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Alaska Pregnancy Risk Assessment Monitoring System (PRAMS)

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What is Alaska PRAMS?

The Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) Project is an on-going survey of mothers of newborns initiated by the State of Alaska Division of Public Health, Section of Maternal, Child and Family Health in 1990. PRAMS was developed by the Centers for Disease Control and Prevention (CDC) Division of Reproductive Health and is part of CDC's initiative to reduce infant mortality and low birth weight. PRAMS collects state-specific, population-based data on maternal attitudes and experiences before, during, and after pregnancy.

What is the purpose of PRAMS?

Research has indicated that maternal behaviors during pregnancy may influence infant birth weight and mortality rates. The goal of the PRAMS project is to improve the health of mothers and infants by reducing adverse outcomes such as low birth weight, infant mortality and morbidity, and maternal morbidity. PRAMS provides state-specific data for planning and assessing health programs and for describing maternal experiences that may contribute to maternal and infant health.

PRAMS was designed to supplement Vital Records data by providing state-specific data on maternal behaviors and experiences to be used for planning and assessing perinatal health programs. In addition, because PRAMS uses standardized data collection methods, it allows data to be compared among states.

What are the goals and objectives of PRAMS?

The global goal of PRAMS is to reduce infant morbidity and mortality by influencing maternal behaviors during and immediately after pregnancy. Four specific objectives to achieve PRAMS' goal are:

  • To collect population-based data of high scientific quality.
  • To conduct comprehensive analyses.
  • To translate results from analyses into information for planning and evaluating public health programs and policy.
  • To build state capacity to collect, analyze, and translate data to address relevant public health issues dealing with pregnancy and early infancy.

Who are the partners in PRAMS?

In Alaska, the PRAMS Project resides in the Maternal and Child Health Epidemiology Unit of the Section of Women's, Children's and Family Health. The project is funded jointly through a five-year cooperative grant agreement with CDC and state funds. A local steering committee includes a multi-disciplinary mixture of individuals from the public and private sector as well as the academic community. Thirty-seven states, New York City, and South Dakota (Yankton Sioux Tribe) currently participate in PRAMS. PRAMS surveillance currently covers about 75% of all U.S. births.

Alabama Maine New York Tennessee
Alaska Maryland New York City Texas
Arkansas Massachusetts North Carolina Utah
Colorado Michigan Ohio Vermont
Delaware Minnesota Oklahoma Virginia
Florida Mississippi Oregon Washington
Georgia Missouri Pennsylvania West Virginia
Hawaii Nebraska Rhode Island Wisconsin
Illinois New Jersey South Carolina Wyoming
Louisiana New Mexico South Dakota (Point in Time)

Click here for more information about CDC PRAMS or PRAMS projects in other states.

How are data collected?

In Alaska, approximately one of every six mothers of newborns is selected for PRAMS. Mothers are randomly selected from birth records at the Bureau of Vital Statistics. Women from some groups are sampled at a higher rate to ensure adequate data are available in smaller but higher risk populations. Selected women are first contacted by mail approximately 2 to 6 months after delivery of their baby. If there is no response to repeated mailings, women are contacted and interviewed by telephone. Data collection procedures and instruments are standardized to allow comparisons between states.

What information does PRAMS collect?

The PRAMS questionnaire includes core questions that are asked by all participating states and state-specific questions that are chosen or developed by individual states. The core portion of the questionnaire includes questions about the following:

  • Attitudes and feelings about the most recent pregnancy
  • Barriers to and content of prenatal care
  • Use of alcohol and tobacco before and during pregnancy
  • Awareness of benefits of folic acid
  • Pregnancy-related violence
  • Infant health care, sleep position, and exposure to tobacco smoke
  • Psychosocial support and stress

Topics specific to Alaska include the following:

  • Post-partum birth control use
  • Infant safety and co-sleeping habits
  • Marijuana and cocaine use
  • Smokeless tobacco use
  • Family income
  • Controlling partner
  • Oral health

Click here to see the Alaska PRAMS Phase 4 survey for data collected 2000–2003.
Click here to see the Alaska PRAMS Phase 5 survey for data collected 2004–2008.
Click here to see the current Alaska PRAMS Phase 6 survey for data collection starting with 2009.

How can data from PRAMS be used?

Findings from analyses of PRAMS population-based data can be generalized to Alaska's entire population of women who delivered a live-born infant. Because the same data collection methods are used in all PRAMS states, Alaska data can be compared to other participating states. Given these important factors, PRAMS data are used in the following contexts.

  • Alaska PRAMS provides data not available from other sources about pregnancy and the first few months after birth. These data can be used to identify groups of women and infants at high risk for health problems, to monitor changes in health status, and to measure progress towards goals in improving the health of mothers and infants.
  • Alaska PRAMS data are used by the State of Alaska to plan and review programs and policies aimed at reducing health problems among mothers and babies.
  • Alaska PRAMS data are used by state agencies to identify other agencies that have important contributions to make in planning maternal and infant health programs and to develop partnerships with those agencies.

What surveyed Alaskan mothers say…

  • "I like that you are asking these questions, it's a good thing."
  • "I would just like to thank whoever thought of something like this."
  • "If you did not have this calling system, I probably would have never done the survey, my kids are a handful. Thank you for doing this over the phone, I didn't realize how important it really was."
  • "Thank you for allowing me to have this opportunity to help you. I am glad these type of studies are happening."

Click here for Mom-to-Mom Advice and other related links of practical use for mothers of newborns.



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