Dr. Lockwood is a nurse scientist with a deep commitment to a research career in clinical pain research. The supplement will allow Dr. Lockwood to further his clinical research training with a focus on examining the relationship between the composition and function of the gut microbiome, including the symbiotic bacteria residing in the gut and their functional gene content, and chronic pain among adults with end-stage kidney disease (ESKD). Interest in how the microbiome influences psychoneurological symptoms, including pain, has been increasing in recent years but remains incompletely understood. Hence, further investigation into this area is needed. Examining how the brain-gut-microbiome affects chronic pain in ESKD patients is a natural extension of Dr. Lockwood’s current research program and represents an excellent opportunity for him to expand his skill set as a pain investigator. Dr. Lockwood’s short-term career development goals are: (1) Gain knowledge and research skills specifically focused on implementing and evaluating pain management interventions in adults with ESKD and chronic pain receiving maintenance hemodialysis. (2) Further develop scientific presentation, manuscript, and grant writing skills. (3) Cultivate the team leadership skills necessary for successful team science projects. (4) Explore the acceptability and feasibility of collecting feces to explore the gene content of the gut microbiota and short-chain fatty acids (SCFAs) among people with ESKD on maintenance hemodialysis before and after pain management interventions. The acceptability and feasibility study has two specific aims: Aim 1: Determine the acceptability of collecting feces. (Benchmark: 70% recruitment rate.) Aim 2: Determine the feasibility of fecal data collection procedures. (Benchmark: 80% of participants return fecal microbiome samples at all 4 time points.) The study will enroll 30 adult participants enrolled in the HOPE consortium trial at the UIC site. Microbiome samples will be collected at 12-week intervals that match the data collection procedures timeline outlined in the HOPE consortium trial protocol (i.e., baseline, week 12, week 24, week 36). Participants will be provided with a fecal collection kit (OmniGene Gut and OmniGene Oral sampling devices from DNA Genotek, which allow samples to be stored at room temperature for short and medium terms, necessary for home collection) and asked to collect a fecal sample and bring the sample to their next hemodialysis visit when they will be completing HOPE consortium trial data collection procedures. This acceptability and feasibility study will help determine the best strategies for recruiting research participants from multiple dialysis facilities, sample collection logistics, and protocols for collection and storage of metabolites (e.g., SCFAs). By conducting this study as principal investigator, Dr. Lockwood will also obtain new skills in leading a team science project, including managing team member...