Integrating the RE-AIM Framework and Theory of Change in the Evaluation of Health Interventions: Scoping Review

Background Frameworks for implementation evaluation and program theory have been increasingly used to support the design, implementation, and assessment of complex health interventions. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework provides a structured approach to evaluating reach, effectiveness, adoption, implementation, and maintenance, while the theory of change and logic models explicitly articulate causal mechanisms and pathways of impact. Despite their conceptual complementarity, how these approaches have been jointly applied in empirical studies, particularly in digital health and telehealth contexts, remains insufficiently mapped. Objective This scoping review aimed to map and characterize how empirical studies have integrated the RE-AIM framework with theory of change or logic models in the design, implementation, and evaluation of health interventions; identify levels and patterns of integration; and examine how this combined use has been applied in digital health and telehealth interventions. Methods A scoping review was conducted following the methodological guidance of the Joanna Briggs Institute and reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. Searches were performed in the PubMed (MEDLINE), Embase, Scopus, and Web of Science databases without restrictions on language, study design, or publication year. Eligible sources were studies, protocols, implementation reports, and other indexed publications that explicitly addressed both the RE-AIM framework and theory of change or logic models in the context of health interventions. Data were extracted using a structured chart and analyzed descriptively to identify characteristics of the included studies, levels of framework integration, and patterns of use across intervention types. Results A total of 28 studies published between 2016 and 2025 met the inclusion criteria. Digital health or telehealth constituted a core component in 21.4% (n=6), was present in a limited or secondary role in 21.4% (n=6), and was not identified in 57.1% (n=16) of the studies. Strong integration between the RE-AIM framework and theory of change or logic models was identified in 57.1% (n=16) of the studies, moderate integration was identified in 35.7% (n=10), and weak integration was identified in 3.6% (n=1); integration was classified as not applicable in 3.6% (n=1) of the studies, which were of a methodological and conceptual nature. Conclusions The integration of the RE-AIM framework with theory of change or logic models represents a promising methodological strategy for strengthening the planning, implementation, and evaluation of complex health interventions, including digital health initiatives. While the combined use of these frameworks has increased over time, important gaps persist, particularly regarding long-term sustainability assessment and systematic application in telehealth and digital health contexts. Greater methodological rigor and deeper integration between causal models and implementation metrics are needed to advance the field.