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Table 1 Example indicators and data method/source based on the RE-AIM domains

From: MSF experiences of providing multidisciplinary primary level NCD care for Syrian refugees and the host population in Jordan: an implementation study guided by the RE-AIM framework

Objective / domain (questions) Sub-domain Indicator Methods
(a methodology may feature under several headings)
Reach
• Target population reached?
Coverage ▪ % people among the target population eligible for programme and number served by the programme
▪ Prevalence of NCD and MH comorbidityb
• Existing MSF household survey a
• Routine cohort data
• Qualitative data
“Effectiveness”/ Quality of Care
▪ Trends in clinical outcomes and quality indicators?
▪ Perceived benefits/unintended consequences from a patient and provider perspective?
Clinical Outcomes ▪ % HTN patients with most recent BP < 140/90 mmHg, 6 & 12 months post enrolment and trend from baselineb
▪ % Patients with diabetes with last HbA1c < 8.0% 6 & 12 months post enrolment and trend from baselineb
▪ % Patients who report decreased/quitting smoking
• Routine cohort data
• Qualitative data
Quality Indicators ▪ % activec CVD patients prescribed a statin
▪ % COPD/ asthma patients with inhaler technique check documented
▪ Trend in defaultersc and deaths as a proportion of active cohort
• Clinical audit
• Routine cohort data
Perceived Effectiveness ▪ Patients’ and providers’ perspectives on effectiveness of programme components (clinical review, medications, HE, HLO, MHPSS, HV) • Qualitative data
Adoption/ acceptance
▪ Care model accessible and acceptable to patients, providers, organisation and community?
▪ Guideline acceptable to staff?
Accessibility/ acceptability ▪ Availability and accessibility / barriers to access
▪ Acceptability/usability of NCD guideline
▪ Self-reported medication adherence and medication beliefs
▪ Routine cohort data
▪ Qualitative data
▪ Self-report medication adherence questionnaire
Adoption/participation ▪ Description of intervention location, cadres of staff and qualifications
▪ Experience of receiving and providing NCD care, use of clinical guideline
▪ How participation influenced patient/staff well-being and/or work practices
▪ Routine cohort data
▪ Qualitative data
Implementation
▪ Intervention delivered as intended?
▪ Facilitators and barriers to implementing the programme?
▪ Essential components and adaptations necessary?
▪ Implementation costs?
Fidelity of programme delivery ▪ % DM patients with micro-albuminuria or urinary protein tested
▪ % Activec cohort attending a health education session at last clinical visit
▪ No. of MHPSS group sessions monthly during reporting period
▪ Clinical audit
▪ Routine cohort data
Adaptations • NCD care adaptations to local setting (e.g. cultural; dietary, exercise)
• Programme adaptations related to humanitarian setting e.g. response to patients’ psychosocial needs
▪ Qualitative data
Cost • Staff time;
• Capital and recurrent implementation costsb
▪ Qualitative data
▪ Medicine/supply/ staff costsb
▪ Staff time estimates
Maintenance
• Challenges and facilitators for patients to stay in programme?
• Organisational challenges, and costs; adaptations made to maintain programme?
Individual Level • % Patients activec 6 months post enrolmentb
• Self-reported medication adherence rates
• Key challenges in altering lifestyle (diet, exercise, smoking)
▪ Routine cohort data
▪ Clinical Audit
▪ Qualitative data
▪ Medicine/supply/staff costsb
▪ Staff time estimates
▪ Self-report medication adherence questionnaire
Organisational Level • Measures of cost of maintenanceb
• Institutionalisation of the programme/modifications made for maintenance
• Alignment with organisational mission
  1. Key: BP blood pressure, COPD chronic obstructive pulmonary disease, CVD cardiovascular disease, HbA1c glycosylated haemoglobin, HLO humanitarian liaison officer, HV home visit, MH mental health, MHPSS mental health and psychosocial support, NCD non-communicable disease
  2. aRelevant methods and results are reported in Rehr et al. [19]
  3. bDetailed methods and results are reported in linked papers [20, 21]
  4. c“Active patients” means continued to attend the service and not exited [i.e. died, departed the area or defaulted (i.e. have not attended for more than 90 days since their last planned appointment)]