Reporting guidelines have become essential tools for ensuring that research is reported comprehensively and transparently.12 Gaps in reporting persist in many areas of health research, including in the science and practice of scaling.345
By extending proven practices beyond pilot settings, the process of scaling increases population level reach, enhances equity by improving access for underserved groups, and reduces waste associated with repeatedly implementing isolated, short term projects. Scaling strengthens sustainability by embedding effective interventions into routine care and supports large scale system improvement. Across low, middle, and high income countries, the scaling of promising health interventions is being used to resolve a variety of health and health system challenges and build systems that support the implementation of large scale change. Researchers, innovators, and major research funders have articulated the need for and benefits of a science of scaling.26789101112
Scaling science complements but is distinct from implementation science.13 Recently, the knowledge to action model by Graham et al14 (one of the most highly cited, middle range, knowledge translation models) has been updated to include scaling as a distinctive phase of KTA beyond implementation.15 While implementation science focuses on introducing and integrating an effective solution to a problem (intervention) into a specific setting, scaling science is conceptually rooted in deliberate efforts to optimise the impact of this solution.1617
Existing implementation guidelines18 such as StaRI (Standards for Reporting Implementation Studies),19 which have made important contributions to improving rigor and reproducibility in implementation science, do not include certain elements that are unique to scaling. The key practical and ethical elements of scaling that differ from the original implementation of the intervention, or pilot, are:
The need for scalability assessments (ie, analysing the potential of an intervention for scaling)
Ethical/technical justification for expanding an intervention at scale, with a corresponding need for supporting technical and values based evidence. Scaling impacts may multiply the benefits of an intervention but they may also replicate its harms or inequities at scale, harms that may not have been observable at the original implementation level, with the risk that, for example, underrepresented populations are marginalised at a society-wide level
Determining optimal scale (with evidence) and considering coverage (ie, determining the population expected to benefit from the scaled intervention and collecting data on the population who adopted it)
A highly complex coordination effort is required, often at regional, state, national, or international levels12
Outcomes: while implementation guidelines focus on results such as behaviour change outcomes or programme improvement outcomes, scaling guidelines focus on broader societal outcomes such better health, economic returns, or social stability.17
The increase in scaling has been accompanied by the emergence of an increasing number of definitions and frameworks to characterise and guide the scaling process.78111718202122 Despite increasing scaling studies,812131823 researchers and other interested parties often struggle to include sufficient detail to replicate the study or synthesise evidence for systematic reviews. A reporting guideline specific to scaling is therefore needed. Building on the previous work of our team and a vast international network, we registered with the EQUATOR (Enhancing the quality and transparency of health research) Network and developed SUCCEED (Standards for reporting studies of scaling evidenced-informed interventions).235111724 The aim of this reporting guideline for scaling studies is to provide a comprehensive checklist of items to be reported in any project about the scaling of health interventions anywhere in the world. For the purposes of SUCCEED, our international consensus group defined scaling as a systematic process to broaden the reach and impact of evidence-informed interventions so as to optimise their benefits to individuals and society. Interventions include innovations or products already in use, technologies, programmes, application of services, policies, models of care, and de-implementation strategies (eg, of low value care, such as inappropriate medical tests). An evidence-informed intervention is not only considered effective according to the best available scientific evidence but also to other factors such as professional expertise, local context, stakeholder perspectives, practical experience, and feasibility considerations.
Summary points
Scaling of evidence-informed health interventions aims to broaden the reach and impact of these interventions so as to optimise their benefits to individuals and to society
The SUCCEED (Standards for reporting studies of scaling evidenced-informed interventions) reporting guideline provides standards for reporting the scaling of health interventions
The guideline consists of a checklist of 33 essential items with explanations and examples of reporting for each item
Development of the SUCCEED guideline was coordinated by an international expert committee and followed the EQUATOR (Enhancing the quality and transparency of health research) framework; the guideline was derived from a systematic review, a two round Delphi panel from six countries, and consensus meetings among interested parties
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原文链接：
https://www.bmj.com/content/394/bmj-2026-069389
