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National Experiment of Self-management Applications for Rewarding my Choices (SARC) with AI, Contingency Management, & Technology Enhancements to Reduce Emerging Adult Substance Use, Overdose, & Costs

Award Number: R01DA011323
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 06/30/2031

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National Experiment of Self-management Applications for Rewarding my Choices (SARC) with AI, Contingency Management, & Technology Enhancements to Reduce Emerging Adult Substance Use, Overdose, & Costs - PROJECT SUMMARY/ABSTRACT Emerging adulthood (ages 18-25) is a critical developmental stage characterized by the highest rates of substance use disorders (SUDs) across the lifespan. In fact, substance use is the second leading cause of death in this age group. Unfortunately, while 28% of emerging adults meet criteria for SUD, compared to 17% of more mature adults and 9% of youth under 18, this group is the least likely to access and be retained in treatment. Developmental changes, reduced family and school supports, and increased exposure to risks such as homelessness, victimization, and crime contribute to their vulnerability. The challenges faced by emerging adults are magnified in rural areas with limited services. All of this contributes to high societal costs related to healthcare utilization and mortality from accidents, substance use, and suicide. Innovative ways to help emerging adults reduce or eliminate their substance use are urgently needed to prevent devastating outcomes and save lives. Mobile health (mHealth) tools, especially those that are self-managed and are not attached to being in treatment, offer a scalable solution, as 97-98% of emerging adults already carry smartphones. Prior studies, including our own, show that mHealth self-management tools can reduce overdose risks and substance use. However, prior research also revealed barriers—some specific to emerging adults—to sustained engagement in mHealth tools, including technical disruptions caused by changes in devices and mobile technology, limited customization, burdensome self-monitoring demands, and reduced utilization over time. Emerging adults also have low self-identification with addiction or recovery language. To address these challenges, we redeveloped our digital self-management suite, the Self-management Applications for Rewarding my Choices (SARC), with input from emerging adults in recovery. SARC now features a transportable Progressive Web Application (PWA), customizable content and ability to add external apps, reduced self-monitoring burden, an AI-based coach ( Mia ), and an integrated contingency management (CM) incentive structure (specifically to target engagement and utilization). We will recruit a national sample of 600 emerging adults with SUD or a recent overdose or blackout, stratified by rural and non-rural communities. Urn randomization will assign participants to 3 arms: 1) measurement-only control, 2) SARC for 12 months with CM in the first 6 months, or 3) SARC for 12 months with CM in the second 6 months. The crossover design in the latter two groups creates an economic equipoise to evaluate SARC-alone, as well as the additive effect of CM to increase SARC utilization and the effect of initial vs. delayed CM timing. After month 12, SARC and CM will both be withdrawn from the latter two groups to evaluate the durability of the observed effects. Direct and indirect effects of SARC, with and without CM, will be examined, as will cost-effectiveness and moderation by rurality. Exploratory analyses also will investigate SARC components’ contribution to intervention outcomes. We will continue partnering with a community board of emerging adults to ensure scalability and sustainability.


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 = $896,399 )
2026	2026	CHESTNUT HEALTH SYSTEMS INC	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	20	8/21/2026	COMPETING CONTINUATION	$896,399
2026	2026	CHESTNUT HEALTH SYSTEMS INC	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	002	20	9/4/2026	COMPETING CONTINUATION	$0
2026	2026	CHESTNUT HEALTH SYSTEMS INC	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	001	20	9/1/2026	COMPETING CONTINUATION	$0
														Subtotal = $896,399

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2022	CHESTNUT HEALTH SYSTEMS INC	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	19	9/17/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2022	CHESTNUT HEALTH SYSTEMS INC	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	19	8/17/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $509,350 )
2022	2022	CHESTNUT HEALTH SYSTEMS INC	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	19	6/1/2022	NON-COMPETING CONTINUATION	$509,350
														Subtotal = $509,350

Issue Date FY: 2021 ( Subtotal = $578,564 )
2021	2021	CHESTNUT HEALTH SYSTEMS, INC.	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	18	5/14/2021	NON-COMPETING CONTINUATION	$578,564
														Subtotal = $578,564

Issue Date FY: 2020 ( Subtotal = $0 )
2020	2019	CHESTNUT HEALTH SYSTEMS, INC.	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	17	5/26/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2019 ( Subtotal = $580,659 )
2019	2019	CHESTNUT HEALTH SYSTEMS, INC.	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	17	5/17/2019	NON-COMPETING CONTINUATION	$580,659
														Subtotal = $580,659

Issue Date FY: 2018 ( Subtotal = $582,865 )
2018	2018	CHESTNUT HEALTH SYSTEMS, INC.	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	16	5/11/2018	NON-COMPETING CONTINUATION	$582,865
														Subtotal = $582,865

Issue Date FY: 2017 ( Subtotal = $583,250 )
2017	2017	CHESTNUT HEALTH SYSTEMS, INC.	1003 MARTIN LUTHER KING DR	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	15	8/14/2017	COMPETING CONTINUATION	$583,250
														Subtotal = $583,250

Issue Date FY: 2003 ( Subtotal = $718,407 )
2003	2003	CHESTNUT HEALTH SYSTEMS, INC	1003 MARTIN LUTHER KING DRIVE	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	5	9/22/2003	COMPETING CONTINUATION	$718,407
														Subtotal = $718,407

Issue Date FY: 2002 ( Subtotal = $541,224 )
2002	2002	CHESTNUT HEALTH SYSTEMS, INC	1003 MARTIN LUTHER KING DRIVE	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	4	7/26/2002	NON-COMPETING CONTINUATION	$541,224
														Subtotal = $541,224

Issue Date FY: 2001 ( Subtotal = $540,693 )
2001	2001	CHESTNUT HEALTH SYSTEMS, INC	1003 MARTIN LUTHER KING DRIVE	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	3	8/27/2001	NON-COMPETING CONTINUATION	$540,693
														Subtotal = $540,693

Issue Date FY: 2000 ( Subtotal = $645,784 )
2000	2000	CHESTNUT HEALTH SYSTEMS, INC	1003 MARTIN LUTHER KING DRIVE	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	2	8/7/2000	NON-COMPETING CONTINUATION	$645,784
														Subtotal = $645,784

Issue Date FY: 1999 ( Subtotal = $603,504 )
1999	1999	CHESTNUT HEALTH SYSTEMS, INC	1003 MARTIN LUTHER KING DRIVE	BLOOMINGTON	IL	61701	MCLEAN	USA	Drug Use and Addiction Research Programs	000	1	7/31/1999	NEW	$603,504
														Subtotal = $603,504

Grand Total All Awards = $6,780,699

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National Experiment of Self-management Applications for Rewarding my Choices (SARC) with AI, Contingency Management, & Technology Enhancements to Reduce Emerging Adult Substance Use, Overdose, & Costs

Award Number: R01DA011323

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 06/30/2031

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