[NCCDPHP] Pregnancy Risk Assessment Monitoring System (PRAMS)

ICR 202305-0920-012

OMB: 0920-1273

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-1273 can be found here:

2025-05-01 - No material or nonsubstantive change to a currently approved collection
2024-11-22 - No material or nonsubstantive change to a currently approved collection

Forms and Documents

Document Name	Status
PRAMS Stillbirth Survey Form and Instruction	Unchanged
PRAMS Field Test Form and Instruction	Unchanged
PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction	Unchanged
PRAMS Supplemental Modules Form and Instruction	Unchanged
PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction	Unchanged
Att 17 - PRAMS Phase 9 Cognitive Testing Report.pdf Supplementary Document	2023-05-25
0920-1273 Response to Terms of Clearance _05_23_2023.docx Justification for No Material/Nonsubstantive Change	2023-05-25
FINAL for signature - Stacey Y Brayboy_March of Dimes - CAPS 00264282_signed.docx Supplementary Document	2023-05-25
Att 19 - PRAMS Nonresponse Bias Assessment of 2019 Data.pdf Supplementary Document	2023-03-22
Att 18 - PRAMS Phase 9 Field Testing Report.pdf Supplementary Document	2023-03-22
Att 2f - PRAMS Phase 8 Web Mode Data Collection Metrics_03132023.docx Supplementary Document	2023-03-22
Att 16 Summary of Changes between Phase 8 and 9.docx Supplementary Document	2022-11-29
Att 15a - PRAMS Field Testing Methodology _03 13 2023 clean.docx Supplementary Document	2023-03-22
Att 14 - PRAMS Live Birth Sample Size by Jurisdiction.xlsx Supplementary Document	2022-11-29
Att 13 - PRAMS IRB Approval_2022.docx Supplementary Document	2022-11-29
Att 12j - Livebirth Web Introduction and Informed Consent - SPANISH.docx Supplementary Document	2022-11-29
Att 12i - PRAMS Livebirth Web Introduction and Informed Consent - ENGLISH.docx Supplementary Document	2022-11-29
Att 12h - Stillbirth Phone Introduction and Informed Consent_SPANISH.docx Supplementary Document	2022-11-29
Att 12g - Stillbirth Phone Introduction and Informed Consent_ENGLISH.docx Supplementary Document	2022-11-29
Att 12f - PRAMS Livebirth Phone Introduction and Informed Consent - SPANISH.docx Supplementary Document	2022-11-29
Att 12e - PRAMS Livebirth Phone Introduction and Informed Consent - ENGLISH.docx Supplementary Document	2022-11-29
Att 12d - Stillbirth Mail Introduction and Informed Consent - SPANISH.docx Supplementary Document	2022-11-29
Att 12c - Stillbirth Mail Introduction and Informed Consent_ENGLISH.docx Supplementary Document	2022-11-29
Att 12b - PRAMS Livebirth Mail Introduction and Informed Consent - SPANISH.docx Supplementary Document	2022-11-29
Att 12a - PRAMS Livebirth Mail Introduction and Informed Consent - ENGLISH.docx Supplementary Document	2022-11-29
Att 7 - PRAMS Livebirth Phase 8 and Phase 9 Questionnaire Topic Reference.docx Supplementary Document	2022-11-29
Att 6 - PIDS Privacy Impact Assessment.pdf Supplementary Document	2022-11-29
Att 5 - PRAMS Response Gifts and Incentives by Jurisdiction 03 13 2023 clean.docx Supplementary Document	2023-03-22
Att 4 - PRAMS Questionnaire Development Process.docx Supplementary Document	2022-11-29
Att 3b - Program Response to Comments 60 Day FRN.pdf Supplementary Document	2022-11-29
Att 3a - Published 60 Day FRN.pdf Supplementary Document	2022-11-29
Att 1c PREEMIE Reauthorization Act of 2018.pdf Supplementary Document	2022-11-29
Att 1b Safe Motherhood and Infant Health Authorization.docx Supplementary Document	2022-11-29
Att 1a-Section 301 of the Public Health Service Act (42 U.S.C. 241).docx Supplementary Document	2022-11-29
PRAMS SS-B_30 Day_11-16-2022_3-21-2023.docx Supporting Statement B	2023-03-22
1273 PRAMS SSA 11-16-2022_3-21-2023.docx Supporting Statement A	2023-03-22

IC Document Collections

IC ID	Document Title	Status
257195	Submission of Data File to CDC Instruction	Unchanged
236591	PRAMS Stillbirth Survey Form and Instruction	Unchanged
236590	PRAMS Field Test Form and Instruction	Unchanged
236589	PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction	Unchanged
236588	PRAMS Supplemental Modules Form and Instruction	Unchanged
236587	PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction	Unchanged

ICR Details