In this K24 renewal application, I am seeking funding to continue support for my mentoring activities in patient oriented research (POR), engage in further career development activities, conduct POR with mentees, and conduct three pilot studies that expand the aims of my current grants. My work is focused on the devel- opment, evaluation, and dissemination of adaptive, patient-oriented treatment models across the continuum of care for substance use disorders (SUD). Much of this work is concerned with identifying the treatment compo- nents and features that promote sustained participation and better outcomes, including adaptive protocols that address patient nonresponse, mobile health communication technology, and incentives. I will continue to mentor postdoctoral fellows and new clinician investigators at UPENN, the Treatment Research Institute (TRI), and other institutions, and will add additional mentees. This work will include time spent in planning, reviewing, and providing feedback on manuscripts and grant applications; giving career counseling; and providing further training in the design and evaluation of adaptive treatment interventions for substance use disorders, sequential multiple assignment randomized trial (SMART) designs, and mobile health technology. For this renewal, mentees will include a number of junior faculty members from the University of Michigan (UMICH), with interest in adaptive treatment, SMART designs, and continuing care. With regard to career development, I will obtain additional knowledge in behavioral econom- ics/incentives, new developments in adaptive treatments and SMART designs, and mobile health technology. To that end, I will attend workshops at UPENN at the Center for Health Incentives and Behavioral Economics, and consult with current collaborators at the University of Connecticut (UCONN; Dr. Nancy Petry), University of Wisconsin (UWISC; Dr. David Gustafson), UMICH (Dr. Susan Murphy), and North Shore Long Island Jewish Health System (NSLIJHS; Drs. Jon Morgenstern and Fred Muench) who are experts in these areas. I am currently the PI of a NIAAA R01 and a DoD grant equivalent to an R01, and a co-investigator on a NIDA R01 awarded to Dr. Alan Budney at Dartmouth and on a NIAAA R01 awarded to Dr. Jon Morgenstern at NSLIJHS. All of these projects are randomized clinical trials. My NIAAA R01 is testing the relative efficacy and cost-effectiveness of telephone continuing care, an automated smartphone recovery app, and an integrat- ed protocol that combines these two interventions. The DoD grant is evaluating the efficacy of an adaptive prevention intervention designed to reduce hazardous alcohol and benzodiazepine use in veterans taking opi- oid medications for pain. Funds are requested to conduct three pilot studies addressing: (1) Counselor percep- tions of use and value of mobile technology as a clinician extender in SUD treatment, (2) Patient use of differ- ent mobile heath technology functions and their contributions to SUD outcomes, and (3) Further work on tailor- ing of adaptive interventions for SUD.

Public Health Relevance

This K24 renewal will provide continued support for the PI?s mentoring efforts with postdoctoral fellows and junior faculty seeking careers in clinical research, provide additional training to facilitate the PI?s efforts to broaden his research program on adaptive interventions for substance use disorders, and fund three pilot studies that will provide important information on use of multicomponent smartphone based automated recovery support systems and methods to improve the tailoring of adaptive interventions. These activities will help to facilitate the careers of postdoctoral fellows and junior faculty conducting clinical research and will advance the SUD treatment field in the areas of automated mobile health technology and person-centered care.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Special Emphasis Panel (ZRG1)
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Aklin, Will
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University of Pennsylvania
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United States
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Wimberly, Alexandra S; Stern, Max R; Rosenbach, Sarah B et al. (2017) Challenges to Practicing HIV Sex-Risk Prevention Among People in Continuing Care for Cocaine Addiction. Subst Use Misuse 52:614-623
Wimberly, Alexandra S; Ivey, Megan; Rennert, Lior et al. (2017) Effect of Continuing Care for Cocaine Dependence on HIV Sex-Risk Behaviors. AIDS Behav 21:1082-1090
McKay, James R (2017) Making the hard work of recovery more attractive for those with substance use disorders. Addiction 112:751-757
Shepard, Donald S; Daley, Marilyn C; Neuman, Matthew J et al. (2016) Telephone-based continuing care counseling in substance abuse treatment: Economic analysis of a randomized trial. Drug Alcohol Depend 159:109-16
McKay, James R; Knepper, Cheryl; Deneke, Erin et al. (2016) An Initial Evaluation of a Comprehensive Continuing Care Intervention for Clients with Substance Use Disorders: My First Year of Recovery (MyFYR). J Subst Abuse Treat 67:50-4
Van Horn, Deborah H A; Drapkin, Michelle; Lynch, Kevin G et al. (2015) Treatment choices and subsequent attendance by substance-dependent patients who disengage from intensive outpatient treatment. Addict Res Theory 23:391-403
Van Horn, Deborah H A; Rennert, Lior; Lynch, Kevin G et al. (2014) Social network correlates of participation in telephone continuing care for alcohol dependence. Am J Addict 23:447-52
Oslin, David W; Lynch, Kevin G; Maisto, Stephen A et al. (2014) A randomized clinical trial of alcohol care management delivered in Department of Veterans Affairs primary care clinics versus specialty addiction treatment. J Gen Intern Med 29:162-8
McKay, James R; Van Horn, Deborah H A; Lynch, Kevin G et al. (2014) Who benefits from extended continuing care for cocaine dependence? Addict Behav 39:660-8
McKay, James R; van Horn, Deborah; Ivey, Megan et al. (2013) Enhanced continuing care provided in parallel to intensive outpatient treatment does not improve outcomes for patients with cocaine dependence. J Stud Alcohol Drugs 74:642-51

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