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Updated: Feb 3, 2026

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

Lisa T Washburn1, LaVona Traywick2, Lauren Thornton1

  • 1University of Arkansas System, Little Rock, AR, USA.

Health Promotion Practice
|October 28, 2018
PubMed
Summary

Ripple Effects Mapping (REM) is a participatory evaluation method that captures community program impacts beyond the individual level. This approach helps refine program theory and demonstrates feasibility for health promotion practitioners.

Keywords:
community-basedhealth volunteermaster volunteer programprogram evaluationqualitative methodsripple effects mapping

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Area of Science:

  • Community Health Program Evaluation
  • Participatory Research Methods
  • Health Promotion Impact Assessment

Background:

  • Traditional evaluation tools often fail in community settings due to complex, multi-level intervention outcomes.
  • Community-based programs require methods that capture impacts influenced by interacting factors.
  • Existing methods may not adequately assess outcomes beyond the individual level.

Purpose of the Study:

  • To describe the Ripple Effects Mapping (REM) method.
  • To explore the impact and refine program theory of the Extension Wellness Ambassador Program (EWAP) using REM.
  • To assess the feasibility of REM for community health program evaluation.

Main Methods:

  • Employed Ripple Effects Mapping (REM), a participatory technique engaging stakeholders.
  • Utilized appreciative inquiry to understand the context of program-induced changes.
  • Applied REM with program implementers (n=10) of a community-based health master volunteer program (EWAP).

Main Results:

  • REM identified that EWAP promotes health behavior change.
  • Insights revealed EWAP contributes to community development through enhanced leadership capacity.
  • Findings indicated EWAP sustains and grows implementing organizations.

Conclusions:

  • The REM method successfully captured impacts beyond individual levels, refining EWAP's program theory.
  • REM application demonstrated feasibility for evaluating community health programs.
  • Health promotion practitioners are encouraged to consider REM for understanding program context and capturing hard-to-measure outcomes.