PROUD-R² is a study based in Southern Ohio, Oregon, and Kentucky that seeks to encourage the involvement of rural communities in research surrounding substance use. Despite high morbidity and mortality from opioid use in rural America, clinical trials of treatments for substance use disorders recruit most study participants from urban areas. PROUD-R² aims to overcome two significant roadblocks in clinical trials research:

• widely dispersed rural populations that complicate clinical trial implementation
• inclusion of people who used drugs whose social circumstances make clinical trial participation difficult

PROUD-R²  is also studying the effectiveness of peer-driven intervention, which involves training study participants on skills to recruit and retain more study participants from their communities. We hope to develop effective and evidence-based strategies for encouraging people who use drugs in rural communities to participate in clinical trials.