Method and design issues in evaluation of community health education programs: a case study in breast and cervical cancer.

Systemic evaluation efforts are often neglected in community health education programs due to lack of financial or technical resources. The utility of including program evaluation at an early state in program development and implementation is demonstrated in this case study of a community-wide breast and cervical cancer education program. A number of methodological issues that the health education practitioner should consider in evaluations of community health programs are identified and discussed including: 1) selection of design; 2) establishing controls; 3) determination of sample size; 4) standardization of instruments; 5) selection bias; and 6) participant attrition. Implications for program development are examined.