Table 5 Study outcomes
RE-AIM component | Outcome measures |
|---|---|
Reach | • Rate of clinic encounters where SDH is documented: among any patients and targeted patients |
Effectiveness—secondary outcome (among patients with/at risk for diabetes, a subset of study CHC patients) | Rate of all/targeted patients seen that month who have:  • Controlled diabetes risks (BP < 140/80; A1c < 7.0%; BMI < 30; LDL < 100 mg/dL)  • Incident comorbidities, e.g., retinopathy, neuropathy  • Up-to-date diabetes tests (lipid panel, HbA1c, eye/foot exams) |
Adoption—primary outcome | Rate of  • All patients seen for whom SDH data are documented  • Targeted patients seen for whom SDH data are documented  • Patients with an identified SDH need with documented referrals to community agencies: overall; among those who requested clinic assistance; and according to reported SDH needs |
Implementation | • Participation in implementation support activities • Realist evaluation results |
Maintenance | • All measures over time • Change in diabetes risks/measures over time |