Advancing scaling science in health and social care : a scoping review and appraisal of scaling frameworks

Abstract

Scaling is typically discussed as a way to amplify or expand a health innovation. However, there is limited knowledge about the specific techniques that can enhance access to or improve the quality of innovations. We sought to identify, compare, and contrast scaling frameworks to advance the science and practice of scaling. Starting from an umbrella review, we identified relevant studies and extracted data about the characteristics of the articles, attributes of framework development, attributes of framework components, transferability, and the framework’s underlying ethical lens. Grey literature was included through expert consultation. Data were summarized using frequencies and qualitative description. Much may be learned through further support for, and development of, scaling frameworks by primary authors affiliated with the Global South. Important aspects of framework development were identified, especially understanding the nuances of diverse stakeholder involvement in development.