WISEWOMAN Best Practices Toolkit:
Lessons Learned from Selected Projects

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The Best Practices Toolkit is available in both HTML format using the Toolkit Chapters links on the right-side menu on each page, as well as in PDF format in it's entirety below, and by chapter on each chapter's HTML page.

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Toolkit Overview

Toolkit Chapters
	Index Page
	Chapter I: Methods Used to Identify Best Practices
	Chapter II: REACH
	Chapter III: Effectiveness
	Chapter IV: Adoption
	Chapter V: Implementation
	Chapter VI: Maintenance
	Appendix A: Tools from the Field
	Appendix B: Descriptions of Projects Included in Study

General Information about the Toolkit

Welcome to the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Best Practices Toolkit.  The toolkit provides guidance, resources, and technical tools to help WISEWOMAN programs serve women.  The described practices address recruitment and engagement of program participants, lifestyle intervention delivery, facilitation and maintenance of behavior change, and participant retention in the WISEWOMAN program.  The toolkit also lists strategies to assist WISEWOMAN projects in recruiting and retaining local sites and in facilitating local site adoption of the described practices.

The toolkit is a compendium of best program practices identified through in-depth case studies with selected WISEWOMAN projects.  The methods used to identify best practices are outlined in Chapter I.  The toolkit is meant as a reference guide from which projects and local sites can select practices that might be useful in their states or tribal organizations.  The writers recognize that the practices included in this toolkit might not be effective in all settings; therefore, the toolkit is not meant to dictate practices that all projects should use.

Target Audience

The primary audience for the toolkit consists of Centers for Disease Control and Prevention (CDC)-funded WISEWOMAN projects and their local sites.  Programs interested in learning more about WISEWOMAN should contact CDC.  WISEWOMAN is a trademarked brand and use of the name should be discussed with CDC. 

While many of the practices are specific to WISEWOMAN, it is anticipated that the toolkit will appeal to a broader audience.  This audience includes practitioners delivering public health and health promotion interventions that target cardiovascular disease and provide lifestyle interventions.  In addition, practitioners working more broadly in public health and health promotion might find adaptable practices in the toolkit.

Toolkit Organization

The toolkit is organized around the five dimensions of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) developed by Dr. Russell Glasgow and colleagues.¹  The purpose of RE-AIM is to facilitate evaluations of the translatability and overall public health impact of a health promotion intervention.  The framework specifies dimensions at the individual and institutional levels.  For this study, dimensions are defined as (1) the intervention’s reach into the intended population, (2) its effectiveness in modifying risk, (3) its adoption by target settings, (4) its consistent implementation, and (5) maintenance of its effects among participants and target settings.

The best practices for each RE-AIM dimension are presented in Chapters II–VI.  For simplicity, the Reach, Effectiveness, Adoption, Implementation, and Maintenance chapters are formatted in an identical manner.  The first page of each chapter provides a definition of the RE-AIM dimension to be presented, an illustration of how the dimension applies to WISEWOMAN, a description of the practices that fit within the dimension, and an overview of the information included in the chapter.  The page numbers for key sections of the chapter are also listed on this page.

Starting on the second page of each chapter is a table with “Snapshots of Practices from Selected Projects.”  In this table, the best practices are listed by category.  All practices are numbered sequentially and subpractices are numbered to coordinate with the associated practice.  For example, if a main practice is numbered “3,” the subpractice is numbered “3A.”    Each snapshots table has columns for Project-Level Practice, Local-Level Practice, Page Described, and Tool Included on Page.  Checkmarks in the first two of these columns (project- and local-level practices) indicate whether the best practice applies to the project-level, the local-level, or both.  The page on which each practice is described in detail is listed under the Page Described column.  If a technical tool from the field is available for a given practice, the page where this tool can be found is listed under the Tool Included on Page column.  All tools are provided in Appendix A of the toolkit.

The next pages of each chapter present Details of Practices from Selected WISEWOMAN Programs.  Each practice is presented in this section as described in the table below. 

The final section of each chapter is an Action Checklist.  This is another list of the practices in the chapter (grouped by categories) that is aimed at engaging toolkit users by encouraging them to mark practices that they might consider using in their project or local site.  The main column in the table is labeled “Is the Project or Site Interested in Adopting this Strategy?” for this purpose.

Definitions

Terms frequently used in the toolkit are defined below:

Best Practices are project or local site activities, practices, or processes that are considered successful for delivering WISEWOMAN program services, as indicated by quantitative measures combined with systematically gathered qualitative data.  Best practices take into account existing variation in the program and policy, cultural, socioeconomic, and geographic contexts in which WISEWOMAN projects operate.

Core Elements are central to an intervention’s theory and internal logic.  Core elements are critical features of the intervention’s intent and should be kept intact when the intervention is implemented or adapted for it to produce program outcomes similar to those of the original research.²

Local-Level Practices are practices that this study identified and that are directly applicable to local sites delivering WISEWOMAN program services.  Toolkit users who do not have WISEWOMAN projects might also find these practices of interest.

Project-Level Practices are practices that this study identified and that are directly applicable to WISEWOMAN projects that typically operate at the state or tribal level and oversee multiple local sites.  Toolkit users who do not have WISEWOMAN projects might also find these practices of interest. 

The RE-AIM framework was developed by Glasgow and colleagues to facilitate evaluation of the translatability and overall public health impact of a health promotion intervention.  The framework identifies five dimensions (reach, effectiveness, adoption, implementation, and maintenance):

• Reach is the degree to which women participate in WISEWOMAN and their representativeness.³
• Effectiveness is the extent to which modifications in risk factors occur as a result of WISEWOMAN participation.³
• Adoption is the degree to which provider sites and service delivery settings adopt WISEWOMAN.³
• Implementation is the extent to which the program and its lifestyle intervention are delivered as intended.³
• Maintenance is the extent to which a program is sustained over time and health improvements in women are maintained over time.³

References

1. Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89(9):1322-7.
    

2. McKleroy VS, Galbraith J, Cummings B, Jones P, Harshbarger C, Collins C, et al. Adapting evidence-based behavioral interventions for new settings and target populations. Atlanta (GA): Centers for Disease Control and Prevention; 2006.
    

3. Definitions of RE-AIM dimensions have been adapted to reflect the WISEWOMAN program.
    

Page last reviewed: July 10, 2007
Page last modified: July 10, 2007

Content source: Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion