In 2018, the article Assessment of scalability of evidence-based innovations in community-based primary health care: a cross-sectional study was published. France Légaré, Scientific Director of the Université Laval branch of the Change Management axis of our unit, is a member of the writing team.
Context
In 2013, the Canadian Institutes of Health Research supported twelve teams to develop evidence-based innovations in primary health care and assess their scalability. This study aimed to explore the scalability of these innovations.
Methods
The authors conducted a cross-sectional study involving the twelve teams, who were invited to assess the scalability of their innovations. A self-administered questionnaire was developed based on a systematic literature review. The tool included 16 criteria grouped into five dimensions: theory, impact, coverage, setting, and cost. Data were analyzed using frequency counts and cluster analysis. The unit of analysis was the innovation.
Results
Of the twelve invited teams, eleven participated in the study. Together, they assessed 33 innovations (median of 3 per team). The innovations focused on access to care, prevention, and chronic disease management. Most were health interventions (n = 21), followed by analytical methods (n = 4), conceptual frameworks (n = 4), measures (n = 3), and capacity-building strategies (n = 1). Most innovations met the theoretical dimension criteria (n = 29), followed by impact (mean = 22.3), setting (21.7), cost (17.5), and coverage (14.0). On average, innovations met 10 out of the 16 criteria. Adoption was the least assessed criterion (n = 9). Twenty innovations were deemed highly scalable.
Conclusion
Scalability varied across innovations, revealing uneven preparedness for scaling. The coverage dimension was under-assessed, highlighting the need for further study to better evaluate the scalability of evidence-based practices in primary care.