A participatory method

Ripple Effects Mapping, or REM, is a participatory and qualitative form of impact evaluation. When we learned of this method, we thought that it would be invaluable in helping understand some of the complex public health interventions we were evaluating – particularly the elements that were deemed hard-to-measure. However, to make it more suited to our needs, we adapted it further. It is this adapted method that we talk more about here.

REM的一个基本方面是它是参与性的。这意味着邀请参与干预设计或交付干预措施的人，并受邀参加数据收集研讨会。这些研讨会本质上是定性的，因此我们旨在建立一份集体描述干预生命过程中发生的事情。

运行REM车间

研讨会通常分为五个主要部分。这第一的部分让每个人都有时间互相交谈；讨论他们如何参与干预措施，他们为之骄傲以及对他们重要的影响。这主要是一项热身活动。

这第二和第三部分s也许是最重要的。组成4-6人的小组，要求小组开始写下并讨论他们参与了什么以及影响了什么。他们在Flip Chart纸上捕获了此中心的时间表（例如，图1）。主持人可以通过提出探测问题来指导参与者进行活动。他们还确保每个人都有平等的机会为活动做出贡献。

One of the adaptations we made was that REM is viewed as both a retrospective and prospective method. In the workshops, participants can map their activities and impacts over the previous 3-6 months, and they can also anticipate what they envisage will happen over the next 3-6 months. Follow up workshops can then be carried out 3-6 months later where they revisit the previous REM outputs and ask, “Did what we think was going to happen, happen?” We also recommend that the first REM workshop is delivered in the first 3-6 months of their work.

这第四部分is a reflective one. Now that activities and impacts are visualised, the facilitator can ask participants to reflect on what they deem to be the most significant and why. But often, a more interesting conversation happens around the least significant impacts. Where did they invest time and energy which didn’t lead to anything meaningful? Why did this happen? What could be done in the future to minimise this happening again? Were other factors at play which prevented their work being impactful? Some of this can also be added to the map, or it could be audio-recorded and analysed later.

这最后一部分研讨会也是反思的。REM不仅是评估工具，而且是可以推动持续干预改进的工具。因此，在这里，主持人可以让小组讨论他们接下来要做什么，因为参加了REM研讨会。可能有些参与者以前不认识彼此，而仅在研讨会中为新合作创造了机会。

讲习班通常需要几个小时。如果您的时间较少，则可以缩短研讨会的元素。随着参与者对该方法越来越熟悉，后续研讨会也可以更短。我们已经测试了在线和面对面格式的改编方法。两者都可以工作，并且每个人都有利弊，但是面对面的格式可能允许更多的参与和讨论。

Further information

Within thepaper还有我们的supplementary online training，，，，we provide further details on how to apply the method, the circumstances in which it may be useful, and perhaps most importantly, we encourage others to adapt the method to meet their own needs. Hopefully, this method, and future iterations of it, offer one means of capturing the realities of efforts to improve public health.