In the RE-AIM framework, how is 'adoption' measured?

• A. Proportion and representativeness of settings/organizations that deliver the program.
• B. Number of participants who complete the program.
• C. Long-term health outcomes in the target population.
• D. Cost per participant.

Answer: (A)

Adoption looks at how widely and who actually starts delivering the program in real-world settings. It measures the proportion of settings or organizations that choose to implement the program and, just as importantly, how representative those adopting settings are of all potential settings. This matters because a program can be effective in theory, but if only a small, non-representative slice of settings adopt it, the real-world impact will be limited and not generalizable to the broader population. So the best way to capture adoption is to consider both how many settings adopt and how well their characteristics reflect the range of settings that could adopt the program.

The idea differs from participant-focused measures (which look at how many people participate or complete the program), outcomes-focused measures (which look at long-term health effects), or cost-focused measures (which look at the expense per participant).