Evaluating an Insurance-Sponsored Weight Management Program With the RE-AIM Model, West Virginia, 2004-2008

INTRODUCTION: Evaluations of weight management programs in real-world settings are lacking. The RE-AIM model (reach, effectiveness, adoption, implementation, maintenance) was developed to address this deficiency. Our primary objective was to evaluate a 12-week insurance-sponsored weight management intervention by using the RE-AIM model, including short-term and long-term individual outcomes and setting-level implementation factors. Our secondary objective was to critique the RE-AIM model and its revised calculation methods. METHODS: We created operational definitions for components of the 5 RE-AIM indices and used standardized effect size values from various statistical procedures to measure multiple components or outcomes within each index. We used χ(2) analysis to compare categorical variables and repeated-measures analysis of variance to assess the magnitude of outcome changes over time. RESULTS: On the basis of data for 1,952 participants and surveys completed by administrators at 23 sites, RE-AIM indices ranging from 0 to 100 revealed low program reach and adoption (5.4 and 8.8, respectively), moderate effectiveness (43.8), high implementation (91.4), low to moderate individual maintenance (21.2), and moderate to high site maintenance (77.8). Median (interquartile range) weight loss was 13 lb (6.5-21.4 lb) among participants who completed phase I (12 weeks; 76.5%) and 15 lb (6.1-30.3 lb) among those who completed phase II (1 year; 45.7%). CONCLUSIONS: This program had a significant, positive effect on participants and has been sustainable but needs to be expanded for more public health benefit. The RE-AIM model provided a useful framework to determine program strengths and weaknesses and to present them to the insurance agency and public health decision makers.