PREGNANCY RISK ASSESSMENT MONITORING SYSTEM (PRAMS)
OUR PROGRAM
The Pregnancy Risk Assessment Monitoring System (PRAMS) is a population-based public health surveillance program designed to better understand the experiences, behaviors, and needs of women before, during, and after pregnancy.
PRAMS collects data directly from new mothers through a confidential survey that complements birth records. This information helps health officials identify health risks, monitor trends, and inform maternal and infant health programs, services, and policies.
By tracking key factors such as access to prenatal care, health behaviors, and birth outcomes, CNMI PRAMS supports evidence-based decision-making to reduce adverse outcomes—including preterm birth, low birth weight, and maternal and infant morbidity and mortality—and to improve the overall health of families in the Northern Mariana Islands.
Pregnancy Risk Assessment Monitoring System (PRAMS)
This is a population-based survey that uses a mixed-mode approach, including mail, phone, and web-based methods, to survey mothers in the Commonwealth of the Northern Mariana Islands (CNMI) who have recently given birth. The survey utilizes a stratified sampling method.
A sample is drawn by the Health Vital Statistics Office (HVSO) on the first of each month and processed through the Statistical Analysis System (SAS) by PRAMS staff. Once the sample is cleaned, it is uploaded into the PRAMS Integrated Data Collection System (PIDS) on the 15th of the month. Each birth record included in the survey is typically two to three months old.
Data collection occurs over a maximum period of 95 days and follows a structured schedule for mailings and telephone contact. The web survey option is introduced at the beginning of the pre-letter, allowing mothers to complete the survey at their convenience.
Throughout the data collection period, mothers receive two mailing packets with opportunities to return completed surveys by mail or drop them off at designated drop boxes. PRAMS staff are trained to conduct telephone interviews using a standardized script, with calls scheduled during regular business hours and, by appointment, during evenings and weekends to maximize participation.
Mothers who participate receive a small reward as a token of appreciation. All responses are kept completely confidential and are aggregated to provide insights into the health and well-being of CNMI mothers and babies. The collected data are used to inform improvements in healthcare services and to guide programs and policies for women and children in the CNMI.
Data Collection Schedule
| Activity | Timeline |
|---|---|
| Pre-letter | Day 1 |
| First Questionnaire | Day 5 |
| Tickler (Reminder) | Day 15 |
| Second Questionnaire | Day 29 |
| Telephone Follow-up | Day 55 |
| End of Data Collection | Day 95 |
1. What is PRAMS?
PRAMS (Pregnancy Risk Assessment Monitoring System) is a joint research project between the Commonwealth Healthcare Corporation and the Centers for Disease Control and Prevention (CDC). The purpose of PRAMS is to understand why some babies are born healthy while others are not.
The questionnaire asks new mothers about their behaviors and experiences before, during, and shortly after pregnancy. Each year in the CNMI, hundreds of babies are born with serious health problems, and many do not survive. No matter how your pregnancy went, your answers help us learn how to improve outcomes for future mothers and babies in the CNMI.
2. Will my answers be kept private?
Yes. All answers are kept completely private and are used only for purposes related to this study. Responses are grouped together to provide information about CNMI mothers of new babies. No individual woman is ever identified by name in any reports.
3. Is it really important that I answer these questions?
Yes. Because only a small number of mothers are selected, every response is important. Each pregnancy is different, and your answers help provide a more complete picture of the health of mothers and babies in the CNMI.
The information you provide may help improve healthcare services for women and children. We need to know what went well as well as what challenges occurred during pregnancy. Your participation is critical to the success of the program.
4. Some of the questions do not seem related to health care. Why are they asked?
Many factors in a mother’s life can affect pregnancy outcomes. These questions help us better understand overall health care experiences and life circumstances that may impact pregnancy and infant health.
5. How was I chosen to participate in PRAMS?
Mothers are selected from the CNMI birth certificate registry. All selected participants are CNMI residents who have recently given birth. You are one of a small number of women chosen to represent mothers in the CNMI.
6. What if I want to ask more questions about PRAMS?
If you have additional questions or would like to complete the questionnaire by phone, please call (670) 236-8723. Our staff will be happy to assist you.