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11 Pregnancy Risk Assessment Monitoring System (PRAMS) CAPT Wanda Barfield MD, MPH Director, Division of Reproductive Health National Center for Chronic.

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Presentation on theme: "11 Pregnancy Risk Assessment Monitoring System (PRAMS) CAPT Wanda Barfield MD, MPH Director, Division of Reproductive Health National Center for Chronic."— Presentation transcript:

1 11 Pregnancy Risk Assessment Monitoring System (PRAMS) CAPT Wanda Barfield MD, MPH Director, Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion Secretary’s Advisory Committee on Infant Mortality November 14, 2012

2 2 PRAMS Overview  Population-based surveillance system  Self-reported maternal behaviors and experiences around the time of pregnancy  Supplements birth certificate information  State and near-national estimates

3 33 PRAMS Background and Goals  Established in 1987 as part of an Infant Health Initiative  Congressional funding provided to CDC to establish state-based programs  Reduce maternal and infant morbidity and mortality  Maternal and infant health programs  Health policies  Maternal behaviors

4 4 Who Participates in the PRAMS Surveys?  Women who recently delivered a live infant  Random sample from birth certificate records  Women are sampled when infants are months old  State sample ~1500–3000 women per year  40 states and NYC (combined annual sample ~ 77,000)

5 55 PRAMS Participation, 2012 WY WI PA TN MO VA DE MA PRAMS represents approximately 78% of all U.S. live births IA CT NH

6 6 PRAMS Surveys  Data collection primarily by mailed paper survey  Survey booklets are 14 pages and around 85 questions in length  Telephone follow-up  Takes minutes to complete

7 77 PRAMS Questionnaire Cycle  PRAMS collects data in phases  Corresponds to questionnaire revision length and time in the field  Phases usually last 3-5 years  Affected by various factors such as funding new sites, launching new data collection systems, or plans to do quality assessment  Phase 6 data for 2009 – 2010 are currently available for analysis  Phase 7 data for 2012 are currently being collected

8 88 PRAMS Bread & Butter  Key long-term PRAMS topics  Adequacy, barriers, and content of PNC  Breastfeeding  Contraceptive Use  Infant Sleep Position  Medicaid and WIC participation  Physical Abuse  Unintended Pregnancy  Data going back to 1988 for some states

9 99 PRAMS Phase 6 Priority Topics  New topics for Phase 6  Cesarean section/labor induction (non-core)  Chronic Disease  Health Insurance  Infant 1-Week Check-Up  Influenza Vaccination (non-core)  Obesity  Preconception Health  Postpartum Depression  Data currently available (2009 – 2010)

10 10 PRAMS Scientific Work Group  First meeting on October 25, 2012  Multi-disciplinary group of specialists in MCH, chronic disease, public health, survey methods and clinical practice  Purpose is to provide guidance to PRAMS on: 1.Ensuring that PRAMS data maintain high quality to impact policy and programmatic efforts 2.Crafting new questions given renewed focus on science translation and possible use of PRAMS for quality assessment 3.Generating constant and greater awareness of PRAMS and its value

11 11 PRAMS use: past, present and future  Special populations

12 12 South Dakota Tribal Pregnancy Risk Assessment Monitoring System  The South Dakota Tribal Pregnancy Risk Assessment Monitoring System known as SD Tribal PRAMS was:  led by the Yankton Sioux Tribe,  managed by the Northern Plains Tribal Epidemiology Center (NPTEC) of the Aberdeen Area Tribal Chairmen’s Health Board (AATCHB),  funded through a cooperative agreement with the Centers for Disease Control and Prevention and additional financial support from the Indian Health Service  implemented in collaboration with all South Dakota tribes, the South Dakota and North Dakota Departments of Health  This survey conducted in 2007 addressed the experiences and behaviors before, during, and after the most recent births of women from South Dakota  South Dakota Tribal PRAMS Statewide Surveillance Report provided information on findings from the questionnaire conducted between June and November 2007

13 13 PRAMS use: past, present and future  Special populations  Emerging health issues and priority topics

14 14 PRAMS Influenza Questionnaire Supplement  H1N1 Flu Pandemic:  Little data on seasonal influenza vaccine coverage among pregnant women  Pregnant women priority group for H1N1 vaccination  Partners  EOC H1N1 Vaccine Task Force  CDC Immunization Services Division  PRAMS sites  Funding  For supplemental question implementation by states ( flu season)  For support of CDC & state dissemination activities

15 15 PRAMS use: past, past, present and future  Special populations  Emerging health issues and priority topics  Program evaluation

16 16 PRAMS-WKKF Kellogg Foundation Partnership  Kellogg Programming in LA, MI, MS, NM & data needed:  Focus on vulnerable populations (minority, low income, children)  Enrollment in WIC and Medicaid  Breastfeeding rates and exposure to baby friendly practices  Home visitations including access to prenatal care  Medical Home  PRAMS CDC & State partners:  Modified state sampling  Modified PRAMS questionnaire to capture target indicators  Develop new community partnerships to increase visibility & use of data  Develop and test new data collection methods to increase response rates  Analyze data for Kellogg program evaluation use

17 17 PRAMS use: past, present and future  Special populations  Emerging health issues and priority topics  Program evaluation  Chronic disease prevention

18 18 PRAMS and Chronic disease prevention PRAMS data can monitor and evaluate screening and diagnosis of chronic disease conditions among women of reproductive age during:  Preconception  Pregnancy  Postpartum  Inter-conception

19 19 Chronic Disease Related Topics in PRAMS

20 20 PRAMS use: past, present and future  Special populations  Emerging health issues and priority topics  Program evaluation  Chronic disease prevention  Data linkages

21 21 Data Linkages Live Birth Certificates PRAMS Infant Deaths SIDS/SUID Registry ART Indirect linkages Direct linkages Live birth certificates – intermediate files Birth Defects Newborn Screening Hospital Discharge Medicaid WIC ART: Assisted Reproductive Technology WIC: Special Supplemental Nutrition Program for Women, Infants and Children Grigorescu V, Kleyn MJ, Korzeniewski SJ et al. Am J Prev Med 2010;38(4S):S522–S527

22 22 PRAMS use: past, present and future  Special populations  Emerging health issues and priority topics  Program evaluation  Chronic disease prevention  Data linkages  Service quality and satisfaction

23 23 Customer Satisfaction

24 24 Office of the Director Wanda Barfield, Director Dee Wetterhall, Deputy Director Applied Sciences Branch Violanda Grigorescu, Chief Brenda Reed, Deputy Chief Deborah Dee, Senior Scientist Maternal and Infant Health Branch William Callaghan, Chief Martha Boisseau, Deputy Chief Carrie Shapiro-Mendoza, Senior Scientist Women’s Health and Fertility Branch Denise Jamieson, Chief Sandra Gambescia, Deputy Chief Suzanne Folger, Senior Scientist Teams Adolescent Reproductive Health Maternal Child Health Epidemiology Pregnancy Risk Assessment Monitoring System (PRAMS) Associate Director Science Lee Warner Teams Infant Health Maternal Health Reproductive Health & Chronic Disease Prevention Associate Director Global Health Howie Goldberg Associate Director Policy, Partnership, and Communication Linda West Teams Assisted Reproductive Technology Fertility Epidemiology Studies Unintended Pregnancy STD/HIV Intervention Research Division of Reproductive Health Organizational Chart, October 2012

25 25 Thank you !


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