The Hawai‘i Pregnancy Risk Assessment Monitoring System (PRAMS) Project
is a population-based surveillance system designed to identify and monitor maternal experiences,
attitudes, and behaviors from preconception, throughout pregnancy and into the interconception
periods. The program is funded by the Centers for Disease Control and Prevention (CDC),
Division of Reproductive Health.
HISTORY
PRAMS was developed in 1987 to supplement the birth certificate records by
providing state-specific data on maternal behaviors and experiences to be used for
planning and assessing maternal and child health programs. PRAMS began in Hawai‘i
in 1999 as a pilot project. In 2000, Hawai‘i officially became a PRAMS state with
other CDC-funded states. Thirty-seven states, New York City, and South Dakota
Yankton Sioux Tribe currently participate in the PRAMS program which represents approximately
75% of all U.S. live births. PRAMS provides ongoing monitoring of maternal behaviors to determine
how to reduce infant deaths, decrease low birth weights and how to improve the overall health of
the population in Hawai‘i. This epidemiologic surveillance system employs a method of collection,
analysis, and interpretation of selected pregnancy behaviors from a population sample of mothers
that recently gave birth that can result in improving the health of mothers, infants, and families.
PRAMS PROJECT GOALS AND OBJECTIVES
The overall goal of PRAMS is to reduce infant morbidity and mortality by impacting
maternal and child health programs, policies and maternal behaviors during pregnancy and early infancy.
There are four PRAMS objectives:
- Collect high quality population-based data on maternal behaviors before and during
pregnancy
and during the early life of the infant;
- Conduct epidemiologic analysis and study of maternal behaviors and experiences
during pregnancy
and early infancy and the relationship to health outcomes;
- Translate data analyses into useable information for program planning,
monitoring and evaluation; and
- Increase public awareness of healthy pregnancy behaviors to improve maternal health across the life span.
HOW DOES PRAMS OPERATE?
A PRAMS questionnaire is mailed to approximately 200 new mothers a month in all of the Hawai‘i islands.
The new moms are identified by the Office of Health Status and Monitoring (OHSM),
Hawai‘i Department of Health from the birth certificates of recently born infants.
The questionnaire is divided into questions that are asked by PRAMS programs in all states (core) and
Hawai‘i specific questions. The core questions were developed and researched by CDC to identify relevant topics
and issues. The PRAMS questionnaire addresses priority Maternal and Child Health issues such as
unintended pregnancies, smoking and alcohol use in pregnancy, insurance at time of pregnancy, contraception,
economic status, post-partum depression and domestic violence. State specific questions are developed by the PRAMS Steering Committee, other program staff and health providers. Hawai`i’s state specific questions address HIV, breastfeeding, drug use, dental, general health, and maternal health conditions.
HAWAI‘I PRAMS QUESTIONNAIRES
HAWAI‘I PRAMS DATA
Data collected by the Hawai‘i PRAMS program is used to enhance discussion about important
health issues facing families in Hawaii. For example, Hawai‘i PRAMS data was shared at a statewide
Perinatal Summit held on the Big Island of Hawai‘i in October 2008 on “Developing Strategies for
Healthy Women, Healthy Pregnancy, Healthy Birth Outcomes.” The summit was attended by about 175
people, included national experts on preconception care, and served as a platform to highlight
Hawai‘i data and strengthen relationships to improve health. Some fact sheets on perinatal health
using Hawai‘i PRAMS data were presented and distributed at the summit.
Fact sheets are used to increase discussion, focus further analyses, and serve as a way to present
data on several important issues and how they may vary among common socio-demographic groups. The
length of a fact sheet is limited and is not meant to portray a complete picture for any one
particular issue. We hope that these and other products produced using Hawai‘i PRAMS data will
be useful information to improve the health of all in Hawai‘i.
WHY THE PRAMS QUESTIONNAIRE IS IMPORTANT FOR WOMEN'S HEALTH?
If you have recently had a baby in Hawai‘i and received a PRAMS questionnaire to complete, please do so.
Answering the PRAMS questions helps doctors, health professionals, clinics, and organizations improve health
care services for all women and children in Hawai‘i. A token of appreciation will be sent to you approximately
3-4 weeks after we receive your survey. All questionnaires are kept confidential as provided by Hawai‘i State law.
No reports or responses will be traced back to mother's participating in the survey.
The Hawai‘i PRAMS birth sample is chosen from all women who recently had a live birth. PRAMS provides data not
available from other sources about pregnancy and the first few months after birth. The gathered information can
also be compared to other states participating in PRAMS which can then help maternal and child health
organizations across the country improve their programs and policies.
So, the information you provide on the survey CAN make a real difference!
LINKS
For further information about the PRAMS Project like the other participating states and other ways the survey
information is used for maternal and child health, please visit the
CDC PRAMS website.
The information collected in the PRAMS survey is considered a state initiative and
many of the questions are included in
Healthy Hawai‘i 2010.
To view PRAMS survey results gathered the last few years, please visit
the Hawai‘i Health Data Warehouse.
Emily Roberson, MPH
PRAMS Coordinator
Telephone: 808-733-4060
Fax: 808-733-8369
Email: PRAMS@doh.hawaii.gov
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