From 2004 to 2008, two process evaluations and two outcome evaluations for PPHR have been conducted. External agencies conducted these evaluations, and the recommendations from each were used to enhance and improve the PPHR process and criteria.
The process evaluations were both conducted by the RAND Corporation to provide feedback and recommendations on the Year One and Year Two pilot process. An outcome evaluation was conducted on the PPHR Regional process and criteria by the Association for the Study and Development of Community in 2007. Another outcome evaluation was conducted in 2008 by the Michigan Public Health Institute to measure the effectiveness of PPHR implementation on health departments that participated in the Year One pilot phase, four years after the original recognition.