Scaling What Works: Why Bigger Isn't Always Better in Prevention

Why implementation quality matters more than program replication—and what prevention leaders need to know about creating lasting impact at scale.

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We all want to scale what works. Funders ask for it. Communities desperately need it. And if you're in prevention, you feel that pressure—when something works in one place, why wouldn't we get it everywhere, fast?

Here's the thing: in violence prevention, scaling isn't just about going bigger. When done wrong, it can actually dilute your impact, widen inequities, or spread strategies that look promising but don't actually keep people safer.

So what does it really mean to scale what works—and how do we do it without losing the secret sauce that made it effective in the first place?

The Hard Truth About "What Works"

Let's be honest: most violence prevention programs don't work the way we hope they will.

For decades, research has shown that the most commonly used programs—especially those quick, one-and-done educational sessions—don't produce measurable reductions in violent behavior when you actually study them rigorously.

The approaches that do work? They share some important traits:

• They're multi-session and sustained over time

• They tackle change at multiple levels—individual, relationship, community, society

• They focus on shifting environments and norms, not just knowledge or attitudes

• They're delivered with quality and strong support systems

  
  

In other words, what works is often messy, resource-intensive, and deeply tied to local context.

And that's exactly where scaling gets complicated.

Scaling Is Not Copy-and-Paste

Here's a mistake we see all the time: treating scale like replication. Grab the program manual, train more facilitators, roll it out in more places. Done, right?

Not quite.

Prevention doesn't work like a franchise. When you scale without paying attention to local context, implementation quality, workforce capacity, community readiness, or structural realities, effectiveness doesn't just drop—it can disappear entirely.

Scaling what works isn't about cloning programs. It's about scaling the conditions that allow prevention to succeed.

What We Should Be Scaling Instead

If we want real, population-level impact, we need to rethink what "scaling" actually means.

Here's what the evidence—and years of practice—tell us we should focus on:

• Core Functions, Not Cookie-Cutter Programs

  Effective strategies have active ingredients that drive change. Scale should preserve those core functions, even if what it looks like varies from place to place. Recent research shows that fidelity and adaptation don't have to be enemies—when adaptations align with a program's core principles, they can actually strengthen relevance and engagement.

  
  

• Infrastructure, Not Just Interventions

  Training, coaching, data systems, leadership buy-in, cross-sector partnerships—these aren't nice-to-haves. They're what make effectiveness possible at scale.

  
  

• Policy and Environmental Change

  Strategies that actually change settings—schools, workplaces, neighborhoods—have far more potential for widespread impact than programs targeting individuals alone.

  
  

• Learning Systems

  Scaling requires continuous feedback, adaptation, and evaluation. When learning stops, effectiveness usually follows.

From Pilot Projects to Population Impact

Our field has no shortage of innovation. What we often lack is the patience and investment for the long game—the slow, intentional work of building systems that support quality implementation over time.

This matters across all types of violence prevention—whether we're talking about sexual violence, intimate partner violence, youth violence, or child abuse. The principles remain the same.

Scaling what works means asking tougher questions:

• What level of impact should we expect at scale—and how will we know if we're achieving it?

• Which adaptations are okay, and which ones compromise what makes it work?

• Who benefits when we scale, and who might get left behind?

  
  

These aren't obstacles to scale. They're the foundation of responsible prevention.

The Takeaway

Scaling what works isn't about speed. It's about stewardship.

When we scale with evidence, integrity, and attention to context, we don't just reach more people—we create conditions for lasting, equitable change.

That's how prevention moves from promising to powerful.

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Learn More

CDC's Prevention Resources for Action

Comprehensive, evidence-based strategies for preventing multiple forms of violence, organized by what works at individual, relationship, community, and societal levels.

Implementation and Scaling Violence Prevention Interventions

An in-depth look at the science of implementation—why having an effective intervention is only the first step, and how to actually make it work in real-world settings.