6 Healthcare Georgia Foundation [Left: A Family Nurse Practitioner discusses healthy nutrition with an OB patient during a visit at the Dougherty County (GA) Health Department’s Centering Pregnancy office.] Photo: Albany Herald, Albany GA PURPOSE The purpose of the cross-site evaluation was to examine the overall impact of the TCOY Initiative in building program capacity to monitor the delivery of intervention strategies and outcomes, and in improving the systematic provision of intervention strategies and infant health outcomes related to preterm birth, low birth weight, and sleep-related deaths. METHODOLOGY A longitudinal, mixed-methods process and outcome evaluation design to address the TCOY evaluation questions was employed based on the following: 1. Program-level process indicators – Quantitative data acquired at the program-level were used to track process indicators. 2. Program-level outcomes – Birth weight and gestational age at birth from SendSS were used to measure rates of low birth weight and preterm birth. Cause of infant death data from infant mortality reports were used to measure rates of sleep-related deaths. 3. County-level outcomes – Rates of low birth weight, preterm birth, and sleep-related deaths for the counties in which the programs reside were obtained from Georgia Online Analytical Statistical Information System (OASIS) for comparative purposes. 4. Key informant interviews were conducted with all staff who had any programmatic responsibility for the grantee intervention (e.g., program directors, nursing staff, outreach workers, case managers, women’s health coordinators, lactation consultants) to assess experiences, facilitators, and barriers to planned intervention activities and facilitators and barriers to the interventions. 5. Focus groups were held with intervention participants in Years Two and Three to understand participants’ knowledge and awareness of the interventions as well as their utilization, satisfaction, and perception of value related of value related to the intervention services.