RESEARCH DESIGN & IMPLEMENTATION

To conduct process evaluations on how well services are delivered, data need to be gathered on the content of interventions and on their delivery systems. Suggested methodologies include direct observation, surveys, and record keeping.

Direct observation designs include case studies, in which participant-observers unobtrusively and systematically record encounters within a program setting, and nonparticipant observation, in which long, open-ended (or "focused") interviews are conducted with program participants. 

For example, "professional customers" at counseling and testing sites can act as project clients to monitor activities unobtrusively; alternatively, nonparticipant observers can interview both staff and clients. Surveys—either censuses (of the whole population of interest) or samples—elicit information through interviews or questionnaires completed by project participants or potential users of a project. For example, surveys within community-based projects can collect basic statistical information on project objectives, what services are provided, to whom, when, how often, for how long, and in what context.

Record keeping consists of administrative or other reporting systems that monitor use of services. Standardized reporting ensures consistency in the scope and depth of data collected. To use the media campaign as an example, the panel suggests using standardized data on the use of the AIDS hotline to monitor public attentiveness to the advertisements broadcast by the media campaign.

These designs are simple to understand, but they require expertise to implement. For example, observational studies must be conducted by people who are well trained in how to carry out on-site tasks sensitively and to record their findings uniformly. Observers can either complete narrative accounts of what occurred in a service setting or they can complete some sort of data inventory to ensure that multiple aspects of service delivery are covered. These types of studies are time consuming and benefit from corroboration among several observers.

The use of surveys in research is well-understood, although they, too, require expertise to be well implemented. As the program chapters reflect, survey data collection must be carefully designed to reduce problems of validity and reliability and, if samples are used, to design an appropriate sampling scheme. Record keeping or service inventories are probably the easiest research designs to implement, although preparing standardized internal forms requires attention to detail about salient aspects of service delivery.