Scaling up public health interventions

What is the issue?

Even where there is evidence that a prevention program is effective, not every intervention can or should be scaled up. Scaling up requires considerable financial and human resources, so it is important that decision makers choose interventions that are likely to succeed and be sustainable at scale.

There has been little Australian research into which factors should be taken into consideration when deciding whether to scale up an intervention. As a consequence, decisions about which programs to scale up may be influenced by political, strategic and infrastructure requirements, rather than by evidence of their scalability.

There are several scaling up frameworks and guides in Australia. All of these require an initial assessment of the scalability of the intervention. This PhD project aims to assist policy makers, program managers and other decision makers to make more robust decisions when considering which programs and interventions to scale up.

How did the project address the issue?

This project built on previous understanding of the different pathways to scaling up. PhD canditate, Karen Lee, investigated how scaling up is being implemented in Australia and also examined the facilitators and barriers that decision makers encounter when scaling up.

Karen developed and tested the Intervention Scalability Assessment Tool (ISAT) for policy makers to help them assess the scalability of public health interventions. This can support policy makers and practitioners consider all the different factors that may influence decisions on whether to scale up an intervention, such as financial sustainability, workforce issues and how to maintain fidelity.

Relevance for practice

It is hoped this work will provide policy makers with robust evidence of potential success factors that can be taken into account in future scaling up decisions.

Policy makers were provided with resources and support on how to plan for scaling up, and evidence to inform better decisions on which interventions are suitable for scaling up.

What were the outcomes?

The Intervention Scalability Assessment Tool (ISAT) is accompanied by a guide on how to complete an assessment and a scoring sheet in Excel is also available to help score readiness questions within the guide.

• The Intervention Scalability Assessment Tool: Instruction sheet (PDF 470 KB)
• The Intervention Scalability Assessment Tool: A guide for assessing the scalability of health interventions (PDF 1.3MB)
• The ISAT scoring sheet (Excel 76KB)

The International Agency for Research on Cancer, World Health Organization based in Nice, France has translated the ISAT into French for use in assessing the scalability of a number of their interventions in Morocco, with the Moroccan Ministry of Health.

• • French translation: The Intervention Scalability Assessment Tool: A guide for assessing the scalability of health interventions (PDF 1.0MB)
  • French translation: The ISAT scoring sheet (Excel 76KB)