Florida Pregnancy Risk Assessment Monitoring System (PRAMS) Evaluation

BACKGROUND: Florida PRAMS was implemented in 1993 and is a collaboration between the Florida Department of Health (FDOH) and the Centers for Disease Control and Prevention (CDC). It collects state-specific population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy. The purpose of Florida PRAMS is to improve the health of mothers and infants by maintaining state-specific surveillance of maternal behaviors and generating data. Florida PRAMS captures unique data therefore it is important to understand its functionality as well as the opinions of its primary users. The purpose of this project is to evaluate the usefulness, quality, timeliness, and flexibility of Florida PRAMS data.

METHODS: This evaluation follows the CDC’s Updated Guidelines for Evaluating Public Health Surveillance Systems (2001) and focuses on the attributes of usefulness, data quality, timeliness and flexibility. Data collection occurred in three major ways: (1) Key informant group interview with Florida PRAMS administrators (2) Literature review and synthesis of previously conducted evaluations of PRAMS and (3) Stakeholder survey (17 respondents) administered to primary users of Florida PRAMS across the state.     

RESULTS:  Florida PRAMS data is useful as it consistently provides state-wide population-based estimates and trends of maternal health and behaviors, prenatal and postpartum care, and infant health. The stakeholder survey identified program planning and evaluation, monitoring health status and summarizing data as top uses of Florida PRAMS data. PRAMS data is subject to limitations specific to survey responses such as recall bias, self-selection bias and social desirability. However, studies show that PRAMS variables such as services received and chronic conditions have both high sensitivity and reliability. Timeliness is influenced by both data collection (FDOH) and data production (CDC). The largest effect on data timeliness is the production of the weighted state file by the CDC, which can take up to two years. The PRAMS survey undergoes revision at both the national and state level every 3-4 years to reflect emerging health topics. The establishment of the Florida PRAMS Steering Committee ensures that new questions are added to align with state priorities. 

CONCLUSIONS:  PRAMS is a consistently used data source at the FDOH and the majority of stakeholders agree that Florida PRAMS data is important to their work. Areas of concern voiced by stakeholders include low response rate among certain populations and delay in data production. Suggestions for improvements include taking actions, such as outreach, to increase the response rate and revising survey questions on an annual basis.