10 Healthcare Georgia Foundation Figure 6 demonstrates the percent of new prenatal clients who initiated breastfeeding. Of note, the Lowndes site began monitoring this in 2014 as part of TCOY; thus, there is no baseline data for 2012. The other sites were monitoring this indicator prior to the inception of TCOY but realized improvement from the baseline year through 2016, due to efforts to enhance breastfeeding education in the prenatal period. The benchmark for initiation of breastfeeding among Georgia women with live births per 2013 Georgia PRAMS shows variation by race/ethnicity: 77% for Hispanics, 75% for non- Hispanic Whites, and 59% for non-Hispanic Blacks. By 2016, the program participants for each of the sites had achieved or surpassed the race/ethnicity specific rates in the Georgia PRAMS data. Figure 6. Percent of New Prenatal Clients Who Initiated Breastfeeding OUTCOME EVALUATION Findings from the outcome evaluation (Tables 1-3) indicate that grantees were successful in accessing and utilizing objective data (SendSS for birth weight and gestational age; infant mortality reports for sleep-related infant deaths) to monitor programmatic outcomes. Displayed in Tables 1-3 are tabulations of the race and county-specific rates of the outcomes. The column second-from-right displays the change in percentage points (pp) of the outcome rates for the 2016 compared to the 2012 cohort years, while the right-most column provides the “difference-in-difference” when comparing the change in percentage points (pp) for the rates of interest for program participants vs. the comparator group. Of note, the county comparator is based on sharing the same race and county of residence as the program participants. In most cases, the program participants are at greater risk for poor outcomes than the county comparator due to their low-income status, for which they are targeted by the health department programs. Across sites, the programs experienced similar changes in rates of preterm birth relative to their county comparator, as summarized in Table 1.