Process evaluation. Assessing re-invention of community-based interventions

Area of Science:

• Community Health
• Program Evaluation
• Health Intervention Research

Background:

• Complete program evaluation requires assessing both implementation processes and impact/outcome variables.
• Process evaluation is often omitted, despite its importance in understanding program fidelity.

Purpose of the Study:

• To demonstrate the critical role of process evaluation in identifying the actual independent variable in field research.
• To explore instances of program 'reinvention' during implementation.
• To offer strategies for managing inevitable program modifications in field studies.

Main Methods:

• Case study methodology applied to the Arthritis Self-Care Project, a rural community-based intervention.
• Qualitative analysis of program implementation data to identify deviations from the original protocol.

Main Results:

• The Arthritis Self-Care Project revealed significant instances where the program was altered or 'reinvented' by those implementing it.
• Failure to conduct process evaluation can lead to misinterpretation of program effectiveness due to unacknowledged modifications.

Conclusions:

• Process evaluation is essential for accurately determining the independent variable and understanding program dynamics in real-world settings.
• Acknowledging and managing program reinvention is vital for rigorous field research and effective public health interventions.