Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS) Project Abstract: Long Term Objectives The Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS) provides data for a variety of maternal and child health (MCH) issues. The goal of the study is to reduce the prevalence of maternal and infant morbidity and mortality. PRAMS can accomplish this by providing on-going, statewide preconception, pregnancy, and postpartum specific data. No other statewide study focuses on the pregnancy and postpartum experience, making PRAMS a unique and necessary data source for the state. Specific Aims The specific aims of the Oklahoma PRAMS Project are to provide quality, statewide, population- based surveillance data on the Oklahoma State Department of Health's MCH priorities. Those priorities are: reduce infant mortality; improve access to comprehensive health services for the MCH population; reduce the prevalence of tobacco use among the MCH population; reduce the prevalence of obesity among the MCH population; improve preconception health for females and males of reproductive age; reduce unwanted, unplanned pregnancies; and improve infant safe sleep practices. Monitoring behaviors and outcomes across the state on these priorities will enable programs and agencies to provide targeted interventions to populations of need. Research Design and Methods PRAMS contacts new mothers two to six months after delivering a live birth. The sample is drawn from the Oklahoma live birth registry. The PRAMS Project utilizes a mixed mode surveillance system, meaning respondents are sent up to three mail survey packets, followed by telephone contact for nonrespondents. Oklahoma stratifies by birth weight, oversampling low birth weight (less than 2,500 grams) and high birth weight infants (> 4,000 grams). A response rate of 65% in all strata is required in order to weight the data to the annual birth cohort. Mail packets consist of the PRAMS questionnaire and return envelope, an informed consent sheet, a resource directory, an incentive (Mail 1 only), and a reward sheet (listing several items mothers may choose from for completing the survey). Telephone respondents are also offered a choice of rewards. Incentives and rewards are used in an effort to maximize participation in the study. Currently, Oklahoma PRAMS has an overall response rate of 70% and all strata meet the 65% threshold.