ArticlePloS one2026
STAT-C, an innovative training workshop supporting management of sick leave related to common mental health disorders: A case study for spontaneous scaling in primary care.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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14 authors.
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Abstract
backgroundScaling primary care innovations to benefit broader populations is a key priority for decision-makers. While the science of effective scaling evolves, little is known about innovations that scale spontaneously, i.e., without deliberate guidance.
objectivesTo assess the spontaneous scaling process of STAT-C, a training workshop supporting management of sick leave related to common mental health disorders, and its perceived effects on primary care services and beneficiaries.
methodsWe conducted a mixed-methods descriptive single-case study using an Integrated Knowledge Translation (iKT) approach involving patient users. The case was defined as the spontaneous scaling of STAT-C, presented at the Quebec College of Family Physicians' Innovation Symposium and assessed using a selection criteria checklist. Over one year, we observed the scaling process through monthly meetings with the innovation team and collected documents to retrace key steps. We conducted interviews with decision-makers, healthcare professionals, and end-users, along with a focus group with the innovation team. Data were analyzed thematically using documents, interviews, and meetings. The scaling process was examined using the Scaling Impact principles: justification, optimal scale, coordination, and dynamic evaluation.
resultsSTAT-C met 71% of selection criteria. Fourteen participants were interviewed: innovation team (n = 2), healthcare professionals (n = 5), decision-makers (n = 4), and end-users (n = 3). Technical justifications included the need to standardize information across professionals (n = 10), while moral ones emphasized alignment with patient values (n = 8). Interviews revealed limited awareness of dynamic evaluation and a lack of indicators supporting further scaling. Ethical rationales reflected goal-oriented and duty-based reasoning. Preliminary data suggested improvements in healthcare professionals' self-reported competence in managing CMHD-related sick leave, offering early indications of the innovation's relevance.
conclusionThis study highlights strategies, challenges, and outcomes of spontaneous scaling under real-world conditions, showing how pathways emerge, strategies evolve, and ethical dimensions shape decision-making.
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