Online Program

Using Linked PRAMS DATA to Evaluate Outcomes of a Rural Healthy Start Program

Tuesday, November 3, 2015

Sandra Mobley, PhD, RN, Department of Obstetrics & Gynecology/ Medical College of Georgia, Augusta University, Albany, GA
Sandra Mobley, PhD, RN, Department of Obstetrics & Gynecology, Medical College of Georgia, Georgia Regents Unviersity, Albany, GA
Suzanne Thomas, PhD, APRN-BC, College of Nursing, Augusta University, Augusta, GA
Donald Sutherland, PhD, Enterprise Community Healthy Start, MCG Health System, Augusta, GA
Nicole Kosacz, MPH, Maternal Child Health, Georgia Department of Public Health, Atlanta, GA
Chinelo Ogbuanu, MD, MPH, PhD, Maternal Child Health, Georgia Department of Public Health, Geneva, Switzerland

The Secretary’s Advisory Committee on Infant Mortality recognized the value of linked data sets to evaluate maternal child health programs and encouraged collaboration from local, state, and national programs.  For example, Enterprise Community Healthy Start (ECHS) project data were linked with Georgia vital records and with CDC’s PRAMS data to further evaluate the impact of the program.


Community-based approaches to increasing response rates to PRAMS surveys by women in the ECHS service counties included targeted distribution of posters and flyers. Researchers provided identified ECHS data necessary to link the data sets and verify accuracy of the linkages. Continuous collaboration was necessary to meet HIPAA and IRB requirements and plan the protocols for ECHS program evaluation using the linked data.


Data revealed PRAMS oversampling of the rural ECHS service counties resulted in 196 ECHS-served women completed the survey.  ECHS sample size accounted for approximately one-third of the total PRAMS sample in 2010 and one-fourth in 2011.  

The study design for the local program evaluation using the linked perinatal data will be a secondary analysis of linked PRAMS data conducted among singleton births to assess differences between ECHS clients and: 

  1. non-ECHS women residing in the same project area counties;

  2. non-ECHS women residing outside of the project area but in similar Georgia counties; and

  3. non-ECHS women residing in non-HS Georgia counties.


Linked data files are a rich source for evaluation of service projects.  They provide an opportunity for external comparison groups.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Public health or related research

Learning Objectives:
List community based approaches to increasing response rates without biasing responders. Design a methodology for validating linkage of multiple data sets. Explain the HIPAA and IRB considerations with linked data. Describe the study design for the local program evaluation using the linked perinatal data.

Keyword(s): Evaluation, MCH Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As project director and lead on developing initial and subsequent competing proposals, I have directed the community-based, HRSA-funded Enterprise Community Healthy Start project for 15 years. Having received over 18 million dollars in funding from Robert Wood Johnson, ACF, CMS, and HRSA, I have directed multiple community-based projects. As current PI on several protocols, I am co-author of two recent publications related to Enterprise Community Healthy Start and other publications.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.