PPOR (Perinatal Periods of Risk Approach)

Session 1 described the purpose and scope of the PPOR approach to reducing infant mortality, including all six stages. The importance of both analytic and community readiness, and how PPOR can be used in combination with other efforts were discussed. This was followed by an in-depth teaching of Phase 1 data preparation and analysis (including cross-tabulating a community's fetal and infant deaths to form the PPOR map, calculating rates, creating a reference group, and calculating excess mortality) including . The session concluded with a community example from Chattanooga, Tennessee.

Video   Transcript  

Introduction and Overview of PPOR Slides

Analytic Readiness Slides

Stakeholder Analysis Slides

Community Readiness Slides

FIMR and PPOR Slides

Phase 1 Data Preparation Slides

Phase 1 for Presentation Slides

Chattanooga Community Example Phase 1 Slides

Session 2 included detailed information on Phase 2 of PPOR analysis, including data preparation, the overall strategy of Phase 2 analysis, and suggested steps in each of the three periods of risk in which cities generally experience excess infant mortality. Data sources were addressed, and their strengths and weaknesses discussed. Though PPOR is primarily based on vital records (birth and infant death files), other data sources are also useful in Phase 2 analysis. The session concluded with Chattanooga's story of Phase 2 analysis and that community's actions in response to PPOR and other findings.

Video   Transcript  

Phase 2 Overview and Data Prep Slides

Phase 2 Maternal Health/Prematurity (MHP) period of risk

Resources for MHP

• Kitagawa Exercise Document



• Kitagawa Exercise Spreadsheet



• Kitagawa Exercise Spreadsheet

PHASE 2 Infant Health (IH) Period of Risk Slides

PHASE 2 Maternal Care (MC) Period of Risk Slides

Chattanooga Community Example Phase 2 and Action Slides

About Vital Records Slides

Other Data Sources for PPOR Phase 2 Slides

Best Practice Sources Slides

Session 3 featured guest lectures from Dr. Bill Sappenfield, a lead in the development of the PPOR approach. Because preconception health indicators are often utilized in Phase 2 analysis, he introduced the new State Core Preconception Health Indicators. He also described the validation studies that were done as PPOR was being developed, and the results of those studies. The session ended with some general suggestions and methods for evaluating local PPOR efforts, and ideas for effectively communicating PPOR results.