Background: This application is for a five-year Career Development Award (CDA) to support my transition to becoming an independent VA health services researcher. Career plan: To successfully achieve my career goal of improving Veterans' health and quality of life by enhancing the reach and effectiveness of behavioral sleep interventions, I need further mentored training and content expertise in chronic pain and health services research, including qualitative methodologies, pragmatic randomized trials, and implementation science, including social marketing theory. I will achieve these objectives through formal coursework, seminars, clinical training, and mentorship from Melissa Polusny, PhD (primary mentor; Minneapolis VA Health Care System, MVAHCS), Erin Krebs, MD, MPH (MVAHCS), Michael Vitiello, PhD (University of Washington), and Hildi Hagedorn, PhD (MVAHCS). Research plan: Specific aims include 1) understanding the experience of sleep treatment in comorbid chronic pain and insomnia, 2) optimizing cognitive behavioral therapy for insomnia (CBT-I) delivery for patients with chronic pain and insomnia, and 3) increasing demand for CBT-I among patients with chronic pain and their primary care providers. Projects include a qualitative interview study with patient and CBT-I provider dyads following completion or drop-out from CBT-I to inform hypotheses about strategies to eliminate barriers to adherence. I will use these findings to draft a package of adherence-promoting adaptations for patients with chronic pain. A pilot feasibility study will be used to finalize the adherence package and test feasibility of trial procedures to prepare for a future pragmatic randomized clinical trial. The final project is a local implementation study to test a social marketing campaign to increase demand for CBT-I among patients with chronic pain by increasing patient and primary care provider awareness and positive attitudes toward CBT-I. The social marketing campaign developed in this study will be an important component of a multifaceted implementation intervention that will be tested in a future multisite trial. The first two projects will result in a package of adherence-promoting adaptations to be added to CBT-I for patients with chronic pain. It is likely that components of the adherence package will inform broader efforts to enhance CBT-I adherence in all patients with insomnia, both those with and without chronic pain, as well as adherence to other cognitive behavioral therapies. The final CDA project will result in a social marketing campaign designed to increase demand for CBT-I among patients with chronic pain. We expect that components of the social marketing campaign can also be used as part of broader campaigns to disseminate CBT-I widely among patients with insomnia, leading to higher-rates of guideline-concordant care. Significance and innovation: CBT-I is a highly effective and safe treatment for improving sleep and pain outcomes and represents a p...