Pregnancy Risk Assessment Monitoring System (PRAMS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
PRAMS Stillbirth Phone Questionnaire (Spanish)	Form and Instruction	New	Available
PRAMS Stillbirth Phone Questionnaire (English)	Form and Instruction	New	Available
PRAMS Stillbirth Mail Questionnaire (Spanish)	Form and Instruction	New	Available
PRAMS Stillbirth Mail Questionnaire (English)	Form and Instruction	New	Available
PRAMS Field Testing	Form and Instruction	New	Available
PRAMS Opioid Call-back Survey (Spanish)	Form and Instruction	New	Available
PRAMS Opioid Call-back Survey (English)	Form and Instruction	New	Repair queued
Disabilities Supplement	Form and Instruction	New	Available
Prescription and Illicit Opioid Use Supplement	Form and Instruction	New	Available
Family History of Breast and Ovarian Cancer Supplement	Form and Instruction	New	Available
PRAMS Livebirth Standard Phase 8 Phone Modules (Spanish)	Form and Instruction	New	Available
PRAMS Livebirth Standard Phase 8 Phone Modules (English)	Form and Instruction	New	Available
PRAMS Livebirth Standard Phase 8 Mail Modules (Spanish)	Form and Instruction	New	Available
PRAMS Livebirth Standard Phase 8 Mail Modules (English)	Form and Instruction	New	Available
PRAMS Livebirth Core Phase 8 Phone Questionnaire (Spanish)	Form and Instruction	New	Repair queued
PRAMS Livebirth Core Phase 8 Phone Questionnaire (English)	Form and Instruction	New	Repair queued
PRAMS Livebirth Core Phase 8 Mail Questionnaire (Spanish)	Form and Instruction	New	Available
PRAMS Livebirth Core Phase 8 Mail Questionnaire (English)	Form and Instruction	New	Available
Att 17-Field Testing Methodology.docx	Supplementary Document	Uploaded 2019-06-20	Available
Att 16-Opioid Call-Back Survey Alternate Methods.docx	Supplementary Document	Uploaded 2019-06-20	Available
Att 15-PRAMS Live Birth Sample Size by Jurisdiction.xlsx	Supplementary Document	Uploaded 2019-06-20	Available
Att 14-PRAMS IRB approval_19.docx	Supplementary Document	Uploaded 2019-06-20	Available
Att 5-PIDS Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2019-06-20	Available
Att 4-PRAMS Response Incentives and Rewards by State_rev_080118.docx	Supplementary Document	Uploaded 2019-06-20	Available
Att 3-PRAMS Questionnaire Development Process.docx	Supplementary Document	Uploaded 2019-06-20	Available
Att 2b_Response to Public Comments on 60 Day FRN.pdf	Supplementary Document	Uploaded 2019-06-20	Available
Att 2a-Published 60 Day FRN.pdf	Supplementary Document	Uploaded 2019-06-20	Available
Att 1c-PREEMIE ACT.pdf	Supplementary Document	Uploaded 2019-06-20	Available
Att 1b-SMART ACT.pdf	Supplementary Document	Uploaded 2019-06-20	Repair queued
Att 1a-Section 301 of the Public Health Service Act (42 U.S.C. 241).docx	Supplementary Document	Uploaded 2019-06-20	Available
PRAMS SS-B_5_21_19.docx	Supporting Statement B	Uploaded 2019-06-20	Available
PRAMS SS-A_5_22_19.docx	Supporting Statement A	Uploaded 2019-06-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
236591	PRAMS Stillbirth Survey	Form and Instruction	New	PRAMS Stillbirth Phone Questionnaire (Spanish)
236591	PRAMS Stillbirth Survey	Form and Instruction	New	PRAMS Stillbirth Phone Questionnaire (English)
236591	PRAMS Stillbirth Survey	Form and Instruction	New	PRAMS Stillbirth Mail Questionnaire (Spanish)
236591	PRAMS Stillbirth Survey	Form and Instruction	New	PRAMS Stillbirth Mail Questionnaire (English)
236590	PRAMS Field Test	Form and Instruction	New	PRAMS Field Testing
236589	PRAMS Opioid Call-back Surveys	Form and Instruction	New	PRAMS Opioid Call-back Survey (Spanish)
236589	PRAMS Opioid Call-back Surveys	Form and Instruction	New	PRAMS Opioid Call-back Survey (English)
236588	PRAMS Supplemental Modules	Form and Instruction	New	Disabilities Supplement
236588	PRAMS Supplemental Modules	Form and Instruction	New	Prescription and Illicit Opioid Use Supplement
236588	PRAMS Supplemental Modules	Form and Instruction	New	Family History of Breast and Ovarian Cancer Supplement
236587	PRAMS Phase 8 Questionnaire (Core Questions plus State-selected Standard Modules)	Form and Instruction	New	PRAMS Livebirth Standard Phase 8 Phone Modules (Spanish)
236587	PRAMS Phase 8 Questionnaire (Core Questions plus State-selected Standard Modules)	Form and Instruction	New	PRAMS Livebirth Standard Phase 8 Phone Modules (English)
236587	PRAMS Phase 8 Questionnaire (Core Questions plus State-selected Standard Modules)	Form and Instruction	New	PRAMS Livebirth Standard Phase 8 Mail Modules (Spanish)
236587	PRAMS Phase 8 Questionnaire (Core Questions plus State-selected Standard Modules)	Form and Instruction	New	PRAMS Livebirth Standard Phase 8 Mail Modules (English)
236587	PRAMS Phase 8 Questionnaire (Core Questions plus State-selected Standard Modules)	Form and Instruction	New	PRAMS Livebirth Core Phase 8 Phone Questionnaire (Spanish)
236587	PRAMS Phase 8 Questionnaire (Core Questions plus State-selected Standard Modules)	Form and Instruction	New	PRAMS Livebirth Core Phase 8 Phone Questionnaire (English)
236587	PRAMS Phase 8 Questionnaire (Core Questions plus State-selected Standard Modules)	Form and Instruction	New	PRAMS Livebirth Core Phase 8 Mail Questionnaire (Spanish)
236587	PRAMS Phase 8 Questionnaire (Core Questions plus State-selected Standard Modules)	Form and Instruction	New	PRAMS Livebirth Core Phase 8 Mail Questionnaire (English)
236587	PRAMS Phase 8 Questionnaire (Core Questions plus State-selected Standard Modules)	Other-Reference Material: Phase 8 Core and Standard Questions, b	New

ICR Details

OMB Control No: 0920-1273	ICR Reference No: 201905-0920-003
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-16JO
Title: Pregnancy Risk Assessment Monitoring System (PRAMS)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted	Conclusion Date: 10/30/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/21/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Pregnancy Risk Assessment Monitoring System (PRAMS) collects state-, territory-, and tribal-specific information on maternal experiences and behaviors that occur before, during and shortly after pregnancy. Self-reported survey data are collected by mixed mode methods (mailing, telephone calls). Data collection procedures and instruments are standardized to allow comparison across jurisdictions. Data are used to inform maternal and infant health programs and policy to reduce maternal and infant morbidity and mortality. Data are used to monitor prevalence of behaviors and progress toward various targets (e.g., Healthy People 2020, Title V performance indicators, Healthy Start evaluation).

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act: Research and Investigations
   PL: Pub.L. 109 - 450 3 Name of Law: PREEMIE Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 44630	08/31/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 28817	06/20/2019
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
PRAMS Field Test	n/a	PRAMS Field Testing
PRAMS Opioid Call-back Surveys	n/a, n/a	PRAMS Opioid Call-back Survey (English) ,   PRAMS Opioid Call-back Survey (Spanish)
PRAMS Phase 8 Questionnaire (Core Questions plus State-selected Standard Modules)	n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a	PRAMS Livebirth Core Phase 8 Mail Questionnaire (English) ,   PRAMS Livebirth Core Phase 8 Mail Questionnaire (Spanish) ,   PRAMS Livebirth Core Phase 8 Phone Questionnaire (English) ,   PRAMS Livebirth Core Phase 8 Phone Questionnaire (Spanish) ,   PRAMS Livebirth Standard Phase 8 Mail Modules (English) ,   PRAMS Livebirth Standard Phase 8 Mail Modules (Spanish) ,   PRAMS Livebirth Standard Phase 8 Phone Modules (English) ,   PRAMS Livebirth Standard Phase 8 Phone Modules (Spanish)
PRAMS Stillbirth Survey	n/a, n/a, n/a, n/a	PRAMS Stillbirth Mail Questionnaire (English) ,   PRAMS Stillbirth Mail Questionnaire (Spanish) ,   PRAMS Stillbirth Phone Questionnaire (English) ,   PRAMS Stillbirth Phone Questionnaire (Spanish)
PRAMS Supplemental Modules	n/a, n/a, n/a	Family History of Breast and Ovarian Cancer Supplement ,   Prescription and Illicit Opioid Use Supplement ,   Disabilities Supplement

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new request for OMB approval.

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Annual Cost to Federal Government: $7,025,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/21/2019

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