Which statement best describes process evaluation?

• A. Assess changes in health outcomes
• B. Assess implementation fidelity and reach
• C. Measure cost-effectiveness
• D. Determine patient satisfaction

Answer: (B)

Process evaluation focuses on how an intervention is delivered in real-world settings, examining whether the program is implemented as planned (fidelity) and how many people it actually reaches (reach). Understanding fidelity helps determine if outcomes (or lack thereof) are due to the program design or to how it was carried out. Assessing reach shows whether the intended population was exposed to the intervention, which influences interpretation of results and potential scalability. This type of evaluation also considers the context and any adaptations that occurred during implementation, since these factors can affect how the program works in practice. The other options target different aspects: health outcomes reflect effectiveness, cost-effectiveness looks at value for money, and patient satisfaction relates to the user experience rather than how the program was implemented.