A guide to scaling up population health interventions

Abstract

The 'how to' of scaling up public health interventions for maximum reach and outcomes is receiving greater attention; however, there remains a paucity of practical tools to guide those actively involved in scaling up processes in high-income countries. To fill this gap, the New South Wales Ministry of Health developed Increasing the scale of population health interventions: a guide (2014). The guide was informed by a systematic review of scaling up models and methods, and a two-round Delphi process with a sample of senior policy makers, practitioners and researchers actively involved in scaling up processes.Although it is a practical guide to assist health policy makers, health practitioners and others responsible for scaling up effective population health interventions, it can also be used by researchers in the design of research studies that are potentially suitable for scaling up, particularly where research-practice collaborations are involved. The guide is divided into four steps: step 1, 'scalability assessment', aims to determine if an intervention is scalable; step 2, 'developing a scale up plan', aims to develop a practical and workable scaling up plan that can be used to convince stakeholders there is a compelling case for action.Step 3, 'preparing for scale up', aims to identify ways of securing resources needed for going to scale, operating at scale, and building a foundation of legitimacy and support to sustain the scaling up effort through the implementation stage; and step 4, 'scaling up the intervention', involves putting the plan developed in step 2 into place.Although the guide is written as though the user is starting from the point of assessing the scalability of an intervention, later steps can be used by those already involved in scaling up to review their implementation processes. The guide is not intended to be prescriptive. Its purpose is to help policy makers, practitioners, researchers and other decision makers decide on appropriate methodological and practical choices, and balance what is desirable with what is feasible.

Feasibility and efficacy of the Great Leaders Active StudentS (GLASS) program on children’s physical activity and object control skill competency: A non-randomised trial

“…8 The findings of the study hold promise given the potential scalability of the program. 25 Other studies that have seen similar improvements in students' FMS competency have often involved intensive, multi-component interventions, 8 often relying on the classroom teacher to deliver. The use of multiple peer-leaders to deliver the program may reduce the burden on teachers and hence improve the sustainability of the programme.…”

A systematic review of community‐based interventions for the treatment of adolescents with overweight and obesity

“…Milat et al . identify potentially scalable programs as those achieving a significant intervention effect . Ideally, the effect size is large as it will decrease when the program is scaled up.…”

“…Ideally, the effect size is large as it will decrease when the program is scaled up. Adapting the program to suit the local context and the available organizational, financial and human resources is important for acceptability and efficiency but may reduce effectiveness . Scalability needs to be considered with regard to realistic community delivery and resourcing and be balanced with participant need and expectation .…”

Essential items for reporting of scaling studies of health interventions (SUCCEED): protocol for a systematic review and Delphi process

“…The aim of this project is to develop the SUCCEED, a reporting guideline for studies assessing scaling strategies. [1,5,10,12,21,22] To accomplish this, specific objectives are follows: (1) establish an executive committee that will oversee the development process of the guideline, (2) review the literature to document current reporting and identify relevant items for a reporting guideline for studies assessing the impact of scaling strategies, (3) prioritize items for a reporting guideline for studies assessing the impact of scaling strategies using a Delphi process and/or a consensus meeting, (4) pilot test the new reporting guideline SUCCEED, and (5) develop a comprehensive dissemination plan.…”