# Using policy codesign to achieve multi-sector alignment in adolescent behavioral health

> **NIH NIH R34** · UNIVERSITY OF WASHINGTON · 2024 · $234,746

## Abstract

Project Summary
Adolescent substance use disorder is a public health crisis with over 1 million youth and young adults affected
each year in the United States. County-level policies are well-positioned to reduce adolescent substance use
disorder through funding and regulatory policies; however, the extant literature documents multiple failures in
attempts to effectively leverage policy mechanisms. The challenges of aligning political will, multisector
collaboration, use of research evidence, and resource commitments are well-known problems in the public
policy and public administration literature. To date, the field of behavioral health policy science does not have a
well-supported method of policy design that overcomes downstream policy implementation challenges. We
propose to study a method of policy formation, Policy Codesign, designed to anticipate multiple barriers in the
downstream implementation of evidence-based, adolescent SUD services. The participant structure and
process of Policy Codesign draws from the public policy model of coproduction as well as engineering-based
codesign and is supported by promising, preliminary studies. The process includes well-defined policy
formation stages within a multisector and community-engagement framework, including: Values mapping,
Information gathering, Information integration, Prototyping, Testing, Implementation. The current single-arm,
observational study with two geographically diverse counties in Washington State will inform the research
procedures to prepare for a rigorous trial of Policy Codesign in counties in Washington State, New York, and
Connecticut. The project’s specific aims are 1) to examine the acceptability of Policy Codesign and perceived
feasibility of developed adolescent SUD policies, 2) to measure changes in social network growth, cohesion,
and bridging activities among multiple sectors central to behavioral health policy implementation, and 3) to
examine the perceived replicability of Policy Codesign among well-established behavioral health policy
intermediaries. The project is innovative as the first test of a policy design strategy intended to solve
downstream implementation problems in evidence-based, adolescent SUD prevention. If found to be effective,
Policy Codesign would significantly advance the field’s ability to translate and sustain policy-based solutions to
address adolescent substance use. The core investigative team (Walker, Ahrens, Owens) is well-suited to
carry out the project with extensive practical expertise in real world behavioral health policy design and
community-engaged research. The team is supported by leading policy (Purtle), implementation (Saldana,
Palinkas, Aarons) and adolescent SUD treatment (Hogue) researchers widely regarded as the top experts in
their fields, as well as behavioral health policy and health design organizations actively involved with county
policymaking in adolescent behavioral health systems.

## Key facts

- **NIH application ID:** 10886805
- **Project number:** 5R34DA058806-02
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Sarah Cusworth Walker
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $234,746
- **Award type:** 5
- **Project period:** 2023-07-15 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10886805

## Citation

> US National Institutes of Health, RePORTER application 10886805, Using policy codesign to achieve multi-sector alignment in adolescent behavioral health (5R34DA058806-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10886805. Licensed CC0.

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