Social Impact Measures
Social impact refers to the impact of an intervention on communities and society as a whole. Measures of social impact assess outcomes that go beyond an individual and are important to society, and outcomes that are more global in nature. These measures might include patient placement, rehospitalization, emergency room use, recidivism, or use of some social program or resource such as respite services. Including these measures as indices of clinical significance needs to be done with caution. One issue is that these are gross measures and subject to other influences such as changes in policy or budget cuts. The psychometric properties of these types of measures are also problematic as errors can result from inconsistencies in data-reporting or data-capture techniques. In essence, it is often difficult to link changes in these types of measures with an intervention; absence of change on these measures may not necessarily imply that a program is not impactful (Kazdin, 1994).
The Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) Framework (Glasgow, Vogt, & Boles, 1999) can be conceptualized as an evaluation framework that can be used to assess the social impact of interventions. This framework assesses five dimensions: reach, the percentage and risk characteristics of persons who receive or are affected by a program; efficacy, positive and negative outcomes associated with a program; adoption, the proportion and representativeness of settings that adopt a program; implementation, the extent to which the program is delivered as intended; and maintenance, the extent to which the program becomes ingrained or routine and part of the everyday culture of a community or organization. Some limitations with this approach are that all of the components of the framework may not have equal weight or be needed for a particular program. There also needs to be a strategy for combining the components or indices that represented the combined impact of or interactions among the components. Further, the optimal time points for measurement need to be established.