PROJECT SUMMARY The Arizona Pregnancy Risk Assessment Monitoring System (Arizona PRAMS) proposes to conduct a state-specific, population-based surveillance system of maternal behaviors and experiences before, during, and after pregnancy. Sponsored and partially funded by the Centers for Disease Control and Prevention, Arizona PRAMS will supplement vital records data by providing state-specific data to be used for planning and evaluating preconception, pregnancy and postpartum maternal and infant health programs at the Arizona Department of Health Services. The 2021-2026 grant cycle will mark the second application submission of the Arizona PRAMS Program. Arizona PRAMS will utilize a mixed-mode survey to incorporate both mail and phone systems to increase response rates. A random sample of mothers will be drawn each month from the Arizona Birth Certificate Database. These mothers will be mailed Arizona PRAMS questionnaires that contain questions asking about their preconception, pregnancy and postpartum experience including risk behaviors, pregnancy intention, access to health care, maternal and infant nutrition, and mental health. ADHS will utilize bilingual telephone interviewers to call mothers who do not respond by mail. The Arizona PRAMS survey will include core surveillance questions that have been developed by the CDC and additional state- developed questions to explore the determinants of maternal health unique in Arizona’s diverse population. The survey is estimated to take approximately 20 minutes to complete. In order to increase response rates, a small incentive or reward will be provided to the targeted mother. The CDC has established a goal response rate of 55 percent. Preconception and reproductive health and health equity are priorities of the ADHS Bureau of Women’s and Children’s Health (BWCH). Arizona PRAMS will provide robust surveillance data on the preconception health of reproductive-aged women and allow ADHS-funded prevention programs to tailor their interventions to meet the mental and physical health needs of populations at risk for negative pregnancy outcomes. Combined with data from Arizona Vital Statistics, Arizona PRAMS will serve as an important source of longitudinal surveillance data used to monitor the reproductive health of all of Arizona’s women.