The parent grant R34, Leveraging Parents and Peer Recovery Supports to Increase Recovery Capital in Emerging Adults with Polysubstance Use: Feasibility, Acceptability, and Scaling Up of Launch (R34DA057639), initiates research to fill the service gap for rural emerging adults (EAs) via an innovative adaptation of existing substance use services. This R34 pilots a scalable service for EAs, named Launch, that involves both parents of EAs and peer recovery support services (PRSS), thereby targeting poly-substance use from two crucial angles. After adapting and evaluating training protocols and adherence tools (Aim 1), 48 EAs with poly-substance use and their parents will be recruited and randomized to one of three conditions: parents will engage in web-based coaching to use Contingency Management for Emerging Adults (CM-EA) only; EAs will receive PRSS only; or parents will receive CM-EA coaching and EAs will receive PRSS. Notably, PRSS will consist of standard services plus additional vocational/educational/financial skills. The feasibility and acceptability of the study protocol and Launch services will be assessed (Aim 2). To improve eventual uptake, payors/providers of substance use services will be interviewed. Sites for a future large-scale adaptive trial will also be recruited (Aim3). If Launch is ultimately deemed effective, it would fill a major gap in the substance use services field by providing a highly specified and individualized service for reducing risk and promoting adaptive life functioning in EAs with poly-substance use. In the proposed Diversity Supplement to Launch, a Hispanic woman early-career scientist with direct lived experience of substance use disorder, Dr. Castedo de Martell, will complete two research activities that enhance and expand the aims of the parent grant, while also providing intensive, dedicated mentorship and training to support her transition to independence as a NIDA-funded investigator. The Diversity Supplement research activity (RA) 1 consists of developing a parameters list and preliminary cost-effectiveness analytic model informed by key staff and leadership informants in a community-based participatory research approach to concurrent cost-effectiveness analysis, which will be implemented in a future R01 of the parent grant services. The cost-effectiveness analysis of Launch will help providers and policy-makers understand the long-term economic and patient outcome impacts of the services. The Diversity Supplement RA2 will consist of the initial qualitative work for a larger mixed-methods study of peer worker recovery capital at multiple socioecological levels to understand potential influences on peer worker (1) retention in the workforce, (2) fidelity to delivering specialized interventions outside the scope of standard training, and (3) participant outcomes, focusing initially on rural peer workers. RA2 enhances Aim 2 of the parent grant and expands beyond peer workers involved in the delivery of parent grant services. Finally, the Diversity Supplement will provide dedicated, intensive mentorship and training to prepare Dr. Castedo de Martell to enhance the diversity of the field of NIH-funded substance use disorder researchers as an independent NIDA-funded investigator from an underrepresented background in research with direct lived experience. 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 The proposed Diversity Supplement: Leveraging Parents and Peer Recovery Supports to Increase Recovery Capital in Emerging Adults with Polysubstance Use: Feasibility, Acceptability, and Scaling Up of Launch (R34DA057639) will provide funding support for Dr. Castedo de Martell, a Hispanic woman with direct lived experience of substance use disorder, to complete two research activities that enhance the aims of the parent grant, and to receive intensive training and mentorship to advance to an independent research career. The overarching purpose of the Launch parent grant study is to assess the feasibility and acceptability of an innovative substance use services package, Launch, that leverages supportive parents and peer recovery support services to reduce poly-substance use and increase recovery capital in this critical developmental stage using quantitative, qualitative, and community-based participatory research procedures. The Diversity Supplement research activities will (1) prepare a cost-effectiveness analysis to accompany a future large scale Launch research project, and (2) will investigate recovery capital factors impacting peer workers’ ability to deliver services with fidelity, as well as expanding to peer workforce retention outcomes.