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Development and Testing of a Mechanism-Driven Dialectical Behavior Therapy (DBT) Skills Coaching Powered by Generative AI: A Just-in-Time Adaptive Intervention to Reduce HIV and Substance Use Risks

Award Number: DP2DA066204
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2026
PERIOD OF PERFORMANCE END DATE: 07/31/2030

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Development and Testing of a Mechanism-Driven Dialectical Behavior Therapy (DBT) Skills Coaching Powered by Generative AI: A Just-in-Time Adaptive Intervention to Reduce HIV and Substance Use Risks - PROJECT SUMMARY Individuals who use substances are at heightened risk of HIV infection due to co-occurring behavioral and psychological vulnerabilities. These maladaptive behaviors often lead to additional risks which might hinder engagement with effective HIV prevention strategies (e.g., PrEP). Existing behavioral intervention tools lack the flexibility and precision needed to address idiosyncratic, complex, real-time risk dynamics. I here propose a scalable, context-sensitive intervention that can respond in real time to critical behavioral risk moments. Specifically, I propose to develop and test the feasibility of a Generative AI (GenAI)-powered coaching intervention to reduce substance use and HIV transmission risk and enhance HIV prevention engagement among HIV-negative substance-using adults. The intervention, named “Glow” -- as in the light guiding an alternative path away from substance use and HIV risk behaviors -- leverages a Just-In-Time Adaptive Intervention (JITAI) to deliver GenAI-enhanced Dialectical Behavior Therapy (DBT) skills coaching targeting two key psychological mechanisms: impulsivity and maladaptive coping. This work builds on my prior pilot study on mobile DBT skills training among people living with HIV, which improved emotion regulation, coping self-efficacy, and HIV self-management. We also conducted systematic reviews of GenAI in behavioral health, identifying both its potential for empathetic dialogues and its current limitations in clinical precision. Glow integrates these insights to deliver mechanism-targeted, clinically informed DBT coaching via a GenAI-enabled platform designed for scalability, engagement, and real-world impact Several components render this project innovative, high-risk, and high-reward, making it particularly well-suited for the DP2 mechanism: (1) an innovative JITAI delivery system that combines ecological momentary assessment with passive sensor data to inform context-aware support at moments of elevated risk; (2) a novel fusion of JITAI and GenAI to deliver DBT coaching tailored to user state -- advancing beyond static digital interventions to adaptive, mechanism-driven care; and (3) a high-risk yet high-reward design that tests the feasibility of an autonomous GenAI system in the sensitive domains of substance use and HIV prevention The ethical and safety concerns will be addressed with a multi-layered risk mitigation system to detect suicidal ideation and substance use urges from participants and prevent Glow from prividing harmful response. Glow has the potential to disrupt traditional models of HIV prevention and substance use treatment. This proposal directly addresses NIDA’s goals to reduce HIV incidence, tailor interventions for people who use drugs, and integrate AI technologies into behavioral health. If successful, Glow will lay the groundwork for precision behavioral health platforms that can scale across multiple syndemic contexts, such as trauma-related conditions, and other behaviorally driven health risks beyond HIV and substance use.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $1,963,500 )
2026	2026	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Drug Use and Addiction Research Programs	000	1	7/24/2026	NEW	$1,963,500
														Subtotal = $1,963,500

Grand Total All Awards = $1,963,500

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Development and Testing of a Mechanism-Driven Dialectical Behavior Therapy (DBT) Skills Coaching Powered by Generative AI: A Just-in-Time Adaptive Intervention to Reduce HIV and Substance Use Risks

Award Number: DP2DA066204

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2026

PERIOD OF PERFORMANCE END DATE: 07/31/2030

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