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Process questions are usually used to explain the peculiarities of a program’s intervention (Joosen, Frings-Dresen, and Sluiter 160). This category of questions helps to understand how the process may influence the outcomes of the program and define who or what undergo the most considerable changes during the process under consideration (Hallfors, Cho, Mbai, Milimo, and Itindi 1102). Any public health promotion should answer the following questions:
- Are there any immediate changes the participants, developers or stakeholders have to expect at the beginning of the program offered?
- What are the possible intended and unintended outcomes of the program’s implementation process to be expected?
- What barriers (both internal and external) may take place during the program’s implementation and what are the reasons of their development?
Impact evaluation questions differ from other types of questions due to the necessity to analyze the immediate effects of the program (McKenzie, Neiger, and Thackeray 376). As a rule, these questions aim at “measuring changes in knowledge, attitudes, behaviors, skills, community norms, utilization of health services” (Adamchak, Bond, MacLaren, Magnani, Nelson, and Seltzer 5).
It is necessary to remember that such questions have to be definite and touch upon a particular situation. It is wrong to pose some general questions and expect to get a portion of credible information in return. The following questions are the examples:
- What are the effects of the program in regards to the short-term and long-term goals set by the developers?
- Are the developers of the program confident in the effectiveness of the program? What are the proofs of their confidence or their doubts?
- Can the same program be implemented in a different country by the same people/by different people? Why/why not?
The outcome evaluation questions help to see the evident impact of the program on different stakeholders and processes (W.K. Kellogg Foundation 27). Some researchers admit that it is not always possible to provide the evaluation process with a number of clear and informative outcome questions; still, it remains to be desirable (Thurston, Vollman, and Burgess 45). The following questions may be created to make the developers sharing their own expectations in regards to the program:
- Are there any unexpected effects the program may have on stakeholders?
- Are there any proofs that the outcomes of the program do not correspond to the goals set at the beginning of the program implementation process?
- Are there any possible implementations (not mentioned beforehand) that can be used to improve the already achieved results and change the situation in regards to the expectations?
General Evaluation of the Questions
All these nine questions have much in common; still, all of them make a person consider different aspects of the same program. It is not enough to provide separate answers to the questions. It is more important to find a connection between all three aspects (process, impact, and outcome) and give the answers taking into consideration this connection.
In brief, the main difference between the questions lies in the period when they have to be asked: process questions should be created at the beginning, impact questions should be offered at the end of the implementation process, and outcome questions may be offered after some time after the implementation passes. This is how the evaluation process may be organized in regards to any public health promotion program.
Adamchak, Susan, Bond, Katherine, MacLaren, Laurel, Magnani, Robert, Nelson, Kristin, and Judith Seltzer 2000, A Guide to Monitoring and Evaluating Adolescent Reproductive Health Programs. PDF file.
Hallfors, Denise, Cho, Hyunsan, Mbai, Isabella, Milimo, Benson, and Janet Itindi. “Process and Outcome Evaluation of a Community Intervention for Orphan Adolescents in Western Kenya.” Journal of Community Health 37.5 (2012): 1101-1109. Print.
Joosen, Margot, Frings-Dresen, Monique, and Judith Sluiter. “Process and Outcome Evaluation of Vocational Rehabilitation Interventions in Patients with Prolonged Fatigue Complaints.” International Journal of Behavioral Medicine 18.2 (2011): 160–171. Print.
McKenzie, James, Neiger, Brad, and Rosemary Thackeray. Promotion Programs: A Primer. San Francisco, CA: Pearson, 2013. Print.
Thurston, Wilfreda, Vollman, Adrene, and Michael Burgess. “Ethical Review of Health Promotion Program Evaluation Proposals.” Health Promotion Practice 4.1 (2003): 45-50.
W.K. Kellogg Foundation 2004, W.K. Kellogg Foundation Evaluation Handbook. PDF file.