A RE-AIM analysis of the sources of strength program in a United States high school


Health Promotion and Physical Education

Document Type


Publication Date



The purpose of this study was to analyze the Sources of Strength program implemented at a high school in the southeastern United States using the RE-AIM framework. Students (n = 1,250) were recruited from one high school in the southeastern United States that was implementing Sources of Strength. College undergraduate students mentored high school peer leaders to implement Sources of Strength to promote opioid and suicide protective factors for the high school. This was a cross-sectional design in which a post-implementation survey assessed program effectiveness, satisfaction, and feedback for maintenance. Analysis used the RE-AIM framework of reach, effectiveness, adoption, implementation, and maintenance. Reach: 100 % of students participated in at least one campaign. Effectiveness: Mean protective factor scores were 3.83 for happiness; 3.93 for knowledge of coping skills, and 3.38 for practice of coping skills. Adoption: One high school and 100 % of classrooms participated in at least one campaign. Implementation: 18 high school peer leader meetings were facilitated by the undergraduate mentors. Maintenance: High school students qualitatively provided input on future campaign needs, and the program was continued following this RE-AIM analysis. The Sources of Strength program promoted suicide and opioid protective factors in high school students during COVID-19. Future research should compare the efficacy of Sources of Strength at baseline and follow-up with multiple high school sites.

Journal Title

Preventive Medicine Reports

Journal ISSN




Digital Object Identifier (DOI)