Background: Central Appalachia, comprised of West Virginia, Southwest Virginia, Eastern Kentucky, Southeast Ohio, East Tennessee, and Western North Carolina, is the opioid epidemic epicenter, having the nation’s highest opioid death rates and the least access to treatment.

Proposed Solution to the Problem: Diverse stakeholders concur that research is critically needed to advance the state of knowledge and practice, and to inform wider public and political priority setting around opioid use disorder. Without research that includes robust engagement of patients, communities, clinicians, policy makers, and researchers, outcomes will remain inadequate. The Opioid Research Consortium of Central Appalachia (ORCA) will navigate barriers and accelerate creation of a foundation for patient-centered outcomes research by converging scientific, clinical, and community capacity across central Appalachia. ORCA will establish an open, team-science culture comprised of organizational and individual partners, spanning institutions of higher education, private healthcare systems, state government, and community organizations.

Objectives: The project goal is to rapidly start up ORCA with a culture of community-engaged, patient-centered comparative clinical outcomes research (PCOR) from the outset. Specific objectives include:

• Increase commitment to community-engaged, PCOR partnerships in opioid research
• Develop infrastructure that facilitates efficient mutual pathways to conduct community-engaged PCOR
• Establish open-access training to equip community and patient partners, caregivers, clinicians, researchers, and other stakeholders to engage as meaningful research partners within ORCA
• Develop a collaborative research framework (blueprint) to guide rapid execution of research across ORCA

Activities/Outcomes Outputs (projected): The major outcomes include:

• Leadership advisory team formed with diverse stakeholder composition
• Signed Commitment to Plan MOUs from organizational-level partners
• Leadership retreats to shape governance
• Transparent and inclusive information systems initiated
• ORCA website completed and publicly posted
• Community-engaged PCOR training program (nonresearcher/ researcher versions) finalized
• Training published via Canvas open-source platform
• ORCA Research Blueprint issued
• ORCA Team Science Pilot Grant Program RFA finalized

Patient and Stakeholder Engagement Plan: The project team will fully consider: reciprocal relationships—shared resources and decision making across stakeholders from the highest levels of institutional leadership (presidents, CEOs) to patients in recovery; co-learning—distinct learning and skill building tailored to researchers/nonresearchers; partnerships—respectful requests of member time, considerations of compensation; and transparency—assuring that decisions are made inclusively and information is shared broadly.

Project Collaborators: East Tennessee State University (co-lead); Marshall University; University of Kentucky; Virginia Tech/VT-Carilion (co-lead); and West Virginia University. Expected initial healthcare systems include: Ballad Healthcare System and Carilion Healthcare System.