PROJECT SUMMARY/ABSTRACT This is an application for a K23 award for Dr. Lyen Huang, a surgeon and health services researcher at the University of Utah. Dr. Huang is establishing himself as a young investigator in perioperative patient safety. His current research focuses on reducing our healthcare system’s contributions to the opioid crisis. This K23 will enable Dr. Huang to accomplish the following goals: (1) develop expertise in using patient-facing behavior change components for promoting healthy behaviors, (2) develop expertise in implementation science to close the gap more rapidly between research and health system interventions, (3) gain leadership and management skills to support transdisciplinary, multi-institutional research and trials, and (4) transition to an independent research career. To achieve these goals, Dr. Huang has assembled a mentoring team comprised of a primary mentor, Dr. Kimberly Kaphingst, a leading researcher in health literacy, patient-provider communication, and behavior change interventions; and a co-mentor, Dr. Alex Sox-Harris, a national expert in surgical and addiction health services research and implementation science. Dr. Huang also has five advisors with expertise in surgical leadership; perioperative, addiction medicine, and cancer health equity interventions; pragmatic trials in rural communities; clinical trials; biostatistics; and survey methodology. Although 42 million patients are prescribed opioids after surgery each year, we currently lack an effective and scalable intervention for motivating patients to dispose of leftover opioids. Few patients dispose of their leftover opioids, and existing interventions have shown mixed real-world results. Instead, patients insecurely store, misuse, or share opioids putting themselves, families, and communities at risk. The objective of Dr. Huang’s research is to develop and implement a theory- and evidence-based opioid disposal intervention. Dr. Huang will (Aim 1) evaluate the feasibility and acceptability of behavior change components to enhance the University of Utah’s current disposal intervention; (Aim 2) prepare for implementation and evaluation in different populations and settings; and (Aim 3) test and refine the enhanced opioid disposal intervention. The expected outcome will provide the evidence for multi-institutional trials of an intervention to promote safe opioid disposal across the country. The proposed research is innovative in the application of behavior change and implementation theories to the prevention of iatrogenic contributions to the opioid crisis and the use of an ongoing system-wide opioid disposal intervention allowing for rapid, iterative refinement and evaluation.

PROJECT NARRATIVE Each year, an estimated 42 million Americans will receive prescription opioids after surgery, but few will dispose of their leftover opioids. Leftover opioids are often stored insecurely, misused, or shared putting patients, their families, and communities at risk of overdoses, dependence, addiction, and subsequent illicit drug use. This research will lead to an opioid disposal intervention that can be used by pharmacies and hospitals across the country to increase the safe disposal of prescription opioids.