August 2003 P erinatal P eriods o f R isk B4 U LEAP A CityMatCH “How-to-Do” Workshop

August 2003 PPOR Conceptual Framework

August 2003 Improve Maternal & Infant Health Seeing the “Big Picture”

August 2003 Big Picture Planning Cycle Community readiness and investment Stakeholders Vision Planning process Resources available or planned Timeframe Accountability

August 2003 PPOR Community Readiness What does it mean? Reasoning Results Roles Risks/Rewards Resources

August 2003 PPOR Community Readiness “5 Tent Poles” 1. Reasoning: partners can communicate clear, compelling case for PPOR based on its value-add 2. Results: partners can articulate what measurable results are expected from doing PPOR, and by when 3. Roles: partners are willing and able to champion PPOR over time in their various roles in community 4. Risks/Rewards: sufficient strategic balance exists between benefits and consequences for essential stakeholders to support PPOR implementation 5. Resources: sufficient systems and resources to support full implementation

August 2003 Community Assessment Previous assessments Previous perinatal studies or surveillance Fetal and infant mortality reviews PRAMS or other surveys Health system assessments Asset mapping Previous policy and program evaluations Decision-making process

August 2003 Strong Leadership Agreement & Support? Understands the feto-infant mortality problem Understands the work plan Commits to providing resources for the investigation Commits to providing resources for community collaboration Gives priority and champions the initiative

August 2003 PPOR Analytic Readiness: What does it means? Data access/quality Minimum number of events Adequately trained analytic staff Adequately trained communication staff Analysis team including program staff Sufficient staff hours Strong leadership agreement & support

August 2003 Direct Data Access/Quality? Fetal death files (no gest. age restrictions) Linked birth—infant death certificate files Unlinked infant death certificate files Key data items missing or poor quality Gestational age Birthweight Education Race/Ethnicity

August 2003 PPOR Minimum? Overall, and every subpopulation or geographic region needs roughly 60 feto- infant deaths to have sufficient numbers to calculate rates.

August 2003 Adequately Trained Analytic Staff? Analyze large data files Familiarity with birth and death files Assess data quality and reporting Calculate and compare rates Estimate confidence limits and p-values Investigate causes and risk factors Conduct multivariate analysis Summarize analytic findings Understand perinatal health issues

August 2003 Adequately Trained Communication Staff? Determine Single Overriding Communication Objective Develop compelling messages Condense numbers and figures Write reports and fact sheets Produce graphic presentations Tailor communications to the audience

August 2003 Analysis Team? Data analyst Policymaker or staff Program or content specialist Clinical specialist Vital records specialist Communication expertise

August 2003 Sufficient Staff Hours for Both Phases? Preparation Phase 1 analysis Phase 2 analyses Communication preparation Participation in dissemination and follow up

August 2003 PPOR Readiness Check List A Rapid Review… Effective Community Leadership and Partnerships Direct Access to the “Right” Data of Sufficient Quality Sufficient Staff and Resources to Do Both Analytic Phases Sufficient Staff and Resources to Do the Work over the Long Term Sufficient Community Commitment for Sustainable Change     

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