Theory-based social media intervention for non-medical use of prescription opioids (NMUPO) in young adults - PROJECT SUMMARY/ABSTRACT Non-medical use of prescription opioids (NMUPO) is a timely and significant public health issue in the United States (US). Young adults are the key population vulnerable to NMUPO. Existing literature indicates that NMUPO in young adults is influenced by a robust array of psychosocial factors. Tailored interventions guided by a psychosocial theory, such as the information-motivation-behavioral skills (IMB) model, are urgently needed for addressing NMUPO in young adults. One innovative approach is to reach out to and deliver psychosocial interventions to young adults via social media technology, yet limited efforts have sought to develop such interventions for NMUPO among young adults. Thus the scientific objective of this K01 is to gather data via IMB-guided formative study regarding psychosocial influences on NMPUO and then to use these findings to inform the development of a peer-led social media intervention designed to reduce NMUPO among young adults. The career development objective of this K01 is to obtain intensive mentored training essential to improving the theoretical and practical expertise needed to develop innovative and implementable peer-led psychosocial interventions for NMUPO in high-risk populations. The training will be supported by the rigorous and highly productive research environment at the University of South Carolina and by a mentor team with expertise in addiction treatment, health psychology, peer support group, formative assessment, social media and psychosocial intervention design, mixed methodology, ecological momentary assessment, as well as intervention development, implementation, and evaluation. Training progression is linked to three specific research aims. In Aim 1, we conduct formative research, guided by the IMB model, to explore psychosocial contents associated with NMUPO in young adults. We then use the findings from Aim 1 to develop a peer-led social media intervention to reduce NMUPO among young adults (Aim 2) by integrating promising psychotherapy principles and incorporating with peer leaders who are well-trained for recovery coaching. In Aim 3, we conduct a pretesting of the feasibility, acceptability, usability, and preliminary efficacy on NMUPO reduction and psychosocial changes of the theory-based social media intervention with a 12-week pilot randomized controlled trial among 70 NMUPO engaging young adults (35 for intervention and 35 for control) via pre-test, 12-week ecological momentary assessment (during the intervention), and post-tests (12-month follow-ups). This project will contribute to future largescale and fully-powered psychosocial interventions for NMUPO among young adults or other high-risk populations using innovative technology that can address challenges in traditional substance use interventions.