PROJECT SUMMARY/ABSTRACT In 2017 South Dakota ranked #47 in infant mortality, #49 in neonatal mortality, and #31 in postneonatal mortality despite having one of the lowest rates of low birthweight deliveries (<2500g; #2 in 2018) and preterm births (<37 weeks; #16 in 2018). A Governor’s Task Force on Infant Mortality was formed in 2011 with the First Lady serving as the Chairperson. Several recommendations resulted, including a recommendation to enhance state and county-level data regarding pregnancy experiences, risk, barriers, outcomes and infant care practices. Historically, there have been little data available on factors that influence health behaviors and attitudes of South Dakota mothers around the time of pregnancy. The South Dakota Department of Health (SDDOH) recognized that the PRAMS survey is a tool to provide that information and in 2013 contracted with South Dakota State University (SDSU) to provide Maternal and Child Health (MCH) epidemiological services and to conduct the first statewide SD PRAMS-like surveys in 2014 and 2016. Since 2017 SDDOH and SDSU have successfully participated in the CDC-funded PRAMS, consistently obtaining response rates greater than 64%. SD PRAMS data have been disseminated widely in both peer-reviewed literature and in the form of infographics; it also will be used to address state objectives as part of the upcoming MCH Title V Block Grant renewal. Domestic violence data are utilized by the Sexual Violence/Rape Prevention Education group, data on smoking and alcohol use are used by the Office on Chronic Disease Prevention and Health Promotion, and reports concerning American Indian mothers are being developed for distribution to individual Tribes and the Great Plains Tribal Chairmen’s Health Board and Great Plains Tribal Epidemiology Center. The current proposal is for South Dakota to serve as a Core Surveillance site (Component A) in the CDC PRAMS. The SD PRAMS will stratify sampling by maternal race (non-Hispanic white, American Indian, and other races) in order to obtain race specific prevalence rates that can be used to address racial disparities that occur in South Dakota. The need is significant, the data are being used, and we have had excellent statewide participation rates.