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Alaska Childhood Understanding Behaviors Survey (CUBS)

About the Program

What is Alaska CUBS?

Alaska CUBS is a program designed to find out more about the health and early childhood experiences of young children in Alaska. CUBS collects information by conducting a follow-up survey to the Alaska Pregnancy Risk Assessment Monitoring System (PRAMS). PRAMS sends a survey to approximately one of every six mothers of newborns in Alaska, and CUBS sends a follow-up survey three years later to all mothers who completed PRAMS and are still living in Alaska.  CUBS asks questions about both the mother and her child. About 90 Alaskan mothers are sent a CUBS survey every month.

The CUBS program began sending out surveys in 2006. Although 37 states have a PRAMS program, currently only three other states conduct an on-going follow-up survey with PRAMS respondents.

What is the purpose of CUBS?

In Alaska, health-related data for mothers and infants are collected from PRAMS, for older children and teenagers from Youth Risk Behavior Survey, and for adults from the Behavioral Risk Factor Surveillance System. However, very little is known about the health, behavior and early childhood experiences of young children before they enter school. CUBS seeks to fill that gap by collecting information related to toddler behavior, health, health care access, parenting, and school readiness. By using the methodology of re-interviewing mothers who completed a PRAMS survey, CUBS is able to evaluate those factors present at birth or early life that increase risk for later adverse childhood outcomes.

What are the goals and objectives of CUBS?

The goal of CUBS is to provide data related to the health and well-being of Alaskan toddlers. These data are provided to public health, health-care and education professionals across Alaska to assist them in improving child health. This goal is accomplished through the following objectives:

  • Collect high quality data about the health status and care of Alaskan children at three years of age.
  • Perform data analyses to advance the understanding of how health systems, individual behaviors and family practices contribute to health outcomes during early childhood.
  • Translate analytic results into practical information for planning and evaluating public health interventions and policies and promoting standards for early childhood healthcare.
  • Share findings with stakeholders, including health care providers, educators, and parents.

Who are the partners in CUBS?

The primary partner in CUBS is Alaska PRAMS. Both PRAMS and CUBS reside in the Maternal and Child Health (MCH) Epidemiology Unit of the Section of Women's, Children's and Family Health at the Alaska Division of Public Health (DPH). The CUBS program is federally funded by the Title V, MCH Block Grant. A local steering committee for both PRAMS and CUBS is composed of a multi-disciplinary mixture of individuals from the public and private sector, representatives of Alaska Native Corporations, and the academic community. CUBS also partners with many programs in the Division of Public Health and the Alaska community to produce fact sheets and other publications that use CUBS data.

How are data collected?

Mothers who completed a PRAMS survey are given an opportunity to complete a CUBS survey. When their child turns three years old, women receive a pre-letter telling them about the CUBS survey. This is followed by up to two survey mailouts. If there is no response by mail, women are contacted and interviewed by telephone. Mothers who have moved outside of Alaska are not eligible to participate in CUBS.

See the Alaska PRAMS website for details on PRAMS methodology.

What information does CUBS collect?

Child-focused topics on CUBS include:

  • current height and weight;
  • nutrition and eating habits;
  • general and specialized health care utilization and access, including dental care;
  • child care and barriers to use of child care;
  • parenting behaviors;
  • immunizations;
  • safety; and
  • development and behaviors.

The survey also includes items specific to maternal and family experiences, such as maternal smoking and drinking habits; family stressors; parenting support; food security; and income. The survey questions are modified about every three years.

How can data from CUBS be used?

Alaska CUBS provides statewide population-level data not available from other sources about preschool-age children in Alaska. These data are used:

  • to evaluate and improve program implementation and delivery of health and wellness services for mothers and young children.
  • to identify groups of women and children at high risk for health problems, to monitor changes in health status, to evaluate those factors that increase or reduce risk for later adverse outcomes, and to measure progress towards goals in improving the health of mothers and young children.