The evaluation of comprehensive cancer control efforts: useful techniques and unique requirements.

This article discusses evaluation of comprehensive cancer control efforts as developed in the United States by involved partners at all levels -- community, regional, state, tribal, territorial, and national. Evaluation of comprehensive cancer control can concern the evaluation of a program, a plan or activities from a plan. In its development, it is grounded in both theory and practice, and the results are used in program development and implementation to document activities, inform decision making, and demonstrate accountability. Various types of evaluation have been shown to be important. Challenges to evaluating comprehensive cancer control include incorporating and working with a broad group of stakeholders; developing an agreed upon plan and evaluation, ensuring the necessary infrastructure for overseeing, facilitating, and disseminating results of evaluations; conceptualizing and communicating desired changes; and potentially implementing (and evaluating) programs at the community, regional, tribal, territorial, state, or national level. Using the CDC Framework for Evaluation, selected examples of state program evaluations are presented. These examples show the use of both process and outcome evaluations to illustrate programmatic improvement and the accomplishment of proposed objectives. As evaluation of comprehensive cancer control continues to be developed and results communicated, our ability to evaluate comprehensive cancer control programs increases and the growth of comprehensive cancer control efforts are encouraged.