PI / PD: Diop, Hafsatou RFA-DP-21-001 Project Summary/Abstract The overall goal of the Massachusetts Pregnancy Risk Assessment Monitoring System (PRAMS) is to collect data to improve the health of mothers in the preconception, perinatal, or postpartum periods and the health of their infants. Massachusetts (MA) has implemented PRAMS since 2007 and oversamples women by race/ethnicity to allow women of color to have a greater opportunity to participate in the survey. PRAMS methodology uses a mixed mode survey (mail and telephone) to inquire about maternal attitudes, experiences and behaviors before, during and shortly after pregnancy. There are approximately 70,000 births annually in MA, of which 2,400 are sampled for inclusion in PRAMS. During the last three years for which we have weighted data, the overall weighted response rate was 59.9%, 61.9%, and 62.4%, for 2016, 2017, and 2018, respectively. MA PRAMS response rates have been consistently above the CDC minimum response rate threshold of 55% during 2016-2018. PRAMS will be used to inform the Title V priorities and performance measures, and support MA maternal and child health (MCH) priorities. We propose to use PRAMS to provide reliable data to inform MCH programs with limited or nonexistent data. For example, although MA has taken a number of steps to understand and respond to the opioid epidemic, data on prescription pain relievers and other opioids during pregnancy, particularly among women who have not been diagnosed or treated for substance use disorder were lacking, as they are not captured in administrative and program data. In addition, data on whether women received substance use disorder treatment from providers including medication-assisted treatment (MAT) during pregnancy were limited. We will use the PRAMS Opioid Survey and Opioid Call-Back Survey (OCBS) to obtain these data among new mothers. In addition, the OCBS will provide a unique opportunity to ask about access to substance misuse treatment, including MAT, rehabilitation services, and other programs such as peer-to-peer support systems, and to identify best practices to mitigate the risk of opioid misuse in the postpartum period and reduce maternal opioid misuse and overdose events. Similarly, in response to the current pandemic, MA is also working on implementing a COVID-19 survey to better understand the inequities we see in the spread and treatment of COVID-19.