2 Healthcare Georgia Foundation rom 2013-2017, Healthcare Georgia Foundation invested $2.5 million to support the TCOY Initiative in selected Georgia public health departments serving high-disparity communities, with the goal of building their capacity to implement and assess strategies to reduce adverse infant health outcomes, including preterm birth, low birth weight, and sleep-related deaths. The grantees – Clayton County Board of Health, Lowndes County Board of Health, and Southwest Public Health District’s Dougherty County Health Department and Ellenton Farmworker Health Clinic in Colquitt County – were selected based on a competitive funding announcement and lessons learned from previous Foundation grantmaking in infant health, including: The publication of the Georgia Department of Public Health (DPH) 2012 Infant Mortality Report, From Preconception to Infant Protection: A Regional Look at Periods of Risk for Georgia’s Newborns (2002-2006), which identified six geographical clusters of infant mortality and factors associated with infant mortality in those clusters; and Implementation of the Promising Approaches to Improved Infant Health demonstration project in 2013 among six organizations located in the geographical clusters identified in the DPH Report (Clayton County Board of Health, East Central Health District, Emory University/Grady Memorial Hospital, Lowndes County Board of Health, North Central Health District, and Southwest Public Health District), which assessed their capacity to deliver interventions to improve infant health outcomes in their communities. hree TCOY grantees were funded for a three-year period for a total of $450,000 ($150,000 per year). Grants for $75,000 for a fourth year were awarded to each grantee as part of an exit strategy for limited program support and for continued participation in data collection and evaluation activities. Each of the following public health grantees had unique approaches to addressing the needs of their clients and communities but committed to cross-site process improvement evaluation in the three key areas of intervention for TCOY. Clayton County Board of Health Implemented and evaluated the Every Woman, Every Time program, targeting African- American women of childbearing age, Medicaid eligible pregnant women and males (ages 15-60 years) residing in Clayton County. This project: 1) provided Reproductive Life Plans (RLPs) to both women and men; 2) promoted the use of long-acting reversible contraceptives (LARCs) for women; 3) provided pre-and post-natal education to women in the Making Our Mothers Successful/Parents as Teachers (MOMS/PAT) home visitation program; 4) linked women of childbearing age having chronic medical conditions to a medical home; 5) increased folic acid and supplement intake among childbearing women; 6) completed psycho-social, socio-economic risk assessments for pregnant women; 7) incorporated family planning, birth spacing, and postpartum depression screening into postpartum case management of women enrolled in MOMS/ PAT; and 8) increased knowledge of safe sleep practices among women.