Successful adoption, implementation, improvement, and scale of the Triple P system across the Carolinas holds the promise of improving child health outcomes, including reduced rates of child abuse, reduced out of home foster care placement, and fewer hospital visits due to child abuse injuries. This project is a continuation of almost a decade of ongoing implementation support provided to local, regional, and statewide stakeholders that aims to improve access to Triple P across the state, expand programmatic reach to target populations, and ensure fidelity to the model that will drive programmatic and population level outcomes. Continued collaboration and co-creation is the foundation for ongoing work to provide proactive and responsive implementation support, system-wide support and dissemination of effective implementation approaches, and develop the team of professionals providing these essential supports.