Understanding program outputs and their societal impacts represents one component of an effective transformative program.  Another essential ingredient is the early identification of program inputs.  Program inputs may include features of program design, or resources (e.g., paid and volunteer staff hours) required to plan and run the program. The relationship between program inputs and output/impact can be an important indicator of the effectiveness of the program and allows for program revision if results are either unclear or not as expected.  Where they are identified, program inputs can be clearly communicated to key stakeholders using grids that present all program parameters (inputs, outputs and impacts), their linkages within the program and their strengths and weaknesses.  Corporate community investments can be objectified, where appropriate, to support decision making for future funding requests.  For example, if a program in nutritional wellness that was originally designed to target 5,000 participants over six months only recruits 25% of this total, then questions can be addressed to the non-profit organization (NPO) about recruitment strategies and targets or program design can be corrected if required. 

One of the more effective ways to assess program efficiency is to link program input costs to the societal cost of the impacts. To do this, the cost of the program inputs is estimated and compared to the perceived “value” of the impact.  To value the impact, a cost is applied to all the identified societal impacts.  These may include short and long-term financial gains for program participants and the cost-benefits of observed societal impacts.  In the nutritional wellness example cited above, better diets could translate into improved participant health (measured in terms of increased productivity, fewer doctor visits, lower personal costs, improved quality of life) and direct medical cost savings (lower prescription drug use, fewer hospitalizations), all of which can be expressed as a societal financial gain.  Some impacts may however be difficult to assess.  For example, the impact of a sponsor’s community investment on corporate financial performance may be inferred based on anecdotal evidence, but the application of a valid “value” to this impact requires diligent research and a number of testable assumptions. 

The financial relationship between program inputs and impact can be expressed in two ways.  Costs can be linked to a specific outcome by estimating a cost-effectiveness ratio, where the input costs are expressed in terms of an incremental gain in a specific measurable societal parameter.  For example, input costs can be linked to a clinical outcome by estimating the cost-effectiveness of the intervention expressed in terms of a clinical gain (e.g., on a societal basis the cost per year of life saved or the cost per myocardial infarction avoided by a nutritional wellness program). With careful planning, and using an appropriate clinical outcome, the cost-effectiveness of a specific community involvement program can be compared with other clinical interventions, an outcome that can provide convincing support for continued funding (3).  Alternatively, overall cost gains generated by a program through societal impacts can be expressed in terms of input costs through estimation of the social return on investment (SROI) of the program (4).  The SROI is estimated as the ratio of program impact costs to input costs; any ratio greater than 1.0 demonstrates that the program generates greater societal value than the initial input investment.  In contrast, a ratio less than 1.0 shows that the expected program societal gains are less than the input cost.  However, in a well designed transformative community involvement program a negative SROI can lead to the identification of inputs or outputs that contribute to this negative value and the possibility of a program design change that transforms the SROI to a positive value. 

At first glance, transformative program models may not be achievable for all community investments.    Financial constraints or pre-existing program structures may not allow for a full assessment of project outputs or impacts.  NPOs may not be adequately funded or resourced to integrate impact assessment into their organizational activities and may lack the internal capacity to design or implement research tools or methods.  This is unfortunate, given the NPO’s proximity to program participants and direct engagement in program activities, which makes them ideally suited to collect the data necessary for impact measurement.

The good news is that with careful planning, NPOs can still participate in effective program transformation by implementing a first step such as a small demonstration study that provides proof of concept. Using pilot results, NPOs can engage corporate or even research partners with strategically aligned missions in supporting larger-scale studies (Figure 3).  In general, research expertise is hugely under tapped insofar as its potential to aid decision-making in real-life business and community settings.  There exists an opportunity for business and NPOs to harness this skill set through compelling propositions. In certain instances, less expensive research approaches such as expert panels or academic literature searches can dovetail with NPO expertise to identify gaps in knowledge and to highlight areas of best practice that are relevant to program design.  Mixed methods researchers can generate an impact set, or a combined qualitative and quantitative argument that provides the full picture of the benefits of a program.  In other situations, simple models can be built to aid in decision-making, such as decision grids that align company and social objectives; that generate a guideline for the evaluation of partnership project requests.