Background:
The Family Maternal and Child Health Programs of Contra Costa Health Services launched a 15-year Life Course Initiative, based on the Life Course Perspective (LCP), to reduce disparities in birth outcomes, improve the health of the next generation, and bring about a paradigm shift in our approach to women's and infant health. The LCP suggests that disparities in birth outcomes are a result of differential exposure to protective and risk factors over one's life course, not simply the absence of access to quality prenatal care. To refocus MCAH work at the local level, county staff need to be informed about new approaches for closing the disparities gap in birth outcomes, and be able to identify and articulate ways in which they can incorporate promising practices such as preconception health into current and future work.

Objectives:
Describe innovative. engaging strategies for educating local MCH staff, local policy makers, and other community partners about preconception health and the Life Course Perspective
Utilize lessons learned to recognize and address necessary programmatic and policy changes for the integration of preconception health care at the local level.


Methods:
Educational sessions were conducted over a two-year period with 300 local county staff, policymakers and community partners on the LCP, preconception care, and strategies for redesigning current MCAH practices. A survey evaluated participants' understanding of the LCP, and strategies for incorporating preconception health into program work.

Results:
Local county staff and community partners have a deeper understanding of the Life Course Perspective concepts, have identified strategies for incorporating preconception care into their work, and are becoming catalysts for change as they embrace a deeper understanding of the complex interplay of biological, behavioral, psychological, and environmental factors that contribute to health outcomes across the span of a person's life.

Conclusion and implications for practice:
MCAH staff understand and recognize the value of this important paradigm shift to improving the health of the populations we serve.