Scaling up interventions: Making sure bigger is better

What is the issue?

Scaling up – that is efforts to expand public health interventions from small-scale feasibility studies to wider state, national and international roll-out – is an important way to achieve population-wide health improvements. However, not all interventions that work on a small scale can be expanded under real-world conditions to reach more people and still be effective.

There is limited literature describing frameworks for scaling up public health interventions. Additionally, these frameworks remain largely untested using real-world policy and practice case studies and pay insufficient attention to the economic and system factors that might inform scaling up such interventions.

How did the project address the issue?

The project aimed to address gaps in the literature through:

• A systematic review of models for scaling up health interventions
• Case studies of scaled-up prevention interventions in Australia, successful and unsuccessful
• Testing current scaling-up models with real-world policy and practice interventions
• Further developing conceptual models and tools for scaling up using systems thinking and economic methods.

What were the outcomes?

Tools and guidelines for policy makers, practitioners and researchers to use to scale up health interventions.

Relevance for practice

This research helped define and characterise examples of scaled-up interventions in Australia and elsewhere. This is relevant to research translation and to identifying system approaches to chronic disease prevention.

Case studies and reviews identified the components that contribute to successful scaled-up health interventions. These outcomes will assist policy makers and practitioners to use best practice when scaling up public health interventions.