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Oregon PRAMS Report; 1998-99

Oregon PRAMS: First Year Report, 1998-99

Appendix B:

PRAMS 1998-99 Data Collection Methodology

One strength of the PRAMS surveillance system is the standardized data collection, allowing for observation of Oregon trends over time and comparisons between Oregon and other states.

PRAMS is a mixed-mode surveillance system that combines two modes of data collection. The primary data collection method is a mailed questionnaire. Women who are indicated as being Hispanic on the birth certificate receive the survey and all materials in both English and Spanish. Multiple attempts are made by mail and then by telephone to follow up with non-respondents. Phone surveys are also available in both English and Spanish.

The following is the sequence of contacts for PRAMS surveillance:

  1. Preletter. This letter introduces PRAMS to the mother and informs her that a questionnaire will arrive soon.
  2. Initial mail questionnaire packet. This packet is sent to all sampled mothers about 7 days after the preletter. Its contents are described subsequently. Mothers are instructed to call the Oregon SafeNet toll-free number if they want to be interviewed by phone rather than complete the written survey.
  3. Tickler. The tickler serves as thank you or reminder note. It is sent about 7 days after the initial mail packet.
  4. Second mail questionnaire packet. This packet is sent to all sampled mothers who have not yet responded 14 days after the tickler was sent.
  5. Telephone follow-up. Telephone follow-up is initiated for all non-respondents 14 days afer mailing the second questionnaire. It is done, in both English and Spanish, by Clearwater Research, Inc., Boise, Idaho.
The series of mailings commences two to four months after delivery. The questionnaire contains items asking about the early postpartum period; thus, the mailings are timed to ensure that all women can respond for this period. The data collection cycle from mailing the preletter to the close of telephone follow-up lasts approximately 60-70 days. Each month a stratified random sample is drawn from the current birth certificate file. This sequence of contacts is attempted for each of these monthly samples, or "batches." The median time from birth to completion of the survey is four months.

The mail packets contain the following items:

  1. A multipurpose cover letter that describes PRAMS, explains how and why the mother was chosen, elicits the mother's cooperation, describes procedures for filling out and returning the questionnaire, explains the incentive and provides a toll-free telephone number for additional information. This letter is modified slightly in the second mailing, primarily by adding an additional appeal for response.
  2. The questionnaire booklet. The questionnaire booklet is 20 pages long, has a colorful cover, is [7"x8.5"] and contains two blank pages for comments from the mother. A self-addressed return envelope with postage is provided.
  3. An information sheet that contains answers to the questions most frequently asked about PRAMS. It can be an important tool to convince the mother to participate.
  4. A three-year calendar to be used as a memory aid for answering the questions.
  5. Incentive: each woman who returns the first survey within 8 weeks is entered into a drawing; one woman each month wins $200 in gift certificates from Fred Meyer stores.
In addition to the questionnaire created for the mail packet, a telephone version of the questionnaire has also been developed for use during the telephone phase. Telephone follow-up begins six weeks after the lst questionnaire is mailed (see Appendix of timetable derived from ohd1\prams.19n). Various sources of telephone numbers are used to obtain valid phone numbers. Calls to a particular number are staggered over different times of the day and different days of the week. Up to 15 attempts, on each phone number, are made to contact a mother.

The interviewer-administered questionnaire includes the same content as the self-administered version, however some questions have been reformmatted to facilitate reading them aloud to the mother. Alternate interview arrangements have been made for women who speak neither English nor Spanish.

PRAMS Weighting Process

This report includes data from two versions of the PRAMS survey. The first was used from November 1998 to March 1999 and the second was used from April 1999 to October 1999. The only difference between the versions is in Question 74, the categorizations of answers about family income, and reflects changes in the federal poverty level guidelines.

Ascertainment of family income:
A review of the literature about asking people their income led to the creation of a two-question sequence; the first question asks women their family income and the second question asks them to select the income range that includes their family income. Income questions continue to have slightly greater non-response than other questions. Because PRAMS data is being used to evaluate the recent family planning expansion waiver (to prevent unintended pregnancy in women with 100-185% of the federal poverty level) it was particularly important to obtain precise income information. The income categories are changed annually to reflect changes in the federally defined poverty level that go into effect every April. For example, new federal poverty guidelines going into effect in April 1998 reflect income at time of conception for babies born in January 1999; typically PRAMS is surveying those women in April 1999.

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