ABSTRACT
This essay presents “scaling-out”, a strategy for accelerating and expanding the benefit of evidence-based practices (EBPs) through innovative study designs. When an EBP is implemented in a context that is very similar to the context it was previously found to be effective, one can anticipate similar benefits of the EBP. However, a goal of implementation science is to expand the use of EBPs as broadly as feasible and appropriate in order to have the greatest public health benefit. As such, when implementing an EBP in a novel setting, or targeting a novel population, one must consider whether there is sufficient justification that the EBP would have similar benefits as those found previously. We describe scaling-out as the deliberate use of strategies to implement, test, improve, and sustain EBPs as they are delivered in novel settings and/or targeting novel populations by “borrowing strength” of evidence from prior trials. Borrowing strength means utilizing data from previous trials to compare with data collected from a new trial, thus obviating the need for an entirely new randomized trial. Thus, scaling-out can improve efficiency and practicality of testing EBP implementation in new settings or with new populations.
