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The Carnegie Corporation of New York's (CCNY) Opportunity by Design (ObD) initiative provided support for 16 small schools of choice in seven large, urban districts across the United States to adopt a set of design principles intended to ensure students are prepared for college and careers. CCNY engaged the RAND Corporation in 2014 to conduct a comprehensive study of the ObD initiative. This final report summarizes implementation and outcomes findings from this five-year study and is intended to provide lessons and implementation guidance for the field. The authors estimate the effects of the ObD initiative on student academic, behavioral, and college-readiness outcomes and describe implementation of innovative instructional practices (personalization of learning, mastery-based instruction, and positive youth development) in the final year of the initiative. Enablers of implementation included alignment of school and district grading policies in some districts and autonomy from district curriculum and professional development (PD) requirements. Barriers to implementation in ObD schools included limited district support for selecting or developing curriculum and PD materials and inflexible district policies. The study compared ObD teachers' instructional practices to those of high school teachers nationally. ObD teachers reported more extensive use of instructional practices related to mastery-based learning, personalization, and positive youth development.This research did not find much evidence that ObD's principles-based design process and supports led to more effective schools, but limitations of the study design and available data may not have adequately captured ObD's effects.