{"doi":"10.3389/fpubh.2025.1588457","title":"The application of the RE-AIM and PRISM framework to process evaluations of diabetes self-management programs: a systematic review and secondary analysis of literature","abstract":"<jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>Diabetes self-management programs, often known as DSMPs, are crucial interventions for enhancing clinical and behavioral outcomes in individuals with diabetes. Despite the well-established advantages of these programs, little is known about how they are carried out and maintained in real world environments. This systematic review builds upon a previously published prequel by applying the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) and PRISM (Practical, Robust Implementation and Sustainability Model) frameworks to examine the process evaluations of traditional, group-based DSMPs, with the goal of identifying implementation strengths, gaps, and contextual influences.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>\n                      Using five databases, a comprehensive analysis of peer-reviewed literature up to January 2024 was performed. Eligible studies included traditional, group-based DSMPs for adults with type 1 or type 2 diabetes that reported at least one process evaluation outcome. Sixty-eight studies (\n                      <jats:italic>n</jats:italic>\n                       = 78 articles) met inclusion criteria. Data were extracted and synthesized using RE-AIM and PRISM components, and study quality was appraised using the Mixed Methods Appraisal Tool (MMAT).\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>\n                      Sixty-eight studies (k = 68;\n                      <jats:italic>n</jats:italic>\n                       = 78) satisfied the requirements for inclusion. Fewer research addressed Adoption (k = 5), Implementation (k = 24), and Maintenance (k = 26), whereas the majority focused on Reach (k = 66) and Effectiveness (k = 66). Only four studies found external contextual influences, compared to nineteen that found internal contextual elements. Process-level indicators—such as implementation fidelity, cost, sustainability, and provider engagement—were often underreported, despite consistent evidence of positive clinical and behavioral outcomes.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion</jats:title>\n                    <jats:p>The review highlights a critical gap between outcome evaluation and implementation reporting in DSMP research. The organizational and contextual elements that affect program scalability and durability were overlooked in favor of patient-level outcomes in most of the studies. When the RE-AIM and PRISM frameworks were used systematically, it was discovered that several process components that are essential for long-term integration were underreported. Resolving these shortcomings can help direct the creation of scalable, context-aware DSMPs that are more adaptable to diverse populations and settings.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>Process evaluations should be thorough, context-sensitive, and theory-driven to improve the implementation, execution, and long-term effects of DSMPs. A more comprehensive analysis of program success is made possible by integrating the RE-AIM and PRISM frameworks, which closes the gap between research and real-world implementation. To educate healthcare policy and practice, future evaluations should use mixed method designs that evaluate implementation as well as results.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration</jats:title>\n                    <jats:p>This systematic review was registered in PROSPERO. The registration number is CRD42020177170.</jats:p>\n                  </jats:sec>","journal":"Frontiers in Public Health","year":2025,"id":628682,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1627814,"name":"Yeka Nmadu","orcid":null,"position":1,"is_corresponding":false},{"id":651993,"name":"Nikita Sandeep Wagle","orcid":"0000-0003-1337-483X","position":2,"is_corresponding":false},{"id":1627815,"name":"Oluwafemi Aremu","orcid":null,"position":3,"is_corresponding":false},{"id":1627816,"name":"Allen Eruaga","orcid":null,"position":4,"is_corresponding":false},{"id":1627817,"name":"Ngalula Dolly Mwintshi","orcid":null,"position":5,"is_corresponding":false},{"id":1627818,"name":"Mariam Olamide Salis","orcid":null,"position":6,"is_corresponding":false},{"id":1627819,"name":"Margaret J. Foster","orcid":null,"position":7,"is_corresponding":false},{"id":469099,"name":"Matthew Lee Smith","orcid":"0000-0002-8232-9285","position":8,"is_corresponding":false},{"id":469101,"name":"Marcia G. Ory","orcid":"0000-0001-8036-2383","position":9,"is_corresponding":false},{"id":1627813,"name":"Chinelo Nsobundu","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"The application of the RE-AIM and PRISM framework to process evaluations of diabetes self-management programs: a systematic review and secondary analysis of literature","abstract":"<jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>Diabetes self-management programs, often known as DSMPs, are crucial interventions for enhancing clinical and behavioral outcomes in individuals with diabetes. Despite the well-established advantages of these programs, little is known about how they are carried out and maintained in real world environments. This systematic review builds upon a previously published prequel by applying the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) and PRISM (Practical, Robust Implementation and Sustainability Model) frameworks to examine the process evaluations of traditional, group-based DSMPs, with the goal of identifying implementation strengths, gaps, and contextual influences.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>\n                      Using five databases, a comprehensive analysis of peer-reviewed literature up to January 2024 was performed. Eligible studies included traditional, group-based DSMPs for adults with type 1 or type 2 diabetes that reported at least one process evaluation outcome. Sixty-eight studies (\n                      <jats:italic>n</jats:italic>\n                       = 78 articles) met inclusion criteria. Data were extracted and synthesized using RE-AIM and PRISM components, and study quality was appraised using the Mixed Methods Appraisal Tool (MMAT).\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>\n                      Sixty-eight studies (k = 68;\n                      <jats:italic>n</jats:italic>\n                       = 78) satisfied the requirements for inclusion. Fewer research addressed Adoption (k = 5), Implementation (k = 24), and Maintenance (k = 26), whereas the majority focused on Reach (k = 66) and Effectiveness (k = 66). Only four studies found external contextual influences, compared to nineteen that found internal contextual elements. Process-level indicators—such as implementation fidelity, cost, sustainability, and provider engagement—were often underreported, despite consistent evidence of positive clinical and behavioral outcomes.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion</jats:title>\n                    <jats:p>The review highlights a critical gap between outcome evaluation and implementation reporting in DSMP research. The organizational and contextual elements that affect program scalability and durability were overlooked in favor of patient-level outcomes in most of the studies. When the RE-AIM and PRISM frameworks were used systematically, it was discovered that several process components that are essential for long-term integration were underreported. Resolving these shortcomings can help direct the creation of scalable, context-aware DSMPs that are more adaptable to diverse populations and settings.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>Process evaluations should be thorough, context-sensitive, and theory-driven to improve the implementation, execution, and long-term effects of DSMPs. A more comprehensive analysis of program success is made possible by integrating the RE-AIM and PRISM frameworks, which closes the gap between research and real-world implementation. To educate healthcare policy and practice, future evaluations should use mixed method designs that evaluate implementation as well as results.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration</jats:title>\n                    <jats:p>This systematic review was registered in PROSPERO. The registration number is CRD42020177170.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41458425","pmcid":"PMC12740919","openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://public-pages-files-2025.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1588457/pdf","host_type":"publisher"},{"url":"https://www.frontiersin.org/articles/10.3389/fpubh.2025.1588457/full","host_type":"publisher"},{"url":"https://doaj.org/article/6dcf6f78bfb5429392685524fab3dc16","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12740919/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12740919","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12740919?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Humans","Self-Management","Program Evaluation","Diabetes Mellitus","Diabetes Mellitus, Type 2","Process Assessment, Health Care"],"mesh_terms":["Humans","Diabetes Mellitus","Diabetes Mellitus, Type 2","Program Evaluation","Self-Management","Process Assessment, Health Care"],"keywords":["Implementation","Process Evaluation","Prism","Reaim","Diabetes Self Management"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-05T14:36:19.661150Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}