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

项目摘要 青少年药物使用障碍是一个公共卫生危机，有100多万青年和年轻人受到影响 每年在美国。县级政策能够很好地减少青少年药物使用 通过资金和监管政策的混乱;然而，现存的文献记录了多个失败， 有效利用政策机制。协调政治意愿、多部门 协作、研究证据的使用和资源承诺是公众熟知的问题 政策和公共行政文献。到目前为止，行为健康政策科学领域还没有一个 政策设计的方法得到了很好的支持，克服了下游政策实施的挑战。我们 我建议研究一种政策形成的方法，即政策共同设计，旨在预测政策制定中的多种障碍。 下游实施循证的青少年可持续发展服务。参与者结构和 政策协同设计的过程借鉴了公共政策的协同生产模式， 共同设计，并得到有前途的初步研究的支持。该过程包括明确的政策 在多部门和社区参与框架内的形成阶段，包括： 信息收集，信息集成，原型，测试，实施。目前的单臂， 在华盛顿州两个地理位置不同的县进行的观察性研究将为研究提供信息 为在华盛顿州、纽约的各县进行严格的政策协同设计试验做准备的程序， 康涅狄格该项目的具体目标是：1）检查政策协同设计的可接受性， 制定青少年SUD政策的可行性，2）衡量社会网络增长，凝聚力， 以及在对行为健康政策实施至关重要的多个部门之间开展桥梁活动，以及3） 检查既定行为健康政策中政策协同设计的可复制性 中介机构该项目具有创新性，是对旨在解决以下问题的政策设计战略的首次测试： 在循证预防青少年SUD方面的下游实施问题。如果发现有效， 政策共同设计将大大提高外地转化和维持基于政策的解决方案的能力， 解决青少年药物使用问题。核心调查小组（步行者、阿伦斯、欧文斯）非常适合 在真实的世界行为健康政策设计方面具有广泛的实践专长， 社区参与的研究。该团队得到了领先政策（Purtle）、实施（Saldana， Palinkas，Aarons）和青少年SUD治疗（Hogue）研究人员被广泛认为是 他们的领域，以及行为健康政策和健康设计组织积极参与县 青少年行为健康系统的决策。

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.