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MCHB Conference Webcasts - 15th Annual MCH EPI Conference, December 9-11 2009
young mother and child

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PPOR (Perinatal Periods of Risk Approach)

Carol S. Gilbert, MS
Health Data Analyst
University of Nebraska Medical Center
Department of Pediatrics, Section on Child Health Policy and CityMatCH
Laurin Kasehagen Robinson, MA, PhD
Senior CDC MCH Epidemiologist / Assignee to CityMatCH
Adjunct Assistant Professor in Pediatrics
University of Nebraska Medical Center
Department of Pediatrics, Section on Child Health Policy and CityMatCH

Session 1 — Introduction and Phase 1 of PPOR

Carol  Gilbert, MS, CityMatCH

Laurin  Kasehagen Robinson, PhD, MA

Kasey Decosimo, MPH

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.


Session 2 — PPOR Phase 2 and Action

Carol Gilbert, MS, CityMatCH

Laurin Kasehagen Robinson, PhD, MA

Kasey Decosimo, MPH

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.


Session 3 - Advanced Topics

Dr. Bill Sappenfield

Carol Gilbert, MS, CityMatCH

Laurin Kasehagen Robinson, PhD, MA

Kasey Decosimo, MPH

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.