In 2024, Make-A-Wish International developed a Global Theory of Change model to identify wish-granting outcomes that are universal at an Affiliate, regional and global level.

Make-A-Wish International engaged Research For Impact, a Singapore-based research company, to develop a Theory of Change to help us define and analyze the actual impacts at different stages of the Wish Journey. It shows how these stages affect each other and what needs to be true at each stage to create meaningful change and maximize the impact.

An article based on this research was published in the peer-reviewed journal Children in 2024. The article, titled “Wish-Granting Interventions Promote Positive Emotions in Both the Short and Long Term in Children with Critical Illnesses and Their Families” is accessible here.

Above all, we will use this Theory of Change to evaluate and demonstrate that the Wish Journey makes a true difference in the lives of children with critical illnesses and their families, regardless of where they live.

A Theory of Change is a conceptual theoretical model that articulates the causal pathways between a programme’s interventions and its desired final outcomes. In practice, a Theory of Change provides an explicit step-by-step description of how intervention activities at different stages contribute to the sequence of short, medium and long-term stakeholder outcomes that ultimately lead to impact and makes clear what underlying assumptions or contextual factors may also influence these outcomes.

The development of a Global Theory of Change model for Make-A-Wish International was undertaken in four steps:

1. A literature review of relevant Make-A-Wish policies and materials as well as published work on the outcomes and impact of previous individual wish-granting interventions was carried out. The positive changes related to wish interventions that emerged from the review were collated and classified into seven key outcomes that collectively describe the impact of a wish. These outcomes were then used to inform and design the study.
2. A large-scale survey was developed to study the experiences of Make-A-Wish beneficiaries to understand the impact of wish-granting globally across Make-A-Wish Affiliates. A finalized survey for both children and parents/guardians was issued to wish families with children aged 13 to 17 in 2023 who had received their wish in the last five years. 832 complete responses were received from wish children and 1,479 from wish parents/guardians were collected and analyzed.
3. The findings were synthesized into a Global Theory of Change.
4. Findings were validated through individual stakeholder interviews.

Across all phases of the Wish Journey, Joy and Happiness consistently scored the highest among all types of impact, while the wish realization phase was the moment that both children and parents expressed having the most positive experience during the Wish Journey. Throughout the Wish Journey the positive experience across all types of impact increases, with the peak happening at the wish realization phase, lasting for 5 years or more.

Some highlights of findings were: ​

• 92%of wish children said the wish experience improved their well-being with​ 90% saying it helped them look forward​ and broaden their horizons.​
• 97%of both parents and children said​ it brought them joy and happiness.​
• 93%of wish parents said the wish experience provided family bonding.​
• 90%of parents said the wish provided respite and distraction for their child.

Wish families were surveyed on how important they feel the wish experience, brought to life through the Wish Journey, is:

• 98%of wish children and parents / guardians deemed having a wish experience important for every child with a critical illness. ​
• 98%of wish children and parents / guardians indicated that they would recommend Make-A-Wish to other children and families in a similar situation.

Wish families were also asked about impact on overall family well-being:

• 88%of wish children said the wish experience helped to create a sense of normalcy and provide relief from their medical treatments. ​
• 96%of parents/guardians said the wish experience created a happy lasting memory for the family and 89% said it created a sense of normalcy. ​
• 96%of parents/guardians said that thanks to the wish experience they felt empowered to address their child’s social and emotional needs, as well as the child’s medical needs (92%)

Validated Outcomes

Globally, there is a strong convergence around common outcomes and the Wish Journey:

• The benefits of a wish for a wish child included improved physical, emotional, and social well-being and inspiration of hope and optimism.
• A wish experience has a positive impact on the physical, mental and emotional well-being of parents/guardians.
• The wish experience has positive impacts on families by creating happy lasting memories, benefitting other family members (e.g. siblings) and giving themselves/their child relief from medical treatments and creating a sense of normalcy.