O4 Ripple Effects Mapping to Explore Sustainability for Changes in Policies, Systems, and Environments

Background To improve healthy food systems, collective interventions that focus on promoting positive changes in policies, systems, and environments (PSEs) need sustained involvement and promotion from community members. Ripple Effects Mapping (REM)—a participatory method used to collect qualitative data about interventions impacts—has the potential to capture perceived effectiveness of these interventions as well as provide an opportunity to explore potential for sustainability. Objective The objective was to use REM to identify perceived effectiveness of the PSE interventions and opportunities for sustainability at the end of an obesity prevention grant in 4 rural Southern counties. Study Design, Setting, Participants At the conclusion of a 5-year grant, REM was used to capture qualitative data about perceived effectiveness and unanticipated consequences of PSE interventions focused on increasing access to healthy foods. Four REM sessions were conducted—1 in each county involved in the grant. Forty community members who had contributed to PSE implementations participated. Measurable Outcome/Analysis Trained facilitators guided participants through discussions about project activities and impacts and created a ripple map. The maps visually represented perceived community impacts and how these impacts were interconnected. The facilitators used the maps and detailed notes to code information using the Community Capitals Framework and to identify themes. Results Community capitals centered primarily on increases in human, cultural, and social capitals. One major theme that emerged from the sessions was the ongoing sustainability efforts that participants identified and discussed. The sessions helped participants frame how they could move forward to continue the interventions after the initial grant concluded. Participants discussed future funding efforts and how they could continue to collaborate and expand on interventions. Conclusion REM is a qualitative method that can capture perceived intervention impacts as well as help groups identify areas for sustainability. Funding Centers for Disease Control and Prevention.