How can PRAMS Survey Response Rates be Improved Among American Indian Mothers? Data from 10 States

Abstract

To examine the low response rates to the Pregnancy Risk Assessment and Monitoring System (PRAMS) survey for American Indian (AI) mothers by comparing characteristics of AI participants, AI non-participants, non-Hispanic White (NHW) participants, and NHW non-participants. We analyzed 2000-2002 data from states whose population was at least 5% AI or Alaska Native (AN) (n = 10). Mothers who returned a questionnaire (regardless of completion) or who spoke by telephone with PRAMS personnel were defined as contacts. Mothers who completed a PRAMS questionnaire were defined as respondents. We described overall and state-specific maternal characteristics from birth certificates for both those who were contacted and those not contacted and computed contact and response rates. Contact rates varied by state, ranging from 49% to 92% for AI and AN mothers and 82-93% for NHW mothers. However, once contacted, most mothers completed a questionnaire (85-99%). Both AI and NHW mothers were less likely to be contacted if they were <29 years of age, unmarried, multiparous and had <or=12 years of education. Recognized predictors of response to PRAMS surveys were similar for AI and NHW mothers. Although contact rates among AI mothers were low when compared to whites, both AI and NHW mothers who were successfully contacted had high participation rates. Ultimately, evidence from states with high response rates for AI suggests that successful efforts will require experience and may be state-specific. In addition, increased state and tribal collaboration may facilitate improved PRAMS contact and response rates among AI.