Scaling Beyond Early Adopters: A Systematic Review and Key Informant Perspectives

The process of moving research insights into clinical practice can be slow and a gap often remains between best practices, frequently developed within single sites or small populations, and general practice delivered at a population scale. The field of implementation science seeks to mend this gap by promoting the adoption and appropriate use of effective interventions, practices, and programs, which includes the study of scale-up and spread of innovations. While hard-to-engage sites may have unique characteristics from sites that are engaged quickly or earlier, they are not typically differentiated in scale-up and spread processes.