Scaling Up [to] a Population Health Intervention: A Readiness Assessment Framework
Abstract
Background: Attempts to scale up a population health intervention (PHI) have achieved variable success, which, in part, is attributable to limited knowledge of scale up and lack of systematic guidance to support successful scale up. The concept of readiness is underrepresented in scale up and its consideration may improve the likelihood of success.
Objective: To develop and assess a conceptual framework focused on the successful scale up of a PHI, which may be employed to gauge a PHI’s readiness for scale up success.
Theoretical framework: This study integrated diffusion of innovations, organizational readiness for change, and complex adaptive systems theories.
Methods and Results: The Scale Up Readiness Assessment Framework was developed and refined through a primarily qualitative methods design with three complementary studies, which were informed by the theoretical and empirical literature. Study one used a critical interpretive synthesis of the literature to develop the Framework. The synthesis identified 11 important actions in the successful scale up of a PHI, which were organized into three phases: Groundwork, Implementation, and Sustainment. Key components and hallmarks of a successful scale up approach were also determined. Study two used a modified Delphi method to assess content and face validity of the Framework’s actions and phases. A panel of PHI and scale up experts agreed all phases and actions were important; the Groundwork phase and six actions were representative of a successful scale up; and all were logically presented. Experts’ assessments guided the Framework’s second version. Study three involved pilot tests with potential users of the Framework (version 2.0), who commented how the Framework’s utility, value, and face validity might apply to their PHI. Participants concluded the Framework was informative, offered valuable guidance, and may serve multiple purposes beyond readiness assessment. Pilot feedback led to a final Framework revision (version 3.0).
Conclusion: This research provides important conceptual advancements and insights regarding the practice of successful scale up. The research produced a usable product, the Framework, which may be used by academic and government PHI stakeholders for scale up readiness assessment and planning. Learnings from this framework have potentially diverse applications beyond its initial intended purpose.
Description
Keywords
Public Health
Citation
Nguyen, D. T. (2016). Scaling Up [to] a Population Health Intervention: A Readiness Assessment Framework (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/27710