Data on Health and Well-being of American Indians, Alaska Natives, and Other Native Americans. Pregnancy Risk Assessment Monitoring System (PRAMS)

12/01/2006

Sponsor: U.S. Department of Health and Human Services (DHHS)/Centers for Disease Control and Prevention (CDC)
Description: The Pregnancy Risk Assessment Monitoring System (PRAMS) was initiated in 1987 to monitor maternal experiences and attitudes before, during, and shortly after pregnancy to better understand adverse outcomes of mothers and infants. PRAMS collects the following data: state, most core birth certificate variables (not included are birth certificate number; specific date of the month in the infants date of birth, mothers date of birth, and mothers date of last menses; county of residence; and hospital of birth). On a monthly basis, a sample of women (approximately 1,300-3,400 women per state) who are state residents and have delivered a live-born infant during the preceding 2-4 months are randomly selected (with an oversample of women at higher risk for adverse pregnancy outcomes) from a file of birth certificate records and mailed a questionnaire. Core questions in this instrument include:
  • Attitudes and feelings about the most recent pregnancy,
  • Content and source of prenatal care,
  • Maternal alcohol and tobacco consumption,
  • Physical abuse before and during pregnancy,
  • Pregnancy-related morbidity,
  • Infant health care,
  • Contraceptive use, and
  • Mothers knowledge of pregnancy-related health issues, such as adverse effects of tobacco and alcohol; benefits of folic acid; and risks of HIV.

Thirty-seven states, New York City, and Yankton Sioux Tribe of South Dakota currently participate in PRAMS.

Relevant Policy Issues: Measurement of Health Status, Disease-specific Measurements, Key Health Disparities, and Factors Contributing to Well-being Disparities of Children.
Data Type(s): Survey
Unit of Analysis: Individual
Identification of AI/AN/NA: Race is identified in the data set in the following categories:
  • White
  • Black
  • American Indian or Alaska Native (AI/AN)
  • Asian/Pacific Islander (subdivided into: Chinese, Japanese, Filipino, Hawaiian, Other API)
AI/AN/NA Population in Data Set: An overall total number of AI/AN/NA respondents in the data sets was not available. However, an analysis of 8 PRAMS participating states (see link below) indicated that several states have a sample of 30 or greater American Indian/Alaska Native respondents. This suggests that for analyses aggregated to the national level, there is sufficient sample size for analyses by AI/AN.

http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5304a1.htm.

Geographic Scope: Thirtyseven states, New York City, and the Yankton Sioux Tribe of South Dakota currently participate in PRAMS. Six other states previously participated. The currently participating states are Alabama, Alaska, Arkansas, Colorado, Delaware, Florida, Georgia, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Date or Frequency: PRAMS data are available in annual files by individual participating state. The availability of years 1988 to 2004 varies. The 2004 data are the most recently available data set. Data availability by state and year can be reviewed at http://www.cdc.gov/prams/index.htm.
Data Collection Methodology: PRAMS utilizes two sequential modes of data collection; a mailed questionnaire survey with multiple follow-up attempts to encourage response was followed by a telephone survey.
Participation: Optional, without incentives.
Response Rate: The following reference notes that the median response rate across participating states was 76 percent among surveyed mothers: The Pregnancy Risk Assessment Monitoring System (PRAMS): Current Methods and Evaluation of 2001 Response Rates. Public Health Rep. 2006 Jan-Feb;121(1):74-83.
Sampling Methodology: Each participating state draws a stratified systematic sample of 100 to 250 new mothers every month from a frame of eligible birth certificates (mother recently gave live birth), with most states oversampling low birth weights.
Analysis: The PRAMS data set includes weights to adjust for non-response bias and to help generate accurate standard errors for estimates. Because PRAMS data also contains information from birth certificate data, there is basic information on women who did not respond to the survey, which allowed the research team to further refine the weights. A discussion of the methods can be accessed at http://www.cdc.gov/prams/methodology.htm.
Strengths: There are multiple years of data available. Sample size appears to be sufficient for AI/AN analyses.
Limitations: Only 37 states plus New York City and 1 tribe participate in the PRAMS data collection effort, thus impacting the generalizability of estimates to the national level.
Access Requirements and Use Restrictions: Data are available to the public through a data use agreement at no cost. A research proposal must be mailed or sent electronically to:

Denise DAngelo, MPH
Applied Sciences Branch MS-K22, Division of Reproductive Health,
Centers for Disease Control and Prevention
4770 Buford Hwy, NE
Atlanta GA 30341-3724
DDAngelo@cdc.gov

Proposal guidelines and review processes are available at: http://www.cdc.gov/prams/.

Contact Information: PRAMS website: http://www.cdc.gov/prams.
CDC/Division of Reproductive Health
4770 Buford Hwy, NE
MS K-20
Atlanta, GA 30341-3717
(770) 488-5200

 

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