Construct Details

ConstructMaintenance and sustainability
DefinitionMaintenance: The extent to which a program or policy becomes institutionalized or part of the routine organizational practices and policies. Maintenance in the RE-AIM framework also has referents at the individual level. At the individual level, maintenance has been defined as the long-term effects of a program on outcomes after 6 or more months after the most recent intervention contact.
Sustainability: "Extent to which a newly implemented treatment is maintained or institutionalized within a service setting’s ongoing, stable operations." A part of late implementation stages, sustainability of a treatment/innovation can be observed within aspects of organizational culture through "policies and practices." Often there is high sustainability when penetration is strong.

Sustainability is also defined as the existence of structures and processes which allow a program to leverage resources to most effectively implement evidence-based policies and activities over time.
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Adoption, Implementation and Institutionalization

Developing Mechanisms to Maintain the Innovation Over Time

Expectation of sustainability

Feasibility, fidelity, penetration, acceptability, sustainability, uptake, costs

Integrate & Maintain



Integration of Evidence into Practice

Maintain program/services


Maintenance and Evolution

Organizational and Financial Changes to sustain intervention

Practice Integration




Sustainable Ongoing Learning System



ModelsConduct and Utilization of Research in Nursing (CURN)

ACE Star Model of Knowledge Transformation

Technology Transfer Model

Framework for the Dissemination & Utilization of Research for Health-Care Policy & Practice

Framework of Dissemination in Health Services Intervention Research

Knowledge Exchange Framework

Framework for Dissemination of Evidence-Based Policy

Framework for the Transfer of Patient Safety Research into Practice

Interacting Elements of Integrating Science, Policy, and Practice

Dissemination of Evidence-based Interventions to Prevent Obesity

RE-AIM Framework

Facilitating Adoption of Best Practices (FAB) Model

CDC DHAP's Research-to-Practice Framework

Practical, Robust Implementation and Sustainability Model (PRISM)

Active Implementation Framework

Conceptual Model of Implementation Research

Sticky Knowledge

Replicating Effective Programs Plus Framework

Exploration, Preparation, Implementation, Sustainment (EPIS) model (Conceptual Model of Evidence-based Practice Implementation in Public Service Sectors)

General theory of implementation

A Model for Evidence-Based Practice

Framework for Enhancing the Value of Research for Dissemination and Implementation

Number of Models22
MeasureGEM D&I link: Maintenance and sustainability