In September 1996, an internal process evaluation study of the Growing Together (GT) program was conducted. The following report summarizes the findings of the Evaluation, which was designed to facilitate program planning and development.

      This study involved a one year (1996) retrospective examination of the program's activities, procedures and routines. It used process data gathered from the Growing Together Management Information System (MIS); case files; and semi-structured interviews with GT workers, local community providers and Growing Together clients.

      The study found the following services to be particularly effective, both in terms of reaching families and client satisfaction:

• Contacting new mothers living in St. Jamestown soon after birth us successfully accomplished. The use of birth notices was the most successful method, while follow up by the GT intake worker has been useful in enabling families to become involved in various program components.
• Other parents join the program by self-referral, referral through an outside agency, or other means. In 1996 there was a total participation rate of 477 families and 543 children.
• At entry into the program approximately one-half of the families who join complete a Risk Factor Assessment (RFA) interview. This allows for collection on background and intake information and assessment of level of risk and needs of families. This facilitates the process of referring parents to optimum services to meet their needs. These range from the most intensive clinical/counselling interventions to informational and practical groups.
• Clients who received counselling and therapy sessions from the GT program found they met a number of their needs such as: alleviating feelings of loneliness and isolation, education and teaching about health and developmental issues.
• GT groups are well used and were attended by 229 participants in 1996. Childcare services while parents attended groups were provided for 166 children.
• A recognized and valued service involves the tracking and monitoring of the development of infants and young children through the Infant Monitoring System (IMS) and the Developmental Clinic. In 1996, 128 children were seen at the Developmental Clinic and currently over 200 children are being monitored the IMS.
• Community Development initiatives complement the other work being carried out by GT and provide valuable experiences for parents. Community members play an increasingly important role in the planning and operation of community events and initiatives. Listening to community members and integrating their ideas into programming directions is a priority of the program.
• Advocacy services are a very important aspect of the program with 134 families having been referred to the advocacy specialist in 1996.
• Services are provided by a multidisciplinary team; students from various disciplines and volunteers from St. Jamestown and other areas of the city. The varied education, background and experience of the GT team enable it to meet the multiple and complex needs of GT families.

      Based on the findings of the Process Evaluation Study recommendations were as follows:

1. That the following services and program components should continue to be considered and supported as essential components of the program: maintaining of a community site, telephoning and offering immediate services to new mothers on receipt of Birth Registration Notices (BRN's); home visiting as an outreach strategy; the tracking of infants and young children through the Infant Monitoring System and Developmental Clinic; groups; and community initiatives.
2. That efforts be made to secure sufficient and stable finding to ensure that the key components of the program (see 1 above) be adequately maintained.
3. That the GT team continues to have responsibilities from various disciplines as well as community home visitors from St. Jamestown, and students and volunteers.
4. That various procedure and policy issues to be discussed and further developed including, for example research directions and program feedback procedures.
5. That efforts for program promotion continue and be further explored.
6. That consideration is given to the collection of certain types of data, as well as the design and development of new forms to address database gaps.