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What is the REAIM framework?

Before HAT, it is important to consider the stages of implementation and the enablers and potential barriers to implementation.

In this article you will find out more details on implementation. An implementation framework worth mentioning is the RE-AIM framework (see figure 1). This stands for:

  • R – Reach (reaching the target population);
  • E – Effectiveness;
  • A – Adoption (by target staff or institutions);
  • I – Implementation (consistency, costs, and adaptations made during delivery);
  • M – Maintenance (of intervention effects in individuals and settings over time).

The goal of RE-AIM is to provide a framework to improve the sustainable adoption and implementation of effective, generalisable and evidence-based practices. This is designed for practitioners, programme implementers/planners, funders, researchers and policymakers.

RE-AIM Framework by Belza, Toobert & Glasgow (2006)(Click to expand)
Figure 1: RE-AIM Framework by Belza, Toobert & Glasgow (2006)

Readiness for change

However, before practice can change or a new programme or way of working is introduced the practice or the organisation must be ready for change. This is an important first step to explore. The Hexagon Tool can be used as a planning tool to evaluate potential interventions during the Exploration Stage of implementation. Using the table below the practitioner or organisation can rate the following aspects of implementation readiness in accordance with the intervention. By simply ticking the appropriate box we can assess where more preparation may be needed.

High Medium Low
Resource availability
Intervention readiness
Capacity to implement

Table 1: Rating readiness for change and implementation of a new practice or programme within a setting in the planning and preparation stages

To conclude, before implementing the Healthy Addiction Treatment (HAT) recovery model or indeed any other model or programme into your practice, it is important to consider the stages of implementation and the enablers and potential barriers to implementation.

The needs of your clients or patients must be assessed to ensure that they are the focus. Readiness for change must be assessed in the early stages. Finally, and perhaps most importantly, we should mention the importance of good leadership. This, we know, can be in the form of distributed leadership, where all members of the team including your clients in a co-creation process can share both the challenges and the rewards of improved practice.

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Identifying and Responding to Drug and Alcohol Addiction in Nursing, Midwifery and Allied Healthcare Practice

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