. Nearly 70% provided information on intervention deliverers, while information on representativeness of organizations was limited (‘Adoption’). A great deficit was found in reporting ‘Implementation’ (e.g. completion and costs of implementation) and ‘Maintenance’ (e.g. program sustainability and adaptations). Conclusion: Determining the potential public health impact of interventions is difficult due to inconsistent reporting on the RE-AIM dimensions. More information on external validity and sustainability is needed in order to implement effective interventions in real-world settings