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Our recent research demonstrates strong connections between participatory budgeting (PB) in Brazilian municipalities and increased social spending and improvements in infant mortality at the local level. However, the precise mechanisms connecting PB programs to improved outcomes are still unclear. There is wide variation within PB programs in terms of their rules and organizational structures that could explain improvements in wellbeing, but the data required to assess potential causal mechanisms such as voting requirements or participants' demographic characteristics has not been available. We address this issue by constructing a unique dataset of four different surveys of Brazilian PB programs from 1997 to the present. We then use our dataset to evaluate whether and how internal mechanisms within PB programs explain variation in municipal spending patterns and local outcomes associated with wellbeing, such as infant mortality rates. Using statistical models to test causal mechanisms within PB then offers scholars and practitioners a framework for designing PB programs to maximize impact and improve citizens' lives in Brazil, Latin America and around the world.