From Start-Up to Scale-Up of a Health-Promoting Intervention for Older Adults: The Choose to Move Story

Interventions that are effective in research (efficacy or effectiveness) trials cannot improve health at a population level unless they are successfully delivered more broadly (scaled up) outside of the research setting. However, scale-up is often relegated to the too hard basket. Factors such as the need to adapt interventions prior to implementing them in diverse settings at scale, retaining fidelity to the intervention, and cultivating the necessary community and funding partnerships can all present a challenge. In the present review article, we present a scale-up case study—Choose to Move—an effective health-promoting intervention for older adults. The objectives of this review were to (a) describe the frameworks and processes adopted to implement, adapt, and scale up Choose to Move across British Columbia, Canada; (b) provide an overview of the phased approach to scale-up; and (c) share key lessons learned while implementing and scaling up health-promoting interventions with community partners across more than 2 decades.