Abstract for: The determinants of adequate provision of substance use disorders services: A systematic method to integrate co-produced causal loop diagrams

In Oregon, USA, decision-makers working in substance use disorder (SUD) services and policies strive to make data-driven decisions. However, they experience challenges in accessing, interpreting, and evaluating data. Data2Action Oregon seeks to address these gaps by collaborating with local decision-makers to identify data needs and improve SUD- related outcomes. Co-Design Sessions foster cross-sector collaboration and systems thinking, utilizing participatory methods to develop actionable data products that inform and enhance data-informed decision-making. This study uses a stepped-wedge design to evaluate the impact of Co-Design Sessions (CDS) in reducing SUD service gaps across Oregon counties. Group Model Building and participatory methods supported the co-creation of causal loop diagrams (CLDs), with ethnographic documentation of sessions. A systematic feedback analysis method is being used to integrate and synthesize CLDs, resulting in a comprehensive, community-informed understanding of system determinants and data needs for improved behavioral health decision-making. Preliminary results show that participants developed a shared vision statement emphasizing a continuum of SUD services, emphasizing transparency in data use. Co-produced causal loop diagrams captured multi-level social and structural factors affecting SUD outcomes, including stigma, workforce needs, and cross-system partnerships. Key themes identified include public policy, workforce capacity, access to care, stigma, prevention, criminal justice systems, social risk factors, peer support, health outcomes, and service gaps. This paper demonstrates how participatory approaches and systems thinking, through Co-Design Sessions and Group Model Building, enable decision-makers to collaboratively map substance use disorder systems with causal loop diagrams. By applying feedback analysis to synthesize these diagrams, the study produces actionable insights and tailored data products. The methodology offers a replicable framework and practical recommendations for developing data-driven strategies to enhance behavioral health and SUD service systems in varied community contexts.