Background:
The CDC preconception health recommendations focus primarily on the role of community medical providers and public health programs to develop a seamless process of care and interventions. Considering that adolescents as a population are less likely to access traditional health care systems, many existing implementation strategies lack a systems approach to effectively engage and involve youth in preconception care delivery systems.

Objectives:
To identify a systems strategy for: 1) developing a cross-system infrastructure to provide school-based/-linked adolescent health and wellness services, 2) engaging and involving youth in preconception care delivery systems, and 3) providing preconceptional health information.

Methods:
Alameda County has developed a coalition of school-based health centers (SBHCs) that provide a systematic, interdisciplinary service delivery model that addresses many of the recommended preconception health interventions and barriers to health care access among adolescents. Founded in 1996, the Alameda County School Health Services Coalition integrates cross-disciplined stakeholders, including school and school district administrators, community medical and mental health providers, youth, advocates and policy makers, to provide culturally-appropriate, site-based and primary prevention health services.

Results:
Through its network of eleven school-based health centers supported by partnerships with six Federally Qualified Health Centers (FQHC), six mental health providers, six school districts, and Alameda County Health Care Services Agency, the SBHCs provides more than 25,000 clinical visits to more than 6,100 students annually through four core service areas—medical, behavioral health, health education and youth development. The majority of the students who access SBHC services are 15 to 18 years old and are primarily females. Coalition members reflect the diversity of the community, particularly the cultural and ethnic diversity of the student populations that they serve.

Conclusion and implications for practice:
By advancing program planning through advocacy, long-term diversified funding strategies and data-driven public health policies, the SBHC Coalition serves as a viable, efficacious and youth-focused preconception health education and health services delivery model.