PROJECT SUMMARY/ABSTRACT The opioid epidemic does not differentiate based on gender or life experience, with impacts on a range of individuals, including women who are pregnant. Infants born to mothers who use opioids during pregnancy are at risk for neonatal opioid withdrawal syndrome (NOWS). However, mothers with opioid use disorder (OUD) often face many challenges in seeking health care and treatment, including concerns about stigma, prosecution, and loss of their infant. The ACT NOW Outcomes of Babies with Opioid Exposure (OBOE) Study is a multisite longitudinal cohort study of infants with antenatal opioid exposure and control infants designed to (1) determine the impact of antenatal opioid exposure on brain structure and connectivity over the first 2 years of life; (2) define medical, developmental, and behavioral outcomes over the first 2 years of life in infants exposed to opioids; and (3) explore whether and how the home environment, maternal mental health, and parenting modify trajectories of brain connectivity and neurodevelopment over the first 2 years of life. The ACT NOW OBOE Study has the potential to significantly advance understanding of outcomes among infants with antenatal opioid exposure through this groundbreaking neuroimaging study. The study investigators propose the addition of peer navigators to ensure a diverse and inclusive study population and thereby improve the generalizability of study findings. Common challenges encountered in recruiting study participants from underrepresented populations have included distrust in science, concerns about safety of MRIs, placements of infants in foster care, and practical and logistical challenges for the mother and family, including food insecurity, transportation concerns, and lack of childcare for other children. The specific aim of this administrative supplement is to provide data management and logistical coordination to support an increase in capitation funds to address challenges in study recruitment and retention through the inclusion of peer navigators in the ACT NOW OBOE Study. In addition to assisting with study recruitment and retention, peer navigators will provide much needed support and resources to mothers with OUD and connect them to available services, including food programs, and psychosocial or material supports such as counseling, peer recovery support, and community linkages to care.