Developing a framework to inform scale-up success for population health interventions: a critical interpretive synthesis of the literature
Abstract Background Population health interventions (PHIs) have the potential to improve the health of large populations by systematically addressing underlying conditions of poor health outcomes (i.e., social determinants of health) and reducing health inequities. Scaling-up may be one means of enh...
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | Global Health Research and Policy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41256-020-00141-8 |
| _version_ | 1818904268363530240 |
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| author | Duyen Thi Kim Nguyen Lindsay McLaren Nelly D. Oelke Lynn McIntyre |
| author_facet | Duyen Thi Kim Nguyen Lindsay McLaren Nelly D. Oelke Lynn McIntyre |
| author_sort | Duyen Thi Kim Nguyen |
| collection | DOAJ |
| description | Abstract Background Population health interventions (PHIs) have the potential to improve the health of large populations by systematically addressing underlying conditions of poor health outcomes (i.e., social determinants of health) and reducing health inequities. Scaling-up may be one means of enhancing the impact of effective PHIs. However, not all scale-up attempts have been successful. In an attempt to help guide the process of successful scale-up of a PHI, we look to the organizational readiness for change theory for a new perspective on how we may better understand the scale-up pathway. Using the change theory, our goal was to develop the foundations of an evidence-based, theory-informed framework for a PHI, through a critical examination of various PHI scale-up experiences documented in the literature. Methods We conducted a multi-step, critical interpretive synthesis (CIS) to gather and examine insights from scale-up experiences detailed in peer-reviewed and grey literatures, with a focus on PHIs from a variety of global settings. The CIS included iterative cycles of systematic searching, sampling, data extraction, critiquing, interpreting, coding, reflecting, and synthesizing. Theories relevant to innovations, complexity, and organizational readiness guided our analysis and synthesis. Results We retained and examined twenty different PHI scale-up experiences, which were extracted from 77 documents (47 peer-reviewed, 30 grey literature) published between 1995 and 2013. Overall, we identified three phases (i.e., Groundwork, Implementing Scale-up, and Sustaining Scale-up), 11 actions, and four key components (i.e., PHI, context, capacity, stakeholders) pertinent to the scale-up process. Our guiding theories provided explanatory power to various aspects of the scale-up process and to scale-up success, and an alternative perspective to the assessment of scale-up readiness for a PHI. Conclusion Our synthesis provided the foundations of the Scale-up Readiness Assessment Framework. Our theoretically-informed and rigorous synthesis methodology permitted identification of disparate processes involved in the successful scale-up of a PHI. Our findings complement the guidance and resources currently available, and offer an added perspective to assessing scale-up readiness for a PHI. |
| first_indexed | 2024-12-19T21:04:44Z |
| format | Article |
| id | doaj.art-1e9b34d8d43047869979dd7d7245b32e |
| institution | Directory Open Access Journal |
| issn | 2397-0642 |
| language | English |
| last_indexed | 2024-12-19T21:04:44Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Global Health Research and Policy |
| spelling | doaj.art-1e9b34d8d43047869979dd7d7245b32e2022-12-21T20:05:41ZengBMCGlobal Health Research and Policy2397-06422020-04-015111110.1186/s41256-020-00141-8Developing a framework to inform scale-up success for population health interventions: a critical interpretive synthesis of the literatureDuyen Thi Kim Nguyen0Lindsay McLaren1Nelly D. Oelke2Lynn McIntyre3Department of Economics, Faculty of Business, University of New BrunswickDepartment of Community Health Sciences, Cumming School of Medicine, University of CalgaryDepartment of Community Health Sciences, Cumming School of Medicine, University of CalgaryDepartment of Community Health Sciences, Cumming School of Medicine, University of CalgaryAbstract Background Population health interventions (PHIs) have the potential to improve the health of large populations by systematically addressing underlying conditions of poor health outcomes (i.e., social determinants of health) and reducing health inequities. Scaling-up may be one means of enhancing the impact of effective PHIs. However, not all scale-up attempts have been successful. In an attempt to help guide the process of successful scale-up of a PHI, we look to the organizational readiness for change theory for a new perspective on how we may better understand the scale-up pathway. Using the change theory, our goal was to develop the foundations of an evidence-based, theory-informed framework for a PHI, through a critical examination of various PHI scale-up experiences documented in the literature. Methods We conducted a multi-step, critical interpretive synthesis (CIS) to gather and examine insights from scale-up experiences detailed in peer-reviewed and grey literatures, with a focus on PHIs from a variety of global settings. The CIS included iterative cycles of systematic searching, sampling, data extraction, critiquing, interpreting, coding, reflecting, and synthesizing. Theories relevant to innovations, complexity, and organizational readiness guided our analysis and synthesis. Results We retained and examined twenty different PHI scale-up experiences, which were extracted from 77 documents (47 peer-reviewed, 30 grey literature) published between 1995 and 2013. Overall, we identified three phases (i.e., Groundwork, Implementing Scale-up, and Sustaining Scale-up), 11 actions, and four key components (i.e., PHI, context, capacity, stakeholders) pertinent to the scale-up process. Our guiding theories provided explanatory power to various aspects of the scale-up process and to scale-up success, and an alternative perspective to the assessment of scale-up readiness for a PHI. Conclusion Our synthesis provided the foundations of the Scale-up Readiness Assessment Framework. Our theoretically-informed and rigorous synthesis methodology permitted identification of disparate processes involved in the successful scale-up of a PHI. Our findings complement the guidance and resources currently available, and offer an added perspective to assessing scale-up readiness for a PHI.http://link.springer.com/article/10.1186/s41256-020-00141-8Population health interventionScale-upFrameworkCritical interpretive synthesisReadiness |
| spellingShingle | Duyen Thi Kim Nguyen Lindsay McLaren Nelly D. Oelke Lynn McIntyre Developing a framework to inform scale-up success for population health interventions: a critical interpretive synthesis of the literature Global Health Research and Policy Population health intervention Scale-up Framework Critical interpretive synthesis Readiness |
| title | Developing a framework to inform scale-up success for population health interventions: a critical interpretive synthesis of the literature |
| title_full | Developing a framework to inform scale-up success for population health interventions: a critical interpretive synthesis of the literature |
| title_fullStr | Developing a framework to inform scale-up success for population health interventions: a critical interpretive synthesis of the literature |
| title_full_unstemmed | Developing a framework to inform scale-up success for population health interventions: a critical interpretive synthesis of the literature |
| title_short | Developing a framework to inform scale-up success for population health interventions: a critical interpretive synthesis of the literature |
| title_sort | developing a framework to inform scale up success for population health interventions a critical interpretive synthesis of the literature |
| topic | Population health intervention Scale-up Framework Critical interpretive synthesis Readiness |
| url | http://link.springer.com/article/10.1186/s41256-020-00141-8 |
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