Which of the following is an example of an impact evaluation in the final step of a community nutrition program for type 2 diabetes?

• A. Whether the age of participants reflected the target population
• B. Whether staff were trained using standardized patient education modules
• C. Whether patient data were accurately recorded and properly stored
• D. Whether participants learned the role of carbohydrate counting in managing their condition

Answer: (D)

The main idea being tested is whether the evaluation looks at the actual effects the program has on participants. Impact evaluation focuses on whether participants show changes in knowledge, behavior, or health outcomes as a result of the intervention. Learning the role of carbohydrate counting and being able to apply it to manage diabetes is a knowledge/behavior change outcome, which reflects the program’s real effect on participants. That’s why this option best fits impact evaluation in the final step. The other choices relate to who was included (age reflected the target population), how the program was delivered (staff training), or how data were handled (data recording)—areas more about implementation or data quality than about the program’s effects on participants.