The value of process evaluation in a community-based cancer control program

Louise E. Cunningham, Robert Michielutte, Mark Dignan, Penny Sharp, Jeanne Boxley

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


The Cancer Awareness Program was a four-year community health education project conducted in six rural North Carolina counties. The educational program was designed to increase breast, cervical, and skin cancer screening behaviors in low income women. Female clients of the health department in each county, aged 20 and older, were eligible for the program. Program intervention activities were targeted both to the health departments and to the individual women, in addition to the community. Intervention activities included media messages, telephone counseling of participants, community presentations, printed materials, bulletin boards, and direct education. Process evaluation allowed for regular monitoring of all program components, identifying any areas in need of modification, and was developed for the long distance supervision of the project as well. Measures consisted of videotaping of presentations, meetings with key individuals and staff, participant evaluations and feedback, focus groups, and weekly activity reports from staff. The results of the process evaluation enabled investigators to pinpoint effective intervention components that led to desired results. In addition, it allowed investigators to define areas in need of modification, and adjust specific components. Final evaluation of the project indicated that the intervention significantly increased participation in screening for skin cancer and breast cancer. Included in the paper are the purposes of each process method, problems identified, and their resolution. Suggestions are made for use of process evaluation in community health education programs.

Original languageEnglish
Pages (from-to)13-25
Number of pages13
JournalEvaluation and Program Planning
Issue number1
StatePublished - Feb 2000

Bibliographical note

Funding Information:
The authors would like to thank Allan Steckler, DrPH, Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill for his assistance in preparing this article. We would also like to thank Virginia Burnette for her tireless commitment and contribution to the project. In addition, special thanks to our project health educators for their hard work: Kathryn Alverson, Heather Andrews, Misty Harris, Jennifer Rubino, Sylvia Saxon, and Ann Simmons. Lastly, we would like to thank all the staff from the Alexander, Alleghany, Burke, Clay, Henderson, and Transylvania County Health Departments for allowing us to conduct our project in their clinics. This study was funded by a grant by the National Cancer Institute (R01 CA60504).


  • Cancer screening
  • Community education
  • Process evaluation
  • Public health department

ASJC Scopus subject areas

  • Business and International Management
  • Social Psychology
  • Geography, Planning and Development
  • Strategy and Management
  • Public Health, Environmental and Occupational Health


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