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Strengthening the evidence for maternal and child health programs

Perinatal Periods of Risk (PPOR) Bibliography

Perinatal Periods of Risk (PPOR)

Bibliography of Materials from MCHLine®

This bibliography of 23 items is drawn from MCHLine®, the MCH Digital Library online catalog.

The MCH Digital Library focuses on publications from federal and state agencies, from grantees of federal and state agencies, and from professional and voluntary organizations. It contains unique materials on the history of maternal and child health in the United States, policy papers, reports, conference proceedings, manuals, survey instruments, guidelines, and curricula. The library does not collect materials on clinical medicine. Consumer health materials and commercially published materials are collected very selectively.

Displaying 23 records.

Kuklish S. n.d.. Combating infant mortality: Perinatal periods of risk analysis–A comparison of 2000-2002 and 2003-2005 birth cohort results. Phoenix, AZ: Arizona Department of Health Services, Bureau of Women's and Children's Health, 21 pp.

Annotation: This electronic file presents PowerPoint-type slides that describe the Perinatal Periods of Risk (PPOR) analysis process and findings from a study of a reference group of individuals in Arizona that include a chart of feto-infant death, how different data can lead to potential actions, and changes between the first (2000-2002) and second (2003-2005) cohorts. Data are analyzed according to ethnicity, age, and level of education. It concludes with a statement of which groups and which periods on the prenatal-infancy continuum need to be focused on.

Contact: Arizona Department of Health Services, Bureau of Women's and Children's Health, 150 N. 18th Ave., Suite 320, Phoenix, AZ 85007, Telephone: (602) 364-1400 Fax: (602) 364- 1495 E-mail: sjolans@azdhs.gov Web Site: http://www.azdhs.gov/phs/owch/index.htm Out of print.

Keywords: Arizona, Fetal mortality, Infant mortality, State surveys

Perinatal Periods of Risk Work Group. n.d.. Perinatal Periods of Risk approach: The U.S. urban experience—A new community approach to fetal and infant mortality. [Omaha, NE: CityMatCH], 33 pp.

Annotation: These annotated slides outline a presentation on prevention efforts to improve fetal and infant mortality using an approach, called Perinatal Periods of Risk (PPOR), developed by the World Health Organization for developing countries and applying concepts to urban efforts in the United States. It highlights five major steps: (1) engaging community partners, (2) mapping feto-infant mortality, (3) focusing on reducing the overall feto-infant mortality rate, (4) examining potential opportunity gaps, and (5) targeting further investigations and prevention efforts. [Funded in part by the Maternal and Child Health Bureau]

Contact: CityMatCH, University of Nebraska Medical Center, Department of Pediatrics, 982170 Nebraska Medical Center, Omaha, NE 68198-2170, Telephone: (402) 552-9500 E-mail: citymch@unmc.edu Web Site: http://www.citymatch.org Available from the website.

Keywords: Community coordination, Developing countries, Fetal mortality, Infant mortality, International health, Needs assessment, Prevention, Risk assessment, Statistical analysis

Barnes-Josiah D. 2012. Using PPOR in an exploration of infant mortality trends Nebraska, 1979-2010. Lincoln, NE: Nebraska Department of Health and Human Services, 42 slides.

Annotation: This resource, a presentation at the Council of State and Territorial Epidemiologists 2012 annual conference, compares data on infant mortality rates in the United States and Nebraska, examines points where the Nebraska rate exceeded the U.S. rate, and describes using Perinatal Periods of Risk (PPOR) categories in an attempt to understand these rates.

Contact: Nebraska Department of Health and Human Services, P.O. Box 95026, Lincoln, NE 68509-5026, Telephone: (402) 471-3121 E-mail: dhhs.helpline@nebraska.gov Web Site: http://www.hhs.state.ne.us Contact author for cost information.

Keywords: Fetal mortality, Infant mortality, Nebraska, State surveys

CityMatCH. 2012. The Perinatal Periods of Risk (PPOR) approach for preventing infant mortality in US urban communities. Omaha, NE: CityMatCH,

Annotation: This fact sheet describes a community approach and an analytic framework for investigating and addressing high infant mortality rates in urban settings. The fact sheet describes the development of the Perinatal Periods of Risk (PPOR) approach and how it is used to monitor progress, (surveillance), guide public health planning, and prioritize prevention activities. Related resources including training materials, a learning network, presentations, data tables, and publications are available from the website.

Contact: CityMatCH, University of Nebraska Medical Center, Department of Pediatrics, 982170 Nebraska Medical Center, Omaha, NE 68198-2170, Telephone: (402) 552-9500 E-mail: citymch@unmc.edu Web Site: http://www.citymatch.org Available from the website.

Keywords: Community action, Data analysis, Infant mortality, Interdisciplinary approach, Perinatal influences, Planning, Urban environment

Kasehagen L, Gilbert C. 2011. Perinatal Periods of Risk: Using data and community involvement to prevent infant mortality. Rockville, MD: U.S. Maternal and Child Health Bureau,

Annotation: This archived webcast outlines the Perinatal Periods of Risk (PPOR) analysis from start to finish, showing where the numbers come from, how to make PPOR maps, and how to use phase 2 analysis to help make the greatest impact on local infant mortality. The session also explains the role of community stakeholders and what communities need in order to use PPOR successfully. The website provides audio, slides with captioning, and transcripts of the webcast.

Contact: U.S. Maternal and Child Health Bureau, Health Resources and Services Administration, 5600 Fishers Lane, Rockville, MD 20857, Telephone: (301) 443-2170 Web Site: https://mchb.hrsa.gov Available from the website.

Keywords: Community coordination, Fetal mortality, Infant mortality, Multimedia, Prevention, Risk assessment

Craig J, Conard T, Vaughn S. 2010. Integrating PPOR into MCH programs: Marion County, Indiana = PPOR for the Long Haul in Marion County Indiana. [no place,no publisher], 12 pp.

Annotation: This document presents graphics illustrating results of a Perinatal Periods of Risk (PPOR) analysis of 2001-2005 deaths in Marion County, Indiana. It itemizes risk factors for very low birthweight infants, causes of postneonatal death including sudden unexpected infant death, and strategic actions to improve birth outcomes. It also discusses how PPOR became a part of the fetal and infant mortality review (FIMR) process and Indianapolis Healthy Start, the need for safe sleep education, and the local health systems action plan.

Contact: CityMatCH, University of Nebraska Medical Center, Department of Pediatrics, 982170 Nebraska Medical Center, Omaha, NE 68198-2170, Telephone: (402) 552-9500 E-mail: citymch@unmc.edu Web Site: http://www.citymatch.org Available from the website.

Keywords: Fetal mortality, Indiana, Infant mortality, State surveys

Vishnubhakta V. 2010. Perinatal Periods of Risk analysis. Dover, DE: Delaware Health and Social Services, Division of Public Health, 49 pp.

Annotation: This report provides details of feto-infant mortality in Delaware during 2001-2005, as the second of five steps in the Perinatal Periods of Risk (PPOR) analysis. It describes the PPOR process, discusses how the data are calculated, and presents tables of data in numerous categories.

Contact: Delaware Health and Social Services, Division of Public Health, Jesse Cooper Building, 417 Federal Street, Dover, DE 19901, Telephone: (302) 744-4700 Secondary Telephone: (888) 459-2943 Fax: (302) 739-6659 E-mail: dhssinfo@state.de.us Web Site: http://www.dhss.delaware.gov/dhss/dph/ Available from the website.

Keywords: Delaware, Fetal mortality, Infant mortality, Prevention, Risk assessment, State surveys

Gilbert CS, Robinson LK. 2009. PPOR (Perinatal Periods of Risk Approach). [Atlanta, GA]: Centers for Disease Control and Prevention; [Rockville, MD]: U.S. Maternal and Child Health Bureau; Omaha, NE: CityMatCH,

Annotation: This archived webcast comprises videos and transcripts from a data skills session at the MCH Epi Conference held on December 9-11, 2009, in Tampa, Florida. It describes the purpose and scope of the Perinatal Periods of Risk (PPOR) approach to reducing infant mortality. Topics include the importance of analytic and community readiness and how PPOR can be used in combination with other efforts. Additional topics include data preparation and analysis, data sources and their strengths and weaknesses, PPOR validation studies, and suggestions for evaluating local PPOR efforts and effectively communicating results. [Funded by the Maternal and Child Health Bureau]

Contact: U.S. Maternal and Child Health Bureau, Health Resources and Services Administration, 5600 Fishers Lane, Rockville, MD 20857, Telephone: (301) 443-2170 Web Site: https://mchb.hrsa.gov Available from the website.

Keywords: Community action, Data analysis, Data sources, Evaluation methods, Infant mortality, Interdisciplinary approach, Perinatal influences, Planning, Training

Urban Indian Health Institute. 2009. Fact sheet: Fetal and infant deaths and perinatal periods of risk among American Indians and Alaska Natives in Washington. Seattle, WA: Urban Indian Health Institute, 2 pp.

Annotation: This fact sheet compares the rate of all races of infants and American Indian/Alaska Native (AI/AN) infants who die before their first birthdays and describes the Perinatal Periods of Risk (PPOR) Project which looked at the data for deaths between 2000 and 2004 to better understand these rates. It includes a discussion of preventable deaths and opportunities for change.

Contact: Urban Indian Health Institute, Seattle Indian Health Board, P.O. Box 3364, Seattle, WA 98114, Telephone: (206) 812-3030 Fax: (206) 812-3044 E-mail: info@uihi.org Web Site: http://www.uihi.org Available from the website.

Keywords: Alaska natives, American Indians, Fetal mortality, Infant mortality, State data, Washington

Chattanooga-Hamilton County Health Department, Community Health Services, Office of Assessment. 2008. Mobilizing communities to action: Perinatal periods of risk (PPOR) approach to infant mortality in Hamilton County, TN 2001-2005. Chattanooga, TN: Chattanooga-Hamilton County Health Department, 41 pp.

Annotation: This report examines historical and current trends in infant mortality, low birthweight, and prematurity in Chattanooga and Hamilton County, Tennessee, describes the Perinatal Periods of Risk (PPOR) analysis of 2001-2005 data, and provides recommendations for action.

Contact: Chattanooga-Hamilton County Health Department, 921 East Third Street, Chattanooga, TN 37403, Telephone: (423) 209-8000 Secondary Telephone: (423) 209-8229 Web Site: http://health.hamiltontn.org Available from the website.

Keywords: Fetal mortality, Infant mortality, Local surveys, State surveys, Tennessee

Landis MJ. 2007. Perinatal periods of risk in Wisconsin: 2002-2004. [Madison, WI: Wisconsin] Department of Health and Family Services, Bureau of Health Information and Policy, 3 pp.

Annotation: This paper describes a study of infant mortality in Wisconsin for the years 2002-2004 using the Perinatal Periods of Risk (PPOR) model. It presents brief results and provides links to additional data for Wisconsin and other examples of PPOR being used to inform public health practice.

Contact: Wisconsin Department of Health Services, Data and Statistics, 1 West Wilson Street, Madison, WI 53703, Telephone: (608) 266-1865 Secondary Telephone: (888) 701-1251 Web Site: https://www.dhs.wisconsin.gov/stats/index.htm Available from the website.

Keywords: Fetal mortality, Infant mortality, State surveys, Wisconsin

CityMatCH. 2006. Seeing it through: Preventing fetal and infant deaths. CityLights 14(3-4):1-8,

Annotation: This issue of CityLights focuses on the prevention of fetal and infant deaths in the United States. It includes articles on the revised sudden unexplained infant death investigation (SUIDI) form; the American Academy of Pediatric's revised recommendations for pacifier use and safe sleep; changes to federal Medicaid law and how this will impact child and family health policy; and data highlights from CityMatCH's Perinatal Periods of Risk (PPOR) Framework pointing out where fetal and/or infant mortality interventions may have a primary impact. Included is a data insert with updated PPOR fetal-infant mortality tables for the nation's largest cities and counties, [Funded by the Maternal and Child Health Bureau]

Contact: CityMatCH, University of Nebraska Medical Center, Department of Pediatrics, 982170 Nebraska Medical Center, Omaha, NE 68198-2170, Telephone: (402) 552-9500 E-mail: citymch@unmc.edu Web Site: http://www.citymatch.org Available from the website.

Keywords: Data, Early intervention, Fetal mortality, Forms, Infant mortality, Prevention programs, SIDS

Kent H, Johnson K, Curtis M, Hood JR, Atrash H. 2006. Proceedings of the Preconception Health and Health Care Clinical, Public Health, and Consumer Workgroup Meetings: June 27-28, 2006—Atlanta, Georgia. Atlanta, GA: National Center on Birth Defects and Developmental Disabilities, 30 pp.

Annotation: These proceedings summarize the strategies that emerged from the June 2006 workgroup meetings convened to discuss how to translate recommendations into action in improving preconception health and health care in the United States. Topics include the role of preconception care in improving birth outcomes; risk factors for adverse pregnancy outcomes; issues for clinical, public health, and consumer workgroups; and core strategies for state and local levels. Contents include (1) background on the recommendations, (2) moving recommendations to action with guidance of key stakeholders, and (3) implementing the strategies. Additional information is provided on the workgroup members activities. The appendix lists the workgroup participants and members and provides information on research recommendations and examples of state and local initiatives.

Contact: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027, Telephone: (800) 232-4636 Secondary Telephone: (888) 232-6348 E-mail: cdcinfo@cdc.gov Web Site: http://www.cdc.gov/ncbddd Available from the website.

Keywords: Conferences, Local initiatives, MCH research, Preconception care, Pregnancy outcome, Prenatal care, Risk factors, State initiatives, Strategic plans

Tarrant County Public Health, City of Fort Worth Public Health Department, and the Tarrant County Infant Mortality Task Force. 2006. Report of perinatal periods of risk in Tarrant County. Fort Worth, TX: Tarrant County Public Health, 21 pp.

Annotation: This report presents data updates to phase I of the Perinatal Periods of Risk (PPOR) study in Tarrant County, Texas, which identified the population with excess deaths and the mortality component that is responsible for the highest rates of excess death, and introduces findings from phase II, which explores the reasons behind the excess mortality. It includes regional differences in Tarrant County, Fort Worth, Arlington, and North East Tarrant County. Stratification of data by race/ethnicity is included.

Contact: Tarrant County Public Health, Fort Worth, TX Web Site: http://www.tarrantcounty.com/ehealth/site/default.asp Available from the website.

Keywords: Fetal mortality, Infant mortality, Local surveys, State surveys, Texas

Thompson DL, Alexander NT, Kahn, EB. 2006. Perinatal periods of risk: A district-level analysis in Georgia. GA: Georgia Division of Public Health, Maternal and Child Health Epidemiology Section, 182 pp.

Annotation: This report describes how the Perinatal Periods of Risk (PPOR) analysis was conducted; lists possible reasons for high PPOR rates, risk factors, and interventions in the categories of maternal health and prematurity, maternal care, newborn care, and infant care; and provides graphs and maps for the state of Georgia as a whole and for each of the 18 public health districts.

Contact: Georgia Department of Public Health, Two Peachtree Street, N.W., 15th Floor, Atlanta, GA 30303-3186, Telephone: (404) 657-2700 Web Site: http://dph.georgia.gov Available from the website.

Keywords: Fetal mortality, Georgia, Infant mortality: State surveys

Mittal M. 2005. Perinatal periods of risk (PPOR): A useful tool for analyzing infant mortality. Raleigh, NC: North Carolina Department of Health and Human Services, State Center for Health Statistics, 4 pp.

Annotation: This statistical brief describes the Perinatal Periods of Risk (PPOR) tool for analyzing fetal and infant mortality and gives statistics for North Carolina for 2000-2002.

Contact: North Carolina State Center for Health Statistics , 1908 Mail Service Center, Raleigh, NC 27699-1908, Telephone: (919) 733-4728 Fax: (919) 733-8485 E-mail: schs.info@dhhs.nc.gov Web Site: http://www.schs.state.nc.us/SCHS/ Available from the website.

Keywords: Fetal mortality, Infant mortality, North Carolina, State surveys

Maricopa County Department of Public Health, Department of Epidemiology and Data Services and Department of Maternal, Child, and Family Health. 2004. Perinatal periods of risk: A community approach to address fetal and infant mortality in Maricopa County. Phoenix, AZ: Maricopa County Department of Public Health, 147 pp.

Annotation: This report provides an overview of the Perinatal Periods of Risk (PPOR) process; a description of presentations on PPOR made in the Maryvale and South Phoenix communities and other public health groups; recommendations on priority areas that need to be addressed in the areas of socio-economic environment, health of women before, during, and between pregnancies, access to health care, and infant health; and recommendations for interventions selected by community groups in response to the PPOR information.

Contact: Maricopa County Department of Public Health, 4041 N. Central Avenue, suite 1400, Phoenix, AZ 85012, Telephone: (602) 506-6900 Fax: (602) 506-6885 Web Site: http://maricopa.gov/public_health/ Available from the website.

Keywords: Arizona, Fetal mortality, Infant mortality, State surveys, l Community surveys

Alexander GR, Nabukera S, Bader D, Slay-Wingate M. [2003]. Infant mortality assessment manual. Birmingham, AL: University of Alabama at Birmingham, Department of Maternal and Child Health,

Annotation: This manual outlines a process for analyzing and interpreting perinatal-related data that will inform needs assessment and program development efforts. Contents include sample analyses using data from the United States and Alabama to provide a framework for selecting appropriate indicators, analyzing data, interpreting findings, and developing community interventions. The manual highlights indicators of infant mortality including definitions and data sources, demonstrates methodological and statistical approaches to analyzing the data and interpreting the findings, and offers recommendations for agencies working to reduce infant mortality.

Contact: University of Alabama at Birmingham, Department of Maternal and Child Health, RPHB 320, 1530 Third Avenue South, Birmingham, AL 35294-0022, Telephone: (205) 934-7161 Fax: (205) 934-8248 Available from the website.

Keywords: Community based services, Data analysis, Epidemiology, Infant mortality, MCH programs, Needs assessment, Perinatal influences, Program development

Metropolitan Public Health Department of Nashville and Davidson County, Division of Epidemiology and Division of Child and Adolescent Health. 2003. Perinatal periods of risk: A community tool for addressing fetal and infant mortality. Nashville, TN: Metropolitan Public Health Department of Nashville and Davidson County, 38 pp.

Annotation: This report presents findings and conclusions from Nashville's two-year involvement with the Perinatal Periods of Risk (PPOR) process, which examined infant mortality data in Nashville.

Contact: Metropolitan Public Health Department of Nashville and Davidson County, 311 23rd Avenue North, Nashville, TN 37203, Telephone: (615) 340-5616 Web Site: http://health.nashville.gov Available from the website.

Keywords: Fetal mortality, Infant mortality, Local surveys, State surveys, Tennessee

Myers P, Ricketts SA, Trierweiler K. 2003. Infant mortality in Colorado: Trends, 1990-2002, perinatal periods of risk analysis, 1997-2002, infant mortality rate 2010 goals, county starting point worksheets by perinatal periods of risk. Denver, CO: Colorado Department of Public Health and Environment, Prevention Services Division, 43 pp. (numbered 1-41, 119-120,appendices A-D lacking).

Annotation: This report provides data on infant mortality in Colorado by race/ethnicity and by county or region; describes a Perinatal Periods of Risk (PPOR) analysis; and lists recommendations and strategies for several counties. The table of contents refers to 6 appendices but only 2 are included in the electronic file.

Contact: Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive, South, Denver, CO 80246, Telephone: (303) 692-2000 Secondary Telephone: (800) 886-7689 E-mail: cdphe.information@state.co.us Web Site: https://www.colorado.gov/cdphe Available from the website.

Keywords: Colorado, Fetal mortality, Infant mortality, State surveys

Peck M, Sappenfield B, Haynatzka V. 2003. Perinatal periods of risk analysis: Using local, state and national data. Omaha, NE: CityMatCH, 67 pp.

Annotation: This archived webcast comprises presentation slides and notes from the 2003 MCH Epi Conference. It describes the Perinatal Periods of Risk (PPOR) Approach and the effective use of local, state, and national data. Topics include the strengths and limitations of using National Center for Health Statistics data to assess feto-infant mortality; results from an analysis using PPOR to assess feto-infant mortality in U.S. cities, urban counties, states, and the U.S. as a whole for selected periods of time; and recommendations and options for using PPOR in the future. [Funded by the Maternal and Child Health Bureau]

Contact: CityMatCH, University of Nebraska Medical Center, Department of Pediatrics, 982170 Nebraska Medical Center, Omaha, NE 68198-2170, Telephone: (402) 552-9500 E-mail: citymch@unmc.edu Web Site: http://www.citymatch.org Available from the website.

Keywords: Conference proceedings, Data analysis, Epidemiology, Fetal mortality, Infant mortality, Perinatal influences

Lawn J, McCarthy BJ, Ross SR. [2002]. The healthy newborn: A reference manual for program managers. [Atlanta, GA]: CARE/CDC Health Initiative, 1 v., 1 CD-ROM.

Annotation: This manual is designed to help program managers systematically implement evidence-based standards that will have the greatest effect on newborn health in their setting. Topics include newborn health as a priority, using information for decision-making for newborn programming, a step-by-step approach to the program management cycle, and what to do to improve newborn health (interventions and lessons learned).

Contact: CARE USA, P.O. Box 7039, Merrifield, VA 22116, Telephone: (404) 681-2552 Secondary Telephone: (800) 521-CARE Fax: (404) 577-5977 E-mail: http://www.care.org/feedback Web Site: http://www.care.org Available from the website.

Keywords: Case studies, Infant mortality, International health, MCH programs, Newborn infants, Program development, Program management

Hopkins RS, Miller CA, Thompson D. 2001. Perinatal Periods of Risk: An assessment approach to understanding fetal and infant deaths in Florida, 1995-1998. Tallahassee, FL: Florida Department of Health, Bureau of Epidemiology, 110 pp.

Annotation: This document introduces Florida MCH staff to the Perinatal Periods of Risk (PPOR) methodology and provides PPOR data from Florida, to assist with planning and evaluation and to stimulate examination of additional local data. It is based on descriptions of PPOR developed by CityMatch. It describes risk factors for fetal and infant deaths and associated interventions to reduce risk and provides extensive data from the linked-birth-death cohort file of 1995-1998. A chart of Healthy Start coalitions in the state is included.

Contact: Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL 32399, Telephone: (850) 245-4147 Fax: (850) 487-4574 Web Site: http://www.doh.state.fl.us Available from the website.

Keywords: Fetal mortality, Florida, Infant mortality, Prevention, Risk assessment, State surveys

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.