PROJECT SUMMARY: OVERALL Effective prevention, treatment, and recovery services for substance use disorders (SUD) and HIV demand an increasing array of evidence-based interventions to address individuals' changing strengths, needs, and circumstances. This can be achieved via adaptive interventions, which explicitly guide how to modify the type/ intensity of services based on information about the individual. Further, advances in digital technologies, such as electronic health records (EHRs) and mobile devices, have created unprecedented opportunities to obtain data for use in adapting interventions to different levels (e.g., individual, clinic, health system), modalities (e.g., digital, in-person), and/or time scales (e.g., monthly, many times a day). However, new research methodologies are needed to realize these opportunities and inform a new generation of SUD/HIV services. The focus of the proposed Center for Methodologies for Adapting and Personalizing Prevention, Treatment, and Recovery Services for SUD and HIV (MAPS Center) is the development and dissemination of novel research methodologies that are essential to optimize adaptive interventions to combat SUD/HIV. We propose three exciting, thematically integrated research projects, each developing new methods to empirically inform the construction of adaptive SUD/HIV services. Two innovative themes — optimization (i.e., developing services that achieve the best expected outcome in a way that is not too expensive, complex, or demanding to be scalable) and adaptation (i.e., using information about context and changing needs to decide when and how to intervene) — cut across these projects, enabling our team to move SUD/HIV intervention science forward while creating enormous potential for scientific synergy. Along with the three projects, two cores — Dissemination & Training Core and Administrative Core — will enable the MAPS Center to serve as a national resource by training SUD/HIV scientists in the critical use of the methods, recruiting scientists to work on optimizing adaptive SUD/HIV services, and mentoring early career scholars. The overall Specific Aims of the MAPS Center are: (Aim A) To develop novel experimental and data analytic methods to optimize the adaptation of SUD/HIV services across different levels (e.g., individual, clinic), modalities (e.g., in-person, digital), and time scales (e.g., monthly, daily); (Aim B) To serve as a national resource by placing the innovative methods developed in the MAPS Center directly into the hands of SUD/HIV scientists; and (Aim C) To nurture and build capacity among scientists to design experiments and analyze data to inform the development of adaptive SUD/HIV services. The MAPS Center will pave the way for a new generation of highly effective and scalable interventions that will reduce the prevalence and incidence of SUD and HIV infection.

PUBLIC HEALTH RELEVANCE Effective prevention, treatment, and recovery services for substance use disorders (SUD) and HIV and their effective implementation in real-world service settings can be achieved via adaptive interventions; these interventions explicitly guide the modification of the type/intensity of services (or implementation supports) based on the context and changing needs of individuals with or at risk for SUD/HIV and the settings where they receive care. However, (i) existing adaptive intervention approaches have been unable to harness the unprecedented opportunities offered by advances in digital technologies, such as electronic health records (EHRs) and mobile devices; and (ii) existing experimental designs and data analytics have not kept up with the critical questions investigators must address to optimize the adaptation of SUD/HIV services across different levels, modalities, and timescales. The focus of the Methodologies for Adapting and Personalizing Prevention, Treatment, and Recovery Services for SUD and HIV (MAPS Center) is the development, evaluation, and dissemination of novel data collection and data analysis methodologies that are essential to optimize adaptive interventions to combat SUD/HIV.