PROJECT SUMMARY/ABSTRACT This proposal seeks to develop and evaluate a novel culturally tailored family-based videogame, FamilyBond (FamB), to prevent increases in substance misuse among urban Black mid-adolescents with early substance use in primary care settings. Compared to white adolescents, Black adolescents who misuse substances are more likely to die from a drug overdose, with an alarming 86% increase in drug overdose rates in ages 15-24 years from 2019 to 2020. Black adolescents have risk/protective factors for substance misuse that differ from other racial/ethnic adolescents. Urban Black adolescents differ from rural Black adolescents in their perception of harm from substances, substance misuse norms, and exposure to community violence, underscoring the need for tailored interventions. Family-based interventions can address these factors, and digital interventions can mitigate barriers to intervention access that Black adolescents and their caregivers face, facilitating wide uptake. However, digital family-based interventions for urban Black adolescents with early substance misuse are lacking. The scientific objective of this proposal is to apply theoretically and empirically driven approaches to develop and test FamB, an intervention to prevent increases in substance misuse among Black adolescents. Research Aims are: 1) To develop FamB and assess its usability among Black adolescents and parents, 2) to assess the feasibility and effect size of FamB among 60 Black parent-adolescent (14-17-year-old) dyads in a) lowering adolescent intention to misuse substances (primary outcome), b) improving parental self-efficacy regarding parent-adolescent substance misuse communication, and c) improving parent-adolescent communication about substance misuse. Completing this K23 proposal will provide Dr. Aneni with critical new training in several key areas to achieve her long-term career goal of becoming an independent investigator capable of developing, testing, and implementing effective, accessible, and culturally informed substance use prevention interventions for Black adolescents. Dr. Aneni and her mentors have compiled a comprehensive plan that will allow her to achieve the following training goals: 1) Gain mastery in conducting community- engaged research for substance misuse prevention among Black adolescents, 2) acquire expertise in developing family-based digital substance misuse prevention interventions for Black adolescents, 3) obtain knowledge and skills in Implementation Science methods, and 4) hone skills in conducting randomized controlled trials, responsible conduct of research, and grant writing. This proposal is significant in addressing a major public health problem, substance misuse among Black adolescents, by implementing novel approaches to addressing both risk and protective factors and care access barriers. The vital support from this K23 award will allow Dr. Aneni’s scientific development, leading to an independent, highly integrated community-engaged research program addressing substance misuse and improving wellbeing among Black adolescents.

PROJECT NARRATIVE This study will develop and test a novel culturally tailored family-based videogame, FamilyBond, to prevent worsening substance misuse among urban Black adolescents in community-based primary care settings by addressing both universal and unique risk and protective factors for this population. Findings from the study will provide the first effective family-based digital intervention to lower intentions to misuse substances among urban Black adolescents. The intervention will reduce barriers to accessing care among Black adolescents and their parents by delivering a mobile videogame intervention in primary care settings.