In 2026, the article “Building a Scaling Architecture: Our Outputs, Lessons, and Perspectives” was published. Several members of our unit are part of the team that wrote it.
A multidisciplinary team bringing together members from the Canada Research Chair on Shared Decision Making and Knowledge Mobilization, VITAM – Centre de recherche en santé durable (Sustainable health research in Québec), and the Québec Learning Health Support Unit (SPOR–CIHR), including researchers, clinicians, policy-makers, as well as patient and public partners, representing diverse disciplines and continents.
- Odilon Quentin Assan
- Claude Bernard Uwizeye
- Oscar Nduwimana
- Ginette Saucier
- Roberta de Carvalho Côroa
- Amédé Gogovor
- Briscia Anaid Tinoco
- Ana Luisa Zapata Viveros
- Georgina Suelene Dofara
- France Légaré
Assan OQ, Uwizeye CB, Nduwimana O, Saucier G, de Carvalho Côroa R, Gogovor A, Tinoco BA, Zapata Viveros AL, Dofara GS, Légaré F. (2026). Building a scaling architecture: our outputs, lessons learned, and perspectives. Scaling Community of Practice (SCoP), Dalberg Catalyst. April 15, 2026.
Available at: https://scalingcommunityofpractice.com/building-a-scaling-architecture-our-outputs-lessons-and-perspectives/
Context
In response to a call for contributions from the international Scaling Community of Practice, our team proposed a synthesis of its scaling architecture. We highlighted that scaling innovations in health and social services remains complex and insufficiently structured. To strengthen its rigor, responsibility, and equity, our team has, over the past several years, developed a portfolio of evidence-informed work aimed at structuring scaling processes and supporting informed decision-making that bridges science and practice.
Methods
In this synthesis, we emphasized that the proposed scaling architecture is grounded in an integrated research program combining multiple methodological approaches:
- cross-sectional, exploratory, and thematic empirical studies;
- systematic, umbrella, and scoping reviews;
- consensus-based approaches;
- co-development of tools, training programs, and guides integrating public engagement;
- real-world case studies using experimental and mixed-methods designs;
- knowledge translation and mobilization activities at national and international levels.
Results
We highlighted several key achievements constituting the different components of this scaling architecture.
Consolidation of the evidence base
This body of work made it possible to identify key components, leverage points, and methodological gaps in scaling, including scalability assessment, economic dimensions, equity, and patient and public engagement.
Knowledge syntheses
Several major reviews were conducted, focusing in particular on scalability assessment tools, domains of scaling knowledge, patient and public engagement in scaling (REPOS), economic considerations (EcoScaling), implementation strategies, and the documentation of scaling initiatives (SUCCEED).
Tools and training
Structuring tools were developed, including ISSaQ 4.0, which includes 37 items across 12 domains and integrates equity considerations. Open-access training programs co-developed with citizens (éLARGIE, LENGAGE) were also created to support capacity building among teams involved in scaling initiatives.
Case studies
Several concrete scaling initiatives were documented, including assessments of innovation sustainability, the scaling of citizen workshops in public libraries, a stepped-wedge cluster randomized trial in shared decision making, and structured support for the scaling of local innovations.
Knowledge mobilization
Workshops, webinars, and expert briefs contributed to the uptake of scaling tools and practices by scientific, professional, and policy-making communities.
Conclusion
The findings indicate that rigorous scaling efforts rely on a solid evidence base, deliberate planning, early integration of equity and economic considerations, public engagement, and continuous adaptation to context. The scaling architecture developed contributes to structuring the scaling of innovations in health and social services in a more responsible and equitable way.