The original PRAMS was developed in 1987. An extensive list of topics was identified and researched for the questionnaire. From this list, questions were developed and tested and ultimately placed on the questionnaire. Participating states used this questionnaire (Phase 1) from fall 1988 through 1989. After an evaluation of the Phase 1 questionnaire, CDC and the participating PRAMS states developed the Phase 2 questionnaire and put it in the field during 1990. Although the questionnaire maintained its original structure, selected questions were revised, some were deleted, and new questions were added. In 1994, CDC again collaborated with the participating PRAMS states to develop a Phase 3 questionnaire. This revision was more extensive than the revision of 1989. As with the development of the first and second questionnaires, a list of potential topics was extensively researched. Based on this research, questions were revised or dropped, and new questions were added. As before, the questionnaire retained its original structure. In fall 1995 and early 1996, states began to use the Phase 3 questionnaire. States implemented the fourth revision of the questionnaire with January 2000 births. This revision followed was similar to the Phase 3 revision in terms of evaluation, revision, and addition of new questions. The Phase 4 revision also introduced a new format to the questionnaire changing it from a single column, to a two-column layout with shading to help differentiate the questions from each other. In April 2004, states implemented the fifth phase of the questionnaire.
The PRAMS questionnaire has two parts. There are core questions that are asked by all states. The core portion of the questionnaire includes questions about the following:
- Attitudes and feelings about the most recent pregnancy.
- Content and source of prenatal care.
- Maternal alcohol and tobacco consumption.
- Physical abuse before and during pregnancy.
- Pregnancy-related morbidity.
- Infant health care.
- Contraceptive use.
- Mother's knowledge of pregnancy-related health issues, such as adverse effects of tobacco and alcohol; benefits of folic acid; and risks of HIV.
The remaining questions on the questionnaire are chosen from a pretested list of standard questions developed by CDC or developed by states on their own. As a result, each state's PRAMS questionnaire is unique. The following documents are lists of core and standard questions from the different phases of the PRAMS survey. The Phase 6 questions are currently in the field. The topic reference documents provide a comprehensive list of all questions used by all states organized by topic area.
Beginning with the Phase 3 questionnaire and continued with the Phase 4 and Phase 5 questionnaire, CDC coordinated the development and testing standard questions with significant input from state, CDC, and other researchers. These questions reflect additional topics that are of interest to the states and are made available to the states to add to their questionnaires as they choose. There are currently 185 standard questions developed by CDC from which states can choose to include on their survey. State developed questions are specific to the state that created them, and cover a variety of topics for which there are no core or standard questions.
Topics addressed in the PRAMS core questionnaire include barriers to and content of prenatal care, obstetric history, maternal use of alcohol and cigarettes, physical abuse, contraception, economic status, maternal stress, and early infant development and health status. Some standard questions provide additional information on topics already addressed in the core questionnaire, including content of prenatal care, contraception, and physical abuse. Other standard questions address different topics, including social support and services, mental health, and injury prevention.
Because PRAMS employs a mixed-mode methodology, two types of questionnaires are available. The self-administered questionnaire is used with the mailing packets, and an interviewer-administered questionnaire is used with the telephone phase. The interviewer-administered questionnaire contains the same questions that are on the self-administered questionnaire; however, some questions have been formatted differently to facilitate the different mode of administration. The PRAMS questionnaire is available in English and in Spanish; those states with a large Hispanic population may choose to use the Spanish questionnaire.
Phase 6 Core Questions (2009) [PDF - 107KB]
Phase 6 (2009) Standard Questions [PDF- 278KB]
Phase 6 (2009 ) Topic Reference [PDF - 837KB]
Spanish Phase 6 Core Questions [PDF - 110KB]
Spanish Phase 6 Standard Questions [PDF - 357KB]
Phase 6 Codebook and the Phase 6 Analysis Variables will be released 2012.
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