Utah
PRAMS
What
is PRAMS?
PRAMS,
the Pregnancy Risk Assessment Monitoring System, is a surveillance
project of the Centers for Disease Control and Prevention
(CDC) and state health departments. PRAMS was initiated
by the CDC in 1987 because infant mortality rates were no
longer declining as rapidly as they had in prior years.
In addition, the incidence of low birth weight infants had
changed little in the previous 20 years. PRAMS is an ongoing,
state-specific, population-based surveillance system designed
to identify and monitor selected maternal experiences and
behaviors prior to, during, and immediately following pregnancy
among a stratified sample of mothers who have recently given
birth to a live infant.
As
of 2001, there are 31 states conducting PRAMS surveillance.
PRAMS surveillance in Utah began in May 1999.
What
is the purpose of PRAMS?
The
goal of the Utah PRAMS project is to reduce infant morbidity
and mortality by influencing maternal experiences during
and immediately after pregnancy. Four specific objectives
to achieve this goal are:
-
To
collect population-based data of high scientific quality
on topics related to pregnancy and early infancy
-
To conduct comprehensive analyses to better understand
the relationships between behaviors, attitudes, and experiences
during and immediately after pregnancy
-
To translate results from analyses
into information for planning and evaluating public health
programs and policy
-
To build the capacity of states
to collect, analyze, and translate data to address relevant
public health issues
Why
is PRAMS important?
The
Utah PRAMS project provides data for public health officials
to use to improve the health of mothers and infants.
PRAMS
enhances information from birth certificates and is used
to plan and review state maternal and infant health programs.
PRAMS
allows CDC and the states to monitor changes in maternal
and child health indicators (e.g. unintended pregnancy,
prenatal care, breast-feeding, smoking, drinking, infant
health).
Maternal
and infant health data can be compared among other participating
states as the same data collection methods are used in all
states.
Why
is it important to conduct PRAMS in Utah?
-
Utah
has the highest fertility rate in the nation and
often there is close spacing of children.1
-
In
Utah, the general fertility rate in 1999 was 92.8 (the
number of live births per 1000 women 15-44 years of age)
compared to 65.8 nationally.1
-
Historically,
Utah’s crude birth rate (the number of births per
1,000 population in a given year) has also been among
the highest in the nation. In 1999, Utah’s
crude birth rate was 21.8 compared with the national rate
of 14.5.1
-
In
Utah, low birth weight (LBW) rates and very low birth
weight rates (VLBW) are experiencing an increasing trend
(as is national).1
-
The
incidence of LBW in Utah was 6.8% and 1.0% for VLBW in
1999.1 The Healthy People 2010 objective for
LBW is to reduce the incidence to no more than 5% of live
births and very low birth weight (VLBW) to no more than
1% of live births.
How
does PRAMS work?
Every
month, a systematic stratified sample of approximately 200
new mothers are selected from birth certificates. In Utah,
the sample is stratified by birth weight and race in order
to over-sample these populations.
PRAMS
is a mixed mode surveillance system. The primary data collection
method is by mail and the secondary method is by telephone.
Approximately one out of every 18 new Utah mothers will
be selected to participate in the PRAMS project.
Two
to four months after delivery an explanatory letter that
introduces the project is mailed to each woman in the sample.
A questionnaire is mailed a week later. A second and third
questionnaire are mailed to those who do not respond. A
health research agency will then telephone mothers who have
not responded to the mailings. Following this CDC developed
protocol, a 70% response rate is expected. The responses
are then weighted to be representative of all women giving
birth in Utah.
What
information does PRAMS collect?
The
questionnaire consists of a core component used by each
of the participating states and a state-specific component
developed to address each state’s particular data needs.
The questionnaire, which is comprehensive and contains topics
not available elsewhere, includes 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
-
Physical
abuse before and during pregnancy
-
Psychosocial
support and stress
-
Infant’s
early development, health care, sleep position, and exposure
to passive smoke
-
Mother’s
knowledge of pregnancy-related health issues, such as
adverse effects of tobacco and alcohol; benefits of folic
acid; and the risks of HIV
-
Maternal
living conditions
-
Health
insurance coverage
-
To
enhance understanding of maternal behaviors and experiences
and their relationship to adverse pregnancy outcomes
-
To
develop and implement new maternal and child health programs
and to modify existing programs
-
To
influence public health policy
-
To
assist health professionals in incorporating the latest
research findings into their standards of practice
-
To
monitor progress towards local, state, and national health
objectives and goals
What
Surveyed Mothers Say…
"Thank
you for caring".
"I
think this is a great idea. I hope it will help to make
mothers and babies healthier in the future".
For
additional information…
If
you have any questions or would like additional information
about PRAMS, please call Joanne Barley, Utah PRAMS Operations
Manager in the Salt Lake metro area at 538-9962 or our toll-free
number at
1-800-826-9662.
Or
write to us at:
Utah
Department of Health
Maternal and Infant Health Program
PRAMS
Attention: Joanne Barley, PRAMS Operations Manager
P.O. Box 142001
Salt Lake City, Utah 84114-2001
Fax: 801-538-9409
References:
- Bureau
of Vital Records, Utah Department of Health.
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