When randomization is impractical, which evaluation design is recommended as an alternative?

• A. Cross-sectional survey only
• B. Pre/post evaluation
• C. Randomized controlled trial
• D. Anecdotal reports

Answer: (B)

When randomization isn’t feasible, comparing outcomes before and after the program within the same group is the best practical alternative. A pre/post evaluation measures the target outcomes (like knowledge, attitudes, or intended behaviors) before the intervention and again after it, showing how much change occurred and suggesting the program’s association with that change. It’s more informative than a single-time-point survey because it tracks progress over time, yet it’s still realistic to implement in real-world settings.

Keep in mind this design can be influenced by other factors that change over time, since there isn’t a separate untreated group to control for those factors. That’s why cross-sectional surveys, which capture data at only one moment, can’t show change due to the program. Randomized controlled trials offer stronger evidence of causality but are often impractical in FLSE settings. Anecdotal reports aren’t systematic and can’t reliably demonstrate impact.