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J Adv Nurs. 2019 Oct 23. doi: 10.1111/jan.14239. [Epub ahead of print]

What does it take to scale-up a complex intervention? Lessons learned from the Connect-Home transitional care intervention.

Author information

1
School of Nursing, University of North Carolina, Chapel Hill, NC, USA.

Abstract

AIMS:

To discuss the multiple phases of research done to plan for wide-scale implementation (i.e. scale-up) of Connect-Home, a complex nurse-develop intervention. Barker et al.'s (Implementation Science, 2016, 11, 12) framework for intervention scale-up is applied to address the methods used to answer the following four questions: 'Who' needs to be involved in scale-up? 'What' intervention and implementation strategies need to be taken to scale? 'How' will scale-up be achieved? And what contextual factors influence 'when' scale-up is or is not successful?

DESIGN:

Discussion paper.

DATA SOURCES:

Data sources include the experience of our research team, supported by literature and theory. The Connect-Home team conducted multiple research studies to plan for Connect-Home scale-up. Early studies (2008-2015) focused on formative work to design the Connect-Home intervention. Recent studies have involved successive pilot tests of Connect-Home's effectiveness, implementation, and scale-up (2015-2019).

IMPLICATIONS FOR NURSING:

This article describes a systematic approach that nurse researchers can apply to plan for taking their interventions to scale.

CONCLUSIONS:

Planning for scale-up early in the process of intervention development is essential to speeding the translation of effective interventions into wide-scale practice.

IMPACT:

This article details the methods that nursing researchers applied to develop and test the strategies needed to plan for taking a complex intervention to scale across multiple settings. The methods described are applicable to nursing and other health researchers' development and scale-up of any complex intervention.

KEYWORDS:

implementation science; nursing; nursing home; scale-up; sustainability; transitional care

PMID:
31642091
DOI:
10.1111/jan.14239

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