State funded preschool programs were constantly faced with the need to change in order to address internal and external demands. As programs engaged in efforts towards change, minimal research was available on how to support continuous improvement efforts within the context unique to state funded preschool programs. Guidance available had primarily been borrowed from what was known about change within the kindergarten through twelfth grade (K-12) sector. Understanding the current context of continuous improvement within state funded preschool programs was identified as the first step in translating the literature base and validating it for the intended audience. The purpose of the study was to explore the approaches to continuous improvement utilized within nine state funded preschool programs in northeast Ohio. A grounded theory research design was used as the framework in which to explore the topic. Content analysis and a multiple sequential interview processes were utilized to gather data and a four step data analysis process was used to review the collected data. The study resulted in the development of a theory that identified context and process elements that were represented within the continuous improvement efforts of programs that achieved successful change. Three context elements, including change as a guiding philosophy, teaching staff, and supportive relationships, defined the conditions, relationships, and beliefs that shaped the support available for the continuous improvement efforts. Understood purpose, opportunity for input, shared decision making, revisiting change, and communication were the five process elements used to describe the actions taken by the programs that resulted in change. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]