**5. Evaluating health communication interventions**

Evaluation research should be a basic process that is built in to all cancer prevention and control communication efforts.50 Cancer communication efforts should always begin with careful needs analysis and audience analysis to identify the best goals, targets, and strategies for communication interventions. The messages designed and channels identified for delivering cancer prevention and control messages should be carefully tested with representatives from targeted groups to make sure they communicate effectively to these groups and provide them with the intended information. Message testing can also be used to refine and improve message strategies as a form of formative research. Usability testing is also a useful formative research strategy for testing consumer access to, comfort with, and ability to effectively use communication channels and tools.

A critical juncture in communicating risk and benefit information to vulnerable audiences is evaluating how well different communication strategies work to educate targeted audiences about important health issues.50 It is important to assess how well consumers really understand the risks and benefits that are being communicated and what differences communication programs are making in promoting informed consumer decision-making. A first step in evaluating the outcomes of communication efforts is to establish clear baseline measures of consumer understanding before introducing new health education programs. These baseline measures can be used as a starting point for tracking the influences of communication efforts on consumer attitudes, beliefs, and behaviors concerning cancer prevention and control.45 Feedback mechanisms, such as consumer surveys, focus groups, hotlines, help-desks, and comment cards, can be introduced as integral parts of communication interventions for tracking and evaluating consumer understanding of health messages, as well as their reaction to campaign strategies. The data gathered through these feedback mechanisms can be used to refine health communication programs and track progress in health education. Evaluation research can track the influences of communication efforts on consumer beliefs, behaviors, and even their physiological outcomes. Furthermore, it is important to conduct cost-benefit analyses to determine whether cancer prevention and control communication interventions are cost-effective. (See Figure 1 for a summary of the different forms of evaluation research that should be used to inform strategic cancer communication interventions).
