Table 6 Case example of a ‘high use’ systems approach to scaling up

Study: Tong et al. 2020: The Emergence of a Sustainable Tobacco Treatment Program across the Cancer Care Continuum: A Systems Approach for Implementation at the University of California Davis Comprehensive Cancer Center

Intervention and scale up context: A sustainable tobacco treatment programme across a systems framework, targeting smoking reduction among smokers. Scaled up state-wide in California

Use of a systems approach or term ‘systems’: This study targeted different systems points, and systems thinking was used to inform implementation. The systems framework was described as a framework that facilitates viewing plans, progress, and priorities. It allowed the identification of research gaps where collaboration was needed to achieve an impact. Systems thinking informed the intervention approach/strategies, and their implementation, as different systems were targeted. The Cancer Care Continuum was adapted as a systems framework, it identified the multiple touchpoints by providers as patients move from primary care to cancer care, with concurrent psychosocial and supportive care that continues survivorship or through to end of life, depending on the patient’s needs. The Systems framework was described as 'a useful framework on which to view plans, progress, and priorities. It helps us identify research gaps, where we must collaborate with others to have an impact, and where more resources may be needed