From 2007-2010, the March of Dimes California Chapter is funding four Prematurity Prevention Demonstration Projects focused on preconception/interconception health and health care*. These projects, with the potential to be replicated across the state and country, are designed to enhance education and support services for women at high-risk due to previous poor outcomes, chronic conditions (i.e. diabetes, hypertension) or other risk factors that are known to have an impact on pregnancy.

California Family Health Council – Project Year Three
Los Angeles, San Francisco and Yolo Counties   
$100,000
This project will assess the delivery of preconception/interconception care at Title X Family Planning Clinics in San Francisco, Los Angeles and Yolo counties. Upon completion of the assessments, a curriculum will be developed and training will be held within each clinic.  An evaluation will be conducted to measure the effectiveness of the training as it relates to clinician and client adoption of preconception/interconception concepts. A cost allocation model associated with the delivery of these services will be developed and used within the context of policy change and program sustainability.

Harbor-UCLA Medical Center – Project Year Two
Los Angeles County   
The Maternal-Child Intervention project will enroll women with gestational diabetes/pre-diabetes in a coordinated maternal-child preventive care program to promote: i) her role in establishing healthy lifestyle to control/prevent diabetes and achieve healthy weights for herself and her child; ii) breastfeeding during the first six months of life; iii) effective, safe contraception and diabetes control/prevention during interconception; and iv) planned pregnancies in optimal glycemic control.  The project will use case management to implement best practices and preventive care protocols by coordinating existing separate medical and social services.  

PHFE-WIC Program – Project Year Three
Los Angeles County  
$90,978
The WOW – WIC Offers Wellness project will: i) explore Los Angeles County WIC data to locate neighborhoods with high rates of prematurity and low birth weight in WIC mothers; ii) implement care coordination strategies/activities/protocols for postpartum WIC mothers, iii) design and implement a database such that, for the first time, WIC women may be tracked during their interconception period and iv) evaluate the impact of WOW by comparing women receiving WOW services with women at a matched control site.

Sutter Medical Center – Project Year Three  
Sacramento County  
$72,714
The Teen Care project will provide interconception risk assessment and intervention through home visitation to pregnant and parenting teens with high risk medical and/or social risk factors or with prior adverse pregnancy outcomes.  The goals of the project are to achieve decreased adverse birth outcomes; positively impact changeable health behaviors and create a replicable package of interconception services for pregnant and parenting teens that includes innovative, culturally appropriate resources such as on-line risk assessment tools. 

Community Service Grants
Alameda County Public Health Department (Improving Pregnancy Outcomes Program)  
$44,000
The ClubMom program will provide risk reduction education and support to low-income African-American women at-risk for adverse birth outcomes.  Participants at three program sites, or “health education homes”, will be recruited from the zip codes in Alameda County with the highest infant mortality rates. The group education and activity model will emphasize social support, self-care, peer leadership, increased health knowledge and health behavior change.

MOMS Orange County 
$49,500
The VietMOMS program is a health promotion and maternal-child care coordination program for low-income Vietnamese women and their babies.  This is the only program in Orange County providing linguistically and culturally appropriate in-home care coordination services for this population that experiences adverse birth outcomes. The program is designed to increase health knowledge, increase access to prenatal care and improve birth outcomes.

Scripps Whittier Diabetes Institute 
$45,351
The Dulce Mothers program will provide interconception education and clinical management for uninsured and underinsured, high-risk, low-income Latina women previously diagnosed with gestational diabetes. Through group education and individual care management, the program is designed to support health behavior change and prevention development of Type 2 diabetes, increase health knowledge and improve health indicators such as physical activity level, BMI, blood glucose level and blood pressure.

University of California, San Diego  
$10,637
The Supporting Premature Infant Nutrition (SPIN) program will develop a website focused on premature infant nutrition. The website will house educational materials and practical information for families and continuing education, policies and procedures for health professionals in newborn intensive care units.  The website will be accessible to parents and professionals across California. 

Cooperative Partnerships
American College of Obstetricians & Gynecologists, District IX 
$50,000 - 2009
The goal of the Interconception Care Project is to develop interconception guidelines for the postpartum medical visit to assist the obstetric provider in screening, risk-reduction counseling, treatment and referral to improve outcomes of subsequent pregnancies.

Loma Linda University Medical Center / Regional Perinatal Programs of California  
$21,071 - 2008-2009
Through this cooperative agreement, Loma Linda University Medical Center/Regional Perinatal Programs will lead the implementation of the March of Dimes Preterm Labor Assessment Toolkit in 10 hospitals within the Inland Empire region. 

Miller Children’s Hospital - MemorialCare Center for Women, Long Beach 
$50,000 - 2007-2009
Through this cooperative agreement, Miller Children’s Hospital will lead the implementation of the March of Dimes Preterm Labor Assessment Toolkit in over 10 hospitals within Los Angeles and Orange Counties. 

*Preconception care is defined as interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management, emphasizing factors which must be acted on before conception or early in pregnancy to have maximum impact. More than 60% of pregnancies in California are unplanned, further pointing to the need to integrate preconception services into health care for all women of reproductive age. Interconception care is interventions provided to women between their pregnancies or to women who have had a prior adverse pregnancy outcome.