Leveraging Parents and Peer Recovery Supports to Increase Recovery Capital in Emerging Adults with Polysubstance Use: Feasibility, Acceptability, and Scaling Up of Launch

新兴成年人（EA; 18-26岁）与所有其他年龄段相比，使用多种药物的比例最高 组他们受到阿片类药物危机的打击尤其严重，估计每年花费美国1万亿美元。在 事实上，几乎所有存在药物使用问题的EA都报告定期使用多种药物。恢复资本，或 可用于促进物质使用恢复的资源（例如，职业/教育技能，康复支持 与老年人相比，社区）对EA的影响也要低得多。这并不奇怪，因为这种发展 不稳定和过渡阶段。不幸的是，大多数使用多种物质的选举机构没有得到服务， 这一问题在农村社区更为严重，农村社区往往无法获得任何行为健康服务。 此外，获得物质使用服务的EA不太可能获得循证护理， 与老年人相比，他们可能会辍学。显然，更适合发展和吸引人的服务 对于使用多种物质的EA，无论其居住地如何，特别是在农村社区，都需要采取这些措施。这 R34，从一个早期阶段的研究者，开始研究，以填补这一服务差距，通过创新的适应， 现有的物质使用服务。它利用（1）EA的父代和（2）对等恢复支持（PRS）， 确保服务的公平性和可扩展性。物质使用服务的EA很少涉及父母，但他们的 参与可以成为持续复苏的重要因素。除了父母，缺乏以康复为重点的 同伴社会支持是影响幼儿园持续康复的主要障碍。幸运的是，经过认证的PRS经过培训， EA找到一个恢复同行社区，并可能建立恢复资本。因此，该R34引导可扩展的服务 对于名为Launch的EA，涉及父母和PRS，从而针对来自两个 关键的角度在调整和评估培训方案和依从性工具（目标1）后，48名使用聚乙烯的EA 使用药物和他们的父母将被招募。家庭将被随机分配到三个条件之一。在 第一个条件是，父母将参与基于网络的辅导，以使用新兴成人应急管理 （CM-EA），建立在数十年的工作支持CM作为多物质使用的主要干预措施的基础上。在第二 条件下，PRS将提供典型的服务，包括恢复社交网络，并将进一步建立 职业教育机构通过职业/教育/金融技能恢复资本。在第三种情况下，家庭将得到一个CM- 教练和PRS。将评估研究方案和上市服务的可行性和可接受性 (Aim 2）。值得注意的是，该项目已被告知基于社区的示范性研究（CBPR）的做法， 在R34中继续通过结合具有恢复生活经验的EA和父母的反馈， 教练，PRS，和家庭。此外，为了提高最终的吸收率，物质使用服务的支付者/提供者将 接受采访。还将招募未来大规模适应性试验的研究中心（目标3）。如果发射最终 被认为是有效的，它将填补物质使用服务领域的一个主要空白， 个性化的服务，以降低风险，促进适应性生活功能的EA与多种物质的使用。

Emerging adults (EAs; aged 18-26) have the highest rates of poly-substance use compared to all other age groups. They have been hit particularly hard by the opioid crisis, estimated to cost the U.S. $1 trillion a year. In fact, nearly all EAs with a substance use problem report regular use of multiple drugs. Recovery capital, or the resources available to promote substance use recovery (e.g., vocational/educational skills, recovery-supportive community) is also much lower for EAs compared to older adults. This is not surprising given this developmental stage of instability and transition. Unfortunately, most EAs with poly-substance use are not receiving services, a problem that is exacerbated in rural communities, which often lack access to any behavioral health services. Further, EAs who do access substance use services are unlikely to receive evidence-based care and are more likely to drop out compared to older adults. Clearly, more developmentally appropriate and engaging services are needed for EAs with poly-substance use, regardless of residence, but particularly in rural communities. This R34, from an early stage investigator, initiates research to fill this service gap via an innovative adaptation of existing substance use services. It leverages (1) parents of EAs and (2) peer recovery supports (PRS), while ensuring services are equitable and scalable. Substance use services for EAs rarely involve parents, but their involvement could be the difference-maker for sustaining recovery. Beyond parents, the lack of recovery-focused peer social support is a major barrier to sustained recovery in EAs. Fortuitously, certified PRS are trained to help EAs find a recovery peer community and possibly build recovery capital. Thus, this R34 pilots a scalable service for EAs, named Launch, that involves both parents and PRS, thereby targeting poly-substance use from two crucial angles. After adapting and evaluating training protocols and adherence tools (Aim 1), 48 EAs with poly- substance use and their parents will be recruited. Families will be randomized to one of three conditions. In the first condition, parents will engage in web-based coaching to use Contingency Management for Emerging Adults (CM-EA), built on decades of work supporting CM as a leading intervention for poly-substance use. In the second condition, PRS will provide typical services, including recovery social networking and will also further build the EAs’ recovery capital via vocational/educational/ financial skills. In the third condition, families will get both a CM- EA coach and a PRS. The feasibility and acceptability of the study protocol and Launch services will be assessed (Aim 2). Notably, this project has been informed by Community-Based Participatory Research (CBPR) practices, which continue in the R34 by incorporating feedback from EAs with lived experience in recovery and the parent coach, PRS, and families. Further, to improve eventual uptake, payors/providers of substance use services will be interviewed. Sites for a future large-scale adaptive trial will also be recruited (Aim 3). If Launch is ultimately deemed effective, it would fill a major gap in the substance use services field by providing a highly specified and individualized service for reducing risk and promoting adaptive life functioning in EAs with poly-substance use.