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Methodological considerations for evaluating scale-up programmes in healthcare: a methods review.

Bastiaan Van Grootven^1,2, Serena Sibilio¹, Nereide Curreri³

¹Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland.

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care

|December 8, 2025

Summary

This summary is machine-generated.

Evaluating the scale-up of healthcare interventions requires longitudinal, adaptive, and mixed-methods designs. Key dimensions of scale-up success include coverage, reach, effectiveness, and institutionalization, influenced by cost, adoption, fidelity, and adaptations.

Keywords:

Implementation science Scale-up general methodology healthcare system public health

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Area of Science:

Health Services Research
Implementation Science
Public Health Interventions

Background:

Achieving sustained population-level health improvements necessitates effective intervention scale-up.
Scale-up involves integrating evidence-based interventions into routine practice and policy.
Evaluating the success of healthcare intervention scale-up presents unique methodological challenges.

Purpose of the Study:

To conduct a methodological review on evaluating the scale-up of evidence-based healthcare interventions.
To identify appropriate research designs, outcomes, measures, and key methodological considerations for scale-up evaluation.
To propose a conceptualization of scale-up success.

Main Methods:

A methodological review of relevant literature was performed.
Searches included databases, hand searching journals, and screening references.
A narrative synthesis of included studies was conducted to analyze findings.

Main Results:

Pre-scale-up considerations include evidence assessment, program theory development, and contextual analysis.
Evaluation domains for scale-up include adoption, coverage, reach, institutionalization, and cost.
Recommended designs are predominantly nonexperimental (pre-post, time series) with mixed-methods approaches to capture implementation dynamics.

Conclusions:

Longitudinal, adaptive, and mixed-methods designs are essential for evaluating real-world implementation dynamics.
Scale-up success is conceptualized through coverage, reach, effectiveness, and institutionalization.
These dimensions are influenced by factors such as cost, adoption, fidelity, and adaptations.