Information Collection Request

Pregnancy Risk Assessment Monitoring System (PRAMS)

ICR 202211-0920-018 · OMB 0920-1273 · Received in OIRA

⚠️ Notice: This information collection may be outdated.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

Forms and Documents

Document Name	Status
PRAMS Stillbirth Survey Form and Instruction	Modified
PRAMS Field Test Form and Instruction	Modified
PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction	Modified
PRAMS Supplemental Modules Form and Instruction	Modified
PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction	Modified
Att 2f - PRAMS Phase 8 Web Mode Data Collection Metrics.docx Supplementary Document	2022-11-29
Att 16 Summary of Changes between Phase 8 and 9.docx Supplementary Document	2022-11-29
Att 15a - PRAMS Field Testing Methodology.docx Supplementary Document	2022-11-29
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 Rewards by Jurisdiction.docx Supplementary Document	2022-11-29
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 clean.docx Supporting Statement B	2022-11-29
1273 PRAMS SSA 11-16-2022 clean.docx Supporting Statement A	2022-11-29

IC Document Collections

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

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CDC
OMB Control No	0920-1273
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	202207-0920-006
Agency Tracking No	0920-1273
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31