Background: The Pacific Science for Health Literacy Project pilot (2013-2017) identified that school-based multisectoral interventions facilitated sustained healthful behaviour change for adolescents and increased inter-sectoral interactions. The project promoted positive professional practice change in the health and education sectors, and facilitated development of evidence-driven policy and planning in schools. These outcomes signalled that ongoing implementation may support the potential for sustained long-term benefits. Transforming a project from pilot to sustainable practice requires commitment from all stakeholders to engage in the strategic development of a scale-up phase.
Methods: Principles from tivaevae and community-based participatory-research shaped the process by which the project team explored with stakeholders whether the pilot should be transformed to test the potential for the programme to grow, and benefits to evolve nationally. This process involved seeking, making sense of, and bringing together multiple perspectives to develop a vision and framework.
Outcomes: Between June 2016 and August 2017 the notion of transforming the pilot to sustainable practice was explored with stakeholders, and a concept proposal presented to the New Zealand Ministry of Foreign Affairs and Trade (MFAT). In November 2017 MFAT invited the partners to develop a full design for this concept. The design centres around a scale-up framework aligned to the National Sustainable Development Plan. It comprises three components required to shift a pilot to sustainable practice. Vertical scale-up facilitates the process of policy, budgetary and systems practice change; Horizontal scale-up facilitates expansion to Pā Enua communities; Diversification scale-up enables emerging evidence to be applied and establishes processes enabling continuous improvement. This design, presented to MFAT in June 2018, will be reviewed to assess its potential to achieve the vision.
Conclusions: The process of consultation and development has enabled the stitching of a strong framework. If funding is enabled, this frame can guide participating agencies and communities to build on the pilot to realise the long-term vision of young people engaged in building a better future for all Cook Islanders.