Canada Research Chair in Shared Decision Making and Knowledge Translation

Our team publishes an article on the pitfalls of scaling up evidence-based interventions in health

Policy-makers worldwide are increasingly interested in scaling up evidence-based interventions (EBIs) to larger populations, and implementation scientists are developing frameworks and methodologies for achieving this. But scaling-up does not always produce the desired results. Why not? The authors identify the following major pitfalls: 1) accurate cost-effectiveness estimates about real-world implementation are almost impossible, making predictions of economies of scale unreliable; 2) some people will necessarily be left out and therefore not benefit from the scaled-up EBIs; 3) the harms as well as the benefits may be amplified by the scaling-up; 4) informed consent may be a challenge on a grander scale; 5) the needs, preferences and culture of end-users may be forgotten when scale-up is directed from above; and 6) it may not be possible to adapt the EBIs to every context. If these pitfalls are addressed head on, scaling-up may be a powerful process for translating research data into practical improvements in healthcare, ensuring that more people benefit from EBIs. Read the article here.

By Titilayo Agbadje, 02/10/2019