OBJECTIVES/SPECIFIC AIMS: Diabetic retinopathy is the leading cause of blindness in adults aged 25–64 years. The prevalence of diabetic retinopathy is projected to increase 4-fold by 2050. Racial and ethnic minorities have a higher prevalence and greater severity of diabetic retinopathy. Over 50% of racial and ethnic minorities are not screened for diabetic retinopathy per guidelines. With timely diagnosis and sight-saving treatment, blindness from diabetic retinopathy is largely preventable. The objective of this study is to identify racial and ethnic disparities in the population that do not know they have diabetic retinopathy and to compare those disparities to those in the population that do know they have diabetic retinopathy. METHODS/STUDY POPULATION: Specifically, we have identified a nationally representative survey and clinical examination data to estimate the prevalence of undiagnosed diabetic retinopathy, to identify racial and ethnic disparities in that population, and to compare those disparities in the population with known diabetic retinopathy. We hypothesize that racial and ethnic disparities will be higher in the population with undiagnosed diabetic retinopathy in comparison to the population with known diabetic retinopathy. RESULTS/ANTICIPATED RESULTS: We hypothesize that racial and ethnic disparities will be higher in the population with undiagnosed diabetic retinopathy in comparison to the population with known diabetic retinopathy. The results of that analysis will instruct qualitative interviews that will advance the understanding of the factors that contribute to the decision whether to be screened for diabetic retinopathy. A decision tree will be created to categorize the hierarchy of barriers and facilitators. DISCUSSION/SIGNIFICANCE OF IMPACT: A better understanding of the population with undiagnosed diabetic retinopathy and the factors that influence the decision to get screened will help us not only to address disparities in diabetic retinopathy, but also to prevent blindness from retinopathy.

Objectives/Goals: By synergizing our efforts, we believe this to be a fruitful collaboration for UCLA Clinical and Translational Science Institute (CTSI) and California Institute for Regenerative Medicine (CIRM). With multiple levels to stem cell training, focusing on specific educational goals is integral to our pilot event. This was held on July 26th and offered an exciting and valuable day for trainees. Methods/Study Population: Leadership was comprised of leaders at the UCLA Health Alpha Clinic, Broad Stem Cell Research Center (BSCRC), Human Gene and Cell Therapy Facility (HGCTF), UCLA Campus, Clinical and Translational Research Center (CTRC), and the Santa Barbara COMPASS program. Trainees from UCLA, CSUN, and UCSB were represented. The agenda included a didactic overview of the entire translational and clinical research process from discovery in the laboratory to bedside nursing in the patient care areas. Onsite tours were conducted at the HGCTF and the CTRC with a meet and greet with the nurses. The curriculum covered the clinical research process, regulatory requirements, ethics, current clinical trials, manufacturing, quality control, and compliance. A career opportunities discussion and network sessions closed out the day. Results/Anticipated Results: Of the 13 trainees who attended the session, 10 replied to the evaluation survey. All the responding students (100%) rated the event as “excellent” and found it to be “highly valuable” to their current training program. The trainees indicated that they were “very likely” (100%) to recommend a friend to attend this type of event. When asked what they liked most about the event, they indicated that the programming was “insightful, and “inspiring” for seeing beyond their current trainee responsibilities. They valued the responsiveness to questions, sharing experiences, and mentoring for career advancement. They especially liked the tours at the HGCTF and the session with the front-line nurses. Changes for the future will include timing and length, information on graduate programs and more student interactions. Discussion/Significance of Impact: Overall, our first educational session was very well-received by both trainees and staff involved as stakeholders. Due to the success of this inaugural event, we intend to continue to draw on the expertise of this collaboration and use a similar blueprint for future events and scientific sessions.

OBJECTIVES/GOALS: Penn instituted a Professional Development Core (PDC) to complement existing CTS education programs. Sessions were designed to advance participant knowledge and skills in key competency areas including communication, expectation setting, implicit bias and organizational structure, self-efficacy and resilience in order to enhance abilities to successfully execute career and research goals. METHODS/STUDY POPULATION: The PDC enrolled 4 cohorts totaling 87 trainees and scholars from 2016-2019. This included 35% predoctoral trainees (27 MD, 3 PhD), 39% postdoctoral trainees (29 MD, 3 PhD, 2 VMD/DVM), and 26% junior faculty (16 MD, 6 MD/PhD, 1 PhD). The two-year curriculum consists of 14 lunchtime sessions held bimonthly during academic terms. Session structures include a variety of interactive presentations, activities and facilitated discussions as well as reading material, assessment tools, and case studies. Facilitators include topic experts in academia, entrepreneurship, communications, and professional and personal development. The program is evaluated qualitatively through student satisfaction surveys after each session. RESULTS/ANTICIPATED RESULTS: Of the 2018-2019 participants, 90.8% rated the overall quality of PDC sessions as Very Good (56.05%) or Outstanding (34.75%). DISCUSSION/SIGNIFICANCE OF IMPACT: Feedback indicates that the group benefited from combining predoctoral and postdoctoral trainees, although not all content was immediately relevant to early stage trainees. Trainees appreciated the opportunity to engage with experts in disciplines typically considered outside of traditional science but critical to CTS career success. The flexibility of the curriculum allowed for inclusion of timely topics, newer suites of sessions focus on the multiple dimensions of valuing your science.

CTSI Career Development Award (KL2) programs provide junior faculty with protected time and multidisciplinary, mentored research training in clinical and translational science research. The KL2 Visiting Scholars Program was developed to promote collaborative cross-CTSA training, leverage academic strengths at host CTSAs, and support the career development of participating scholars through experiential training and the development of new partnerships. This manuscript provides a detailed programmatic description and reports outcomes from post-visit and outcomes surveys. Since 2016, 12 scholars have completed the program, with 6 scheduled to complete it in 2021. Post-visit surveys (n = 12) indicate all scholars reported the program valuable to career development, 11 reported benefit for research development, and 11 expansion of collaborative networks. Outcomes surveys (n = 11) revealed subsequent scholar interaction with host institution faculty for 10 scholars, 2 collaborative grant submissions (1 funded), 2 planned grant submissions, 1 published collaborative manuscript, and 3 planned manuscript/abstract submissions. The Visiting Scholars Program is a cost- and time-efficient program that leverages the academic strengths of CTSAs. The program enhanced KL2 scholar training by expanding their professional portfolio, promoting research development, and expanding collaborative networks. Resources to support the program are shared in this report to expedite the development of similar programs at regional and national levels.

The prioritization of English language in clinical research is a barrier to translational science. We explored promising practices to advance the inclusion of people who speak languages other than English in research conducted within and supported by NIH Clinical Translational Science Award (CTSA) hubs. Key informant interviews were conducted with representatives (n = 24) from CTSA hubs (n = 17). Purposive sampling was used to identify CTSA hubs focused on language inclusion. Hubs electing to participate were interviewed via Zoom. Thematic analysis was performed to analyze interview transcripts. We report on strategies employed by hubs to advance linguistic inclusion and influence institutional change that were identified. Strategies ranged from translations, development of culturally relevant materials and consultations to policies and procedural changes and workforce initiatives. An existing framework was adapted to conceptualize hub strategies. Language justice is paramount to bringing more effective treatments to all people more quickly. Inclusion will require institutional transformation and CTSA hubs are well positioned to catalyze change.

The African American population of Buffalo, New York experiences striking race-based health disparities due to adverse social determinants of health. A team of community leaders and university faculty determined that a community dialogue was needed to focus research and advocacy on the root causes of these disparities. In response, we organized the annual Igniting Hope conference series that has become the premier conference on health disparities in the region. The series, now supported by an R13 conference grant from NCATS, has been held four times (2018–2021) and has attracted community members, community leaders, university faculty, and trainees. The agenda includes talks by national leaders and breakout/working groups that led to a new state law that has reduced disproportionate traffic-ticketing and drivers' license suspensions in Black neighborhoods; mitigation of the disproportionate COVID-19 fatalities in Black communities; and the launching of a university-supported institute. We describe the key elements of success for a conference series designed by a community–university partnership to catalyze initiatives that are having an impact on social determinants of health in Buffalo.

OBJECTIVES/SPECIFIC AIMS: The goal of this study was to evaluate the effect of a junior faculty mentoring program on change in confidence in key academic skills. METHODS/STUDY POPULATION: The Department of Medicine at the Albert Einstein College of Medicine/Montefiore Medical Center enrolled 33 mentees over three years (2015-2018) in a mentoring program that consisted of monthly interactive seminars focused on topics related to building academic careers, works-in-progress, and pairing of each mentee with a mentor. Mentees were asked about their confidence in key academic skills prior to and after completing the program. Confidence levels were assessed on a seven point scale, ranging from 1 (weak) to 7 (strong). Mean confidence levels were compared between pre and post surveys using independent samples t-test. Matching was not accounted for because not all individuals who completed the pre survey also completed the post survey and vice-versa. Of those mentees who completed both pre and post surveys, confidence scores were analyzed using Wilcoxon matched pairs signed rank test, with similar results to those reported here. Each mentoring session was evaluated by those in attendance at the end of each particular session with possible scores of 1 (unsatisfactory) to 5 (excellent). RESULTS/ANTICIPATED RESULTS: On average the mentees had a fair level of confidence in all nine areas assessed at baseline, with the exception of how to get funding (2.4 ± 1.7). Confidence increased in all areas assessed, and except for how to write a paper (p=.05) all represented a significant increase in confidence (Table 1). Evaluations of each of the mentoring sessions were high, with mean values ranging from 4.3 to 4.9 on the five point scale. DISCUSSION/SIGNIFICANCE OF IMPACT: This mentoring program significantly improved mentees’ confidence in identifying their own professional values and goals, as well as knowing how to turn education into scholarship, work with a mentor, integrate work and life, and give a presentation.

OBJECTIVES/GOALS: Approximately 10% of COVID-19 patients experience multiple symptoms weeks and months after the acute phase of infection. Our goal was to use advanced machine learning methods to identify PASC phenotypes based on their symptom profiles, and their association with critical adverse outcomes, with the goal of designing future targeted interventions. METHODS/STUDY POPULATION: Data. All COVID-19 outpatients from 12 University of Minnesota hospitals and 60 clinics. Independent variables consisted of 20 CDC-defined PASC symptoms extracted from clinical notes using NLP. Covariates included demographics, and outcomes included New Psychological Diagnostic Evaluation, and Number of PASC Hospital Visits (>=5). Cases (n=3235) consisted of patients with at least one symptom, and controls (n=3034) consisted of patients with no symptoms. Method. (1) Used bipartite network analysis and modularity maximization to identify patient-symptom biclusters. (2) Used multivariable logistic regression (adjusted for demographics and corrected through Bonferroni) to measure the odds ratio of each patient bicluster to adverse outcomes, compared to controls, and to each of the other biclusters. RESULTS/ANTICIPATED RESULTS: The analysis identified 6 PASC phenotypes (http://www.skbhavnani.com/DIVA/Images/Fig-1-PASC-Network.jpg), which was statistically significant compared to 1000 random permutations of the data (PASC=.31, Random Median=.27, z=11, P<.01). Three of the clusters (Cluster-1, Cluster-4, and Cluster-5 encircled with ovals in Fig. 1) contained CNS-related symptoms, which had statistically significant risk for one or both of the adverse outcomes. For example, Cluster-1 with critical CNS symptoms (depression, insomnia, anxiety, brain-fog/difficulty-thinking), had a significantly higher OR compared to the controls for New Psychological Diagnostic Evaluation (OR=6.6, CI=4.9-9.1, P-corr<.001), in addition to having a significantly higher ORs for the same outcome compared to all the other clusters. DISCUSSION/SIGNIFICANCE: The results identified distinct PASC phenotypes based on symptom profiles, with three of them related to CNS symptoms, each of which had significantly higher risk for specific adverse outcomes compared to controls. We will test whether these phenotypes replicate in the N3C data, and explore their translation into triage and treatment strategies.

Objectives/Goals: Our study’s objective is to evaluate RadOnc-GPT, a GPT-4o powered LLM, in generating responses to in-basket messages related to prostate cancer treatment in the Radiation Oncology department. By integrating it with electronic health record (EHR) systems, the goal is to assess its impact on clinician workload, response quality, and efficiency in healthcare communication. Methods/Study Population: RadOnc-GPT was integrated with patient EHRs from both hospital-wide and radiation-oncology-specific databases. The study examined 158 pre-recorded in-basket message interactions from 90 non-metastatic prostate cancer patients. Quantitative natural language processing analysis and two randomized single-blinded grading studies, involving four clinicians and four nurses, were conducted to evaluate RadOnc-GPT’s response quality in completeness, correctness, clarity, empathy, and estimated editing time. Response times were measured to estimate the time saved for clinicians and nurses. The study population included patient messages across all phases of care (pre-, during, and post-treatment) for those undergoing radiotherapy. Results/Anticipated Results: In the single-blinded grader study, clinician graders evaluated 316 responses (158 from human care teams and 158 from RadOnc-GPT). Results showed RadOnc-GPT outperformed human responses in empathy and clarity, while humans excelled in completeness and correctness. Sentiment analyses using TextBlob and VADER revealed RadOnc-GPT responses had a positive mean score of 0.25, whereas human responses clustered around neutral. VADER analysis indicated a high median score for RadOnc-GPT, nearing 1.0, reflecting predominantly positive sentiment, while human responses displayed a broader sentiment range, indicating sensitivity to context. Clinicians averaged 3.60 minutes (SD 1.44) to respond, compared to 6.39 minutes (SD 4.05) for nurses, highlighting RadOnc-GPT’s efficiency in generating timely responses. Discussion/Significance of Impact: RadOnc-GPT effectively generated responses to individualized patient in-basket messages, comparable to those from radiation oncologists and nurses. While human oversight is still necessary to avoid errors, RadOnc-GPT can speed up response times and reduce pressure on care teams, shifting their role from drafting to reviewing responses.

ABSTRACT IMPACT: Recommendations for increasing trainee productivity will be highlighted. OBJECTIVES/GOALS: Using a combination of qualitative (interview) and quantitative (publications tracking) data, we undertook to describe the hurdles and concerns impeding academic accomplishments among T and K awardees at one CTSA hub and to examine whether hurdles at 6 months would predict academic output within one year following completion of the training program. METHODS/STUDY POPULATION: Semi-structured interviews were conducted with 29 trainees (28 TL1 and 8 KL2) 6 months into their training. Interview transcripts were analyzed using Atlas.ti to identify hurdles (factors that had already impeded research progress) and concerns (future challenges anticipated by the trainee). PubMed searches yielded the number of publications within one year of exiting the training program. Frequencies of hurdles and concerns were examined to characterize the factors most likely to impact trainee progress during the first 6 months of their training program. Among 18 trainees who had completed their training, the mean number of publications within one year of exiting the program (identified via verified PubMed searches) was compared across the total number of hurdles reported at 6 months (range = 0 to 3). RESULTS/ANTICIPATED RESULTS: The thematic analysis yielded 19 categories of hurdles and 14 categories of concerns. The top three hurdles were technological challenges (e.g., issues with equipment or data reduction; reported by 63% of trainees), professional competing responsibilities (40%), and navigating collaborations (30%). The top three concerns were future funding (33%), potential as an independent researcher (27%), and institutional context (e.g., departmental structure; 23%). The number of hurdles reported at 6 months significantly predicted number of publications one year post-exit (F (3,14) = 3.14, p < .05). Trainees reporting zero hurdles generated a mean of 8.67 publications; those with 3 hurdles generated a mean of 2.4 publications. DISCUSSION/SIGNIFICANCE OF FINDINGS: Future concerns were completely different from past hurdles, suggesting that the issues impeding research progress are not anticipated. Results suggest trainees would benefit from training related to how to balance competing professional responsibilities and navigate collaborations and that early attention to hurdles may enhance productivity.

OBJECTIVES/GOALS: Several studies compare perioperative parameters and postoperative morphology of open cranial vault remodeling (CVR) and endoscopic-assisted craniectomy (EAC) in the treatment of sagittal craniosynostosis. However, data on neurodevelopmental outcomes comparing these techniques is lacking. METHODS/STUDY POPULATION: Patients with repaired sagittal synostosis were enrolled from a single tertiary care center between five and fifteen years of age. Patients with any craniofacial syndrome (e.g., 22q11.2 deletion) or other medical conditions that could affect neurodevelopment were excluded. Neurodevelopment was measured using the Differential Ability Scale-II (DAS-II). The General Cognitive Ability (GCA) score was the primary outcome measure, describing overall intellectual ability. Secondary outcome measures were measurements of cephalic index (CI) from pre- and postoperative imaging studies. Family socioeconomic status (SES) was estimated using the Hollingshead index (total score, continuous). RESULTS/ANTICIPATED RESULTS: 26 patients [10 CVR (2 Female:8 Male), 16 EAC (6 F:10 M)] were studied. Mean age at repair was greater with CVR than EAC (15.5 ± 8.5 months vs 3.5 ± 1.3 months, respectively, p < 0.001). Mean age at DAS-II testing was 9.0 ± 2.2 years. Patients GCA scores were within the average range relative to test norms (CVR 95.7 ± 15.4 vs EAC 102.6 ± 17.4). After adjusting for SES and preoperative CI, group differences in GCA were modest and statistically nonsignificant (p = 0.646). GCA scores were associated with SES (p = 0.054) but not preop CI (p = 0.479). Differences between CVR and EAC were not statistically significant for any of the imaging parameters (pre and postop CI, pre to postop change in CI, or age at postop imaging; 0.131 <= p <= 0.867). None of the independent variables were significantly associated with postop CI (0.140 <= p <= 0.689). DISCUSSION/SIGNIFICANCE: Interim analysis of the preliminary data suggests no association between surgical procedure and cognitive and morphological outcomes at school-age in patients with sagittal craniosynostosis who underwent CVR versus EAC. Collection of data continues, with the goal to enroll 50 participants in each group by 2022.

Objectives/Goals: Glucagon-like peptide-1 (GLP1) use prior to bariatric surgery may represent a novel approach to treating obesity. The objectives of this study were to describe trends in pre-bariatric GLP1 use, investigate social and clinical factors associated with their use, and evaluate differences in clinical outcomes based on preoperative GLP1RA use. Methods/Study Population: Patients who underwent bariatric surgery at three Indiana hospitals from 2018 to 2023 were identified. Patients who utilized GLP1 in the year preceding surgery were compared to those who did not. Social determinants of health included insurance, income, and unemployment. Outcomes included rates of GLP1 use, 30-day postoperative readmissions, ED visits, and percent total weight lost (%TWL) at one year. Associations between preoperative GLP1 use and outcomes of interest were evaluated using multivariable logistic and linear regressions. Results/Anticipated Results: Of 2,169 patients who underwent surgery, 293 (13.5%) utilized GLP1 preoperatively. The rate of GLP1 utilization increased threefold from 2018 to 2023. Males were more likely to receive preoperative GLP1 (20.1% vs, 12.2%, p<0.001). There were no significant differences in social determinants of health or 30-day postoperative outcomes between patients who did and did not use GLP1RA preoperatively. Similarly, there were no significant differences in %TWL at one year postoperatively between groups (median 25.5% vs. 27.3%, coefficient: -0.78, 95%CI: -2.26–0.70). Discussion/Significance of Impact: Utilization of GLP1 in the year prior to bariatric surgery has significantly increased. Preoperative GLP1 use is not associated with worse 30-day outcomes or differences in %TWL at one year postoperatively. Further work is needed to evaluate whether GLP1 dosing and duration of treatment impact postoperative outcomes.

OBJECTIVES/SPECIFIC AIMS: (1) Determine person (sex, age, education level), environment (marital status, living alone, insurance), and health and illness (BMI, type of AF, comorbidities) characteristics that are associated with outcomes (QOL, symptom severity, and emotional and functional status). (2) Determine the association of symptom management strategies (ablation, cardioversion, and rate and rhythm control medications) and outcomes (QOL, symptom severity, and emotional and functional status). (3) Test person (sex, age, and education level) and environment (marital status, living alone, insurance) characteristics as moderators of the effect of symptom management strategies (ablation, cardioversion, and rate and rhythm control medications) on outcomes (QOL, symptom severity, and emotional and functional status). METHODS/STUDY POPULATION: AF patients (≥18 years of age) already enrolled in the PaTH study will be included. To date, 1026 total participants have been enrolled. Based on the enrolled participants, 92% (945) of our study population are Caucasian and 36% (362) are female. The age range of the enrolled participants is: 2% (16) 18−39, 4% (42) 40−49, 11% (108) 50−59, 33% (343) 60−69, 34% (353) 70−79, and 16% (162) 80+. Participants are recruited through in-person, email, phone, patient portal messaging and post mail techniques to ensure a representative sample. The PaTH study integrates electronic health record and insurance claims data with patient-reported outcome measures collected through online surveys. RESULTS/ANTICIPATED RESULTS: We hypothesize that sex, older age, low education level, living alone, absence of partner, absence of insurance coverage, high BMI, and a high number of comorbidities will be associated with lower QOL, high symptom severity, and low emotional and functional status. We further hypothesize that symptom management strategies will be associated with higher QOL, low symptom severity, and high emotional and functional status, and that these associations will be moderated by person and environment characteristics. DISCUSSION/SIGNIFICANCE OF IMPACT: The proposed research is an important first step in determining potential causes of person and environment differences in symptom severity. It will lead to tailored symptom management interventions for individuals most at risk for experiencing high symptom severity.

OBJECTIVES/GOALS: UNC-Chapel Hill’s CTSA implemented a community feedback session (CFS) service to help researchers gather actionable, authentic, and constructive feedback on their projects from community experts. Simultaneously, we conducted an ongoing, participatory evaluation process to improve the experience for researchers and community members. METHODS/STUDY POPULATION: Informed by the Community Engagement Studio model (Yoosten, 2015), a CFS is a 2-hour consultative session that includes facilitated discussion with community experts around topics or questions posed by a research team. UNC-Chapel Hill’s CTSA staff conducted 7 CFSs during the pilot phase of the service and collected evaluation surveys from researchers and community experts. We held a data party – a participatory evaluation method – to analyze and interpret survey data. Resulting recommendations were used to improve CFS materials and processes. We conducted 11 CFSs after the pilot phase, then analyzed survey data again to gauge improvement and make further adjustments to the service. We also surveyed researchers three months after their last CFS to assess the impact of community experts’ feedback on their studies. RESULTS/ANTICIPATED RESULTS: Since January 2022, 108 community experts have participated in 18 CFSs spanning 9 research projects. Data party interpretations of pilot evaluation data yielded several changes in service delivery; since those changes were instituted, all researchers have highly rated the service, unanimously recommending it to colleagues. Researchers praised well-structured sessions and productive engagement, citing direct benefits to their work and significant impact on recruitment processes 3 months post CFS. Community experts also echoed satisfaction, with 100% finding CFSs worthwhile and 95% desiring to participate again, emphasizing the sessions' supportive atmosphere. A community expert reported that the sessions 'made me feel seen and allowed for a greater understanding of what I have been dealing with.' DISCUSSION/SIGNIFICANCE: The CFS model allows research teams to elicit rapid and meaningful community input, which is key to improving research relevance and impact. Ongoing participatory evaluation of the service ensures continuous improvement, yielding more meaningful interactions and studies that reflect the perspectives of people affected by the research.

OBJECTIVES/SPECIFIC AIMS: Aim 1—estimate prevalence and associated characteristics of nonfatal, non-self-inflicted strangulation among women ages 18 and older who presented to a US emergency department between 2006 and 2013. Aim 2—explore care-seeking behaviors, the context of the care seeking, treatment expectations and perceived diagnosis in a sample of women ages 18 and older who present to a US emergency department and report being strangled by an intimate partner. Aim 3—merge and synthesize findings from both the quantitative and qualitative strands to provide a more complete understanding of post-strangulation emergency care of women. METHODS/STUDY POPULATION: This mixed-methods study will use a convergent parallel design, with a single phase of concurrent and independent data collection. Analysis of quantitative and qualitative data will be performed separately then compared, with main findings integrated during the interpretation phase and presented in a merged data analysis display. IRB review and approval will be obtained before initiating this study. Aim 1 will include a cross-sectional analysis of 2006–2013 Nationwide Emergency Department Sample (NEDS) data, from the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project (HCUP). NEDS is the US’s largest all-payer emergency department (ED) database, providing national estimates of hospital-based ED visits from ~120 to 135 million ED visits/year (weighted). For this study, we will examine data from patients meeting inclusion criteria with an International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM; Medicode, 1996) code of strangulation. For this strand, females aged 18 years or older who presented to a US emergency department between 2006 and 2013 will be included. The outcome variable will be non-fatal, non-self-inflicted strangulation, defined using at least one of the ICD-9-CM codes for strangulation. These codes are: 994.7 (“asphyxiation and strangulation”), E963 (“assault by hanging and strangulation”), E983.8 (“strangulation or suffocation by other specified means undetermined whether accidentally or purposely inflicted”), and E983.9 (“strangulation or suffocation by unspecified means undetermined whether accidentally or purposely inflicted”). Patients with a concurrent ICD-9-CM code for suicide attempt (E953, “Suicide and self-inflicted injury by hanging, strangulation and suffocation”) will be excluded, to minimize self-inflicted assault events. Aim 2 will employ a narrative descriptive approach, with semistructured individual interviews to gather more information about women’s experiences when engaging the health care system after being strangled. Medical records related to the strangulation event will also be reviewed for diagnostic codes and other nursing and/or medical notes that may relate to diagnoses, treatment and referrals. For this strand, women aged 18 years or older who present for care to an urban, academic ED will be recruited, purposely sampling those reporting strangulation as a reason for their visit. We anticipate interviewing ~20–30 women to achieve saturation of information. RESULTS/ANTICIPATED RESULTS: Data from the NEDS from 2006 to 2013 will be analyzed for prevalence and associated characteristics of women seeking care after being strangled. Individual interviews and medical record reviews of a small sample of adult women will be conducted to explore women’s in-depth experiences within the health care system. Results from both the quantitative and qualitative analyses will then be collectively compared and interpreted to better synthesize the evidence from this work. Convergent and divergent findings will be presented in a merged data analysis display (Creswell and Plano Clark, 2011). Qualitative data will be used to fill the knowledge gap remaining from the quantitative analysis, and to explain and contextualize some of the findings. Such integration will help expand the current limited evidence on care of strangled women, and will identify additional research questions that will guide future research in this area. DISCUSSION/SIGNIFICANCE OF IMPACT: To our knowledge, this study will be the first to explore this issue using a nationally representative sample of adult women who sought emergency medical care for strangulation analyzed in conjunction with a detailed qualitative analysis of strangled women’s experiences with the health care system. The resulting knowledge will be critical to informing clinical assessment, intervention and prevention efforts for this vulnerable population, as well as public policy and future research regarding this specific violence tactic.

OBJECTIVES/GOALS: Stress is amplified in parents of children with Down syndrome (DS). However, little is known about caregivers’use of coping strategies in relation to stress-related eating and their child with DS. The purpose of this study is to explore stressors and coping resources that increase or decrease stress-related eating among caregivers of children with DS. METHODS/STUDY POPULATION: This descriptive qualitative study sought to understand and describe the lived experiences of caregivers of children with DS. Fifteen caregivers of children, ages 2-6-years with DS, completed an online survey and individual interview. The Transactional Model of Stress and Coping was used to develop the interview guide and to assess related constructs using the Mindful Eating Questionnaire (MEQ), Perceived Stress Scale (PSS), Salzburg Stress Eating Scale (SSES), and a subscale of the Eating and Appraisal Due to Emotions and Stress Questionnaire (EADES). Interviews were audio-recorded, transcribed verbatim, coded using NVivo 12, and analyzed using deductive thematic analysis based on theoretical constructs and content analysis approaches. RESULTS/ANTICIPATED RESULTS: Thirteen of the 15 participants reported moderate to high perceived stress on the PSS. Stressors identified by caregivers included caring for a child with DS, feeding difficulties, physical and mental health, family and social interactions, and finances. Caregivers utilized various interpersonal resources to cope, including family, friends, and social media groups. In the interviews, stress-related eating was revealed as a coping mechanism for 9 caregivers. Also, 13 caregivers reported eating more or eating less when stressed on the SSES and 7 caregivers reported increased emotional eating as measured on the sub-scale of the MEQ. Only two caregivers described using mindfulness strategies throughout the interview. DISCUSSION/SIGNIFICANCE: Overall, caregivers of children with DS report increased perceived stress related to their role as a caregiver of a child with DS, which may be related to changes in caregivers’dietary intake. Dietary interventions developed for these families should include mindful eating and stress management strategies.

OBJECTIVES/GOALS: Caregivers often identify signs of autism in infancy but face multiple barriers when seeking specialized evaluations and subsequent services. This study sought to understand the experiences of families with early developmental concerns to identify acceptable and feasible strategies to support them during this period of uncertainty. METHODS/STUDY POPULATION: We interviewed 15 families participating in a larger longitudinal project developing telehealth assessments for infants with early developmental concerns. Interviews were conducted virtually following the final toddler-age assessment, and focused on caregivers’ experiences navigating early concerns, appropriateness of existing supports, and suggestions for future directions. Interviews were transcribed and coded across multiple passes, focusing on both phenomenological experience and frequency of specific supports mentioned. RESULTS/ANTICIPATED RESULTS: Core themes expressed across multiple included: (1) Uncertainty; (2) Navigating Supports; (3) Community and Connection; and (4) Information is Power. Caregivers also provided specific suggestions for addressing these areas. These included suggestions for parent coaching topics, modalities for sharing information with parents (e.g., group meetings, online modules), and research practices. DISCUSSION/SIGNIFICANCE: There have been recent efforts to develop pre-diagnostic interventions for infants, but few studies have investigated the needs and priorities of families during this period. Our approach can help bridge the gap between research and practice by identifying family priorities to target when developing interventions.