Measurement Measurement occurs throughout the planning and evaluation cycle. Measurement of health status and of factors contributing to the health problem occurs during the community needs assessment phase. Program delivery and participation measurement occurs during the process evaluation phase. Measurement of program effects occurs during program evaluation. At each of these points in the planning and evaluation cycle, diversity in the target audience and in program participants or recipients has ramifications regarding what is measured, which data are collected, and how data are collected.
The first consideration is always the purpose of measuring an aspect of diversity. This purpose is paramount in deciding how diversity will be measured. Imagine that in a Bowe County community assessment, an atheist born in Layetteville and a Muslim born in a neigh- boring town were grouped into the same ethnic category. Stated in this way, it seems strange to
factors. The message is that diversity in culture is related to diversity in illness manifestations and responses to illnesses, even within ethnic subgroups. Such differences can only be identified through cross-cultural comparisons and astute observations. If program planners lack direct personal knowledge of the culture, they will need to rely on key informants and published reports of cultural influences on illness manifestations that are specific to the target audience.
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