Appendix f individual Evaluation Plan Outline

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Module 1 Asthma Program Evaluation Guide

Appendix F

Individual Evaluation Plan Outline
{State Program Name}

Individual Evaluation Plan

{Evaluation Name}

Prepared by:




1. Introduction and Stakeholder Engagement
This section provides information about the purpose of the evaluation and identifies stakeholders who are––or need to be––involved in the evaluation.
Evaluation Purpose

  • What is the purpose of this evaluation?

  • How will findings from the evaluation be used?

  • How does this evaluation “fit” with the overall strategic evaluation plan for the program?


Table F.1. Stakeholder Assessment and Engagement Plan (* indicates member of planning team)

Stakeholder Name

Stakeholder Category

Interest or Perspective

Role in the Evaluation

{May be an individual or a group}

{primary, secondary, tertiary}

{program participant, staff, etc.}

{planning team, external reviewer, etc.}

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