ArticlePloS one2026
Structural models for spreading and scaling digital health initiatives: A scoping review protocol.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealthcare initiatives have a larger impact if effective initiatives are spread (brought from one site to the next) or scaled (infrastructure developed to underpin and support widespread implementation), while sustaining initial benefits. Unfortunately, many initiatives, including digital health initiatives, remain confined to the pilot stage. Of those initiatives that do progress, little is known about how to plan for the equitable spread and scale of effective initiatives. There are many structural "models" of spread and scale, defined here as conceptual representations of how initiatives are organised and delivered across multiple settings (i.e., hub-and-spoke model), yet little is known about these models.
objectivesPrimary Objective: To identify and describe structural models for spreading and scaling digital health initiatives. Secondary Objectives: 1. To describe the associated factors, strengths, limitations, and necessary preconditions associated with each model. 2. To describe the barriers and facilitators experienced when applying each model. 3. To explore whether and how each model prioritized equitable delivery of care. 4. To determine which pre-established types of scale (horizontal, vertical, diversification, and spontaneous) are associated with each model.
methodsA scoping review will be conducted following Joanna Briggs Institute (JBI) methodology and reported in accordance with PRISMA-ScR guidelines. The search strategy includes peer-reviewed databases for health and business, alongside grey literature sources. Eligibility criteria follow the Population-Concept-Context framework, focusing on digital health initiatives delivered in healthcare settings.
resultsThe review will produce a comprehensive overview of structural models for spreading and scaling digital health initiatives, including model names, descriptions, strengths, limitations, preconditions, associated barriers and facilitators of applying each model, relationships between models and established types of scale, and equity considerations.
conclusionsThis novel review aims to inform practical planning of how to bring digital health initiatives to new settings and populations, to support more equitable access to these initiatives.
Indexed as
Identifiers
What Socratic 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 Socratic graph.