From: “Scaling-out” evidence-based interventions to new populations or new health care delivery systems
Key term | Definition |
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Scale-up | The deliberate effort to broaden the delivery of an EBI with the intention of reaching larger numbers of a target audience. Often an EBI scale-up will target health delivery units within the same, or very similar settings, under which the EBI has already been tested. |
Scale-out | A deliberate effort to broaden the delivery of an EBI. Scale-out is an extension of scale-up and uniquely refers to the deliberate use of strategies to implement, test, improve, and sustain an EBI as it is delivered to new populations and/or through new delivery systems that differ from those in effectiveness trials. There are three types of scale-out, each indicating the extent to which the EBI is delivered to new populations and/or through new delivery systems. |
Type I scale-out: population fixed, different delivery system | A type of scaling-out wherein an EBI is scaled-out to the same population as previously tested, but through a different delivery system. |
Type II scale-out: delivery system fixed, different population | A type of scaling-out wherein an EBI is scaled-out to a different target population through the same delivery system as previously tested. |
Type III scale-out: different population and delivery system | A type of scaling-out wherein an EBI is scaled-out to a different target population, through a different delivery system, than previously tested. |
Borrowing strength | Utilizing empirical evidence from a previous EBI effectiveness trial in combination with new evidence from a scale-out trial to test EBI effectiveness when moving it to a new population and/or through a new delivery system. Borrowing strength allows for a more limited evaluation, typically prioritizing implementation outcomes, that takes less time and expense to conduct than the original effectiveness trial. |
Intervention adaptation | Modifications to an EBI to facilitate its feasible, practical, and acceptable implementation in new contexts. |
External validity | The representativeness or generalizability of an effect. |
Core elements | Prototypical and/or necessary activities or components of an EBI. When scaling-out an EBI to a new population and/or through a new delivery system, core elements of the EBI should be retained to ensure its effectiveness. |