DESCRIPTION: We propose to establish a new Node of the NIDA Clinical Trials Network (CTN) -- the Northeast Node spanning the rural communities of New Hampshire, Vermont, and Maine. This Node will be based out of Dartmouth College in collaboration with several large provider networks spanning over 400 adult and/or adolescent general medical care partners, an array of addiction-specialty programs, and a national behavioral health managed care partner. Dartmouth is an ideal home for this Node, as it also the home of the NIDA- funded Center for Technology and Behavioral Health (CTBH), a P30 "Center of Excellence" that uses science to inform the development, evaluation, and strategic implementation of technology (web, mobile)-based therapeutic tools targeting substance use disorders (SUDs) and related issues (including HIV risk behavior and psychiatric comorbidities). CTBH is led by Dr. Lisa Marsch, who will also serve as the Principal Investigator on the proposed CTN node. Our team has led the field by enhancing the quality, pace of achievement, and impact of scientific research focused on the application of technology to SUD and behavioral health treatment. Our team has expertise in all stages of SUD intervention development, ranging from feasibility, acceptability, efficacy, efficacy-effectiveness, effectiveness (including multi-site effectiveness trials), cost-effectivenes, and implementation research in many contexts, including addiction and mental health specialty programs, medical specialty programs, hospitals, schools, criminal justice settings, and primary care. This work has included seminal research on the integration of SUD interventions into rural health care systems. This work has been conducted with a wide array of populations including chronic drug users, smokers, veterans, chronic pain patients, persons at risk for HIV, and persons with co-occurring SUDs and mental illness. Our group has particular expertise in research with youth, ranging from screening and assessment, prevention, treatment, recovery support, and care coordination for adolescents -- including several lines of research focused on cannabis use and prescription opioid use disorders among youth. The Aims of this proposal are to (1) Expand the NIDA CTN to new states in rural regions by launching the Northeast Node of the CTN and thereby expanding our collaborations with primary care and other community treatment partners in identifying and implementing timely and significant trials targeting SUDs, (2) Support and grow a productive research agenda with a particular focus on CTN trials that centrally leverage technology-based tools and/or have a priority focus on youth - both within the Northeast Node and via leadership and advisory roles within the national CTN community, and (3) Develop and support an infrastructure to enhance synergy and support bidirectional sharing of knowledge and resources between CTBH and the CTN. These activities will inform key scientific discoveries and insights regarding the substance use-related needs and priorities in rural health care systems as well as the effectiveness of technology-based interventions in a diverse array of community systems.

PUBLIC HEALTH RELEVANCE: The National Institute on Drug Abuse's (NIDA's) Clinical Trials Network (CTN) conducts practical trials evaluating screening, prevention, treatment, and recovery support interventions for substance use disorders (SUDs) in real-world community systems across the nation. The proposed Northeast Node of the CTN will enable an expanded focus of CTN activities on technology-based interventions for SUDs, SUD care for adolescents, and SUD care for rural communities. Through these activities, the Node seeks to create new knowledge to inform unprecedented, science-based treatment of SUDs and serve as a resource for science, education, services, and tools for the national CTN community and substance abuse field.