JMIR Publications

ABSTRACT

Background:

Scaling effective primary care innovations to benefit more people is of interest to decision makers. However, we know little about how promising innovations are being scaled “spontaneously,” i.e., without deliberate guidance.

Objective:

We aim to observe, document and analyze how, in real-life conditions, one primary care innovation spontaneously scales up across Quebec, Canada.

Methods:

We will conduct a participative study using a descriptive single-case study. It will be guided by McLean and Gargani’s principles for scaling and reported according to the COREQ guidelines. Informed by an Integrated Knowledge Translation approach (iKT), our steering committee will include patient users throughout the project. Inspired by the Quebec College of Family Physician’s “Dragons’ Den” primary care program, we will identify a promising primary care innovation that is being or will be scaled in a spontaneous fashion. We will interview the innovation team about their scaling experiences monthly for one year. We will conduct interviews and/or focus groups with decision-makers, healthcare providers, and end-users in the innovation team and the target site about their experience of both scaling and receiving the scaled innovation, and document meetings as non- participant observers. Interview transcripts and documentary data will be analyzed to 1) compare the spontaneous scaling plan and implementation with McLean & Gargani’s principles for scaling; 2) determine how it was consistent with or diverged from McLean and Gargani’s four guiding principles: justification, optimal scale, coordination, and dynamic evaluation.

Results:

This study was funded in March 2020 by the Canadian Institutes of Health Research. Data collection will begin in December 2023. Results are expected to be published in the spring of 2024.

Conclusions:

Our results will provide practical evidence-based material about scaling health and social care interventions in the context of integrating McLean & Gargani’s four guiding principles into real-world settings contributing to advance the field of scaling science.