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Table 3 Operationalization of RE-AIM dimensions measurement methods

From: Integrating palliative care in long-term care facilities across Europe (PACE): protocol of a cluster randomized controlled trial of the ‘PACE Steps to Success’ intervention in seven countries

Dimension Operationalized in pace process evaluation Measurement methods
Reach
(Proportion of caregivers in care settings that participated in the intervention during the study)
- Number of participants (care staff attending each training or meeting) divided by the total number of care staff (eligible participants) who work in the facility or facility unit
- Comparing characteristics of participating facilities with non-participating facilities
- Attendance lists of trainings and meetings
- Documentation of recruitment process by the researcher
Efficacy
(primary and secondary outcomes (positive and negative)
- Primary and secondary outcome measures - Questionnaires about deceased resident
- Questionnaire about staff
(see Table 2)
Adoption
(Extent to which caregivers actually adopt the intervention in the study (followed the intervention or showed compliance with the intervention)
- Number of Looking and Thinking Ahead Forms documented and Pain/Depression Assessments documented
- Experiences with applying the intervention steps in daily practice (e.g. reasons for (not) applying steps, changes in practice)
- Report from PACE coordinators
- Group interviews with care staff and PACE coordinators
Implementation
(Extent to which the intervention is implemented as intended in the real world, including implementation barriers and facilitators)
- Fidelity: extent to which the steps of the intervention were delivered as intended (frequency, order and content of the sessions)
- Satisfaction of care staff members towards the intervention program and trainer’s competences
- Barriers and facilitators for implementation
- Structured diaries filled in by country trainers
- Evaluation questionnaire after last training session filled in by care staff
- List of Barriers and Facilitators for Implementation, added to the Nurses’ experiences and attitudes questionnaire
- Group interviews with care staff and PACE coordinators
- Online discussion groups with trainers from all countries
- Semi-structured interviews with nursing home managers
- Structured diaries for country trainers and PACE coordinators
(Intention to) Maintenance
(Extent to which the intervention is intended to be sustained over time) a
- Care staff members’ intention for using PACE documents in the future
- Organizational intention for long-term implementation
- Recommendations for improving usability of intervention program
- Evaluation questionnaire after last training session
- Semi-structured interviews with facility managers
- Group interviews with care staff
- Group interview with PACE coordinators
- Online discussion group with trainers from all countries
  1. aBecause of the limited duration of the study, we will measure intention for maintenance instead of actual maintenance