Pregnancy Risk Assessment Monitoring System (PRAMS)
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.
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.
- Survey Guidelines
- PRAMS Questionnaires
- PRAMS Reports
- Data Request
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 2,500 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
Starting in 2014, the sampling frame was changed to draw random samples from three strata:
Stratum 1: Black / normal birth weight
Stratum 2: Non-Black/normal birth weight
Stratum 3: Low 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 60 percent.
The PRAMS questionnaire is comprised of three parts:
(1) CDC core questions
(2) Standard questions available for the state to choose
(3) State-added questions
The core component addresses such topics as maternal pre-pregnancy status, prenatal care, source of payment for prenatal care and delivery, smoking and alcohol consumption, family planning, breastfeeding, and complications of pregnancy. Florida’s standard questions include Medicaid, maternal health problems, fertility treatments, HIV testing, folic acid, co-sleeping, insurance for delivery, breastfeeding, birth control, and infections/diseases. State-added questions include depression and sick-baby care. The survey is revised every 3-4 years. Florida initiated the survey with phase II questionnaire in 1993.
Phase VII: 2012-2015
Phase VI: 2009-2011
Phase V: 2004-2008
Phase IV: 2000-2003
Phase III: 1996-1999
Phase II: 1993-1995
Erratum: Florida PRAMS reports from 1993 through 2010 state that PRAMS survey data "can be generalized to the entire state population of live births" during one calendar year. In actuality, survey participants for PRAMS are randomly drawn from birth registration records, so that data collected on infants are limited to one infant per survey participant, regardless of whether the survey participant had multiple births. This criterion typically excludes about 2% of births from the sample frame. Thus, PRAMS data is representative of the entire population of pregnancies which resulted in a live birth. For data on the entire population of live births in Florida, please use CHARTS Florida Birth Query System.
PRAMS Annual Surveillance Data Books
Phase VII (2012 - 2014)
Local PRAMS Data
Phase V (2004 - 2008)
The following reports contain data from 2004 and 2005:
If you want to obtain a data set with which to conduct your own data analysis, please see our Data Request Guidelines.
Data Analysis Report
If you want our statisticians to conduct analysis for you and provide you with the results, please send your request to:
FL PRAMS Coordinator
Florida Department of Health
4052 Bald Cypress Way, Bin# A-24
Tallahassee, FL, 32399-1720
In your request, please explain precisely which question(s) or variable(s) are of interest and how to analyze the data (e.g. data year, age or racial/ethnic group, region, etc.). All requests will be processed in a timely manner on a first-come, first-serve basis. Once your study is finished, please provide a courtesy copy of any articles and/or reports to the Department of Health based on the PRAMS data provided from the request.
Please note: Florida has a very broad public records law. Most written communications to or from state officials regarding state business are public records available to the public and media upon request. Your e-mail communications may therefore be subject to public disclosure.