Project Summary/Abstract This Mentored Patient-Oriented Research Career Development application (K23) will provide protected time for Dr. Frank Schwebel to strengthen his trajectory as independent researcher at the University of New Mexico, Center on Alcohol, Substance use, And Addictions (UNM-CASAA). His goal is to develop expertise in mindfulness-based interventions, advanced quantitative methods, and interactive, personalized mHealth interventions to improve medication adherence and treatment outcomes among individuals struggling with opioid use disorder (OUD) and other substance use disorders. In order to develop expertise in these areas, the candidate proposes an innovative, mentored research study using text messages to deliver medication adherence reminders and mindfulness-based intervention content for individuals taking medications for opioid use disorder (MOUD). OUD and opioid overdose have increased significantly over the past 20 years and are considered an epidemic. MOUD has proven to be an effective treatment option, however, medication adherence is a significant problem with most dropout occurring within one month of MOUD initiation. Mindfulness-based interventions show promise in helping decrease opioid use. This study builds on existing literature suggesting the effectiveness of medication reminders and supplements it by focusing on factors that might help decrease risk of opioid use (e.g., mindfulness, self-efficacy, craving, withdrawal symptoms) (consistent with NIDA FY 2021-2025 Strategic Plan Outline Goal 2). By conducting a microrandomized trial (MRT), the study takes an innovative approach to identify effective mindfulness-based intervention content and is a necessary step in creating a cutting-edge, just-in-time adaptive intervention (JITAI) (consistent with NIDA Strategic Plan Action 2.1). This mentored study will offer the necessary training to help the candidate develop expertise to establish his own independent mHealth intervention program of research that specializes in using mindfulness-based interventions to treat OUD. With the guidance of his mentorship team, Dr. Schwebel’s training plan and mentored study are integrated and selected to promote the development of a comprehensive skillset in the following areas: 1) mindfulness-based interventions for OUD (Dr. Witkiewitz [UNM]), 2) integration of pharmacological and psychological treatments (Drs. Witkiewitz [UNM], Tofighi [NYU]), 3) advanced mHealth approaches and user-centered design (Drs. Pearson [UNM], Murphy [Harvard], Suffoletto [Stanford]), 4) advanced quantitative methods (Drs. Witkiewitz [UNM], Pearson [UNM], Murphy [Harvard]), and 5) professional development, dissemination, grantsmanship, and ethics (Drs. Witkiewitz [UNM], Pearson [UNM], Murphy [Harvard], Suffoletto [Stanford], Tofighi [NYU]). In addition to training at CASAA, Dr. Schwebel will visit Dr. Murphy’s lab at Harvard University and complete trainings at a variety of institutes across the country (e.g., mHealth Training Institute, Penn State Methodology Center). Through this training, Dr. Schwebel will be prepared to develop an independent research program.

Project Narrative This project will provide Dr. Frank Schwebel with training in mindfulness-based interventions, psychosocial and pharmacological treatment approaches for opioid use disorder, advanced mobile health approaches and quantitative methods, and research ethics. The proposed research will evaluate the efficacy of a microrandomized intervention designed to increase state mindfulness, decrease craving, and increase self- efficacy among individuals who take daily medication for an opioid use disorder. Together, the well-integrated research and career development plans will support Dr. Schwebel’s independent research program focused on developing mobile health treatments for opioid use disorder.