在当前社会平稳发展的前提下，人民群众对个人健康需求日益提升。党和国家基于现 实因素考虑，于 2010 年发起慢性病示范区项目建设工作，10 年间效果斐然。H 市慢性病 示范区于 2018 年起步，在当年底即有多辖区建成省级慢性病示范区，之后进展相对滞后， 截止去年第五批国家级慢性病示范区名单中，H 市仍未有辖区入列。因此尝试借用过程评 估的基本逻辑了解项目流程以及现实问题。 笔者在 2020 年 6 月到 10 月在内蒙古疾控中心慢性病科实习，直接进入实地研究场域， 因此本文使用质性研究方法。通过文献查阅、访谈与参与式观察收集资料。以 8 名疾控系 统工作人员，2 名“健康地摊”服务送达对象，即 10 名与 H 市慢性病示范区有关系的访谈 对象作为本文的切入点，结合项目实施过程中的重点关注内容，对“三减三健”行动与监 测评估项目中，工作主体、具体活动开展情况、资源链接使用和服务提供状况的内容。找 出其中的问题与缺陷。 研究发现，H 市慢性病示范区项目执行过程中工作人员角色职责明确；不同活动有各 自的侧重点；可以使用的资源类型较多，但需要对部分资源进行开发和深层利用；服务可 以准确的送达至服务对象。 通过对结果的梳理讨论，本文得出以下结论：H 市在项目执行过程中，较好的做到了 合理分配工作人员，充分利用内部资源，服务内容丰富，在服务投送过程中利用一定符合 社会工作服务的技巧与手段，项目取得了一定成效。项目因对工作人员继续教育不足，整 体服务计划结构不完善，外部资源发掘不够，服务提供方式不清晰，致使具体内容落地难， 进而导致示范区整体建设滞后。 进而得出四条对策：为工作人员赋能、制定具体项目的工作计划、整合使用资源以及 高效利用媒体宣传。对于社会工作服务项目有三点启示：项目工作者需要完备的知识、对 服务项目实现动态控制、重视服务工作计划。 最后，对本次研究的方法选取和个人能力的不足进行反思。

Under the premise of steady development in the current society, people's growing demand for personal health. Considering the realistic factors, the Party and the state initiated the construction of chronic disease demonstration area project in 2010, and the effect has been remarkable in the past 10 years. In 2018, City H began to build a demonstration zone for chronic diseases. At the end of the year, some chronic disease demonstration areas have been built.However, the progress of the project has been slow. Until 2020, there is still no national chronic disease demonstration zone. Understand the project operation process and problems. This article uses qualitative research methods, based on the author's internship experience at the Center for Disease Control and Prevention from June to October 2020.Data is collected in the form of literature, case interviews and participant observation. Based on ten interviewees, there are eight staff members and two clients.Then, use the four indicators of process evaluation to study the content of the main body of work, the development of specific activities, the use of resource links and the status of service provision in the two projects,and find out the shortcomings. The study found that the roles and responsibilities of the staff in the operation of the Chronic Disease Demonstration Zone in City H are clear; different activities have their own focuses; there are many types of resources that can be used, but some resources need to be developed and used in depth; services can be accurate delivered to clients. Through the analysis and discussion of the results, this paper draws the following conclusions: in the process of project implementation, H City has done a good job in allocating staff reasonably, making full use of internal resources, and providing rich service content. In the process of service delivery, it has made certain achievements by using certain skills and means in line with social work service. Due to insufficient continuing education for staff, imperfect overall service plan structure, insufficient external resource exploration, and unclear service provision, the specific content is difficult to be implemented, thus leading to the lag in the overall construction of the demonstration area. 

Then came four countermeasures: empowering staff, formulating work plans for specific projects, integrating resources, and efficiently using media. There are three enlightenments for social work service projects: project workers need complete knowledge, achieve dynamic control of service projects, and pay attention to service work plans. The shortcomings of this paper are that the selection of research methods is not appropriate and the author's ability is insufficient.