Adapting ripple effects mapping for evaluating public health initiatives in complex systems: Reflections and recommendations from seven case studies

Ripple effects mapping is a qualitative and participatory method, developed to capture the dynamic nature and interacting elements of an initiative, and its impacts. We present our experiences of using ripple effects mapping to evaluate complex public health initiatives across seven case studies in Bradford, UK. Seven researchers engaged in qualitative reflective practice to capture their individual experiences of using ripple effects mapping within their research and practice; outlining how the method has been adapted and highlighting key reflections and recommendations for implementing ripple effects mapping in the future. We developed ten recommendations, with corresponding strategies, for implementing ripple effects mapping sessions. The recommendations outline how ripple effects mapping can be implemented to improve engagement and anticipate and overcome potential barriers. In doing so, we outline how ripple effects mapping can be used, and adapted, to evaluate various public health initiatives, in research and practice.