Which statement best describes the goal of scaling up?

• A. To expand reach by creating a brand-new program from scratch
• B. To extend a program to more settings but with no evidence base
• C. To increase reach by duplicating the original program without any change
• D. To expand an evidence-based program to broader populations or settings while preserving core components and fidelity

Answer: (D)

Scaling up means taking an intervention that has proven effective and extending its reach to more people or settings while keeping the essential elements intact and delivered as intended. This preserves the program’s ability to work as designed, even in new contexts. The best description is expanding an evidence-based program to broader populations or settings while preserving core components and fidelity. That combination—wider reach plus maintaining the proven content and delivery—keeps the program effective as it scales. Creating something brand new ignores the proven evidence base; extending without an evidence base risks poor outcomes; duplicating the exact original without any change may not fit different settings well and can undermine fidelity. Adaptations to fit local context are possible, but the key is preserving the core components that drive effectiveness.