PROJECT SUMMARY. The UW ALACRITY Center Methods Core (MC) has made important contributions to overcome the challenges of implementing evidence-based clinical interventions (CI) in under-resourced health and school settings using implementation strategies (IS). Accomplishments over the last four years include integrating human-centered design and implementation science methods to develop the Discover, Design/Build, and Test (DDBT) framework; developing a Typology of CI/IS Modification Targets; developing a Library of Redesign Solutions; and evaluating the impact of redesign on capacity, usability, and quality. Under the direction of Drs. Munson and Pullmann, the next five years of UWAC funding will focus on the following aims and activities: (1) Identifying and catalog CI/IS modification targets to improve usability, engagement, and appropriateness in accessible nonspecialty settings; (2) Developing redesign solutions with local teams to address CI/IS modification targets; (3) Determining if redesign affects changes in usability, engagement, and appropriateness through changes in CI/IS modification targets. Modification targets and redesign solutions from the original, centralized DDBT approach from the first four years will be compared to those from the local DDBT approach proposed for the next five years via comparative qualitative analysis. The MC will accomplish these aims by supporting application of DDBT in localized settings (i.e., DDBT will be conducted by local project redesign teams) and synthesizing results from three R34 sized research projects, one R01 sized hybrid effectiveness- implementation study, and multiple pilot projects. Systematic, standardized mixed methods assessments across all studies will collect quantitative and qualitative data on adherence to the DDBT process, impacts on engagement, usability, and appropriateness of the CI/IS, and impacts on client functioning and outcomes. Cost data will be collected to determine the impact of the DDBT process on local resources. The MC will provide expert methodological and technical support to all projects, such as structured trainings and supports such as monthly consultations, templates, academic resources, worksheets, data collection portals, and mixed methods analyses. The MC will work to increase diversity, equity, and inclusion within research activities and faculty development. A strong dissemination plan will be implemented to ensure that products are available to the research community.