Changing Policy and Program: Putting Data from the Pregnancy Risk Assessment Monitoring System PRAMS

1

• Changing Policy and Program Putting Data from
  the Pregnancy Risk Assessment Monitoring System
  (PRAMS) to Work

Brenda Colley Gilbert, Mary Rogers, and Chris
Johnson
2

• Ways PRAMS Data Are Being Used

• to raise visibility
• to set priorities
• to obtain resources
• to develop or modify programs
• to inform policy

3

• How Women and Infants are Doing Trends and
  Emerging Issues from the Pregnancy Risk
  Assessment Monitoring System for 1993-1996

Chris Johnson, Mary Lyn Gaffield, Brian Morrow,
Brenda Colley Gilbert, Laurie Fischer, Indu
Ahluwalia, Mary Rogers, Mike Vanchiere, and the
PRAMS Working Group
4
The PRAMS Working Group

• The PRAMS Working Group consists of these people
  AL, Nicole Henderson AK, Kathy Perham-Hester
  AR, Gina Redford CA, Gilberto Chavez CO,
  Marilyn Leff DC, Michelle Davis FL, Richard
  Hopkins GA, Leslie Lipscomb IL, Bruce Steiner
  IN, Roland Gamache LA, Danielle Broussard ME,
  Martha Henson MI, Yasmina Bouraoui NM, Susan
  Nalder NC, Paul Buescher NY, Michael Medvesky
  OK, Richard Lorenz SC, Alexandra Connelly WA,
  Sherilyn Casey WV, Melissa Baker.

5

• Overview of Talk

• description of PRAMS
• surveillance results
• '96 prevalence estimates for 7 indicators, 11
  states
• '93 - '96 trends
• state-specific demographic comparisons

6

• PRAMS

• what PRAMS is
• who participates
• how data are collected

7

• How Data Are Collected

• sample drawn from BC records
• series of mailings
• telephone follow-up
• weighting of data for analysis

8
States Participating in PRAMS
WA
ME
NY
MI
IL
IN
WV
CO
CA
DC
NC

• OK

NM
AR
SC
GA
AL
LA
AK
FL
1987
1991
1996
9

• Topics

• late prenatal care
• length of hospital stay for delivery
• unintended pregnancy
• breast-feeding
• tobacco and alcohol use
• physical abuse

10

• Prevalence of Late Prenatal Care, 1996

Source PRAMS
11

• Late Prenatal Care, 1993 - 1996

Source PRAMS
12

• Prevalence of Short Hospital Stays, 1996

Source PRAMS
13

• Short Hospital Stays, 1993 - 1996

Source PRAMS
14

• Prevalence of Unintended Pregnancy
• Among Women Having a Live Birth, 1996

Source PRAMS
15

• Unintended Pregnancy, 1993 - 1996

Source PRAMS
16

• Unintended Pregnancy, 1996
• by Medicaid

Source PRAMS
17

• Unintended Pregnancy, 1996
• by Education

Source PRAMS
18

• Unintended Pregnancy, 1996
• by Race

Source PRAMS
19

• Unintended Pregnancy, 1996
• by Age

Source PRAMS
20

• Prevalence of Breast-feeding Initiation, 1996

Source PRAMS
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• Breast-feeding Initiation, 1993 - 1996

Source PRAMS
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• Breast-feeding Initiation, 1996
• by Medicaid

Source PRAMS
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• Breast-feeding Initiation, 1996
• by Education

Source PRAMS
24

• Breast-feeding Initiation, 1996
• by Race

Source PRAMS
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• Breast-feeding Initiation, 1996
• by Age

Source PRAMS
26

• Prevalence of Smoking During Last Trimester, 1996

Source PRAMS
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• Smoking During Last Trimester, 1993 - 1996

Source PRAMS
28

• Smoking During Last Trimester, 1996
• by Medicaid

Source PRAMS
29

• Smoking During Last Trimester, 1996
• by Education

Source PRAMS
30

• Smoking During Last Trimester, 1996
• by Race

Source PRAMS
31

• Smoking During Last Trimester, 1996
• by Age

Source PRAMS
32

• Smoking During Last Trimester, 1996
• by Age

Source PRAMS
33

• Prevalence of Drinking During Last Trimester, 1996

Source PRAMS
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• Drinking During Last Trimester, 1993 - 1996

Source PRAMS
35

• Drinking During Last Trimester, 1996
• by Medicaid

Source PRAMS
36

• Drinking During Last Trimester, 1996
• by Education

Source PRAMS
37

• Drinking During Last Trimester, 1996
• by Race

Source PRAMS
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• Drinking During Last Trimester, 1996
• by Age

Source PRAMS
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• Prevalence of Physical Abuse During Pregnancy,
  1996

Source PRAMS
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• Physical Abuse During Pregnancy, 1996
• by Medicaid

Source PRAMS
41

• Physical Abuse During Pregnancy, 1996
• by Education

Source PRAMS
42

• Physical Abuse During Pregnancy, 1996
• by Race

Source PRAMS
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• Physical Abuse During Pregnancy, 1996
• by Age

Source PRAMS
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• Summary

• Trends and lack of change
• Prevalence figures show the magnitude of
  problems.
• Demographic differences show subgroups at
  increased risk.