Outcomes Education Maternal Child Health

The Pregnancy Assistance Fund (PAF) Performance, FY2017-FY2019, revised for cohort 5

0990-0460 Form Outcomes Education MCH rev2018_OMB_OAH42019_CLEAN

Outcomes Education Maternal Child Health

OMB: 0990-0460

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OMB No. 0990-0460

Exp. Date XX/XX/20XX
































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Pregnancy Assistance Fund Program Outcomes Forms


Educational Outcomes (New to this ICR)



  1. For expectant and parenting teens enrolled in high school and served by the PAF program during the federal grant year, how many dropped out of school during the federal grant year? (dropout defined as participant dropping out of school and not returning)

_________


  1. For expectant and parenting teens enrolled in high school and served by the PAF program, how many graduated from high school during the federal grant year? _________


  1. For expectant and parenting teens served by the PAF program and not enrolled in high school, how many obtained a GED (or other high school equivalency credential) during the federal grant year? _________



Maternal and Child Measures (New to this ICR)



For Parenting Female Teens served by the PAF program during the federal grant year:


  1. How many parenting female teens (­< 19) served by the program reported a new pregnancy during the grant year? _______



For Expectant Female Participant served by the PAF program during the federal grant year:



Collect following items to all expectant or parenting females who had a live birth at any point during the federal grant year. Grantees would aggregate responses to report to OAH. These items were adapted from the Pregnancy Risk Assessment Monitoring System (PRAMS) Core Questionnaire [questions 17, 18, 19, 25, 27] from the Centers for Disease Control and Prevention.


  1. How many expectant female participants who were served by the PAF program during the grant year reported a live birth at any point during the federal grant year? _________


  1. How many female participants who were expectant at the time of intake report the birth of an infant that is low birth weight (less than 5 lbs., 8 oz.) while participating in the program during the grant year? __________


  1. How many female participants who were expectant at the time of intake report a premature birth (less than 37 weeks gestation) while participating in the program during the grant year? _____________





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