Tools for assessing the scalability of innovations in health: a systematic review

Ben Charif, Ali; Zomahoun, Hervé Tchala Vignon; Gogovor, Amédé; Abdoulaye Samri, Mamane; Massougbodji, José; Wolfenden, Luke; Ploeg, Jenny; Zwarenstein, Merrick; Milat, Andrew J.; Rheault, Nathalie; Ousseine, Youssoufa M.; Salerno, Jennifer; Markle-Reid, Maureen; Légaré, France

doi:10.1186/s12961-022-00830-5

Health Research Policy and Systems

Table 2 Characteristics of included tools

From: Tools for assessing the scalability of innovations in health: a systematic review

Name (abbreviation)^a [References]	Type and source						Scalability component targeted by tools^b											Number of items	Pitfall predictions^c
Name (abbreviation)^a [References]	Type	Year of issue or publication	Source of funding	Language	Type of stakeholder	Open-access source	C₁	C₂	C₃	C₄	C₅	C₆	C₇	C₈	C₉	C₁₀	C₁₁	Number of items	Pitfall predictions^c
Innovation Scalability Self-administered Questionnaire (ISSaQ) [2, 3]	Checklist	2017	Governmental organization	English, French	Researcher	Peer-reviewed journal		✓		✓	✓	✓	✓	✓	✓	✓	✓	16	\({\text{P}}_{3,8}\)
AnalySe de la Transférabilité et accompagnement à l’Adaptation des Interventions en pRomotion de la santE (ASTAIRE) [53, 54]		2013	Governmental organization	English, French	Researcher	Peer-reviewed journal	✓	✓		✓	✓	✓	✓	✓	✓	✓		23	\({\text{P}}_{2,3,7,8}\)
WHO/ExpendNet [123, 124]		2011	Governmental and nongovernmental organizations	English	Not found	Organizational website	✓	✓	✓	✓	✓	✓			✓	✓		23	\({\text{P}}_{1,3,4,7,8}\)
Scalability Checklist [127,128,129]		2016	Nongovernmental organization	English	Not found	Organizational website	✓			✓	✓	✓	✓	✓	✓	✓		7	\({\text{P}}_{3,8}\)
Baker et al. [47]	Criteria	2011	Governmental organization	English	Not found	ResearchGate			✓					✓	✓	✓		16	\({\text{P}}_{1,2,6,7,8}\)
Bennett et al. [48]		2017	Governmental organization	English	Not found	Peer-reviewed journal			✓		✓	✓	✓	✓		✓	✓	8	\({\text{P}}_{3,8}\)
Burchett et al. [50]		2011	Not found	English	Researcher	ResearchGate			✓		✓	✓	✓	✓	✓		✓	17	\({\text{P}}_{3,5,8}\)
Burchett et al. [51]		2012	Governmental organization	English	Clinician, policy-maker, researcher	Not found	✓		✓		✓	✓	✓	✓	✓		✓	15	\({\text{P}}_{3,6,7,8}\)
Cambon et al. [52]		2012	Governmental organization	English	Not found	Peer-reviewed journal	✓	✓	✓	✓		✓	✓	✓	✓	✓		32	\({\text{P}}_{1,3,6,7,8}\)
Process model for the assessment of transferability (PIET-T) [55]		2018	Governmental organization	English	Not found	Peer-reviewed journal	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	14	\({\text{P}}_{2,8}\)
Spicer et al. [56]		2014	Nongovernmental organization	English	Policy-maker, researcher, civil society organizations	Peer-reviewed journal	✓		✓	✓	✓	✓	✓	✓	✓			22	\({\text{P}}_{3,8}\)
Wang et al. [58]		2005	Not found	English	Not found	Not found	✓			✓			✓	✓	✓	✓		12	\({\text{P}}_{6,8}\)
Milat et al. [20, 21, 120]		2012	Governmental organization	English	Policy-maker, researcher	Peer-reviewed journal, ResearchGate, organizational website				✓	✓	✓	✓	✓	✓	✓	✓	21	\({\text{P}}_{3,5,8}\)
CORRECT attributes^d [6, 121, 122]		2010	Governmental organization	English, French, Spanish	Not found	Organizational website	✓		✓		✓	✓	✓		✓	✓		17	\({\text{P}}_{3,6,8}\)
Bhattacharyya et al. [49]	Scale	2017	Governmental and nongovernmental organizations	English	Policy-maker	Peer-reviewed journal			✓	✓	✓		✓		✓			8	\({\text{P}}_{2,3,8}\)
Scalability assessment framework [57]		2018	Nongovernmental organization	English	Not found	Not found	✓	✓	✓	✓		✓	✓		✓	✓	✓	16	\({\text{P}}_{3,7,8}\)
Intervention Scalability Assessment Tool (ISAT) [22]		2019	Governmental organization	English	Clinician, policy-maker, researcher	Organizational website	✓		✓	✓	✓	✓	✓	✓	✓	✓	✓	19	\({\text{P}}_{3,8}\)
Readiness to Spread Assessment Scoring Sheet [125]		2013	Not found	English	Not found	Organizational website			✓		✓		✓	✓		✓	✓	4	\({\text{P}}_{5}\)
Readiness to Receive Assessment Scoring Sheet [126]		2013	Not found	English	Not found	Organizational website				✓					✓	✓		4	\({\text{P}}_{8}\)
Applicability and Transferability of Evidence Tool (A&T Tool) [118, 119]		2007	Governmental organization	English, French	Not found	Organizational website	✓			✓		✓	✓	✓	✓			21	\({\text{P}}_{3,7,8}\)
Scalability Assessment and Planning (SAP) Toolkit [130]		2018	Not found	English	Researcher	Organizational website					✓		✓			✓	✓	5	Not found

^aWe did not find names for 10 of the tools, in which case we indicated names of authors or organizations
^bScalability components targeted: (\({\text{C}}_{1}\)) health problem addressed by the innovation; (\({\text{C}}_{2}\)) development process of the innovation; (\({\text{C}}_{3}\)) innovation characteristics; (\({\text{C}}_{4}\)) strategic, political or environmental context of the innovation; (\({\text{C}}_{5}\)) evidence available for effectiveness of the innovation; (\({\text{C}}_{6}\)) innovation costs and quantifiable benefits; (\({\text{C}}_{7}\)) potential for implementation fidelity and adaptation of the innovation; (\({\text{C}}_{8}\)) potential reach and acceptability to the target population; (\({\text{C}}_{9}\)) delivery setting and workforce; \({\text{C}}_{10}\)) implementation infrastructure required for scale-up; and (\({\text{C}}_{11}\)) sustainability (i.e. longer-term outcomes of the scale-up)
^cPitfalls of scale-up relate to: (\({\text{P}}_{1}\)) sex and gender considerations; (\({\text{P}}_{2}\)) patient and public involvement; (\({\text{P}}_{3}\)) the difficulty of cost-effectiveness estimates; (\({\text{P}}_{4}\)) the production of health inequities; (\({\text{P}}_{5}\)) scaled-up harm; (\({\text{P}}_{6}\)) ethics (e.g. informed consent at scale); (\({\text{P}}_{7}\)) top-down approaches (i.e. the needs, preferences and culture of beneficiaries of the innovation may be forgotten when scale-up is directed from above); and (\({\text{P}}_{8}\)) context (e.g. difficulty in adapting the innovation to certain contexts)
^dCORRECT attributes: C—credible in that they are based on sound evidence or advocated by respected persons or institutions; O—observable to ensure that potential users can see the results in practice; R—relevant for addressing persistent or sharply felt problems; R—relative advantage over existing practices so that potential users are convinced the costs of implementation are warranted by the benefits; E—easy to install and understand rather than complex and complicated; C—compatible with the potential users’ established values, norms and facilities; fit well into the practices of the national programme; and T—testable so that potential users can see the innovation on a small scale prior to large-scale adoption
✓ is a checkmark for the item

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