Maintenance and Sustainability

Number of Models:
information tooltip image The number of models that include elements aligned with the given construct.


information tooltip image Components abstracted from each model and aligned with the given construct.

Adoption, Implementation and Institutionalization

Cost-efficacy and Feasibility

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

Phase 4: Spread of Effective CW Implementation Program

Practice Integration




Sustainable Ongoing Learning System



information tooltip image The definition of the construct.

Maintenance: 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.

Related Models

information tooltip image External link to measures on the GEM site for the given construct.

GEM D&I link: Maintenance and sustainability