PPOR Local Examples

Perinatal Periods of Risk: A Force Behind Community Change, 2013 (Audio) (PPT) – The Northeast Florida Healthy Start Coalition was searching for answers. Based in Jacksonville (Duval County), the coalition had been battling high infant mortality rates and increasing racial disparities using case management, education, and support to at risk pregnant women and newborns. They knew change was needed, but did not know what change would move them in the right direction. Listen to Caro Brady tell the story of the Magnolia project, and explain how communities can put the Life Course model into practice for needs assessment, delivery of services, community education, and advocacy. 

PPOR Approach in Saint Louis: Community Action Based on A Decade of Data, 2012 (Audio) (PPT) – The coalition used the Perinatal Periods of Risk as a framework for a complete analysis beginning with vital records, but also including consumer surveys, focus groups, key informant interviews, and surveys of public health agencies and providers. They found that nearly half of the city and county preventable deaths occurred among African American in the Maternal Health/Prematurity period of risk. Kitagawa analysis showed that 93% of this excess mortality was due to birth weight distribution, i.e., too many of African American women were delivering very early in their pregnancies. Logistic regression showed large disparities in many risk factors for early prematurity. Surveys and focus groups revealed knowledge and attitudes of women, providers, and community agencies regarding preconception health and other health issues.

Using PPOR with a Health Problem Analysis Framework, 2010 (Audio) (PPT) – The Healthy Start Coalition of Hillsborough County Florida has used PPOR in its planning process for many years. In 2005 the Black infant mortality rate rose to 22.7, more than four times the White rate. After they received that information they became part of the 2008 Black Infant Health Practice Initiative (BHIPI*) The Healthy Start Plan Development Committee formally integrated PPOR into their APEX Health Problem Analysis framework, focusing on excess mortality due to Sudden Unexplained Infant Deaths (SUIDS). More than half of excess deaths in the Infant Health Period of Risk were due to SIDS, suffocation, or unintentional injury. Though the SIDS rate decreased over the decade, the rate of Accidental Suffocation deaths had a corresponding increase. The group used a variety of data sources in a thorough Phase 2 investigation of the underlying causes for this large and persistent disparity. The Health Problem Analysis framework helped the planning committee to integrate information from PPOR, FIMR, focus groups, and public health research based on other populations, into their overall strategic planning process.

PPOR Over the Long-Haul: Integration into the Public Health Planning Process, 2010 (PPT1) (PPT2) – In these presentations, presenters from Eugene, Oregon and Indianapolis, Indiana describe how PPOR has become part of their local planning process, how they have sustained PPOR over the years, and how PPOR has changed infant mortality prevention efforts in their cities.

Community Strategies for Using PPOR: Experiences from Two Cities, 2008 (Audio) (PPT1) (PPT2) – The Baby Blossoms Collaborative in Omaha, Nebraska (Douglas County) and the Tarrant County Infant Mortality Network in Fort Worth, Texas, have both been utilizing the PPOR approach for more than six years. The presentations will outline analytic methods and describe how these communities used the results of PPOR Phase 1 and Phase 2 analyses to inform and influence local programs and policies.