Pregnancy Risk Assessment Monitoring System (PRAMS)
The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing, site-specific, population-based surveillance project of the Centers for Disease Control and Prevention (CDC) and health departments. It uses a two-part survey to collect data on maternal attitudes and experiences before, during, and shortly after pregnancy. Survey data has been collected since 1987 and covers approximately 81% of all births in the United States. PRAMS data helps researchers investigate emerging issues and identify ways to reduce health problems for birthing people and their babies.
Between 2021 and 2023, ASTHO convened the Linking PRAMS and Clinical Outcomes Data Multi-Jurisdiction Learning Community supporting 12 states as they build capacity to conduct data linkage activities between PRAMS and other maternal and child clinical outcomes data sets. These linked data sets will inform patient-centered outcomes research and clinical quality improvement initiatives in maternal and child health.
Data Linkage Series
This series features information about data use agreements and partnerships, legal barriers, and evaluating a data linkage project. Although each session focuses on linking PRAMS and clinical outcomes data for maternal and child health programs, information in these sessions can be applied to any data linkages.
Data Linkage 101
Jan. 12, 2022
In this first session, Russell Kirby, PhD, MS, FACE, provides a high-level overview of the purpose and processes of linking data, as well as factors to consider throughout.
Speaker:
- Russell Kirby is a distinguished university professor, Marrell endowed chair, and strategic area faculty lead for population health science at the College of Public Health, University of South Florida.
Asking the Right Questions
Feb. 16, 2022
In session two, Khaleel Hussaini, PhD, and Milton Kotelchuck, MPH, PhD, discuss how to successfully establish data use agreements and engage partners in the process.
Speakers:
- Khaleel Hussaini is the CDC maternal and child health epidemiology program assignee for the Delaware Division of Public Health.
- Milton Kotelchuck is a professor of Pediatrics at Harvard Medical School, and senior scientist in maternal and child health at both the Center for Child & Adolescent Health Research and Policy at MassGeneral Hospital for Children and the Vincent Obstetrics and Gynecology Department at Massachusetts General Hospital.
Legal Barriers With Data Sharing
March 17, 2022
In session three, Lillian Colasurdo, JD, and Shae Sutton, PhD, discuss national and state legal barriers to data sharing.
Speakers:
- Lillian Colasurdo is the director of public health law and data sharing at the Association of State and Territorials Health Officials.
- Shae Sutton is the senior director of programs at the National Association for Public Health Statistics and Information Systems.
State Share Session
May 19, 2022
In session four, Lizzie Harvey, PhD, MPH, shares successes and challenges with maternal and child health data linkages in Tennessee, while Kara Zivin, PhD, MS, MA, MFA, discusses conducting data linkages of Michigan’s PRAMS and Medicaid data from the perspective of an external partner.
Speakers:
- Lizzie Harvey is the CDC maternal and child health epidemiology program assignee for the Tennessee Department of Health, Division of Family Health and Wellness.
- Kara Zivin is a professor of Psychiatry, Obstetrics, and Gynecology, and Health Management and Policy at the University of Michigan; a research scientist at the Department of Veterans Affairs; and a senior health researcher at Mathematica.
Evaluating Your Data Linkages
June 15, 2022
In session five, Cheryl Clark, DrPH, RHIA, discusses connections between data quality and equity, the impacts of linking equity, and ways to ensure and optimize linking equity.
Speaker:
- Cheryl Clark is the Associate Director of Equity, Epidemiology and Evaluation, at the Association of Maternal & Child Health Programs (AMCHP).
From Benchmarking to Documenting: How NCHS Links and Assesses the Quality of Their Data
Feb. 12, 2023
Lisa Meril, MS, provides an overview of the National Center for Health Statistics Data Linkage program and its end-to-end linkage methodology.
Speaker:
- Lisa Meril is the Chief of the Data Linkage Methodology and Analysis Branch in the Division of Analysis and Epidemiology at the National Center for Health Statistics at the CDC.
Don't Wait, Validate: Estimating Population Outcomes with PRAMS Linked Data
Aug. 7, 2023
Linking PRAMS responses with administrative data is incredibly powerful for exploring population factors associated with various outcomes. However, there are challenges involved: sampling structure, differential response, noncoverage, and small sample sizes can introduce bias. Establishing benchmarks to compare against to validate weighted estimates is critical. Unlike many population-based surveys, PRAMS is directly derived from birth records, which provides a unique validation opportunity.
It’s a Weighty Matter: Exploring PRAMS Weights
Oct. 9, 2023
This session focuses on increasing awareness on how PRAMS weights are constructed, how to properly subset data for weighted analyses, and when health department staff should be worried about over/under estimation. The presenters provide thoughts and methods for checking assumptions of subgroup estimations, potential bias risks, and how re-weighting is sometimes used for smaller subpopulation assessments.
Speakers:
- Jared Parrish, PhD, ASTHO Contractor
- Phil Hastings, PhD, Founder and Principal, Far Harbor.
- Joe Pirozzolo, PhD, Research Statistician, Far Harbor.
Additional Resources
Overcoming Common Barriers to Data Linkage
May 4, 2022
This brief examines themes that emerged from conversations with four states about the challenges encountered during data linking activities.
Leveraging Data Linkage to Address Adverse Childhood Experiences
April 26, 2023
Surveillance data allow public health practitioners and researchers to track changes in the burden of ACEs by collecting data on previous exposure, health conditions that may impact or be impacted by exposure, and other related topics.
Data Strategies to Improve Health Outcomes for Indigenous Communities
June 21, 2023
In this episode, three experts discuss the Federal Advisory Committee on Infant and Maternal Mortality’s most recent report on American Indian and Alaska Native health outcomes and the data-focused recommendations for states and territories.
Linking Datasets to Address Racial Equity in Maternal and Child Health Outcomes
Aug. 1, 2023
This brief examines strategies for promoting racial equity in maternal and infant health through data linkages.
Strengthening Maternal and Infant Health Data in the U.S. Territories
Feb. 19, 2024
This brief highlights the work of Puerto Rico and the Commonwealth of the Northern Mariana Islands and the potential to gain further insights into maternal and infant health outcomes using data linkage methods.