Ripple effects mapping (REM) is emerging as a valuable qualitative approach for evaluating complex public health interventions, particularly in understanding their long-term impacts. A study applied an adapted REM methodology to evaluate the Agenda Gap program, which promotes youth mental health through multi-sector partnerships. Traditional evaluation methods struggle to capture the program’s relational and long-term outcomes.

Through analysis of data from former youth participants and adult allies, three main thematic outcomes were identified: (1) Reimagining Future Possibilities, (2) Systems Integration: Transforming School Practices, and (3) Progressing From Ripple Effects to Sea Change. These outcomes reflect significant changes at various social levels, including individual, family, community, and societal, revealing the broader effects on participants well after the program’s conclusion. The findings highlight the substantial impacts of the Agenda Gap initiative and suggest that qualitative, participatory methods like REM can enhance conventional evaluation approaches by uncovering often overlooked outcomes. The study concludes with recommendations for future research and applications of REM in public health evaluations.