Viadro, C.I., Earp, J.A., and Altpeter, M. Evaluation and Program Planning, 20(3):237-249, April-June, 1997.

Process evaluation is increasingly viewed as a vital adjunct to outcome evaluation. In this paper, we discuss the steps taken to develop a process evaluation plan for an ongoing eight-year, community-based breast cancer screening program (NC-BCSP) for African American women in the five rural North Carolina counties. NC-BCSP builds on community networks, enhances the delivery of local screening services, and reduces health system barriers in the widely dispersed and resource-poor communities that comprise NC-BCSP's 2500-square mile region. This article includes a discussion of: the process evaluation's aims and scope; how and why we selected various methods and approaches; the challenges involved in launching the data collection process; early lesions learned about the resources needed for developing an effective process evaluation; and some of the advantages of gathering process data.