A Multi-Component Evaluation Instrument for Retrospective Assessment of Prevention Programs: A Framework for The Longitudinal Prophylactic-Capacity Evaluation Tool

Background: Despite modern advances, prevention programs often exhibit participant attrition and limited behavior persistence following program cessation. Program evaluation methods have proven helpful for retrospectively examining intervention efficacy; however, there is a lack of standardized methods to jointly assess intervention-period outcomes and post-intervention prevention practice durability with respect to program characteristics. The absence of such an evaluation instrument limits comparative inference and represents a gap in contemporary prevention science. Objectives: To develop and propose a standardized, theory-informed, multi-component program evaluation tool that facilitates systematic assessment of intervention-phase attrition and post-intervention behavior sustainability, while incorporating key program design, implementation, and equity characteristics to enable comparative synthesis across heterogeneous interventions. Methods: The Longitudinal Prophylactic Capacity Evaluation (LPCE) Tool was developed through analytic abstraction of prevailing evaluation constructs used in lifestyle prevention research, with explicit emphasis on participant retention, behavioral durability, and real-world implementation feasibility. LPCE evaluates prevention programs as the unit of analysis, using six ordinally scored domains: (1) Intervention-period attrition; (2) Post-intervention behavior sustainability; (3) Intervention design and behavioral framework fidelity; (4) Engagement and participant-resonance strategies; (5) Implementation and scalability; and (6) Equity and accessibility considerations. Domain scores are synthesized into two standardized indices: (1) A Composite Program Score (CPS), which applies equal domain weights; and (2) A Weighted Program Score (WPS), which prioritizes sustainability domain influence through differential weighting and a durability-based gate rule. LPCE then normalizes domain scores for subsequent integration into a heatmap-based visualization to support transparent, pattern-based comparative analysis. Results: LPCE will facilitate reproducible, interpretable program-level performance profiles that distinguish interventions that achieve only short-term engagement from those that demonstrate durable post-intervention behavior maintenance. The sustainability-weighted scoring structure prevents inflation of overall program performance in the absence of post-intervention durability, while the domain-level heatmap approach facilitates cross-program comparisons and identifies design and implementation features associated with sustained outcomes. Conclusions: The LPCE Tool provides a standardized, extensible framework for evaluating the longitudinal prophylactic capacity of lifestyle prevention programs. By explicitly integrating attrition, sustainability, behavioral design, implementation feasibility, and equity considerations into a unified evaluation system, LPCE addresses a critical methodological gap.