In public health program evaluation, what does process evaluation typically assess?

• A. Long-term health outcomes
• B. The same as outcome evaluation
• C. Implementation, fidelity, reach, and context
• D. Only cost and efficiency

Answer: (C)

Process evaluation focuses on how a program is delivered rather than whether it achieves health effects. It examines the implementation itself—fidelity to the planned intervention, the extent to which the target population is reached, how much is delivered (dose), and the influence of the surrounding context on delivery and uptake. Understanding these elements helps explain why outcomes may or may not occur and guides adjustments to improve implementation. Long-term health outcomes belong to outcome or impact evaluation, not process evaluation. The idea of evaluating the same as outcome evaluation misses the delivery-focused question, and cost and efficiency relate to economic evaluation rather than the implementation process.