Abstract The NIDA News Release for August 2022 highlights the striking problem that young adults in the US face as the COVID-19 pandemic endures: “Marijuana and hallucinogen use among young adults reached all time-high in 2021…past-month nicotine and marijuana vaping levels rebound after early pandemic drop.” We propose a randomized controlled trial of ÚNETE, an innovative multilevel strategy that combines friendship support networks and targeted messaging from celebrity influencers (actors, singers and sport players) to reduce drug use disparities and the negative effects of social determinants of health in Latinx communities. We will focus on low-income, young adult Latinx (19 to 30 years old), who, as predominantly immigrants or first-generation US citizens, suffer from health disparities as well as discrimination. ÚNETE will be implemented in South Florida, where Latinx are 69% of residents, and are three times as likely as non-Latinx Whites to live below the poverty line. Our overall goal is to evaluate effectiveness of the ÚNETE strategy to reduce drug use (marijuana, hallucinogen, nicotine and marijuana vaping). The strategy has three components: 1. Celebrity Influencer Component of 30 celebrities. We will work with celebrity influencers and low-income, young adult Latinx to develop and culturally tailor messages to facilitate conversations and improve friends’ understanding of the risks of drug use. We will produce and pre-test these messages, featuring celebrity influencers, in multiple formats to allow dissemination through principal media channels (television, radio, streaming video, websites, gaming, interactive). 2. Latinx Friendship Networks (groups of 13 friends). Community Health Workers (CHWs) will map the structure of each friendship network. CHWs and popular individuals from each network will use this information to design a one- three- and nine-month plan to increase drug use prevention conversations based on celebrity messages. 3. CHWs will encourage information sharing of Social Determinants of Health Services provided by our community partners (e.g., food security, ESL, housing and transportation, legal services), and build network cohesion to increase peer support for accessing these services. Participants will be randomly assigned to either ÚNETE (N=24 seeds and 288 recruits through friendship ties) or a standard health promotion (N=312). Assessments will be conducted at baseline, 6, and 12 months. ÚNETE’s multidisciplinary team includes a Latinx PI working with Latinx communities, two of the most important community organizations providing social determinant of health services to low-income Latinx in South Florida (Open Arms and MUJER), experts in celebrity-based campaigns with international and local Latinx celebrities, and a Latinx broadcast media partner that reaches and engages Latinx throughout the US. ÚNETE is innovative and high impact because its use of tailored messages from celebrity influencers amplified through Latinx friendship networks can scale up interventions reaching larger populations, generating broad impacts to public health and increase access to services addressing social determinants of health.

Project Narrative This is a randomized controlled trial of ÚNETE, “Join Us” in Spanish, an innovative multilevel strategy that combines friendship support networks and targeted messaging from celebrity influencers (actors, singers and sport players) to reduce substance use disparities and the negative effects of social determinants of health in low-income, young adult Latinx.