Community Approach

Data alone do not create change; community involvement is necessary to assure that appropriate action is taken. A carefully chosen group of community stakeholders will have an in-depth knowledge of their institutions and the people they serve. The Perinatal Periods of Risk approach works best when a group like this collaborates throughout the planning process, including the analytic phases. The PPOR data analysis process includes assessing data quality, selecting a reference group, interpreting results, and exploring sources of information beyond vital records, all of which are improved when stakeholders are involved.

The PPOR approach has six stages that generally follow the public health planning cycle. Community stakeholders, usually led by local health departments, should be involved with PPOR  throughout the process :

  1. Assure Analytic and Community Readiness;
  2. Conduct Analytic Phases of PPOR;
  3. Develop Strategic Actions for Targeted Prevention;
  4. Strengthen Existing and/or Launch New Prevention Initiatives;
  5. Monitor and Evaluate Approach; and
  6. Sustain Stakeholder Investment and Political Will.

If a community already has an infant mortality initiative with a functioning stakeholder group, PPOR analysis can bring new evidence to their planning process. For example, if a Fetal Infant Mortality Review (FIMR) or Healthy Start program already exists, the FIMR Community Action Team or Healthy Start Consortium might elect to use PPOR analytic methods to gain a population perspective that complements the information provided by the case review process. If the community is just beginning to address infant mortality, PPOR can help them recruit and engage stakeholders. PPOR is often the catalyst for re-engaging and mobilizing community partners when renewal is needed. PPOR has become an important part of  surveillance and quality improvement in many local health departments, and it is common practice to repeat the analysis and update prevention plans every 2 to 5 years. 
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