Developing a patient-oriented tool for assessing the scalability of innovations in community-based primary health care in Canada


There is a gap between health innovations whose effectiveness can be demonstrated with evidence and those whose benefits are delivered to the population. In this way, evidenced-based interventions should be scaled up. Nevertheless, despite the existence of models and guides to encourage this practice, there is a lack of practical tools to assess the potential of an innovation to be scaled up (scalability). In this work, we aimed to present the steps we conduct to develop a patient-oriented tool for assessing the scalability of innovations in community-based primary health care in Canada (CBPHC). 


Our tool is developed through the perspective of Integrated knowledge translation (IKT) and we follow the RAND/UCLA Appropriateness Method (RAM). We conducted a systematic review following the COSMIN methodology to identify tools proposed for assessing the scalability of innovations in health. An online Delphi (eDelphi) is in progress to achieve consensus and validate among experts and stakeholders the most pertinent items to assess the scalability components which were retrieved from the review and that will be included in our tool. First, two reviewers independently are selecting the eligible items by excluding the duplicates, merging the complementaries and applying sixteen interpretability criteria. Second, we will proceed with the snowball recruitment method from our research team’s network and ensure that 100 people will participate in the study. They will be patients or citizens representatives, family physicians, policy/decision makers, researchers and members of relevant SPOR and CBPHC Canadian organizations. Finally, the eDelphi will be conducted in three rounds, in which we will collect sociodemographic information from the participants and they will be asked to decide on the relevance of each item included in the preliminary list as well to suggest the inclusion of other item. Participants will use 0 to 10 score (0 = not relevant and 10 = highly relevant) and we will classify their responses as low (0-3), moderate (4-6) and high (7-9). In the end, we will calculate the averages and percentages and the consensus will be considered if there is an 80% agreement for the score of 7-9.


The knowledge synthesis identified 31 reports describing 21 tools to assess scalability. Tools contained a total of 320 items that were categorized through 12 scalability components. 


The eDelphi will provide the expert opinion on the most promising criteria for assessing the scalability of evidence-based innovations in the context of CBPHC. The result expected is the validated version of the self-administered questionnaire to assess the scalability of innovations in CBPHC.

Roberta Coroa poster

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