BACKGROUND Preconception care (PCC) should be provided for all those women capable of becoming pregnant to identify and treat existing risk factors for adverse perinatal outcomes for both the woman and her future baby. behavioral change through evidence-based interventions. METHODS A 6-month randomized controlled trial of a purposeful convenience sample of 100 non-gravid primarily college-attending AA women 18-34 years of age was conducted. All participants were screened at enrollment for over 100 PCH risks and then randomized to the Gabby or control group. Controls were sent a letter listing identified PCH risks suggesting they discuss these risks with a Lersivirine (UK-453061) health care provider. The numbers proportions and types of risks identified and resolved were compared between groups. RESULTS Of the 100 women enrolled 99 provided baseline data 91 Lersivirine (UK-453061) completed the online PCH risk assessment and 80 completed the 6-month follow-up phone call. The mean participant age was 25.5 years and all had at least one PCH risk with a mean (sd) of 23.7 (5.9) range of 11 to 45 PCH risks. In 6 months the Gabby group had significantly greater reductions compared Lersivirine (UK-453061) to controls in both the number of PCH risks (34% higher- 8.3 vs. 5.5 p<.05) and in the proportion of risks resolved (25% higher- 27.8% vs 20.5% p<0.01). Women in the Gabby group averaged 2.9 logins and 63.7 minutes of interaction time. The most common PCH risks triggered were nutrition activity and infectious disease. The majority of women (78%) reported it “was easy to talk to Gabby” and that they had used information from Gabby to improve their health (64%). CONCLUSION Among a group of reproductive age African American women use of the Gabby system was associated with a significant Lersivirine (UK-453061) reduction in identified PCH risks. More research is needed to determine if Gabby can impact risk status among a larger more socio-demographically diverse group of black women and if reducing the number of risks is clinically significant. Background Despite mounting scientific evidence that enhancing a woman’s health before pregnancy improves perinatal outcomes for women and their infants many women enter pregnancy in poor health and at risk for preventable adverse pregnancy outcomes. In addition about half of pregnancies are unplanned making it important to promote KLHL21 antibody preconception health (PCH) and deliver preconception care (PCC) to all women of reproductive age regardless of pregnancy intention.1 The Centers for Disease Control and Prevention (CDC) defines PCC as “interventions that aim to identify and modify biomedical behavioral and interpersonal risks to a woman’s health or pregnancy outcome through prevention and management by emphasizing those factors that must be acted on before conception or early in pregnancy to have maximal impact.”2 PCH and PCC involve addressing a range of issues like family planning specific medical conditions (e.g. diabetes) exposure to teratogens substance abuse and preventive interventions (e.g. immunization and folic acid supplementation).3 In 2008 the CDC Select Expert Preconception Panel’s PCC Clinical Workgroup outlined those content areas important to identify and address to improve maternal and infant outcomes4 and identified implementation strategies as a top priority.5 In 2013 the National Action Plan for Promoting PCH in the U.S. identified the goals of: improving the knowledge attitudes and actions of men and women related to PCC; eliminating disparities in adverse maternal fetal and infant outcomes; and assuring that all U.S. women of childbearing age receive PCC services.6 Progress towards Healthy People 2020 goal to eliminate disparities requires that rates of adverse health outcomes fall more rapidly for AA women which is why the Gabby system was designed for this group. Health information technology presents opportunities to develop innovative tools that assist clinicians in delivering PCC7 and to engage and empower women to improve their PCH. Among the most encouraging advances is the conversational agent a computerized animated character that integrates best practices from provider-patient communication theory. They emulate the face-to-face conversational behavior of an empathic.