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 3 Characteristics of intended context of use of included tools

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

Name (abbreviation)^a [References]	Income level context	Healthcare level	Focus area	Sex or gender of beneficiaries of the targeted innovations	End-user of tool	Aim of tool	Degree of report of validity evidence for content validity^b	Methodological quality of tools^c
Innovation Scalability Self-administered Questionnaire (ISSaQ) [2, 3]	High-income country	Primary healthcare	Not found	Female, male	Clinician, policy-maker, researcher	Assess the scalability of innovations in primary healthcare	2	Inadequate
AnalySe de la Transférabilité et accompagnement à l’Adaptation des Interventions en pRomotion de la santE (ASTAIRE) [53, 54]	High-income country	Not found	Health prevention or promotion	Not found	Not found	Assess transferability and adaptation of health promotion innovations	3	Doubtful
WHO/ExpendNet [123, 124]	Not found	Not found	Not found	Not found	Researcher, policy-maker, programme manager, funder	Assess the scalability of programmatic research; provide a quick assessment of how easy or difficult it will be to scale up a project that is being planned or proposed or is in the process of implementation	2	Doubtful
Scalability Checklist [127,128,129]	Not found	Primary healthcare	Reproductive, maternal, newborn, child or adolescent health	Not found	Not found	Prioritize alternatives and identify actions that can be taken to simplify the scaling-up process	2	Doubtful
Baker et al. [47]	Not found	Primary healthcare, home care, public or population health	Reproductive, maternal, newborn, child or adolescent health	Female	Not found	Assess the applicability and transferability of innovations to the Aboriginal and Torres Strait Islander setting	2	Inadequate
Bennett et al. [48]	Low- or middle-income country	Primary healthcare	Reproductive, maternal, newborn, child or adolescent health	Not found	Not found	Explore feasibility and effectiveness of health innovations	1	Inadequate
Burchett et al. [50]	Not found	Public or population health	Not found	Not found	Not found	Assist in the assessment of applicability and transferability	2	Inadequate
Burchett et al. [51]	Low- or middle-income country	Primary healthcare, public or population health	Reproductive, maternal, newborn, child or adolescent health	Not found	Not found	Assess a study’s applicability and transferability	2	Inadequate
Cambon et al. [52]	Low-, middle- or high-income country	Public or population health	Health prevention or promotion	Not found	Not found	Guide and assess transferability	2	Inadequate
Process model for the assessment of transferability (PIET-T) [55]	Not found	Not found	Health prevention or promotion	Not found	Not found	Accompany the steps for determining transferability	2	Inadequate
Spicer et al. [56]	Low- or middle-income country	Primary healthcare	Reproductive, maternal, newborn, child or adolescent health	Not found	Researcher	Increase the prospects of government adoption and community uptake of innovations at scale	1	Inadequate
Wang et al. [58]	Not found	Public or population health	Not found	Not found	Not found	Assess applicability and transferability from a study setting to a local setting using evidence about both the local setting and the public health innovation of interest	1	Inadequate
Milat et al. [20, 21, 120]	High-income country	Public or population health	Health prevention or promotion	Not found	Policy-maker, researcher	Explore whether an innovation is scalable	2	Inadequate
CORRECT attributes^d [6, 121, 122]	Low- or middle-income country	Primary healthcare, public or population health	Reproductive, maternal, newborn, child or adolescent health	Not found	Researcher, manager, funder	Assess the attributes that determine the scalability of the innovation and identify needed actions	2	Doubtful
Bhattacharyya et al. [49]	Transnational	Not found	Not found	Not found	Policy-maker, funder	Assess promising low- or middle-income country innovations for adaptation in high-income countries and identify those with high potential for more in-depth review and evaluation	3	Doubtful
Scalability assessment framework [57]	Low-, middle- or high-income country	Public or population health	Education, nutrition, sanitation, hygiene or international development more broadly	Female, male	Not found	Expand or replicate as part of a planned scaling-up process	2	Inadequate
Intervention Scalability Assessment Tool (ISAT) [22]	High-income country	Public or population health	Not found	Not found	Clinician, policy-maker	Assist practitioners, policy-makers, programme managers, and researchers to determine the scalability of a discrete health programme	3	Doubtful
Readiness to Spread Assessment Scoring Sheet [125]	High-income country	Not found	Not found	Not found	Manager	Help programme champions and leadership understand whether a promising practice is ripe for successful spread across organizations	1	Inadequate
Readiness to Receive Assessment Scoring Sheet [126]	High-income country	Not found	Not found	Not found	Manager	Help a site determine its readiness to receive an effective practice from elsewhere	1	Inadequate
Applicability and Transferability of Evidence Tool (A&T Tool) [118, 119]	Not found	Public or population health	Not found	Not found	Manager	Assist public health managers and planners in decision-making about programme priorities for their community	2	Doubtful
Scalability Assessment and Planning (SAP) Toolkit [130]	Not found	Not found	Reproductive, maternal, newborn, child or adolescent health	Not found	Not found	Guide scaling and assessment planning with corrective actions to strengthen or enable scale-up	1	Doubtful

^aWe did not find names for 10 of the tools, in which case we indicate names of authors or organizations
^bWe found no discussion or data presented as a source of validity evidence for the eight other measurement properties. 1 = Only a limited amount of data (e.g. simply listing items without justification); 2 = listing items with some references and justifications, limited description of the process for creating the tool; 3 = well-defined process for developing tool content, including both an explicit theoretical, conceptual or practical basis for the tool items and systematic item review by experts
^cAccording to COSMIN definitions, a standard is rated as “doubtful” if it is doubtful whether the quality aspect is adequate (i.e. minor methodological flaws), and “inadequate” when evidence is provided that the quality aspect is not adequate (i.e. important methodological flaws)
^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

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