K23 Abstract DESCRIPTION: Nearly one third of individuals with substance use disorders are women of childbearing age. Life-threatening infant complications from maternal opioid use disorders (OUD) include neonatal withdrawal syndrome, acute and chronic developmental and behavioral challenges, increased risks of infection through maternal transmission (i.e. HIV, Syphilis), and death. Mothers with OUD must negotiate micro and macro level challenges that impact parenting and recovery management, including reluctance to disclose drug use for fear of legal issues, child custody and domestic disputes, stigma, financial, and transportation barriers. There are few proven interventions that support long-term recovery management and parenting for addicted new mothers embedded within this unique context. Using a community based participatory research (CBPR) approach, we will determine the feasibility and preliminary effects of a customized evidence-based digital technology self-management recovery program for women with OUD during the pregnancy and postpartum period. Based on our preliminary data, our central hypothesis is that once tailored strategies are identified by primary stakeholders, an evidence-based program that uses digital technology can be delivered to pregnant and parenting women with OUD to expand accessibility to evidence-based parenting and recovery resources. The specific aims of this study include: (1) Customize eRecovery technology integrating preferred parenting resources and recovery supports in collaboration with a community advisory board (CAB) and new mothers in early recovery from substance use disorders; (2) Evaluate the feasibility of using the customized eRecovery technology for pregnant and postpartum women in early recovery from OUD to determine use and usefulness based on participant perceptions, engagement and retention in care, drug abstinence, and parenting outcomes. The results from this proof-of-concept study will provide strong pilot data to guide development of a full-scale trial in a future RO1 application in Year 4 of this award. The career development award will provide Dr. Raynor the mentoring and training needed to develop knowledge and skills in rural health disparities, CBPR methods, digital intervention development and program evaluation, population health interventions and advanced research training. At the close of the award, she will be positioned to design, implement, and evaluate research that will significantly improve the health outcomes of pregnant and parenting women with OUD and their vulnerable newborn infants living in a rural Southeastern state.

PROJECT NARRATIVE There are few proven interventions that support parenting and long-term recovery for pregnant and postpartum women with Opioid Use Disorders (OUD). Using a community-based participatory research approach, the feasibility and preliminary effects of using a customized evidence-based digital technology self-management recovery program for women with OUD during the pregnancy and postpartum period will be evaluated. The findings from the proposed research will support the development of a targeted and cost-effective digital intervention to improve mother and infant outcomes for this vulnerable population.