Cited by 1,031Health Policy Implementation ScienceEvaluation and Performance AssessmentPublic Health Policies and Education

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Developing a Process-Evaluation Plan for Assessing Health Promotion Program Implementation: A How-To Guide

Saunders, Ruth P., Evans, Martin H., Joshi, Praphul·2005·Health Promotion Practice

DOI 10.1177/1524839904273387

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Abstract

Process evaluation is used to monitor and document program implementation and can aid in understanding the relationship between specific program elements and program outcomes. The scope and implementation of process evaluation has grown in complexity as its importance and utility have become more widely recognized. Several practical frameworks and models are available to practitioners to guide the development of a comprehensive evaluation plan, including process evaluation for collaborative community initiatives. However, frameworks for developing a comprehensive process-evaluation plan for targeted programs are less common. Building from previous frameworks, the authors present a comprehensive and systematic approach for developing a process-evaluation plan to assess the implementation of a targeted health promotion intervention. Suggested elements for process-evaluation plans include fidelity, dose (delivered and received), reach, recruitment, and context. The purpose of this article is to describe and illustrate the steps involved in developing a processevaluation plan for any healthpromotion program.

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Additional file 3 of Feasibility of a multicomponent cognitive behavioral intervention for fear of falling after hip fracture: process evaluation of the FIT-HIP intervention
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Additional file 4 of Mixed method evaluation of the CEBHA+ integrated knowledge translation approach: a protocol
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Additional file 1 of Sahaj Samadhi Meditation versus a Health Enhancement Program for depression in chronic pain: protocol for a randomized controlled trial and implementation evaluation
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Additional file 4 of Process evaluation of a programme to empower community nurse leadership
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Additional file 4 of Optimising personal continuity for older patients in general practice: a study protocol for a cluster randomised stepped wedge pragmatic trial
Groot, L., Schers, H., Burgers, J. S., Schellevis, F., Smalbrugge, M., Uijen, A. A., van de Ven, P. M., van der Horst, H. E., & Maarsingh, O. R. (2021) · Figshare · doi:10.6084/m9.figshare.16835251
Additional file 1 of Process evaluation of a reablement training program for homecare staff to encourage independence in community-dwelling older adults
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Additional file 2 of Mixed method evaluation of the CEBHA+ integrated knowledge translation approach: a protocol
Pfadenhauer, L. M., Grath, T., Delobelle, P., Jessani, N., Meerpohl, J. J., Rohwer, A. C., Schmidt, B.-M., Toews, I., Akiteng, A. R., Chapotera, G., et al. (2021) · Figshare · doi:10.6084/m9.figshare.13605295
Additional file 4 of Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario
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Additional file 3 of Process evaluation of a programme to empower community nurse leadership
Vogel, R., Bours, G. J. J. W., Rooijackers, T. H., Metzelthin, S., Erkens, P. M. G., van Rossum, E., & Zwakhalen, S. M. G. (2021) · Figshare · doi:10.6084/m9.figshare.14966312
Additional file 1 of Aligning intuition and theory: a novel approach to identifying the determinants of behaviours necessary to support implementation of evidence into practice
Taylor, N., McKay, S., Long, J. C., Gaff, C., North, K., Braithwaite, J., Francis, J. J., & Best, S. (2023) · Figshare · doi:10.6084/m9.figshare.23722272
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Additional file 5 of Mixed method evaluation of the CEBHA+ integrated knowledge translation approach: a protocol
Pfadenhauer, L. M., Grath, T., Delobelle, P., Jessani, N., Meerpohl, J. J., Rohwer, A. C., Schmidt, B.-M., Toews, I., Akiteng, A. R., Chapotera, G., et al. (2021) · Figshare · doi:10.6084/m9.figshare.13605304
Additional file 1 of Guidance for conducting feasibility and pilot studies for implementation trials
Pearson, N., Naylor, P.-J., Ashe, M. C., Fernandez, M., Yoong, S. L., & Wolfenden, L. (2020) · Figshare · doi:10.6084/m9.figshare.13173938
Additional file 3 of Mixed method evaluation of the CEBHA+ integrated knowledge translation approach: a protocol
Pfadenhauer, L. M., Grath, T., Delobelle, P., Jessani, N., Meerpohl, J. J., Rohwer, A. C., Schmidt, B.-M., Toews, I., Akiteng, A. R., Chapotera, G., et al. (2021) · Figshare · doi:10.6084/m9.figshare.13605298
Additional file 1 of Determinants of low breastfeeding self-efficacy amongst mothers of children aged less than six months: results from the BADUTA study in East Java, Indonesia
Titaley, C. R., Dibley, M. J., Ariawan, I., Mu’asyaroh, A., Alam, A., Damayanti, R., Do, T. T., Ferguson, E., Htet, K., Li, M., et al. (2021) · Figshare · doi:10.6084/m9.figshare.13612727
Additional file 3 of Optimising personal continuity for older patients in general practice: a study protocol for a cluster randomised stepped wedge pragmatic trial
Groot, L., Schers, H., Burgers, J. S., Schellevis, F., Smalbrugge, M., Uijen, A. A., van de Ven, P. M., van der Horst, H. E., & Maarsingh, O. R. (2021) · Figshare · doi:10.6084/m9.figshare.16835248
Additional file 1 of Process evaluation of a complex workplace intervention to prevent musculoskeletal pain in nursing staff: results from INTEVAL_Spain
Soler-Font, M., Ramada, J. M., Merelles, A., Amat, A., de la Flor, C., Martínez, O., Palma-Vásquez, C., Sancho, C., Peña, P., Bültmann, U., et al. (2021) · Figshare · doi:10.6084/m9.figshare.16756025
Additional file 1 of Is level of implementation linked with intervention outcomes? Process evaluation of the TransformUs intervention to increase children’s physical activity and reduce sedentary behaviour
Koorts, H., Timperio, A. F., Abbott, G., Arundell, L., Ridgers, N. D., Cerin, E., Brown, H. E., Daly, R. M., Dunstan, D. W., Hume, C., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21152888
Additional file 2 of Feasibility of a multicomponent cognitive behavioral intervention for fear of falling after hip fracture: process evaluation of the FIT-HIP intervention
Scheffers-Barnhoorn, M. N., van Eijk, M., Schols, J. M. G. A., van Balen, R., Kempen, G. I. J. M., Achterberg, W. P., & van Haastregt, J. C. M. (2021) · Figshare · doi:10.6084/m9.figshare.14361686
Additional file 3 of Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario
Kamali, M., Sivapalan, S., Kata, A., Kim, N., Shanmugalingam, N., Duku, E., Zwaigenbaum, L., & Georgiades, S. (2022) · Figshare · doi:10.6084/m9.figshare.19498164
Additional file 4 of Implementation evaluation of a collective impact initiative to promote adolescent health in Oklahoma County, USA
Garney, W. R., Panjwani, S., Wilson, K. L., Garcia, K. E., Fore, S., Lautner, S. C., Lang, L., Criswell, B., & Mathews, R. (2022) · Figshare · doi:10.6084/m9.figshare.18132130
Additional file 3 of Role of early childhood educators’ demographic characteristics and perceived work environment in implementation of a preschool health promotion intervention
Gustafsson, J., Ray, C., Lehto, E., Roos, E., & Lehto, R. (2024) · Figshare · doi:10.6084/m9.figshare.26602885
Additional file 5 of Is level of implementation linked with intervention outcomes? Process evaluation of the TransformUs intervention to increase children’s physical activity and reduce sedentary behaviour
Koorts, H., Timperio, A. F., Abbott, G., Arundell, L., Ridgers, N. D., Cerin, E., Brown, H. E., Daly, R. M., Dunstan, D. W., Hume, C., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21152900
Additional file 1 of Implementation evaluation of a collective impact initiative to promote adolescent health in Oklahoma County, USA
Garney, W. R., Panjwani, S., Wilson, K. L., Garcia, K. E., Fore, S., Lautner, S. C., Lang, L., Criswell, B., & Mathews, R. (2022) · Figshare · doi:10.6084/m9.figshare.18132121
Additional file 1 of Process evaluation of a programme to empower community nurse leadership
Vogel, R., Bours, G. J. J. W., Rooijackers, T. H., Metzelthin, S., Erkens, P. M. G., van Rossum, E., & Zwakhalen, S. M. G. (2021) · Figshare · doi:10.6084/m9.figshare.14966306
Additional file 1 of Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario
Kamali, M., Sivapalan, S., Kata, A., Kim, N., Shanmugalingam, N., Duku, E., Zwaigenbaum, L., & Georgiades, S. (2022) · Figshare · doi:10.6084/m9.figshare.19498158
Additional file 2 of Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario
Kamali, M., Sivapalan, S., Kata, A., Kim, N., Shanmugalingam, N., Duku, E., Zwaigenbaum, L., & Georgiades, S. (2022) · Figshare · doi:10.6084/m9.figshare.19498161
Additional file 2 of Is level of implementation linked with intervention outcomes? Process evaluation of the TransformUs intervention to increase children’s physical activity and reduce sedentary behaviour
Koorts, H., Timperio, A. F., Abbott, G., Arundell, L., Ridgers, N. D., Cerin, E., Brown, H. E., Daly, R. M., Dunstan, D. W., Hume, C., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21152891
Additional file 1 of RESTART: a stepped-care approach to facilitate return to work for employees with psychological distress: design of a randomized controlled trial
Lettinga, H., van Oostrom, S. H., Zijlstra, H. P., Anema, J. R., & Proper, K. I. (2024) · Figshare · doi:10.6084/m9.figshare.26816170
Additional file 1 of Role of early childhood educators’ demographic characteristics and perceived work environment in implementation of a preschool health promotion intervention
Gustafsson, J., Ray, C., Lehto, E., Roos, E., & Lehto, R. (2024) · Figshare · doi:10.6084/m9.figshare.26602879
Additional file 3 of Is level of implementation linked with intervention outcomes? Process evaluation of the TransformUs intervention to increase children’s physical activity and reduce sedentary behaviour
Koorts, H., Timperio, A. F., Abbott, G., Arundell, L., Ridgers, N. D., Cerin, E., Brown, H. E., Daly, R. M., Dunstan, D. W., Hume, C., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21152894
Additional file 4 of Aligning intuition and theory: a novel approach to identifying the determinants of behaviours necessary to support implementation of evidence into practice
Taylor, N., McKay, S., Long, J. C., Gaff, C., North, K., Braithwaite, J., Francis, J. J., & Best, S. (2023) · Figshare · doi:10.6084/m9.figshare.23722281
Additional file 3 of Implementation evaluation of a collective impact initiative to promote adolescent health in Oklahoma County, USA
Garney, W. R., Panjwani, S., Wilson, K. L., Garcia, K. E., Fore, S., Lautner, S. C., Lang, L., Criswell, B., & Mathews, R. (2022) · Figshare · doi:10.6084/m9.figshare.18132127
Additional file 5 of Role of early childhood educators’ demographic characteristics and perceived work environment in implementation of a preschool health promotion intervention
Gustafsson, J., Ray, C., Lehto, E., Roos, E., & Lehto, R. (2024) · Figshare · doi:10.6084/m9.figshare.26602891
Additional file 1 of Optimising personal continuity for older patients in general practice: a study protocol for a cluster randomised stepped wedge pragmatic trial
Groot, L., Schers, H., Burgers, J. S., Schellevis, F., Smalbrugge, M., Uijen, A. A., van de Ven, P. M., van der Horst, H. E., & Maarsingh, O. R. (2021) · Figshare · doi:10.6084/m9.figshare.16835242
Additional file 3 of Individualized mobile health interventions for cardiovascular event prevention in patients with coronary heart disease: study protocol for the iCARE randomized controlled trial
Chen, Y., Ji, M., Wu, Y., Deng, Y., Wu, F., & Lu, Y. (2021) · Figshare · doi:10.6084/m9.figshare.14978272
Additional file 4 of Role of early childhood educators’ demographic characteristics and perceived work environment in implementation of a preschool health promotion intervention
Gustafsson, J., Ray, C., Lehto, E., Roos, E., & Lehto, R. (2024) · Figshare · doi:10.6084/m9.figshare.26602888
A process evaluation of “Show Me Strong Kids”: Improving child health through pediatrician-led community partnerships
Krantz, L. B., Porter, T., Koehn, K. L., Hoffman, K. G., Sohl, K., & Mmari, K. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108595

Authors: Saunders, R. P., Evans, M. H., & Joshi, P.
Affiliations: University of South Carolina (US)
South Carolina Department of Health and Environmental Control (US)
ORCID: Saunders, Ruth P.
Joshi, Praphul
Venue: Health Promotion Practice
Publisher: SAGE Publications
Published: 2005-04
Volume: 6
Issue: 2
Pages: 134-147
ISSN: 1524-8399 (ISSN-L)
1552-6372
DOI: 10.1177/1524839904273387
OpenAlex: W2156843619
Cited by: 1,031
References: 24
Citations by year: 2026: 40 · 2025: 55 · 2024: 61 · 2023: 57 · 2022: 70 · 2021: 107 · 2020: 77 · 2019: 65 · 2018: 64 · 2017: 81 · 2016: 54 · 2015: 72 · 2014: 63 · 2013: 48 · 2012: 37
FWCI: 12.59
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Health Promotion Practice (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Social Sciences › Public Administration › Evaluation and Performance Assessment
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Public Health Policies and Education
Keywords: process evaluation, health promotion programs, program implementation, evaluation planning, fidelity, dosage, REACH regulation, recruitment (clinical trials), context, targeted interventions, evaluation framework
MeSH terms: Adolescent, Health Plan Implementation, Health Promotion, Humans, Planning Techniques, School Health Services, United States, Process Assessment, Health Care, Community Health Planning

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Developing a Process-Evaluation Plan for Assessing Health Promotion Program Implementation: A How-To Guide

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