7. Project Summary/Abstract In the proposed research, we will adapt and pilot an online, telehealth intervention to improve risk factors for opioid use, opioid misuse, and opioid use disorder (OUD) in young adults who are living in rural Oregon. We will examine the efficacy of the Family Check-Up Online (FCU Online), an evidence-based intervention to prevent substance abuse and promote successful development and adaptation from early childhood to emerging adulthood. The FCU Online program will be delivered as a mobile intervention with coaching support and will be adapted to include content focused on supporting young adult parents at-risk of OUD as a tool for prevention. Focus groups that include both parents and community stakeholders will guide the adaptation of the model in a formative development phase of the project. A pilot study population of 100 young adult parents will be recruited in collaboration with our community partners, and randomly assigned to receive either the intervention or community services as usual. The intervention will be delivered online as a telehealth model using mobile devices in order to reach parents in rural and outlying areas. We will also use mobile devices to collect active and passive sensing data, to measure key mediators and outcomes in brief assessment bursts.This research will significantly contribute to our understanding of effective prevention during the young adult years with high-risk parents to enhance long-term reductions in young adult opioid use and substance abuse across two generations, and will be synergistic with the overall goals of the P50 Prevention Research Center: Parenting Among Women Who Are Opioid Users (PWO Center). Results will enable us to refine and improve the proposed intervention in Project 2 of the PWO Center, and will inform our work with community partners with the potential to lead to independent funding in prevention.

8. Project Narrative This research will focus on examining the feasibility, acceptability, and potential effectiveness of the FCU- Online for preventing opioid use, opioid misuse, and opioid use disorder in a high-risk sample of young adults living in rural Oregon. Young adult parents with substance misuse histories will be the target of the intervention, and the curricula will focus on risk factors that predict continued long-term substance abuse, such as young adult mental health and wellness. This research will significantly advance our understanding of effective interventions during the young adult years to improve health and prevent substance abuse across the lifespan, and has the potential to substantially improve public health in the United States.