BALANCED INCOMPLETE BLOCK DESIGN - DESCRIPTION, CASE-STUDY, AND IMPLICATIONS FOR PRACTICE

This article discusses the use of balanced incomplete block design for process evaluation and presents a case study of its use. This techniq ue produces a weighted ranking of program elements, showing the relati ve importance of each element and allowing comparison of process and c ontent elements. The article presents a case study in which the techni que was used to evaluate the Chronic Disease Self-Management Program. Participants and lay course leaders were asked to rank 13 course eleme nts for their helpfulness. The most valued element, sharing or unstruc tured interactions among participants, was not an explicitly planned p art of the intervention. Some of the elements least valued (nutrition, use of community resources, and medication use) are elements most emp hasized by the health care system and by patient education. We found t hat balanced incomplete block design was easy to administer and tally. The results could be readily applied to program redesign and to needs assessment.