Maternal, Child & Adolescent Health Division

Preconception Health Preconception Medical Assessment (PreMA) Tool: Best Practices for Implementation

PreMA, created by the Office of the California Surgeon General, is a validated, easy-to-use quiz designed to help people understand how their current health status and medical history may affect a future pregnancy.

Purpose

Support preconception health awareness and empower individuals to take proactive steps toward healthy pregnancies.

Where & How to Use PreMA
- Primary Care Settings: Display QR codes and prompts on waiting room boards or patient education screens; include in patient education materials and flyers. This could expand to dental offices and other healthcare settings.
- Community Outreach: Share during home visits (e.g., BIH, PEI programs); promote at health fairs, and community events; integrate into newsletters and listservs for LHJs and other community organizations.
- Digital Integration: Embed links on websites and social media; use QR codes on devices (e.g., BP kits) for chronic disease patients; embed the PreMA widget on websites and apps.
- Schools & Youth Engagement: Collaborate with Office of School Health and MCAH for adolescent outreach. Frame as proactive health planning, not pregnancy focused.
Messaging & Framing
- Use inclusive language: Avoid blame or judgment, especially for those with prior negative pregnancy outcomes.
- Position as a conversation starter, not a diagnostic tool, that can be taken anytime anywhere and encourages early actions to improve overall health.
- PreMA is a tool to inform and empower pregnant-capable people and their families and friends with information to advocate for their healthcare needs.
Provider & System Readiness
- Educate networks and providers about PreMA and resources – the bottom portion of PreMA can be customized with local resources.
- Clarify next steps for patients after completing PreMA: Encourage primary care visits for risk management; provide examples of what a preconception visit may include (e.g., folic acid, chronic condition screening).
- Address billing and coding possibilities for “preconception visit".
Overcoming Barriers
- Recognize systemic challenges: Avoid placing full responsibility on individuals; Collaboration with healthcare systems, technology companies, community partners, and government agencies is vital to improving maternal health outcomes.
- Emphasize that PreMA is a patient-initiated quiz with results visible only to the individual and sharing those results are optional.
Collaboration & Next Steps
- Leverage awareness weeks and campaigns (e.g., Heart Health Month).
- Promote within network using email blasts and newsletters.
- Explore partnerships with LHJs, CBOs, and health programs for broader dissemination.

Population Group Specific Strategies

Population Group	Recommended Strategies	Messaging Focus	Key Integration Points
Disease Intervention (STI/HIV)	Use PreMA during STI/HIV counseling; embed in case management systems.	Whole-person care, link to prevention resources.	Share QR codes during counseling and statewide calls.
Clinicians (OB-GYN, Primary Care) Dental Offices	Display QR codes in waiting rooms; integrate into patient education.	Identify risk factors before pregnancy.	Clarify referral pathways and billing codes for preconception visits.
PEI Programs (Fatherhood, Equity)	Introduce PreMA fatherhood engagement programs.	Family involvement and partner support.	Promote at community events and culturally tailored outreach.
Home Visitation and BIH Programs	Use PreMA tool as a conversation starter in visits or sessions	Incorporate into postpartum support and future pregnancy planning	Emphasize empowerment. Paril with mental health and social support resources.
Adolescent Health & School Health	Promote PreMA in school-based health centers and newsletters.	Frame as proactive health planning, not pregnancy focused.	Collaborate with MCAH and Office of School Health for outreach.