OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[NCCDPHP] Pregnancy Risk Assessment Monitoring System (PRAMS)

ICR 202602-0920-010 · OMB 0920-1273 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-1273 PRAMS Stillbirth Phone Questionnaire (Spanish) Form and Instruction Modified Available
Form 0920-1273 PRAMS Stillbirth Phone Questionnaire (English) Form and Instruction Modified Available
Form 0920-1273 PRAMS Stillbirth Mail Questionnaire (Spanish) Form and Instruction Modified Available
Form 0920-1273 PRAMS Stillbirth Mail Questionnaire (English) Form and Instruction Modified Available
PRAMS Field Testing Questionnaire (English and Spanish) Form and Instruction Removed Available
PRAMS Opioid Call-back Survey (Spanish) Form and Instruction Removed Available
PRAMS Opioid Call-back Survey (English) Form and Instruction Removed Available
PRAMS Disabilities Supplement (web mode) Form and Instruction Modified Available
PRAMS Disabilities Supplement (mail and phone) Form and Instruction Modified Available
PRAMS Marijuana Use Supplement (web mode) Form and Instruction Modified Available
PRAMS Marijuana Use Supplement (mail and phone) Form and Instruction Modified Available
PRAMS Opioid Use Supplement (web mode) Form and Instruction Modified Available
PRAMS Opioid Use Supplement (mail and phone) Form and Instruction Modified Available
PRAMS COVID-19 Experience Supplement (web mode) Form and Instruction Modified Available
PRAMS COVID-19 Experience Supplement (mail and phone) Form and Instruction Modified Available
PRAMS COVID-19 Vaccine Supplement (web mode) Form and Instruction Modified Available
PRAMS COVID-19 Vaccine Supplement (mail and phone) Form and Instruction Modified Available
PRAMS Social Determinants of Health Supplement (web mode) Form and Instruction Modified Available
PRAMS Social Determinants of Health Supplement (mail and phone) Form and Instruction Modified Available
Form 0920-1273 Phase 9 Standard Web Module – Spanish Form and Instruction Modified Available
Form 0920-1273 Phase 9 Standard Web Module – English Form and Instruction Modified Available
Form 0920-1273 Phase 9 Standard Phone Questionnaire – Spanish Form and Instruction Modified Available
Form 0920-1273 Phase 9 Standard Phone Questionnaire – English Form and Instruction Modified Available
Form 0920-1273 Phase 9 Standard Mail Questionnaire – Spanish Form and Instruction Modified Available
Form 0920-1273 Phase 9 Standard Mail Questionnaire – English Form and Instruction Modified Available
Form 0920-1273 Phase 9 Core Web Questionnaire – Spanish Form and Instruction Modified Available
Form 0920-1273 Phase 9 Core Web Questionnaire – English Form and Instruction Modified Available
Form 0920-1273 Phase 9 Core Phone Questionnaire – Spanish Form and Instruction Modified Available
Form 0920-1273 Phase 9 Core Phone Questionnaire – English Form and Instruction Modified Available
Form 0920-1273 Phase 9 Core Mail Questionnaire – Spanish Form and Instruction Modified Available
Form 0920-1273 Phase 9 Core Mail Questionnaire – English Form and Instruction Modified Available
1273 PRAMS Supporting Statement B.docx Supporting Statement B Uploaded 2026-02-25 Available
1273 PRAMS Supporting Statement Part A.docx Supporting Statement A Uploaded 2026-02-25 Available
Att 4 - PRAMS Questionnaire Development Process.docx Supplementary Document Uploaded 2026-02-25 Available
Att 3b_ Public Comments.docx Public Comments Uploaded 2026-02-25 Available
Att 3b_ Public Comments.docx Supplementary Document Uploaded 2026-02-25 Available
Att 3a -Published 60 day FRN.pdf Supplementary Document Uploaded 2026-02-25 Available
OMB_Change Request_0920_1273_PRAMS_04_10_25.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-16 Available
OMB_Change Request_PRAMS 11-13-24.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-11-21 Available
Att 17 - PRAMS Phase 9 Cognitive Testing Report.pdf Supplementary Document Uploaded 2023-05-25 Available
0920-1273 Response to Terms of Clearance _05_23_2023.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-05-25 Available
FINAL for signature - Stacey Y Brayboy_March of Dimes - CAPS 00264282_signed.docx Supplementary Document Uploaded 2023-05-25 Available
Attachment 19a. Nonresponse Bias Assessment of 2020 and 2021 Data.docx Supplementary Document Uploaded 2024-11-21 Available
Att 18 - PRAMS Phase 9 Field Testing Report.pdf Supplementary Document Uploaded 2023-03-22 Available
Att 2f - PRAMS Phase 8 Web Mode Data Collection Metrics_03132023.docx Supplementary Document Uploaded 2023-03-22 Available
Att 16 Summary of Changes between Phase 8 and 9.docx Supplementary Document Uploaded 2022-11-29 Available
Att 15a - PRAMS Field Testing Methodology _03 13 2023 clean.docx Supplementary Document Uploaded 2023-03-22 Available
Att 14 - PRAMS Live Birth Sample Size by Jurisdiction.xlsx Supplementary Document Uploaded 2022-11-29 Available
Att 13 - PRAMS IRB Approval_2022.docx Supplementary Document Uploaded 2022-11-29 Available
Att 12j - Livebirth Web Introduction and Informed Consent - SPANISH.docx Supplementary Document Uploaded 2022-11-29 Available
Att 12i - PRAMS Livebirth Web Introduction and Informed Consent - ENGLISH.docx Supplementary Document Uploaded 2022-11-29 Available
Att 12h - Stillbirth Phone Introduction and Informed Consent_SPANISH.docx Supplementary Document Uploaded 2022-11-29 Available
Att 12g - Stillbirth Phone Introduction and Informed Consent_ENGLISH.docx Supplementary Document Uploaded 2022-11-29 Available
Att 12f - PRAMS Livebirth Phone Introduction and Informed Consent - SPANISH.docx Supplementary Document Uploaded 2022-11-29 Available
Att 12e - PRAMS Livebirth Phone Introduction and Informed Consent - ENGLISH.docx Supplementary Document Uploaded 2022-11-29 Available
Att 12d - Stillbirth Mail Introduction and Informed Consent - SPANISH.docx Supplementary Document Uploaded 2022-11-29 Available
Att 12c - Stillbirth Mail Introduction and Informed Consent_ENGLISH.docx Supplementary Document Uploaded 2022-11-29 Available
Att 12b - PRAMS Livebirth Mail Introduction and Informed Consent - SPANISH.docx Supplementary Document Uploaded 2022-11-29 Available
Att 12a - PRAMS Livebirth Mail Introduction and Informed Consent - ENGLISH.docx Supplementary Document Uploaded 2022-11-29 Available
Att 7 - PRAMS Livebirth Phase 8 and Phase 9 Questionnaire Topic Reference.docx Supplementary Document Uploaded 2022-11-29 Available
Att 6 - PIDS Privacy Impact Assessment.pdf Supplementary Document Uploaded 2022-11-29 Available
Att 5 - PRAMS Response Gifts and Incentives by Jurisdiction 03 13 2023 clean.docx Supplementary Document Uploaded 2023-03-22 Available
Att 4 - PRAMS Questionnaire Development Process.docx Supplementary Document Uploaded 2022-11-29 Available
Att 3b - Program Response to Comments 60 Day FRN.pdf Supplementary Document Uploaded 2022-11-29 Available
Att 3a - Published 60 Day FRN.pdf Supplementary Document Uploaded 2022-11-29 Available
Att 1c PREEMIE Reauthorization Act of 2018.pdf Supplementary Document Uploaded 2022-11-29 Available
Att 1b Safe Motherhood and Infant Health Authorization.docx Supplementary Document Uploaded 2022-11-29 Available
Att 1a-Section 301 of the Public Health Service Act (42 U.S.C. 241).docx Supplementary Document Uploaded 2022-11-29 Available
IC Document Collections
IC IDCollectionTypeStatusForm
257195 Submission of Data File to CDC Instruction Unchanged
236591 PRAMS Stillbirth Questionnaire Form and Instruction ModifiedPRAMS Stillbirth Phone Questionnaire (Spanish)
236591 PRAMS Stillbirth Questionnaire Form and Instruction ModifiedPRAMS Stillbirth Phone Questionnaire (English)
236591 PRAMS Stillbirth Questionnaire Form and Instruction ModifiedPRAMS Stillbirth Mail Questionnaire (Spanish)
236591 PRAMS Stillbirth Questionnaire Form and Instruction ModifiedPRAMS Stillbirth Mail Questionnaire (English)
236591 PRAMS Stillbirth Questionnaire Form and Instruction Modified
236590 PRAMS Field Test Form and Instruction RemovedPRAMS Field Testing Questionnaire (English and Spanish)
236590 PRAMS Field Test Form and Instruction Removed
236589 PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction RemovedPRAMS Opioid Call-back Survey (Spanish)
236589 PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction RemovedPRAMS Opioid Call-back Survey (English)
236589 PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction Removed
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Disabilities Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Disabilities Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Marijuana Use Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Marijuana Use Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Opioid Use Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Opioid Use Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS COVID-19 Experience Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS COVID-19 Experience Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS COVID-19 Vaccine Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS COVID-19 Vaccine Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Social Determinants of Health Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Social Determinants of Health Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction Modified
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Standard Web Module – Spanish
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Standard Web Module – English
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Standard Phone Questionnaire – Spanish
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Standard Phone Questionnaire – English
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Standard Mail Questionnaire – Spanish
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Standard Mail Questionnaire – English
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Core Web Questionnaire – Spanish
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Core Web Questionnaire – English
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Core Phone Questionnaire – Spanish
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Core Phone Questionnaire – English
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Core Mail Questionnaire – Spanish
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction ModifiedPhase 9 Core Mail Questionnaire – English
236587 PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction Modified
ICR Details
0920-1273 202602-0920-010
Received in OIRA 202504-0920-014
HHS/CDC 0920-1273
[NCCDPHP] Pregnancy Risk Assessment Monitoring System (PRAMS)
Revision of a currently approved collection   No
Regular 03/09/2026
  Requested Previously Approved
36 Months From Approved 04/30/2026
105,300 108,240
29,773 31,268
0 0
Pregnancy Risk Assessment Monitoring System (PRAMS) is designed to collect jurisdiction-specific (states, cities, and U.S territories), population-based data on maternal behaviors and experiences before, during, and shortly after pregnancy. PRAMS is a jurisdiction customized survey conducted in 50 jurisdictions in the United States (U.S.). The data are used to identify groups of women and infants at high risk for health problems, monitor changes in health status, and measure progress towards state and national objectives in improving the health of mothers and infants. This Revision is submitted to request approval for an additional three years. Some components of the data collection have been completed (i.e., call back surveys, cognitive and field testing) resulting in reduced burden hours. Specifically, removal of call back surveys decreased annual burden by 1,395 hours and removal of cognitive and field testing decreased annual burden by 100 hours.
US Code: 42 USC 301 Name of Law: Public Health Service Act: Research and Investigations
   PL: Pub.L. 109 - 450 3 Name of Law: PREEMIE Act
   US Code: 42 USC 247b-12 Name of Law: Safe Motherhood and Infant Health
  
None
Not associated with rulemaking
  90 FR 52666 11/21/2025
91 FR 11314 03/09/2026
Yes
4
IC Title Form No. Form Name
PRAMS Call-back Surveys (with Opioid Call-back Survey Example) n/a, n/a PRAMS Opioid Call-back Survey (English) ,   PRAMS Opioid Call-back Survey (Spanish)
PRAMS Field Test None PRAMS Field Testing Questionnaire (English and Spanish)
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273 Phase 9 Core Mail Questionnaire – English ,   Phase 9 Core Mail Questionnaire – Spanish ,   Phase 9 Core Phone Questionnaire – English ,   Phase 9 Core Phone Questionnaire – Spanish ,   Phase 9 Core Web Questionnaire – English ,   Phase 9 Core Web Questionnaire – Spanish ,   Phase 9 Standard Mail Questionnaire – English ,   Phase 9 Standard Mail Questionnaire – Spanish ,   Phase 9 Standard Phone Questionnaire – English ,   Phase 9 Standard Phone Questionnaire – Spanish ,   Phase 9 Standard Web Module – English ,   Phase 9 Standard Web Module – Spanish
PRAMS Stillbirth Questionnaire 0920-1273, 0920-1273, 0920-1273, 0920-1273 PRAMS Stillbirth Mail Questionnaire (English) ,   PRAMS Stillbirth Mail Questionnaire (Spanish) ,   PRAMS Stillbirth Phone Questionnaire (English) ,   PRAMS Stillbirth Phone Questionnaire (Spanish)
PRAMS Supplemental Modules None, None, None, None, None, None, None, None, None, None, None, None PRAMS Social Determinants of Health Supplement (mail and phone) ,   PRAMS Social Determinants of Health Supplement (web mode) ,   PRAMS COVID-19 Vaccine Supplement (mail and phone) ,   PRAMS COVID-19 Vaccine Supplement (web mode) ,   PRAMS COVID-19 Experience Supplement (mail and phone) ,   PRAMS COVID-19 Experience Supplement (web mode) ,   PRAMS Opioid Use Supplement (mail and phone) ,   PRAMS Opioid Use Supplement (web mode) ,   PRAMS Marijuana Use Supplement (mail and phone) ,   PRAMS Marijuana Use Supplement (web mode) ,   PRAMS Disabilities Supplement (mail and phone) ,   PRAMS Disabilities Supplement (web mode)
Submission of Data File to CDC
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 105,300 108,240 0 -2,940 0 0
Annual Time Burden (Hours) 29,773 31,268 0 -1,495 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
Revision package for 0920-1273 is submitted to request approval for an additional three years. Some components of the data collection have been completed (i.e., call back surveys, cognitive and field testing) resulting in reduced burden hours. Specifically, removal of call back surveys decreased annual burden by 1,395 hours and removal of cognitive and field testing decreased annual burden by 100 hours. Total burden is decreased to 29,773 annual burden hours.
$13,714,785
Yes Part B of Supporting Statement
    No
    No
No
No
No
Yes
Jeffrey Zirger 404 639-7118 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/09/2026