Emma P. Bradley Hospital is conducting research to demonstrate the effectiveness of embedding a program evaluation system within the fabric of the Head Start program to maximize service delivery systems and improve child and family outcomes. More specifically, the Head Start Manualized Assessment of Progress: Birth to Five (HS MAP: 0-5) is a program evaluation system designed to monitor child and family progress over time. Teachers use the HS MAP:0-5 to monitor children's progress in 8 specific domains of development (according to the HS Child Outcomes Framework including language, literacy, mathematics, science, creative arts, social-emotional development, approaches to learning, and physical development). Family Advocates use the HS MAP:0-5 to monitor family's progress in 3 general areas including Parent Self-Reliance (e.g., income, employment, food, housing, clothing, utilities, insurance, transportation, credit, child care, and education); Parent Promotion of Child Development (e.g., parenting skill; violence prevention, adult relationships, parent-child relationships, neighborhood and home safety, parent involvement in the program, and community needs); and Health, Nutrition, and Mental Health.