OMB control number

[NCCDPHP] Pregnancy Risk Assessment Monitoring System (PRAMS)

OMB 0920-1273 · HHS/CDC.

OMB 0920-1273

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.

The latest form for [NCCDPHP] Pregnancy Risk Assessment Monitoring System (PRAMS) expires 2029-05-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-1273 PRAMS Stillbirth Phone Questionnaire (Spanish) Form and Instruction
Form 0920-1273 PRAMS Stillbirth Phone Questionnaire (English) Form and Instruction
Form 0920-1273 PRAMS Stillbirth Mail Questionnaire (Spanish) Form and Instruction
Form 0920-1273 PRAMS Stillbirth Mail Questionnaire (English) Form and Instruction
PRAMS Field Testing Questionnaire (English and Spanish) Form and Instruction
PRAMS Opioid Call-back Survey (Spanish) Form and Instruction
PRAMS Opioid Call-back Survey (English) Form and Instruction
PRAMS Disabilities Supplement (web mode) Form and Instruction
PRAMS Disabilities Supplement (mail and phone) Form and Instruction
PRAMS Marijuana Use Supplement (web mode) Form and Instruction
PRAMS Marijuana Use Supplement (mail and phone) Form and Instruction
PRAMS Opioid Use Supplement (web mode) Form and Instruction
PRAMS Opioid Use Supplement (mail and phone) Form and Instruction
PRAMS COVID-19 Experience Supplement (web mode) Form and Instruction
PRAMS COVID-19 Experience Supplement (mail and phone) Form and Instruction
PRAMS COVID-19 Vaccine Supplement (web mode) Form and Instruction
PRAMS COVID-19 Vaccine Supplement (mail and phone) Form and Instruction
PRAMS Social Determinants of Health Supplement (web mode) Form and Instruction
PRAMS Social Determinants of Health Supplement (mail and phone) Form and Instruction
Form 0920-1273 Phase 9 Standard Web Module – Spanish Form and Instruction
Form 0920-1273 Phase 9 Standard Web Module – English Form and Instruction
Form 0920-1273 Phase 9 Standard Phone Questionnaire – Spanish Form and Instruction
Form 0920-1273 Phase 9 Standard Phone Questionnaire – English Form and Instruction
Form 0920-1273 Phase 9 Standard Mail Questionnaire – Spanish Form and Instruction
Form 0920-1273 Phase 9 Standard Mail Questionnaire – English Form and Instruction
Form 0920-1273 Phase 9 Core Web Questionnaire – Spanish Form and Instruction
Form 0920-1273 Phase 9 Core Web Questionnaire – English Form and Instruction
Form 0920-1273 Phase 9 Core Phone Questionnaire – Spanish Form and Instruction
Form 0920-1273 Phase 9 Core Phone Questionnaire – English Form and Instruction
Form 0920-1273 Phase 9 Core Mail Questionnaire – Spanish Form and Instruction
Form 0920-1273 Phase 9 Core Mail Questionnaire – English Form and Instruction
1273 PRAMS Supporting Statement B.docx Supporting Statement B
1273 PRAMS Supporting Statement Part A.docx Supporting Statement A
Att 4 - PRAMS Questionnaire Development Process.docx Supplementary Document
Att 3b_ Public Comments.docx Public Comments
Att 3b_ Public Comments.docx Supplementary Document
Att 3a -Published 60 day FRN.pdf Supplementary Document
OMB_Change Request_0920_1273_PRAMS_04_10_25.docx Justification for No Material/Nonsubstantive Change
OMB_Change Request_PRAMS 11-13-24.docx Justification for No Material/Nonsubstantive Change
Att 17 - PRAMS Phase 9 Cognitive Testing Report.pdf Supplementary Document
0920-1273 Response to Terms of Clearance _05_23_2023.docx Justification for No Material/Nonsubstantive Change
FINAL for signature - Stacey Y Brayboy_March of Dimes - CAPS 00264282_signed.docx Supplementary Document
Attachment 19a. Nonresponse Bias Assessment of 2020 and 2021 Data.docx Supplementary Document
Att 18 - PRAMS Phase 9 Field Testing Report.pdf Supplementary Document
Att 2f - PRAMS Phase 8 Web Mode Data Collection Metrics_03132023.docx Supplementary Document
Att 16 Summary of Changes between Phase 8 and 9.docx Supplementary Document
Att 15a - PRAMS Field Testing Methodology _03 13 2023 clean.docx Supplementary Document
Att 14 - PRAMS Live Birth Sample Size by Jurisdiction.xlsx Supplementary Document
Att 13 - PRAMS IRB Approval_2022.docx Supplementary Document
Att 12j - Livebirth Web Introduction and Informed Consent - SPANISH.docx Supplementary Document
Att 12i - PRAMS Livebirth Web Introduction and Informed Consent - ENGLISH.docx Supplementary Document
Att 12h - Stillbirth Phone Introduction and Informed Consent_SPANISH.docx Supplementary Document
Att 12g - Stillbirth Phone Introduction and Informed Consent_ENGLISH.docx Supplementary Document
Att 12f - PRAMS Livebirth Phone Introduction and Informed Consent - SPANISH.docx Supplementary Document
Att 12e - PRAMS Livebirth Phone Introduction and Informed Consent - ENGLISH.docx Supplementary Document
Att 12d - Stillbirth Mail Introduction and Informed Consent - SPANISH.docx Supplementary Document
Att 12c - Stillbirth Mail Introduction and Informed Consent_ENGLISH.docx Supplementary Document
Att 12b - PRAMS Livebirth Mail Introduction and Informed Consent - SPANISH.docx Supplementary Document
Att 12a - PRAMS Livebirth Mail Introduction and Informed Consent - ENGLISH.docx Supplementary Document
Att 7 - PRAMS Livebirth Phase 8 and Phase 9 Questionnaire Topic Reference.docx Supplementary Document
Att 6 - PIDS Privacy Impact Assessment.pdf Supplementary Document
Att 5 - PRAMS Response Gifts and Incentives by Jurisdiction 03 13 2023 clean.docx Supplementary Document
Att 4 - PRAMS Questionnaire Development Process.docx Supplementary Document
Att 3b - Program Response to Comments 60 Day FRN.pdf Supplementary Document
Att 3a - Published 60 Day FRN.pdf Supplementary Document
Att 1c PREEMIE Reauthorization Act of 2018.pdf Supplementary Document
Att 1b Safe Motherhood and Infant Health Authorization.docx Supplementary Document
Att 1a-Section 301 of the Public Health Service Act (42 U.S.C. 241).docx Supplementary Document
Submission of Data File to CDC Instruction
PRAMS Stillbirth Questionnaire Form and Instruction
PRAMS Stillbirth Questionnaire Form and Instruction
PRAMS Stillbirth Questionnaire Form and Instruction
PRAMS Stillbirth Questionnaire Form and Instruction
PRAMS Stillbirth Questionnaire Form and Instruction
PRAMS Field Test Form and Instruction
PRAMS Field Test Form and Instruction
PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction
PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction
PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Supplemental Modules Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction

All Historical Document Collections

202602-0920-010	Revision of a currently approved collection	2026-03-09
202504-0920-014	No material or nonsubstantive change to a currently approved collection	2025-05-01
202411-0920-014 Approved without change	No material or nonsubstantive change to a currently approved collection	2024-11-22
202305-0920-012 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-05-26
202211-0920-018 Approved with change	Revision of a currently approved collection	2022-11-30
202207-0920-006 Approved with change	No material or nonsubstantive change to a currently approved collection	2022-07-28
202203-0920-012 Approved without change	No material or nonsubstantive change to a currently approved collection	2022-03-31
202109-0920-010 Approved with change	No material or nonsubstantive change to a currently approved collection	2021-09-30
202106-0920-014 Withdrawn and continue	No material or nonsubstantive change to a currently approved collection	2021-06-22
201910-0920-012 Approved with change	Existing collection in use without an OMB Control Number	2019-11-04
201905-0920-003 Improperly submitted	New collection (Request for a new OMB Control Number)	2019-06-21

OMB Details

PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 0920-1273	Phase 9 Core Mail Questionnaire – English	NA	Form and instruction
Form 0920-1273	Phase 9 Standard Web Module – Spanish	NA	Form and instruction
Form 0920-1273	Phase 9 Standard Web Module – English	NA	Form and instruction
Form 0920-1273	Phase 9 Standard Phone Questionnaire – Spanish	NA	Form and instruction
Form 0920-1273	Phase 9 Standard Phone Questionnaire – English	NA	Form and instruction
Form 0920-1273	Phase 9 Standard Mail Questionnaire – Spanish	NA	Form and instruction
Form 0920-1273	Phase 9 Standard Mail Questionnaire – English	NA	Form and instruction
Form 0920-1273	Phase 9 Core Web Questionnaire – Spanish	NA	Form and instruction
Form 0920-1273	Phase 9 Core Web Questionnaire – English	NA	Form and instruction
Form 0920-1273	Phase 9 Core Phone Questionnaire – Spanish	NA	Form and instruction
Form 0920-1273	Phase 9 Core Phone Questionnaire – English	NA	Form and instruction
Form 0920-1273	Phase 9 Core Mail Questionnaire – Spanish	NA	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.