Component A – Pregnancy Risk Assessment Monitoring System PD/PIs: Paulette Valliere, MPH; David Laflamme, PhD, MPH New Hampshire Division of Public Health Services Project Summary The goal of the Pregnancy Risk Assessment Monitoring System (PRAMS) is to reduce infant morbidity and mortality and to promote maternal health by informing maternal and child health (MCH) programs and policies, and influencing maternal behaviors during pregnancy and early infancy. The objectives of PRAMS are: (1) to implement state-specific population- based surveillance on maternal attitudes, behaviors and experiences that occur prior to, during and after pregnancy; (2) to collect population-based data of high scientific quality; (3) to conduct data analyses to inform programmatic activities and public health practice; (4) to translate and disseminate analytic results into usable information for public health action; and (5) to have capacity to respond to post-disaster or pandemic surveillance needs that may arise by implementing a PRAMS survey supplement or oversample. The objectives will be accomplished by ongoing activities such as: collecting data otherwise unavailable; describing maternal behaviors, attitudes, and experiences during pregnancy and early infancy; influencing public health policy by working with policy makers to incorporate findings into the decision-making process; and committing state staff and resources to develop expertise in the skills required to conduct surveillance. The PRAMS methodology includes drawing a sample of women from the state birth file; sending mailed questionnaires (up to three) on a specific timeline; following up all non- responders with a series of up to 15 telephone calls over 30 days by a trained interviewer. These goals, objectives, and methodology are in accordance with the national PRAMS protocol. New Hampshire (NH) PRAMS staff will follow PRAMS research methods in the conduct of this surveillance project to produce high quality data. A statewide MCH needs assessment was conducted in 2015, resulting in the setting of eight priorities as the focus of efforts to improve maternal and child health in NH over the next five years. These priorities include a range of needs such as decreasing the use and abuse of alcohol, tobacco and other substances among pregnant women, decreasing pediatric overweight and obesity, and reducing unintentional injury by promoting safe sleep practices. The information from PRAMS will fill critical data gaps and inform policies, systems, and programs that address these and other MCH priorities.