Background
The Pregnancy Risk Assessment Monitoring System (PRAMS) is a random
population-based surveillance system of maternal behaviors and experiences
before, during, and shortly after pregnancy. The Centers for Disease Control and
Prevention (CDC) and the Florida Department of Health initiated the PRAMS
project for Florida in 1993 in response to research indicating the infant
mortality rate was no longer declining as rapidly as it had been in this
country. Data collected by the Florida PRAMS include information on maternal
health and behaviors, prenatal and postpartum care, and infant health.
Purpose
PRAMS is designed to: 1) establish and maintain state-specific, population-based
surveillance of selected maternal behaviors that occur during pregnancy and
early infancy, and 2) generate state-specific data for planning and evaluating
prenatal health programs. PRAMS data is used to supplement state data from vital
records and to develop and assess programs and policies for women and children
to help reduce infant morbidity and mortality by changing maternal behaviors
during pregnancy and during the child's early infancy.
Methodology
Data collection for PRAMS is the result of joint efforts between the CDC,
Florida Department of Health (DOH) Office of Vital statistics, DOH Bureau of
Epidemiology, and the county health departments (CHDs). Florida PRAMS began data
collection in 1993 with the Phase 2 questionnaire. Every four years, the
questionnaire is revised to address current and important issues for mothers and
newborns, and a new Phase begins. Each year Florida samples approximately 2,800
new mothers that have given birth to a live-born infant. From the
aggregate of all births known to Florida Vital Statistics, a complex sampling
strategy has been designed to draw random samples.
Prior to 2008, samples were drawn from six strata
based on mother's age and race, and the infant's birth weight:
Stratum 1: White/ low birth weight/ age greater
than or equal to 20 years old
Stratum 2: Black/ low birth weight/ age greater than or equal to 20 years old
Stratum 3: Low birth weight/ age less than 20 years old
Stratum 4: White/ normal birth weight/ age greater than or equal to 20 years
old
Stratum 5: Black/ normal birth weight/ age greater than or equal to 20 years
old
Stratum 6: Normal birth weight/ age less than 20 years old
Starting in 2008, the sampling strategy was
redesigned to draw random samples from four strata:
Stratum 1: White / low birth weight
Stratum 2: White / normal birth weight
Stratum 3: Nonwhite / low birth weight
Stratum 4: Nonwhite / normal birth weight
PRAMS is primarily a mail surveillance project with telephone follow-up of non-responders. Participants are surveyed by mailed questionnaire 2-5 months after giving birth, which is followed up by telephone interview one month later if no response is received from mailed survey. Florida PRAMS currently maintains an overall average response rate of 76 percent. |
