Calls for evaluating systems change and transformation in multiple fields present an opportunity to explore cross-field patterns. This article reports on part one of a critical, integrative review of academic and gray literature published between 2011 and 2021 (n = 102) within five areas: evaluation, health, organizational change, sustainability, and philanthropy. Questions address key definitions, how a systemic approach differs from traditional social problem-solving, leverage points to influence change, and implications for evaluation. Four findings include (1) limited normative debate about change and transformation; (2) conventional and systemic approaches contrasted as binary paths; (3) 10 shared leverage areas with the least attention on power and resources; and (4) an expanded role for evaluation that presents challenges and opportunities. Review results provide support for shifts underway within the evaluation field, including funders working in deeper collaborations, evaluators expanding their skill sets, and intermediary agencies facilitating transdisciplinary exchanges.
AbercrombieRHarriesEWhartonR (2015) Systems Change: A Guide to What It Is and How to Do It. London: New Philanthropy Capital (NPC).
2.
AbsonDJFischerJLeventonJ, et al. (2017) Leverage points for sustainability transformation. Ambio46(1): 30–9.
3.
AndrachukMArmitageD (2015) Understanding social-ecological change and transformation through community perceptions of system identity. Ecology and Society20(4): 26.
4.
AntadzeNWestleyFR (2012) Impact metrics for social innovation: barriers or bridges to radical change?Journal of Social Entrepreneurship3(2): 133–50.
5.
ApgarMAstonTSnijderM, et al. (2024) Raising the bar: Improving how to assess evidence quality in evaluating systems-change efforts. The Foundation Review16(2): 7–21.
6.
AtkinsDKilbourneAMShulkinD (2017) Moving from discovery to system-wide change: the role of research in a learning health care system. Annual Review of Public Health38(1): 467–87.
7.
AtkinsonJLasbennesFNabarroD (2021) Reflecting on our times: valuing transformative leadership in real-world “living systems.”American Journal of Evaluation42(1): 130–8.
8.
GatesEF (2016) Making sense of the emerging conversation in evaluation about systems thinking and complexity science. Evaluation and Program Planning59: 62–73.
9.
GatesEF (2018) Towards valuing with critical systems heuristics. American Journal of Evaluation39(2): 201–220.
10.
GatesEFWaltonMVidueiraP, et al. (2021) Introducing systems- and complexity-informed evaluation. New Directions for Evaluation2021: 13–25.
11.
BaptisteLIeseV (2019) The transformative agenda for evaluation in small island developing states: The Caribbean and the Pacific. In: Van den BergRMagroCMulderS (eds) Evaluation for Transformational Change: Opportunities and Challenges for the Sustainable Development Goals. Exeter: International Development Evaluation Association (IDEAS), 34–48.
12.
Barbrook-JohnsonPCastellaniBHillsD, et al. (2021) Policy evaluation for a complex world: Practical methods and reflections from the UK centre for the evaluation of complexity across the Nexus. Evaluation27(1): 4–17.
13.
BarnesMBodinÖGuerreroAM, et al. (2017) The social structural foundations of adaptation and transformation in social–ecological systems. Ecology and Society22(4): 16.
BestAGreenhalghTLewisS, et al. (2012) Large-system transformation in health care: A realist review. The Milbank Quarterly90(3): 421–56.
17.
BirneyA (2021) How do we know where there is potential to intervene and leverage impact in a changing system? The practitioner’s perspective. Sustainability Science16(3): 749–65.
18.
BraithwaiteJChurrucaKLongJC, et al. (2018) When complexity science meets implementation science: A theoretical and empirical analysis of systems change. BMC Medicine16(1): 63.
19.
BrousselleAMcDavidJ (2020) Evaluators in the anthropocene. Evaluation26(2): 190–204.
20.
BurchSShawADaleA, et al. (2014) Triggering transformative change: A development path approach to climate change response in communities. Climate Policy14(4): 467–87.
ChinoM (2012) Tribal capacity building as a complex adaptive system: New insights, new lessons learned. International Public Health Journal4(3): 235–42.
23.
SchwandtTAGatesEF (2021) Evaluating and Valuing in Social Research. Guilford Press.
24.
CristanchoSFieldELingardL (2018) What is the state of complexity science in medical education research?Medical Education53(1): 95–104.
Dean-CoffeyJConéM (2023) The Equitable Evaluation Framework: May 2023 Expansion. Available at: https://www.equitableeval.org/framework (accessed 23 June 2025).
27.
EnglishMNzingaJIrimuG, et al. (2020) Programme theory and linked intervention strategy for large—scale change to improve hospital care in a low and middle—income country—a study pre-protocol. Wellcome Open Research5: 265.
28.
EoyangGOakdenJ (2016) Adaptive evaluation. Emergence: Complexity and Organization18(3/4): 1–14.
29.
EvansJMBakerGRBertaW, et al. (2015) Culture and cognition in health systems change. Journal of Health Organization and Management29(7): 874–92.
30.
FlyvbjergB (2001) Making Social Science Matter: Why Social Inquiry Fails and How It Can Succeed Again (trans. SampsonS.). Cambridge: Cambridge University Press.
31.
GarnettT (2014) Three perspectives on sustainable food security: Efficiency, demand restraint, food system transformation. What role for life cycle assessment?Journal of Cleaner Production73: 10–8.
32.
GrantMJBoothA (2009) A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information & Libraries Journal26(2): 91–108.
33.
HargreavesM (2018) Leveraging Systemic Change: Evaluating What Works. Chicago, IL: NORC at the University of Chicago.
34.
HendyJBarlowJ (2012) The role of the organizational champion in achieving health system change. Social Science and Medicine74(3): 348–55.
HubeauMMarchandFCoteurI, et al. (2017) A new agri-food systems sustainability approach to identify shared transformation pathways towards sustainability. Ecological Economics131: 52–63.
37.
HusseyAJSibbaldSLFerroneM, et al. (2021) Confronting complexity and supporting transformation through health systems mapping: a case study. BMC Health Services Research21(1): 1146.
38.
JacksonMC (2019) Critical Systems Thinking and the Management of Complexity: Responsible Leadership for a Complex World. Hoboken, NJ: Wiley Blackwell.
39.
JonesLFraserAStewartE (2019) Exploring the neglected and hidden dimensions of large-scale healthcare change. Sociology of Health and Illness41(7): 1221–35.
40.
JonesMVerityFWarinM, et al. (2016) OPALesence: Epistemological pluralism in the evaluation of a systems-wide childhood obesity prevention program. Evaluation22(1): 29–48.
41.
JungeKCullenJIacopiniG (2020) Using contribution analysis to evaluate large-scale transformation change processes. Evaluation26(2): 227–45.
KolerosAAdrienM-HTyrrellT (eds) (2024) Theories of Change in Reality: Strengths, Limitations and Future Directions. New York: Routledge.
44.
KolerosAJuppDKirwanS, et al. (2016) Methodological considerations in evaluating long-term systems change: A case study from Eastern Nepal. American Journal of Evaluation37(3): 364–80.
45.
LeeJYWaddockS (2021) How transformation catalysts take catalytic action. Sustainability13(17): 9813.
46.
LoorbachDFrantzeskakiNAvelinoF (2017) Sustainability transitions research: Transforming science and practice for societal change. Annual Review of Environment and Resources42: 599–626.
47.
LynnJCoffmanJ (2024) Passing in the dark: Making visible philanthropy’s hidden and conflicting mental models for systems change. The Foundation Review16(1): 20–35.
48.
MertensDM (2010) Social transformation and evaluation. Evaluation Journal of Australasia10(2): 3–10.
49.
MiyaguchiT (2022) Importance and utilization of theory-based evaluations in the context of sustainable development and social-ecological systems. In: UittoJIBatraG (eds) Transformational Change for People and the Planet: Evaluating Environment and Development. Cham: Springer, 223–35. Available at: https://doi.org/10.1007/978-3-030-78853-7_15 (accessed 16 June 2025).
50.
Molas-GallartJBoniAGiachiS, et al. (2021) A formative approach to the evaluation of transformative innovation policies. Research Evaluation30(4): rvab016.
51.
MorellJA (2018) Systematic iteration between model and methodology: A proposed approach to evaluating unintended consequences. Evaluation and Program Planning68: 243–52.
52.
NaidooIA (2022) Evaluation for transformational change: Learning from practice. In: UittoJIBatraG (eds) Transformational Change for People and the Planet: Evaluating Environment and Development (Sustainable Development Goals Series). Cham: Springer, 17–26. Available at: https://doi.org/10.1007/978-3-030-78853-7_2 (accessed 4 August 2022).
53.
NakaimaASridharanSGardnerB (2013) Towards a performance measurement system for health equity in a local health integration network. Evaluation and Program Planning36(1): 204–12.
54.
NarayananVAdamsCA (2016) Transformative change towards sustainability: The interaction between organisational discourses and organisational practices. Accounting and Business Research47(3): 344–68.
NormanCD (2021) Supporting systems transformation through design-driven evaluation. New Directions for Evaluation2021(170): 149–58.
57.
NyströmMEHöögEGarvareR, et al. (2013) Change and learning strategies in large scale change programs: Describing the variation of strategies used in a health promotion program. Journal of Organizational Change Management26(6): 1020–44.
58.
OfirZRuggD (2021) American Journal of Evaluation section on international developments in evaluation: Transforming evaluation for times of global transformation. American Journal of Evaluation42(1): 47–52.
59.
OlssonAThunborgCBjörkmanA, et al. (2020) A scoping review of complexity science in nursing. Journal of Advanced Nursing76(8): 1961–76.
60.
OlssonPMooreM-LWestleyFR, et al. (2017) The concept of the Anthropocene as a game-changer: a new context for social innovation and transformations to sustainability. Ecology and Society22(2): 31.
61.
PalmatierRWHoustonMBHullandJ (2017) Review articles: purpose, process, and structure. Journal of the Academy of Marketing Science46(1): 15.
62.
PalomoILocatelliBOteroI, et al. (2021) Assessing nature-based solutions for transformative change. One Earth4(5): 730–41.
63.
PattonMRichardsonR (2024) A philanthropic theory of systems transformation for advancing equity in the polycrisis. The Foundation Review16(2): 55–71.
64.
PattonMQ (2019) Transformation to global sustainability: Implications for evaluation and evaluators. New Directions for Evaluation2019(162): 103–17.
65.
PattonMQ (2020) Blue Marble Evaluation: Premises and Principles. New York: The Guilford Press.
66.
PattonMQ (2021) Evaluation criteria for evaluating transformation: Implications for the coronavirus pandemic and the global climate emergency. American Journal of Evaluation42(1): 53–89.
67.
PattonMQ (2023) Evaluating transformation means transforming evaluation. In: EdmondsonB (ed) Sustainability Transformations, Social Transitions and Environmental Accountabilities. Cham: Springer International Publishing, 15–38. Available at: https://doi.org/10.1007/978-3-031-18268-6_2 (accessed 12 June 2025).
68.
PerlaRJBradburyEGunther-MurphyC (2013) Large-scale improvement initiatives in healthcare: A scan of the literature. Journal for Healthcare Quality35(1): 30–40.
69.
PicciottoR (2020) Towards a complexity framework for transformative evaluation. Journal of Multidisciplinary Evaluation16(35): 54–76.
Putnam-WalkerlyK (2017) The Role of Philanthropy in Systems Change: Findings and Lessons from a Field Scan of Systems Change and Policy Advocacy in the Philanthropic Field. Cleveland, OH: Putnam Consulting Group.
72.
RengerRFoltysovaJRengerJ, et al. (2020) Comparing and contrasting a program versus system approach to evaluation: The example of a cardiac care system. Canadian Journal of Program Evaluation35(2): 210–27.
73.
RijswijkKBewsellDSmallB, et al. (2015) Reflexive monitoring in New Zealand: Evaluation lessons in supporting transformative change. Evaluation Journal of Australasia15(4): 38–43.
74.
Rockefeller Philanthropy Advisors (2019) Assessing Systems Change: A Funders’ Workshop Report. Workshop report, October. New York: Rockefeller Philanthropy Advisors.
75.
RogersP (2024) Developing, representing, and using theories of change for interventions in complex systems. In: KolerosAAdrienM-HTyrrellT (eds) Theories of Change in Reality: Strengths, Limitations and Future Directions. New York: Routledge, 94–102.
76.
RusojaEHaynieDSieversJ, et al. (2018) Thinking about complexity in health: A systematic review of the key systems thinking and complexity ideas in health. Journal of Evaluation in Clinical Practice24(3): 600–6.
77.
ScallyCPLoLPettitKLS, et al. (2020) Driving Systems Change Forward: Leveraging Multisite, Cross-sector Initiatives to Change Systems, Advance Racial Equity, and Shift Power. Washington, DC: Federal Reserve Bank of San Francisco and Urban Institute.
78.
ScottKAPringleJ (2018) The power of the frame: Systems transformation framework for health care leaders. Nursing Administration Quarterly42(1): 4–14.
79.
SiegelBWineyDKornetskyA (2015) Pathways to System Change: The Design of Multisite, Cross-sector Initiatives. Working paper. San Francisco, CA: Federal Reserve Bank of San Francisco and Mt. Auburn Associates, Inc.
80.
SiliciLKnoxJRoweA, et al. (2022) Evaluating transformational adaptation in smallholder farming: Insights from an evidence review. In: UittoJIBatraG (eds) Transformational Change for People and the Planet. Sustainable Development Goals Series. Cham: Springer, 187–202. Available at: https://link.springer.com/10.1007/978-3-030-78853-7_13 (accessed 18 January 2025).
81.
SolarOFrenzP (2017) Lessons from Chile’s use of system-level theory of change to implement a policy redesign process to address health inequities. New Directions for Evaluation2017(154): 101–13.
82.
StachowiakSLynnJAkeyT (2020) Finding the impact: Methods for assessing the contribution of collective impact to systems and population change in a multi-site study. New Directions for Evaluation2020(165): 29–44.
83.
SturmbergJPHalloranDMOMartinCM (2012) Understanding health system reform—A complex adaptive systems perspective. Journal of Evaluation in Clinical Practice18(1): 202–8.
84.
The Australian Centre for Social Innovation (2019) Philanthropy, Systems and Change. Adelaide, SA, Australia: The Australian Centre for Social Innovation.
UittoJIPuriJWilliamsA, et al. (2019) Evaluating transformational change — Lessons from international environmental funds. In: Van den BergRMagroCMulderS (eds) Evaluation for Transformational Change: Opportunities and Challenges for the Sustainable Development Goals. Exeter: International Development Evaluation Association (IDEAS), 105–30.
87.
UlrichW (1983) Critical Heuristics of Social Planning: A New Approach to Practical Philosophy. Geneva: Swiss National Science Foundation.
88.
United Nations Development Programme (UNDP) (2022) System Change: A Guidebook for Adopting Portfolio Approaches. Available at: https://unstuck.systems/system-approaches-toolkit/ (accessed 23 June 2025).
89.
Van BruggenANikolicIKwakkelJ (2019) Modeling with stakeholders for transformative change. Sustainability11(3): 825.
90.
Van den BergRMagroCMulderS (2019) Evaluation for Transformational Change: Opportunities and Challenges for the Sustainable Development Goals. Exeter: International Development Evaluation Association (IDEAS).
91.
Van OngevalleJHuyseHVan PetegemP (2014) Dealing with complexity through actor-focused planning, monitoring and evaluation (PME). Evaluation20(4): 447–66.
92.
WaddellSWaddockSCornellS, et al. (2015) Large system change: An emerging field of transformation and transitions. Journal of Corporate Citizenship58: 5–30.
93.
WaddockSWaddellS (2021) Transformation catalysts: Weaving transformational change for a flourishing world for all. CADMUS4(4): 18.
WestleyFOlssonPFolkeC, et al. (2011) Tipping toward sustainability: Emerging pathways of transformation. AMBIO40(7): 762–80.
96.
WhittemoreRKnaflK (2005) The integrative review: Updated methodology. Journal of Advanced Nursing52(5): 546–53.
97.
WillisCDBestARileyB, et al. (2014) Systems thinking for transformational change in health. Evidence and Policy: A Journal of Research, Debate and Practice10(1): 113–26.
