Using Evaluation as a Tool for Program Improvement in the Rural West
Since 2022, we have served as the external evaluator for the Wyoming Cancer Program (WCP). When we began this work, the WCP was looking to change its evaluation approach. Previous evaluations had met federal requirements, but didn’t always translate into day-to-day program decisions. Often, program evaluation can feel like just a box being checked. We work with programs to understand their questions and goals, and then design evaluations that both meet requirements and are useful and actionable to the program.
From the start of program year 1, we prioritized a collaborative relationship with WCP staff. Program staff possess in-depth knowledge of their strengths, constraints, and communities, while we bring expertise in evaluation design, data collection, and analysis. By leveraging both sets of expertise, we were able to design evaluations that were relevant to the program and yielded actionable results.
Over multiple program years, this approach has led to tangible improvements. We have led a comprehensive data management and analysis project for the breast cancer screening program, clarifying true enrollment and screening rates, and identifying patterns in suspended and denied claims. This work directly informed process improvements that reduced claim denials and strengthened program operations.
We have conducted and analyzed primary data. This included interviewing clinics across the state that were implementing evidence-based interventions, producing case studies to be shared statewide. One of the most impactful efforts involved surveying residents of a county that has a high American Indian and Alaska Native population and low breast and cervical cancer screening rates. Through these survey results, the program was better able to understand residents’ experiences, barriers, and service needs.
Each year, our evaluation reports have been accepted by the CDC without revision. More importantly, they are actively used to guide decision-making, inform resource allocation, and support continuous improvement. For these programs, evaluation is no longer a compliance exercise. It is a tool for learning, adaptation, and impact.
Learn more about our work.