Using Ripple Effects Mapping to Evaluate a Community-Based Health Program: Perspectives of Program Implementers.

Traditional evaluation tools are oftentimes ill-suited for use in community settings where intervention outcomes of interest may occur at multiple levels and are influenced by interacting factors. Ripple effects mapping (REM) is a participatory technique engaging stakeholders to visually map project/program efforts and results to collect impact data. Using appreciative inquiry, the method helps participants and evaluators understand context for changes resulting from program experiences and is particularly well suited for community-based, participatory programs where impacts often occur beyond the individual level. This article describes the REM method and how it was applied to explore impact and refine program theory of the Extension Wellness Ambassador Program (EWAP), a community-based health-focused master volunteer program, from the perspective of program implementers (n = 10). Insights emerging from the REM session indicate EWAP promotes health behavior change, contributes to community development due to increased leadership capacity, and sustains and grows implementing organizations. The program theory shaping evaluation was refined to better capture impact beyond individual levels. Application of the REM method to a community health program demonstrates feasibility; health promotion practitioners should consider REM to understand program context and capture outcomes that typically evade measurement using traditional techniques.