Project Summary/Abstract Fetal alcohol spectrum disorders (FASD) represent a major public health problem that affects up to 2 to 5 percent of school-aged children in the US. Unfortunately, only a small fraction of children with FASD and their families can access FASD-informed interventions due to significant systems- and family-level barriers. Research suggests that self-directed and peer-to-peer interventions are acceptable to families and can lead to significant improvements in parenting, child behavior, and resource utilization. Advancements in technology are facilitating more accessible and interactive methods for self-directed education and support. The proposed project will develop and evaluate the efficacy of a novel mobile health (mHealth) application (“app”) to directly provide caregivers with evidence-based content and peer-moderated support they can easily access and use to improve outcomes for their children and families. The app, currently called “FMF Connect,” will be derived from the scientifically-validated Families Moving Forward (FMF) Program and will build on existing frameworks for the development of medical apps. This project will follow a systematic approach to the development and evaluation of the FMF Connect mHealth intervention, including a small-scale feasibility trial (n=30), and a larger-scale hybrid implementation-effectiveness trial (n=120) with caregivers raising children (ages 3-12) with FASD. Implementation data will aid in identifying the patterns of app usage that relate to the greatest improvements in child and caregiver outcomes. Study hypotheses are: 1) that caregivers will find the FMF Connect intervention acceptable, with easy to access content and encouraging support from peer-moderators;; 2) that greater usage of specific intervention components will relate to larger improvements in child and caregiver outcomes;; 3) that caregivers who receive the FMF Connect intervention will have larger gains on child and caregiver outcomes relative to a waitlist comparison group;; and 4) that an increase in neurodevelopmental attributions for behavior will mediate intervention-related improvements in parenting efficacy and child behavior. Project findings will guide further app development both in terms of content and technological advances to optimize intervention effects. Results of this study will further the overall strategic aims of the Collaborative Initiative on FASD (CIFASD), which are to inform and develop effective interventions for FASD. This project will also benefit from resources and collaborations within CIFASD to carry out the proposed work, including recruitment of a diverse sample, diagnostic support, and outreach and dissemination. This is one of the first studies to empirically test an mHealth intervention delivered by parents with peer- moderated support. It has the potential to reach many families raising children with FASD in need and could reduce sig...