SynthesisImplementation science : IS2024
Adaptability, Scalability and Sustainability (ASaS) of complex health interventions: a systematic review of theories, models and frameworks.
Synthesis in Implementation science : IS, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- From legalisation to practice: implementation of newly legalised health interventions in healthcare settings - a systematic review.BMJ open · 2026Pooled it
- Using the RE-AIM framework to evaluate the impact of shared medical appointments for diabetes mellitus: a systematic review and meta-analysis.BMC primary care · 2025Pooled it
- Long-Term, Low-Maintenance, and Impactful: Lessons Learned From Sustaining the NOHARM Pragmatic Clinical Trial.Learning health systems · 2026Article
- Article
- Strengthening Resilience and Mental Well-Being Through the Support4Resilience Toolbox for Leaders in Older Adult Care: Protocol for a Cross-Country Mixed Methods Study (Support4Resilience).JMIR research protocols · 2026Article
- Theorising pathways of multi-dimensional scaling for population health using implementation and complexity science perspectives.Implementation science communications · 2026Article
- Nurses' Genomic Knowledge, Attitudes, and Perceived Organizational Support: A Comparative Secondary Analysis of Genetics and Genomics in Nursing Practice Survey Data.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2026Article
- Species Extinction, Biodiversity, Human Health, and Inevitable Role of Lifestyle Medicine: A Narrative Review.American journal of lifestyle medicine · 2026Review
- Layers of complexity: a directed content analysis of implementation determinants for integrative group medical visits for patients with chronic pain in safety-net primary care.BMC primary care · 2026Article
- The PIECES multi-site comparative case study protocol: mixed methods implementation evaluation of adapting, implementing and tailoring primary cancer prevention programmes in diverse contexts.Implementation science communications · 2026Article
- The Framework of Policy Transition in TBI: From GCS to CBI-M.Neurocritical care · 2026Article
- Main Recommendations for Developing Education and Awareness Strategies for Rare Diseases: Scoping Review.JMIR medical education · 2026Article
- Mapping the Aggregated Behavioural Risk Factors for Colorectal Cancer by Small Areas Across Australia.The Australian journal of rural health · 2026Article
- Identifying a program's "core components" using a co-design approach: a methodological worked example from a youth mental health and addictions navigation service.Research involvement and engagement · 2026Article
- Sustainability through funding and leadership: a mixed-methods study of tobacco treatment programs across U.S. National Cancer Institute-designated Cancer Centers.Implementation science communications · 2026Article
- An Integrated 5I Health Promotion Model for Enhancing Independence and Quality of Life Among Older Adults in Indonesia: A Community-Based Path Analysis Study.International journal of environmental research and public health · 2026Article
- Quality Improvement Initiatives in Pediatric Emergency Care in Low-Resource Settings: Addressing Patient Safety and Outcomes.International journal of pediatrics · 2026Review
- Formal tobacco-control training and thirdhand smoke counseling practices among pediatric nurses in China: a cross-sectional study of cognitive and implementation factors.Frontiers in public health · 2026Article
- Evaluating the Alliance against Violence and Adversity Online Training Program: an online curriculum to support children, women, and gender-diverse people.Frontiers in public health · 2026Article
- The perceived fit of guided iCBT in specialised mental healthcare services: a qualitative study of healthcare professionals' perspectives.Frontiers in digital health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundComplex health interventions (CHIs) are increasingly used in public health, clinical research and education to reduce the burden of disease worldwide. Numerous theories, models and frameworks (TMFs) have been developed to support implementation of CHIs. This systematic review aims to identify and critique theoretical frameworks concerned with three features of implementation; adaptability, scalability and sustainability (ASaS). By dismantling the constituent theories, analysing their component concepts and then exploring factors that influence each theory the review team hopes to offer an enhanced understanding of considerations when implementing CHIs.
methodsThis review searched PubMed MEDLINE, CINAHL, Web of Science, and Google Scholar for research investigating the TMFs of complex health interventions. Narrative synthesis was employed to examine factors that may influence the adaptability, scalability and sustainability of complex health interventions.
resultsA total of 9763 studies were retrieved from the five databases (PubMed, MEDLINE, CINAHL, Web of Science, and Google Scholar). Following removal of duplicates and application of the eligibility criteria, 35 papers were eligible for inclusion. Influencing factors can be grouped within outer context (socio-political context; leadership funding, inter-organisational networks), inner context; (client advocacy; organisational characteristics), intervention characteristics (supervision, monitoring and evaluation), and bridging factors (individual adopter or provider characteristics).
conclusionThis review confirms that identified TMFS do not typically include the three components of adaptability, scalability, and sustainability. Current approaches focus on high income countries or generic "whole world" approaches with few frameworks specific to low- and middle-income countries. The review offers a starting point for further exploration of adaptability, scalability and sustainability, within a low- and middle-income context.
trial registrationNot registered.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.