Graduate Student Internship Program

This internship has been filled.

Arkansas

APRAMS Data Analysis
Arkansas Department of Health, Health Statistics Branch, Little Rock, AR
Skill Area: Data Analysis and Monitoring

Agency Information

The Pregnancy Risk Assessment Monitoring System (PRAMS) program was initiated by the Centers for Disease Control and Prevention in 1987 to help reduce infant mortality and the prevalence of low birthweight infants. The decision to create the program was based on research that pointed out three factors: 1) the U.S. infant mortality rate was no longer declining as rapidly as it had in the past; 2) the prevalence of low birthweight was showing no change; and 3) maternal behaviors such as alcohol and tobacco use and limited use of prenatal and pediatric care were contributing to the slow rates of decline.

The PRAMS survey helps state health departments create and maintain an epidemiologic surveillance system of selected maternal behaviors and experiences (e.g., smoking, drinking, prenatal care, physical abuse, pregnancy intent, stress, well baby checkups). This information is collected using mail and telephone surveys of a monthly stratified sample of women who have had a live, in-state birth. The information is used to supplement data from the birth certificate to generate data for planning and assessing perinatal health programs.

The Health Statistics Branch in the Arkansas Department of Health (ADH) has been in the PRAMS program since 1996 and has been collecting data since 1997. From 1997 through 2006, the annual sample size for the survey has ranged from 2,400 to 2,932 with an overall response rate averaging about 75 percent. The program has two full-time employees: a PRAMS coordinator and a data manager/phone interviewer.

The Health Statistics Branch works with the Family Health Branch in the ADH in investigating infant health problems and developing research plans. Additionally, the Family Health Branch partially funds the position for the PRAMS project director through its Maternal and Child Health grant funds

Purpose, goals, and objectives of internship

Purpose: The purpose of this internship is to provide the ADH with assistance in conducting an in-depth analysis of the characteristics of postpartum women who did not receive adequate prenatal care.

Prenatal care is important because it can be beneficial in improving the health of mothers and their infants. Early and consistent prenatal care for pregnant women allows for early detection and treatment of medical problems such as pregnancy-induced hypertension and diabetes that can affect the health of the mother and the infant. Also, screening can be provided for women at high risk for certain genetic disorders and pregnant women can receive counseling and education about risk behaviors and experiences (e.g., substance abuse, physical violence) that can affect birth outcomes. Not receiving adequate prenatal care can increase the risk for low-birthweight and premature births, neonatal mortality, infant mortality, and maternal mortality.

Overall, the percentage of mothers in Arkansas who received prenatal care in their first trimester (early prenatal care) has only increased from about 70 percent in 1998 to 73 percent in 2006. There are racial disparities in the percentage of women receiving early prenatal care. In 2006, for example, the percentage of White, non-Hispanic women receiving early prenatal care was 76.8 percent, compared to 67.3 percent for Black, non-Hispanic women, and 61 percent for Hispanic women. The Healthy People 2010 target is for 90 percent of pregnant women to begin prenatal care in the first trimester. Developing strategies or programs to reduce the percentage of women who do not receive adequate or early prenatal care requires an understanding of the contributing factors.

Goal: The goal of this internship will be to prepare information that can be useful to the ADH in developing policy and public health programs to increase the percentage of women receiving adequate or early prenatal care, with special emphasis on understanding and reducing the racial and socioeconomic disparities for prenatal care. Adequacy of prenatal care will be measured by information from the PRAMS data on mothers who received early (in first trimester) prenatal care.

Objective: Conduct an in-depth analysis of PRAMS data for 2000-2006 to assist the Arkansas Division of Health in addressing the following questions: (1) What are the demographic and socioeconomic characteristics of and barriers experienced by women who do not receive adequate prenatal care? How do these characteristics and barriers differ from women whose PNC is adequate? What are the differences in the prevalence of these characteristics and barriers by race/ethnicity? (2) Which of these characteristics and barriers help to explain why women do not receive adequate PNC? Does the influence of these characteristics and barriers vary by race/ethnicity? (Race-specific multivariate models will be used.)

Data or analytic tasks and activities

Data: The Arkansas PRAMS datasets for 2000-2006 will be used for the analyses. The PRAMS survey has a number of questions that can be used to analyze factors associated with inadequate prenatal care.

Analytic tasks and activities

• Development of a research outline listing and operationalizing the variables for sociodemographic characteristics and barriers associated with inadequate PNC and steps to be taken in conducting research. This task will be done in consultation with Dr. Richard Nugent, chief of the Family Health Branch.
• A literature review of research articles or publications on factors related to inadequate prenatal care and methodologies used to analyze data.
• A Chi-square analysis of relationships between variables associated with inadequate PNC and percentage of women who did not receive PNC in the first trimester, by race/ethnicity.
• Development of race-specific logistic regression models using significant variables from the Chi-square analyses to determine which variables are related to inadequate PNC.
• Write-up of research results for PRAMS Update newsletter.
• Presentation of research findings to the ADH Science Advisory Committee. This committee reviews publications and research before dissemination.

Data or analytic skills required

• Data or analytical skills – Experience working with health-related or epidemiological databases.
• Software applications – SAS, Excel, Word. The Health Statistics Branch has SAS classes every week on site. The Center for Health Statistics employees have SAS expertise that will be available to the intern.
• Statistical/analytical competencies – Basic statistics. Dr. John Senner, Chief of the Health Statistics Branch, is a statistician and will assist with the analyses.

Supervisors

Primary: Dr. Mary A. McGehee, Senior Research Analyst, Section Leader for Survey Unit, Health Statistics Branch, Arkansas Division of Health, Arkansas Department of Health and Human Services.

Secondary: Dr. Richard Nugent, branch chief for the Family Health Branch (MCH agency) and OB/GYN.

Internship begins

May or June

Housing

Assistance in finding housing is provided. University of Arkansas for Medical Sciences (UAMS) dormitory housing is available at the campus (about 5 minutes away).

Transportation

The worksite is a short walk from the UAMS campus.

Back to top