The "Patient-Responsive Initiatives for Diverse Engagement – LGBTQ+ Community Action in Research to Eliminate Substance Use Disorder (PRIDE-CARES) Center" represents a groundbreaking effort to address the significant gaps in research related to Substance Use Disorder (SUD) treatment and care within the Sexual and Gender Minority (SGM) community. The high prevalence of SUD, co-occurring mental illness, and barriers to care within the SGM community underline the urgency of our research. The PRIDE-CARES Center takes on the challenge of reshaping existing research paradigms and ushering in a new era of patient-centered research by placing patients with SUD from the SGM community at the forefront as co-developers of scientific research projects. By addressing the needs of this diverse community, PRIDE-CARES aspires to make significant contributions to the advancement of SUD research and care for SGM individuals. This proposal delineates our objectives to establish the PRIDE-CARES Center and implement the Virtual Patient Engagement Panel (ViP Panel) to actively engage patients and other stakeholders in SUD research. The primary focus is to address the critical need for research and innovation in SUD treatment services tailored to the SGM community. The proposal encompasses three primary aims: Aim 1 Engagement Panel: This aim involves research capacity building through the active engagement of a diverse group of patients, family members, and individuals in recovery, representing varying sexual orientations, demographic characteristics, and substance use profiles creating the ViP Panel. The ViP Panelists will be equipped with research training, will play a pivotal role in co- developing research priorities, and will collaborate with researchers throughout the US. Aim 2: Research on Patient Experiences, preferences, and barriers to SUD treatment services, with a focus on SGM affirmative care. Through collaboration with patients and providers, we will conduct a mixed-methods study to compare SGM to non-SGM patient experiences within SUD treatment services. Aim 3: Pilot Research Projects. Four pilot research projects will be funded through the TRANSFORM Pilot Research mechanism, developed in collaboration with ViP Panel members. These projects will address patient-centered research priorities. The ViP Panel's consultation with researchers, input on research questions, and alignment with the LGBTQ+community's needs will be instrumental to the success of this initiative. By project completion, we anticipate a patient-engaged evidence base for SUD treatment services, ensuring they are more responsive and inclusive of SGM community needs. This initiative represents a collaborative effort involving academic institutions, clinical partners, and the SGM community, with the overarching goal of positively impacting SUD treatment services. Our ultimate aim is to enhance the mental and physical health of the SGM community affected by substance use disorders. This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction.

PROJECT NARRATIVE Substance Use Disorder (SUD) affects 46.3 million Americans and their communities and Sexual and Gender Minorities (SGMs) face higher rates of SUD than other groups due to complex factors like stigma and discrimination. Our innovative project aims to engage SGM patients to work with researchers to improve SUD treatment services and research. This work will provide valuable insights for healthcare practitioners, policymakers, and SGM community advocates, leading to tailored, patient-centered care for this underserved population.