PRAMS Questionnaires

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
  • Preconception care
  • Content of prenatal care
  • Medicaid and WIC participation
  • Breastfeeding
  • Cigarette smoking and alcohol use
  • Health insurance coverage
  • Physical abuse
  • Infant health care
  • Contraceptive use

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.

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.

Current Questionnaire

The PRAMS questionnaire is revised periodically. With each revision or new phase of the questionnaire, some of the questions change. Although most indicators can be compared across phases, it is often easiest to analyze data within a single phase. The years of available data covered by the different phases are listed below:

Phase 8 (2016-2019)

History of the PRAMS Questionnaire

The original PRAMS questionnaire was developed in 1987. An extensive list of topics was identified and researched for 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 in 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 prior revisions.

Beginning with the Phase 3 questionnaire, CDC coordinated the development and testing of a number of standard questions with significant input from states and other researchers. Standard questions cover core topics in more depth or cover other topics that are not on the core but are of interest across multiple states.  The Standard questions allow for data collection using uniform indicators on optional topics.  There are currently over 200 standard questions developed by CDC that states can choose to include on their surveys. State-developed questions are specific to the state that created them, and cover topics for which there are no core or standard questions.

States implemented the fourth revision of the questionnaire with January 2000 births. The Phase 4 revision 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 sixth phase was implemented in 2009, the seventh version in 2012, and the eighth version in 2016.  There have been no major changes to the questionnaire layout or revision process since Phase 4.

  • Phase 1 Pilot:  1988 – 1989
  • Phase 2: 1990 – 1995
  • Phase 3: 1996 – 1999
  • Phase 4: 2000 – 2003
  • Phase 5: 2004 – 2008
  • Phase 6: 2009 – 2011
  • Phase 7: 2012 – 2015
  • Phase 8: 2016 –