Pregnancy Risk Assessment Monitoring System (PRAMS)
While the United States infant mortality rate is declining, it still remains higher
than rates in other developed countries. The low birth weight rate for the nation
has increased in recent years to a level higher than that of 15 years ago. Studies
indicate that maternal behaviors such as smoking, drug and alcohol abuse, and limited
use of prenatal care may be inhibiting further declines in these rates. PRAMS (Pregnancy
Risk Assessment Monitoring System) is a population-based
risk factor surveillance system designed to identify and monitor behaviors and experiences
of women before, during, and after pregnancy. Information is collected by surveying
a sample of women who have recently given birth. Findings from the PRAMS survey
are used to develop and assess perinatal health programs in public and private health
care settings.
To help state health departments establish and maintain a surveillance system of
selected maternal behaviors, the Centers for Disease
Control and Prevention (CDC) collaborated with several states to initiate
PRAMS in 1987. This surveillance system was developed to supplement vital records
data and to generate state-specific data about perinatal health. Currently, there
are 37 states participating in the PRAMS project. While each state's project is
slightly different, data collection procedures and instruments are standardized
to permit comparisons of data among the PRAMS states. For more information about
PRAMS projects in these states please contact the CDC at
http://www.cdc.gov/PRAMS/states.htm
PRAMS in Colorado
In September of 1996, the Colorado
Department of Public Health and Environment was awarded a grant from CDC
to establish PRAMS in Colorado, and data collection began in the spring of 1997.
Colorado continues to have one of the highest low birth weight rates in the nation
for total births and for births in all major racial and ethnic groups. PRAMS provides
a method for the collection and analysis of perinatal data to better understand
not only low birth weight rates, but also maternal behaviors, access to prenatal
care, pregnancy intendedness, and health care delivery to women and infants in Colorado.
Ultimately, PRAMS data can assist Colorado in evaluating and improving services
to women and infants so that poor pregnancy outcomes can be prevented.
Within state health departments, PRAMS crosses several organizational units. The
Colorado PRAMS Team includes individuals from the
Women's Health Section and the
Health Statistics Section of the Colorado Department of Public Health
and Environment. The Colorado PRAMS Advisory Committee consists of individuals representing
the many agencies and organizations in Colorado interested in perinatal and infant
health issues. This group meets twice a year to provide feedback and support to
the Colorado PRAMS Team.
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PRAMS Survey Topics
The PRAMS questionnaire is mailed to a sample of Colorado women each month. Participants
complete the surveys and return them to the health department where all answers
are grouped to provide data for the entire state. The core set of questions and
the questions developed specifically for Colorado collect information on many topics,
including:
- attitudes and feelings about pregnancy
- prenatal care and barriers to care
- obstetric history
- psychosocial support and stress
- alcohol and tobacco use
- pregnancy-related morbidity
- infant health care
- economic status of the mother
- home safety and injury prevention
- health care coverage during pregnancy and delivery
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PRAMS Data Collection and Analysis
PRAMS uses a combination of two data collection approaches: statewide mailings of
the surveys and telephone follow-up with women who do not return the survey by mail.
The written questionnaires and telephone interviews can both be completed in Spanish
when necessary. Approximately 240 women in Colorado will receive the survey each
month, with an expected response rate of at least 70 percent.
Data collected from women who gave birth in a given year are generally available
for analysis and dissemination by late summer of the following year. Findings from
data analysis are distributed to local health departments, state legislators, professional
societies, voluntary agencies, health care organizations, universities, and other
interested persons.
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Information about Colorado PRAMS
Additional information about Colorado PRAMS can be obtained from:
Health Statistics Section, HSVR-HS-A1
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, CO 80246-1530
Telephone: (303) 692-2160
Women's Health Section, FCHSD-WH-A4
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, CO 80246-1530
e-mail: cdphe.pswomenshealth@state.co.us
The PRAMS Project is funded under grant number U50-CCU-813490-01 from the Centers
for Disease Control and Prevention.