This report examines fundamental changes in the CareerAdvance(R) program that directly relate to the experience and progress of participants through July 2013 (the end of the fourth program year) and the recruitment of Cohort 8 in April 2013. CareerAdvance(R) has evolved over time from a single nursing career training pathway in 2009 to four healthcare career pathways in 2013. The evolution of the program has led to many changes and has increased opportunities for program participants. Additionally, through coordination among Community Action Project of Tulsa County (CAP Tulsa) staff, Ray Marshall Center researchers and Workforce Matters consultants, the Educational Pathways Program (EPP) was created and subsequently launched by CAP Tulsa in January 2013 under the CareerAdvance(R) umbrella. The EPP is intended to help parents build basic skills for future entry into postsecondary education or workforce training opportunities. A key finding of the implementation study to date is that CAP Tulsa has approached the design of the CareerAdvance(R) program and the development of supplemental support programs as a continuous improvement process. The program model, its pathways, and other components have all been refined over time to address participant concerns, barriers to progress, and other factors. Because of these changes, few cohorts have experienced exactly the same program. This report examines key program modifications over time, documents participation and progress in CareerAdvance(R), and explores factors that appear to impede or support participant progress. (author abstract)