OBJECTIVES/GOALS: To evaluate whether a low cost, functional dynamic 3-D printed upper extremity (UE) orthosis could be designed, fabricated and used by children with cerebral palsy (CP) with severe unilateral UE involvement and the ability of common standardized instruments to assess its effectiveness. METHODS/STUDY POPULATION: Five patients, ages 13-17 years, with CP and unilateral UE involvement, MACS levels III-IV, were enrolled. Custom forearm thumb opponens orthosis and dynamic upper extremity orthosis (DUEO) were designed and fabricated by a multidisciplinary team for use during 8 one-hour occupational therapy sessions targeting bimanual UE training. Pre- and post-assessments included Assisting Hand Assessment(AHA), Melbourne-2(MA-2), Pediatric Motor Activity Log-Revised(PMAL-R), and PedsQL Measurement Model for the Pediatric Quality of Life Inventory: CP Module(Peds-QL). RESULTS/ANTICIPATED RESULTS: The 3D printed orthotic device is custom fit to the patient based on scans of their arm and is designed with a tensioning system that allows for functional usage of the arm. It incorporates a rigid polymer to provide support and flexible material for comfort where appropriate. Overall, higher post-treatment scores were found for the majority of participants using the custom orthotic. Four made minimal clinically important differences (MCID) in the AHA. Three met MCID scores in subtests of MA-2 (two positive and one negative). Patient-reported outcome improvements were found for PMAL-R for four, but only one met MCID and at least three reported improvements in more than one domain of PedsQL. DISCUSSION/SIGNIFICANCE: Children with CP may often present with UE impairment, yet current therapeutic orthoses only target the progression of contractures and are still limited by cost and discomfort. Our team designed and fabricated a functional, low cost, 3D printed orthosis that showed significant gains in UE function.

OBJECTIVES/GOALS: The molecular basis of increased risk of triple negative breast cancer in non-Hispanic Black women represents a critical knowledge gap that this research is designed to address; successful completion of this work could lead to better prevention, earlier stage diagnoses, and possible discovery of novel therapeutic strategies for this population. METHODS/STUDY POPULATION: We have recently generated a living tissue cohort of 11 non-Hispanic Black and 25 non-Hispanic White women who underwent breast surgery at Mayo Clinic. Gene expression profiling of normal breast tissue from this cohort has identified a pattern of gene expression differences that have been associated with the development of basal breast cancer and are also reflective of Hedgehog (Hh) signaling. We will identify protein-based biomarkers for Hedgehog signaling within normal breast tissue using immunohistochemistry methods. We will culture primary human mammary epithelial cells and further separate luminal and myoepithelial cells using flow cytometry to then decipher Hedgehog signaling. RESULTS/ANTICIPATED RESULTS: We anticipate identifying and localizing protein-based biomarkers for Hedgehog signaling within myoepithelial cells of non-Hispanic Black women. Using our findings, we aim to create a biomarker risk model for triple negative breast cancer and validate this model within a separate and larger cohort of women to predict breast cancer risk. DISCUSSION/SIGNIFICANCE: In addition to immediate benefits from improved risk prediction, the proposed work has the potential to provide new insight into the driving forces underlying basal breast carcinogenesis and the distinct biological differences that distinguish non-Hispanic Black women from non-Hispanic White women.

OBJECTIVES/SPECIFIC AIMS: Low-income, urban adolescents experience high rates of interpersonal and community violence and consequently post-traumatic stress disorder (PTSD). Memory theory purports that the development of PTSD can be explained by dysfunctional trauma cognitions, high sensory and poor articulation of trauma memories, and poor emotional regulation. The purpose of this paper are as follows: (1) to describe trauma experiences and PTSD symptoms of a high-risk sample of low-income urban youth and (2) to explore if post-traumatic cognitions, trauma memory quality, or emotional regulation means differ in participants screening positive for PTSD as compared with those that did not screen positive. METHODS/STUDY POPULATION: A preliminary sample of low-income, urban adolescents (ages 16–21) at risk for homelessness took a web-based, self-report survey responding to questions related to their experiences of trauma and mental health (n=48). PTSD was measured with the PTSD Checklist for DSM-5 criteria (PCL_5). A cut-off of 33 was used as a positive screen for PTSD. Post-traumatic cognitions was measured with the post-traumatic cognition inventory (pcti) with higher scores representing greater dysfunctions and negative cognitions. Trauma memory was measured with the Trauma Memory Quality Questionnaire (TMQQ) with higher scores representing more sensory-based and poorly verbalized memories. Emotional regulation was measured using the Difficulties in Emotional Regulation Scale (DERS) with higher scores representing greater difficulties with emotional regulation. All 3 variables conceptually represented theoretical constructs of the development of PTSD. Initial data from the baseline survey was used conducted a 1-way ANOVA to compare the difference in post-traumatic cognition, quality of trauma memory, and emotional regulation in those that screened positive for PTSD as compared with their peers. RESULTS/ANTICIPATED RESULTS: The majority of this population (80%) experienced at least 1 traumatic life event. This sample experienced an average of 10.5 lifetime traumas (SD=10.6). Of those experiencing trauma about 20% (n=8) reported a positive PTSD screen (PCL-5). There were significant group differences among those screening positive for PTSD and their peers in the following variables: (1) pcti (F1,24=10.43, p<0.004), (2) TMQQ (F1,29=11.02, p<0.002), and (3) DERS (F1,36=19.68, p=0.000). The majority of this population (80%) experienced at least one traumatic life event. This sample experienced an average of 10.5 lifetime traumas (SD=10.6). Of those experiencing trauma about 20% (N=8) reported a positive PTSD screen (PCL-5). There were significant group differences among those screening positive for PTSD and their peers in the following variables: 1) pcti [F(1,24) = 10.43, p<.004], 2) TMQQ [F(1,29) =11.02, p<.002], [F(1,36) =19.68, p=.000]. DISCUSSION/SIGNIFICANCE OF IMPACT: This sample reported high rates of trauma and PTSD. Constructs representing memory theory (cognition dysfunction, quality of memory, and emotional regulation) all significantly differed among participants with PTSD compared with their peers. Consequently, it may be useful for trauma interventions to target the maladaptive post-traumatic cognitions, quality of traumatic memories, and emotional regulation in this population. These results will inform work that aims to explore if a trauma intervention, based on the memory theory can improve PTSD symptoms. Anticipated data collection completion in March 2017 (n=120).

OBJECTIVES/GOALS: The time between lower extremity amputations and prosthetic acquisition profoundly influences patient rehabilitation and mortality outcomes. Our primary outcome was time to prosthetic acquisition following major limb amputation. We hypothesize that women face an increased time lag between amputation and prosthetic acquisition compared to men. METHODS/STUDY POPULATION: We used the 2015-2021 Truven Marketscan Medicare and Commercial Claims Administrative dataset to identify individuals with lower extremity amputations based on CPT codes. We excluded patients < 18 years old, those with prior/concurrent major extremity amputations, and those with <= 31 days discontinuity in enrollment. To estimate time to prosthetic acquisition after initial amputation, Weibull Accelerated Failure Time multivariable regression models were used to estimate unadjusted and adjusted time ratios and 95% confidence intervals comparing men to women. We adjusted models for age, Medicare supplement/commercial payer, Metropolitan Statistical Area (MSA), amputation type, social deprivation index, and Elixhauser comorbidities. RESULTS/ANTICIPATED RESULTS: We identified 4,054 patients with major lower extremity amputations (75% below knee and 25% at or above knee). Patients were predominantly male (72%). For patients who received prosthetics, 39.06% of men and 31.28% of women received prosthetics within the first three months of amputation (p<0.001). Time ratios > 1 indicated longer time to prosthetic acquisition between comparison groups. The adjusted time ratio for women compared to men for the time to acquisition of prosthetics was increased; this was statistically significant (TR 1.3281, 95% CI 1.1667, 1.5118). This time ratio suggests that if a man received a prosthetic in 100 days, a women would receive her prosthetic in 133 days. DISCUSSION/SIGNIFICANCE: We found a significant difference in the time to prosthetic acquisition following major limb amputation and acquisition rate in the first three months of amputation among men and women. Successful rehabilitation, quality of life, and healthcare costs are influenced by the timeliness of prosthetic acquisition.

Objectives/Goals: The Translational Science Benefits Model (TSBM) offers a key framework for demonstrating the real-world health outcomes of research. This study uses a mixed-methods approach combined with the TSBM to show how researchers from Case Western Reserve University’s Clinical and Translational Science Collaborative (CTSC) have advanced health equity or improved public health in the USA and globally. Methods/Study Population: Using the TSBM indicators, we surveyed 72 former CTSC KL2 Program trainees and 469 CTSC Pilot Program awardees for documented evidence that their research led to demonstrated health benefits. We used purposive sampling of the survey responses to obtain examples highlighting research that led to advances in health equity as well as international public health improvements. We conducted in-depth interviews with six investigators to assess the populations impacted and the scope of their contributions. For each investigator, we examined how their publications informed both national and international policy. Through this approach, we will present specific case studies highlighting research that led to advances in health equity as well as international examples of public health improvements. Results/Anticipated Results: Among KL2 Scholars, we achieved a 40% response rate (29/72), with 90% (26/29) reporting 86 significant benefits across the four TSBM areas. For Pilot Program awardees, 18.5% responded (87/469), with 40% documenting 136 benefits. Several different types of translational science benefits resulted in improved health and health equity for several diverse national and international beneficiaries, including racial and ethnic minorities (e.g., Blacks, Hispanics), potentially vulnerable populations (e.g., pregnant women, victims of intimate partner violence, individuals on Medicaid, infants), international populations (e.g., people from low-resource countries with genetic disorders or parasitic infections), as well as people from rural areas and professions at high risk of developing cancer. Discussion/Significance of Impact: Leveraging KL2 and Pilot Grant successes, the TSBM shows how research improves public health and health equity for underserved populations. It streamlines outcome reporting, enabling researchers to demonstrate their societal impact while providing funders and policymakers with clear, data-driven evidence of the value of translational science.

OBJECTIVES/SPECIFIC AIMS: To fulfill the Indiana Clinical and Translational Sciences Institute’s (Indiana CTSI) Community Health Partnerships’ (CHeP) mission of improving the health of Indiana residents through community-university partnerships, CHeP engaged with community partners to develop and implement a pilot award program for community-based participatory research, the Trailblazer Award (TA). The objective is to describe the engagement processes throughout the pilot program timeline and as the pilot program evolved over the 6-year period since the program started. METHODS/STUDY POPULATION: Though a process of engagement with community stakeholders, we assessed the process for each year of the TA, noting what changes occurred and how they occurred. Engagement for the TA process occurred during the following phases: RFA development, review, active project support, dissemination of project results, and project/partnership follow-up. RESULTS/ANTICIPATED RESULTS: During the RFA development phase, we decided to focus the award on health equity for 5 years; and we implemented structural changes to encourage new partnerships in underrepresented and rural areas. During the review phase, we incorporated both community and university reviewers and co-moderators. To increase capacity among our reviewer pool, we offered webinars and repeated opportunities to serve as reviewers. During the project support phase, we added the following: community-based CITI training; opportunities for networking with peer awardee teams; and community and academic co-led sessions on addressing recruitment barriers, grant writing, and dissemination to a community audiences. Through our active engagement of the CHeP Advisory Board, one Board member (from Indiana State Department of Health) leveraged matching funds for the TA, effectively doubling the number of projects supported each year. DISCUSSION/SIGNIFICANCE OF IMPACT: Whereas previous work has reported on engagement during the review process of pilot award applications, we discuss ways to extend engagement to include other aspects of a pilot program both before and after the review process. In our process, several key partners offered insightful changes that have resulted in a more engaged program.

OBJECTIVES/GOALS: The complex health profile of those supervised by community corrections places them at a greater risk of morbidity and mortality from social disruption, infection, and of substance misuse, relapse, and overdose. This study aims to explore individual and social determinants of SUD and treatment utilization for this population. METHODS/STUDY POPULATION: A secondary data analysis was conducted using an administrative database from the Department of Corrections of Puerto Rico (DoC-PR) that included individuals under community supervision between 2015 and 2018 (N=13,163). Two logistic regression analysis were performed to predict SUD and SUD treatment utilization. The predictors included in the models were: a) age, b) gender, c) civil status, d) education level, e) employment status, f) income, g) number of dependents, h) housing zone, I) type of crime, j) offender classification k) community sentence classification, and k) sentence duration. RESULTS/ANTICIPATED RESULTS: A total of 4,531 cases (34.4%) were identified with an SUD and of these 79.2% were enrolled in treatment. Significant predictors of SUD included a parole sentence (vs probation), commission of felony, decreasing sentence duration and recidivism. Significant demographic variables include, male, single, younger age, unemployed, residing in an urban zone and decreasing income. Significant predictors for SUD treatment utilization were a probation sentence, older age and residing in a rural zone. Mandated treatment may explain a higher likelihood of treatment utilization, yet prevalent modalities consist of residential abstinence based, non-professionalized services known to have poor treatment outcomes. The current data set does not include follow up data to assess changes in treatment utilization. DISCUSSION/SIGNIFICANCE: We should aim to prevent health and social disparities and risk of sentence revocation associated with interventions that lack evidence to support their effectiveness. Next steps should address challenges and opportunities for the adoption of EBPPs for individuals with an SUD under community corrections supervision.

OBJECTIVES/GOALS: The Penn State KL2 Career Development Program provides a comprehensive structured training and mentorship to junior faculty scientists (KL2 scholars). The goal of this study is to describe the perceptions of scholars after completion of the training and determine self-perceived impact of the program using exit interviews as a unique method. METHODS/STUDY POPULATION: Ten KL2 scholars (5 from each cohort of 2014 and 2017) participated in the evaluation. We used a descriptive qualitative design supplemented with quantitative data, to conduct an individual in-depth exit interview with each scholar to understand their perceptions on the impact of the KL2 program. Data were collected using a semi-structured interview guide developed by the program directors including scholars and a Likert scale survey. Thematic analysis of the data involved: reading and re-reading transcripts, identifying and categorizing keywords and phrases and developing overall themes that explained the processes within categories. In establishing rigor, two authors carefully coded, categorized and identified patterns and emerged themes which were also reviewed and confirmed by the other authors. RESULTS/ANTICIPATED RESULTS: Two sets of themes emerged. The main themes that described positive aspects of the KL2 program by scholars included: Interdisciplinary Collaboration, Mentoring, and Protected Time for Independent Research. Scholars also identified some contrary themes that included: Limited Access to Expenditures, Changes in Individual Mentorship Needs and Areas for Improvement. On a Likert scale (1- not at all, 10-extremely likely), scholars reported high positive influence of the KL2 program on their scope of research (8.7±0.52) and future career (8.5±0.70). They also found mentorship experience with primary mentor (9.6±0.22) and team (8.5±0.54) as well as peer collaboration (8.5±0.67) opportunities highly beneficial to their career and professional development. DISCUSSION/SIGNIFICANCE OF IMPACT: The qualitative study strengthens the reliability of data and scholar recommendations collected via other evaluation measures. Findings broaden understanding of the processes through which program outcomes are achieved effectively and where modifications are needed. An updated program for cohort 3 was guided by cohort 1 and 2 interview responses.

OBJECTIVES/SPECIFIC AIMS: Community stakeholder engagement along the translational spectrum of biomedical research has been identified as a potentially crucial factor for encouraging participation among underrepresented groups, improving research relevance, and adoption of evidence into practice. Although we have developed various methods to improve communication between researchers and community stakeholders, we have not focused much attention on the manner by which community stakeholders choose to communicate with researchers in scientific feedback settings. In our PCORI funded study using Community Engagement Studios to elicit feedback on research from community stakeholders, we found that feedback from participants was frequently provided in the form of stories. This presentation aims to describe these narratives, examine their function in the feedback process and consider how a focus on these narratives enhances our understanding of community engagement for clinical and translational research. METHODS/STUDY POPULATION: The present study comes from a larger randomized, controlled methodological study. We randomized 20 investigators seeking input on their research to either a Community Engagement Studio (a panel of community members or patients) or a Translational Studio (a panel of researchers). Any faculty member or research trainee at Vanderbilt University or Meharry Medical College was eligible to participate. Each Studio panel was convened to provide project-specific input. The 153 stakeholders who participated in CE Studios were patients, caregivers, or patient advocates identified by health status, health condition, or demographic variables based on the project-based needs of the 20 researchers randomized in this project. Stakeholders include individuals with diabetes, heart failure, Parkinson’s disease, sickle cell disease, and ICU survivors. All stakeholders had experience as a partner or consultant on a research project or through serving on a research advisory board or committee. All Studios were recorded and transcribed, and experienced qualitative researchers analyzed the data. For this paper, we focus on the narrative feedback in the form of stories elicited in the CE Studios. Using qualitative methods, we coded the transcripts from the 20 CE Studios to identify stories and their functions in the feedback. Stories were defined as narratives with (a) at least one actor (b) action that unfolds over time, and (c) a realization, destination, or conflict resolution (i.e., a point of the story). For example, “I refilled my mother’s pillbox on Sunday and on Friday I found the pillbox still completely full” would be a story, however, “my mother doesn’t take her meds correctly” would not. We coded the stories for how they facilitated communication in the Studio using an open-coding style, that is we did not apply a specific theoretical framework of interaction or communication. It was possible for any given story to have more than one code applied to it; that is they were not classified in a mutually exclusive way. RESULTS/ANTICIPATED RESULTS: We found 5 major functions of stories in the Studios. Basic sender-receiver functions were noted, including responding to queries and seeking mutual understanding. The other functions served to move or add to the conversation, including adding expansion and depth, characterizing abstract concepts, and providing context, with the latter being the most frequent function of stories. Speakers provided context in a wide variety of dimensions, ranging from the context of the body to spatial and institutional contexts. These stories served to help others understand the speakers’ lived experiences. DISCUSSION/SIGNIFICANCE OF IMPACT: We often engage community members in research for their expertise with regards to their lived experiences as patients or community members, and for their experiences of healthcare and social determinants of health in particular community contexts. Yet we may expect them to share their expertise in a manner that is consistent with a scientific, explanatory framing and language. However, we know there is a difference in the way that professional researchers discuss research Versus how community members discuss research. In our PCORI study, we found that our Community Studio participants relied on storytelling as an important means to communicate their lived experiences. Their stories were often key to communicating the complex contexts of their experiences. We focus on examining these narrative practices and their functions in how community members engaged with and provided advice to researchers. This understanding may help us in: (1) Characterizing the contexts, processes, and meanings associated with community stakeholder experiences that are otherwise difficult to access. (2) Identifying community priorities relevant to research that are embedded in community narratives to better align research priorities with community needs and to improve patient outcomes. (3) Collecting insights for improving the design of community engagement activities in research. (4) Harnessing more fully the potential of community engagement in research.

OBJECTIVES/GOALS: The North Carolina Translational and Clinical Sciences Institute (NC TraCS) supports faculty and staff in carrying out clinical and translational research at UNC-Chapel Hill. To better understand customer satisfaction and impact, a survey was administered among NC TraCS users. METHODS/STUDY POPULATION: NC TraCS has 13 program areas that range from Biostatistics to Community and Stakeholder Engagement. These programs provide services to faculty, staff, students, and outside researchers in the area of clinical and translational science. A customer feedback survey was administered in Spring 2019 to anyone who had used at least one NC TraCS service between March 1st, 2017 and February 28th, 2019. A total of 856 survey invitations were sent. The survey included questions around users’ perception of the ease of access, helpfulness, outcome, and promptness of the services received using 6-point Likert scale. The survey also addressed career impact, communications, and suggestions for improvement. RESULTS/ANTICIPATED RESULTS: We received 268 responses, (31% response). Majority of respondents were satisfied with Overall Helpfulness (95%), Outcome of Service (96%), Ease of Access (93%), and Promptness of Service (90%). They also noted that their careers had at least slightly improved in the following areas: Mentorship (76%), Research Methods (75%), Skill Development (77%), Research Direction (71%) and Collaboration (80%). Furthermore, 96% responded positively to returning to TraCS. The feedback received was shared with service administrators and NC TraCS leadership to identify areas of improvement and further strengthen their services. Concerns, when present, were addressed by service directors or the overall PI’s. DISCUSSION/SIGNIFICANCE OF IMPACT: Need to communicate expectations to customers the expected turn-around time for help emerged as a clear take-away. In response, TraCS leadership is working to improve staffing and workflows for efficient service delivery including expectation management, especially among the most popular services.

OBJECTIVES/SPECIFIC AIMS: Verbal communication is a critical component for professional development and leadership. Yet, many clinical translational scientists lack the skills in communication of their scientific work in a meaningful and exciting manner that conveys the potential impact of their work on human health to the lay public, stakeholders, and to other scientists in different fields. We hypothesized that formal communication training could improve information transfer by trainees that would enhance their career development. METHODS/STUDY POPULATION: We therefore formalized a program for the KL2 scholars at the Ohio State University Center for Clinical and Translational Science that provided training from communications experts to develop a short, concise, and relevant talk about their field of research to general audiences. The program was a hybrid of workshop and individualized training. It culminated in each of the six scholars presenting public talk at the OSU STEM research dissemination and outreach space, the STEAM Factory. The scholars were administered a survey to assess their knowledge of the concepts presented in the training prior to and following the receiving the treatment, as well as their overall assessment of the experience. RESULTS/ANTICIPATED RESULTS: The poster will present the positive results of this evaluation and the impact of the training on the KL2 scholars. DISCUSSION/SIGNIFICANCE OF IMPACT: The poster explain the training as a model that other CTSA KL2 programs could adapt for their trainees.

OBJECTIVES/GOALS: All IN for Health’s Advisory Board is an active board providing advice on strategic directions, feedback, contributing ideas, and accountability. Most recently, the HAB had 4 openings. A call to our community of over 13,000 individuals was published. We received 488 applications. We share the lessons in motivations and interests shared respondents. METHODS/STUDY POPULATION: Four hundred eighty-eight individuals submitted applications for participation in the All IN for Health Advisory Board. The call went out to the All IN for Health volunteer research network comprised of community members across the state.The call mentioned a nominal compensation of $50/hour, and time commitment of a 2-hour board meetings via video conferencing every 3 months. The application process included the following questions: 1. What lived experiences and/or personal interests have motivated you to be involved in All IN for Health? 2. Please explain why you are interested in being an All IN for Health Advisory Board member? RESULTS/ANTICIPATED RESULTS: We organize the findings in two categories: Motivation and Interests. The motivation category refers to individual’s motivation to be part of the All IN for Health initiative. Interest category referred to individual’s specific interest in participating in the All IN for Health Advisory Board. Individuals were motivated to participate based on (1) family or friend diagnosis, (2) personal diagnosis, (3) roles as caregivers, (4) desire to impact change and advocacy, (5) role as health professional, and (6) previous participation in research. Interests followed similar themes with additional categories of sharing their experience, previous research and board experience, as well as a desire to educate future generations of researchers. DISCUSSION/SIGNIFICANCE: We share the narratives honoring individual stories for the top three motivations and interest. This information can be used for recruitment to boards, research participation, and healthcare advocacy, and highlights importance of sharing successes and challenges to the processes of forming and sustaining effective boards.

OBJECTIVES/GOALS: Heart failure is a public health problem. Currently, heart failure affects 2-5 % of adults within the age of 65-75 years. (Mosterd & Hoes, 2007)Moreover, rates of hospitalization and rehospitalization among patients with heart failure are high and are associated with poor quality of life(Dunlay et al., 2011)Unsurprisingly, studies have found that poor quality of life is linked to decreased physical activity and increased symptomatology, a perception that can quickly change depending on the patient’s mood. Factors such as age, cultural background, socioeconomical status, ethnicity, and gender are highly correlated with quality of life but have not been studied thoroughly. Quality of life assessment in Puerto Rican Hispanics living with heart failure is non-existent. Objective:•To determine gender-specific differences in quality of life for patients hospitalized due to heart failure in Puerto Rico.•To correlate heart failure symptoms, presence of depression and level of perceived quality of life in Puerto Rican patients hospitalized due to heart failure METHODS/STUDY POPULATION: We will recruit patients admitted with heart failure (n = 300) to the Cardiovascular Hospital of Puerto Rico and The Caribbean between 2019-2021. In the first aim, we will implement the Minnesota Living with Heart Failure Questionnaire to assess the quality of life of Puerto Rican Hispanics diagnosed that life with heart failure and the short form-36 (SF-36) for a generic quality of life assessment. For the second aim, we will provide two instruments: The Geriatrics DepressionScale QuestionnaireShort Form (GDS-SF)and the Memorial Symptom Assessment ScaleShort Form (MSAS-SF) to assess the presence and severity of depression and multiple general symptoms RESULTS/ANTICIPATED RESULTS: We expect that women living with heart failure will have worse quality of life and higher NYHA scale and NT-pro-BNP. DISCUSSION/SIGNIFICANCE OF IMPACT: This contribution is significant because it can clarify the specific risk factors in the Puerto Rican community that are associated with lower quality of life among patients suffering from heart failure. This, in term, can allow physicians to identify which population of HF patients is at risk,and have strategies to improve quality of life

OBJECTIVES/SPECIFIC AIMS: As part of a larger effort to create a longitudinal record of care for patients with chronic kidney disease (CKD) in Delaware, we assessed transitions of care from pediatric to adult care. This study examined the length of time between last pediatric contact and first contact in the adult system in order to determine characteristics associated with delayed transition to adult care. METHODS/STUDY POPULATION: Patients who receive pediatric care at the Nemours/Alfred I. duPont Hospital for Children (Nemours) are transitioned to adult care between the ages of 18 and 21. Our study population consists of all patients seen in the Nephrology unit at Nemours for CKD, hypertension (HTN), or diabetes who turned 21 years old between 2007 and 2013. Records of office visits from Nemours, Christiana Care Health System (CCHS), and Nephrology Associates, P.A. (NAPA) were transformed into the OMOP common data model and merged. Patients who had at least 1 record in the Nemours EHR of pediatric care before age 21 and had at least 1 record in the CCHS or NAPA adult EHRs were considered transitioned. To identify characteristics associated with delayed transition to adult care, we compared gender, race, ethnicity, age, comorbidities, and level of kidney function at the last pediatric visit between patients whose transition gap was less than 1 year and patients whose gap was 1 year or more. Kidney function was estimated by calculating glomerular filtration rate (GFR). Nemours estimates GFR in children using the revised Schwartz equation, which is based on serum creatinine and height. To calculate adult GFR, we used the CKD-Epi equation, which is based on serum creatinine, age, sex, and race and is widely used to derive adult GFR. As kidney function declines, GFR decreases. We used Fisher exact test to compare categorical variables and t-test to compare age and GFR. RESULTS/ANTICIPATED RESULTS: We found only 109 (25%) patients who had records in our adult offices out of the 440 Nemours patients in our data set. Of the 109 transitioned patients, 54 had office visits at CCHS, 37 at NAPA, and 18 at both locations. Examining the office visits of the 109 transitioned patients, 34 (31%) had an overlap in visits defined as an office visit at CCHS or NAPA before the last office visit at Nemours, and 75 (69%) did not have an overlap. The median gap between last pediatric and first adult office visit for the 75 patients without an overlap was 615 days (range 8–3495 d). Only 6 (6%) of the 109 transitioned patients had overlapping GFR measurements from pediatric to adult care, and all of the adult GFR calculations (CKD-Epi) were greater than the pediatric GFR calculations (Schwartz). The difference between child and adult GFR ranged from 8.2 to 87.1 mL/minute per 1.72 m2. DISCUSSION/SIGNIFICANCE OF IMPACT: During the transition from pediatric care to adult care, many young adults with CKD experience declines in health outcomes and comorbidities such as diabetes and HTN complicate self-management. Lack of overlap between pediatric and adult care office visits indicates a delay in executing this transition. In our population of 109 transitioned patients, 69% did not have an overlap in care, and 50% of those without overlap had a gap of more than 615 days (1 y, 8 mo). Our analysis suggests that young adults who are younger at last pediatric office visit are more likely to delay transitioning to adult care. Transitioning from the nurturing environment of pediatric care to adult care is a complex process and could be challenging for young adults with CKD. Transition clinics may be necessary to improve the coordination of care and help these young adults keep their physician appointments.

OBJECTIVES/GOALS: COVID-19 disproportionately impacts rural communities of color. Socioeconomic status, occupation and chronic illnesses lead to worse COVID-19 outcomes. This study identifies motivators and barriers of COVID-19 vaccine uptake in the Latino and Flathead Reservation agricultural communities. METHODS/STUDY POPULATION: Thirty key informant interviews and 6 focus groups (N=39 focus group participants) were conducted with community and tribal leaders using an interview guide informed by the Theory of Planned Behavior, Social Cognitive Theory, and the Social Contextual Factor Frameworks. The interview guide was designed to understand the motivators and barriers of COVID-19 vaccine uptake. The Community Advisory Board, community investigators and community health workers from the community reviewed and revised the guide. A codebook applied deductive coding to informant responses, followed by an inductive, constant comparison approach. Three analysts met to refine the codebook and conduct inter-rater agreement. RESULTS/ANTICIPATED RESULTS: Participants from Flathead reservations and Yakima frequently noted a desire to protect one’s self, family and elders. This significant motivator encouraged individuals to receive the COVID-19 vaccine, despite sincere vaccine concerns and government rollout. Barriers included concerns regarding rumored, serious or rare side effects, speed of vaccine development and misinformation. Key differences exist between both communities. Yakima participants noted religious concerns and ID requirements as major barriers. Flathead reservation participants noted distrust and historical trauma of the U.S. government and issues with access (e.g. transportation, technology). DISCUSSION/SIGNIFICANCE: The pandemic disproportionately impacts vulnerable communities in agricultural settings. Participants in both communities felt vaccine availability had outpaced uptake. Clearly, culturally sensitive education and respectful communication would be key in addressing vaccine concerns and improving vaccine uptake.

OBJECTIVES/GOALS: The Appalachian Translational Research Network (ATRN) Newsletter provides a unique platform that facilitates communication among Appalachian-serving CTSAs/CTSIs and partnering academic and community organizations that strengthens research efforts and advances translational science across the region. METHODS/STUDY POPULATION: Published biannually, each ATRN Newsletter features content submitted by ATRN member universities and organizations. Members of the Communications Committee, who represent both CTSA- or non-CTSA- affiliated ATRN member institutions, provide as well as review and edit content for the Newsletter. Regular features include researcher and community member spotlights; funding opportunity announcements; information on upcoming seminars, trainings, and special events; and opportunities for collaborations among partnering ATRN institutions. Complementing regularly scheduled Newsletters, special editions are released as warranted, such as a special COVID-19 focused edition published in 2020. RESULTS/ANTICIPATED RESULTS: First published in 2012, the ATRN Newsletter initially represented founding ATRN institutions, the University of Kentucky and the Ohio State University CTSAs, and a readership of 50. Reflecting ATRN growth that now represents 9 academic centers including NCATS- and IDeA-funded hubs, affiliated universities and partnering organizations, readership has grown to include 500 subscribers from across the U.S. and 3 other countries. With the establishment of the official ATRN website in 2019, the ATRN Newsletter became a prominent addition, providing ATRN members’ access to both new and archived editions, thereby expanding reach and further strengthening critical communication across the Network. DISCUSSION/SIGNIFICANCE: Providing a vehicle for communication that supports ATRN collaborations and networking, the Newsletter is foundational to the success of the ATRN mission to improve health outcomes across Appalachia by fostering collaborative inter-institutional and community-academic research partnerships.

Objectives/Goals: Our objective is to examine patient and community perspectives on hospital actions that signify accountability to healthcare equity; part of our overall goal is to identify equity measure concepts representative of community perspectives and priorities for future hospital accountability programs. Methods/Study Population: We conducted a qualitative thematic analysis of secondary data – 32 focus group transcripts from our hospital’s Community Health Needs Assessment (CHNA). A tri-annual CHNA is required of nonprofit hospitals to maintain tax exemption. Diverse participants were recruited from our hospital’s large catchment area. Coding focused on responses to 6 pertinent questions. We adapted the National Committee for Quality Assurance, “Health Equity Measurement Framework for Medicaid Accountability” which consists of 5 domains (access, clinical, experience, structure, and social) to guide the development of our a priori coding tree and subsequent analysis. Two coders double-coded 25% of transcripts. The multidisciplinary research team, including community partners, met iteratively to extract and refine themes. Results/Anticipated Results: We organized our analysis by our conceptual framework’s 5 measurement domains. The “access” and “experience” domains were the most salient for participants. We defined “access” by four sub-domains: financial access, physical access, communication access, and navigability; and “experience” by two subdomains: inclusivity and accomodation. Beyond discussing concepts within these measurement domains, participants debated the “scope” of the hospital’s role with regard to healthcare equity. While some did not think “it was the hospitals” responsibility to give people access to good jobs or fair pay, education…, “other participants felt that healthcare involves not just addressing peoples’ physical health but. their housing… because how can someone take care of their health when they are homeless?” Discussion/Significance of Impact: When asked about hospital accountability to healthcare equity, “access” and “experiences” of care are the most salient measurement domains for patients and communities. The “scope” of the hospital’s role is debated. Policy and health system leaders can apply these perspectives to equity measurement initiatives.

OBJECTIVES/GOALS: Perioperative surgical care is team-based with close partnership between surgeons, residents, advanced practice professionals (APPs), and others. The objective is to develop an understanding of the current state and implementation needs required for APPs to engage surgical patients in advanced care planning (ACP) to promote goal concordant care. METHODS/STUDY POPULATION: We will conduct a mixed methods evaluation of ACP knowledge, attitudes, and beliefs amongst surgical APPs to identify barriers and facilitators of APPs engaging in a team-based approach to engaging surgical patients in ACP. We will conduct an online survey and qualitative interviews in the following 4 domains: 1) knowledge, skills, and attitudes about engaging in ACP with a patient or their surrogate decision maker during their perioperative care; 2) prior ACP-specific education; 3) experiences conducting ACP discussions with patients; and 4) perceived training needs to increase ACP uptake and documentation. The findings will provide the foundations to design team-based interventions focused on addressing the barriers and inform training and coaching needs to develop expertise and comfort in the ACP process. RESULTS/ANTICIPATED RESULTS: We expect variability in the knowledge, skills, attitudes, and experiences with the ACP process. We anticipate gaining a better understanding of the educational materials best suited to support APPs as they begin engaging patients in ACP. Possible barriers to APP-led ACP discussions include inconsistent role delineation, uncertainty about the value of pre-operative vs. post-operative ACP discussions, lack of experience engaging in ACP discussion, and lack of familiarity with electronic health records ACP tools. Possible facilitators of APP-led ACP discussions may be related to past work experience settings, exposure to ACP in educational preparation, hands-on observation of value of ACP in surgical patients and influences from attending and residents. DISCUSSION/SIGNIFICANCE: While current ACP research in surgery focuses on physician-led patient engagement in ACP discussions, there is a paucity of research focusing on how to develop a team-based approach to ACP discussions in surgery. This study will provide information necessary for the development of interventions that increase team-based ACP for surgical patients.

ABSTRACT IMPACT: Our work is demonstrative of the value embedded in community engagement as a vehicle to facilitate and expand the focus of translational research. OBJECTIVES/GOALS: To develop a community-informed recruitment process for a population-based DNA integrity longitudinal study aiming to document the average amount of DNA damage as well as DNA repair capacity in a cohort of community-dwelling individuals. METHODS/STUDY POPULATION: The three-member Community Engagement team (CE Team) partnered with a ten-person Community Advisory Board (CAB) to develop recruitment procedures and materials. Through an iterative process taking place over 13 meetings, CAB members answered questions about community context, appropriate recruitment approaches, and tone of communication with potential study participants. They also collaborated in the creation of outreach materials, informational booklets, and the informed consent document. The CAB’s input was recorded in meeting notes that informed successive versions of the materials. The CE Team held post-meeting debriefs to develop consensus on lessons learned and next steps. RESULTS/ANTICIPATED RESULTS: CAB input generated a five-step recruitment process. It informed approaches to communications with potential participants and resulted in a set of printed recruitment materials. Furthermore, the CAB pushed the CE Team and laboratory scientists to think beyond study participation to a comprehensive view of respectful engagement including notification of elected officials and other community institutions. By sharing personal anecdotes and asking how this study would reflect their lived experiences and/or contribute to their communities, CAB members inspired the university team to recognize the environmental context that may underlie DNA damage in residents of an underserved community. DISCUSSION/SIGNIFICANCE OF FINDINGS: The CAB was very effective in generating tools for recruitment. Moreover, CAB members provided insights beyond those originally sought by the CE Team, regarding broader engagement and a focus of future research relevant to the needs of both the community and the university researchers.

OBJECTIVES/SPECIFIC AIMS: The goals of this project are to: (1) Help research teams better understand, anticipate, and adapt research to address the needs of diverse communities. (2) Help clinicians and researchers develop patient-centered communication skills needed for more frequent and meaningful engagement of research participants. (3) Identify additional service support needs of clinical research teams not currently offered by other centers (e.g., translation services by certified translators, access to bilingual/bicultural research staff) so they can effectively recruit diverse communities. METHODS/STUDY POPULATION: Mixed methods evaluation approaches centered on obtaining community and academic input aimed at revising the tool to enhance its feasibility and relevance. Round one of focus groups were conducted (4), 2 with a diverse group of community stakeholders, 2 with a diverse group of academic stakeholders. Focus group feedback guided HLCR Assessment Tool revisions. This round of focus groups, served as an opportunity for community and academic stakeholders to discuss shared and divergent priorities related to the development and utilization of the tool. Feedback from these sessions guided a second set of revisions to the tool. Brief surveys were administered at each time point to gather participant demographic data. For the first round of focus groups with community stakeholders, 2 diverse groups totaling 19 people participated (11 female, 7 male, 1 no answer; 6 Asian/Pacific Islander, 6 Black/African American, 4 Latino/Hispanic, and 3 White/Caucasian). Participants served a variety of populations including seniors, youth, underserved, Muslim Americans, Bangladeshi, Arab, South Asian, refugees, community health centers, service organizations, 1st generation students, Latinos, multi-ethnic groups, limited English speaking, people with lupus, un/underinsured, people with HIV, Korean Americans, African Americans, and the disability community. Data pending on the first round of focus groups with academic stakeholders. All participants of the first round of focus groups will be invited to return to a second round of focus groups (2), this time only 2 groups will be held, and these will combine community and academic participants in each focus group. RESULTS/ANTICIPATED RESULTS: Along with formatting and grammatical revisions, recurring recommendations focused on considerations/clarifications in 3 main areas: compensation for all stakeholders, developing a common language and clarifying terms, and aligning the research process with the community. Considerations around compensation was mentioned in discussions related to multiple tool domains. In particular, community stakeholders recommended inclusion and consideration of compensation not just for research participants but also community partners, sites, community representatives, and other academic partners. It was also very important to make sure the form of compensation for both community partners and participants aligns with what was being asked of them. Community stakeholders sited a few examples where they were involved in studies where the time and requirements for participation were not commensurate with the compensation they received or the study budget did not include compensation for community partner effort. Along with edits to questions in the HLCR Assessment Tool, community stakeholders also recommended education for budget/finance personnel on fair compensation for research participants and community partners. In both focus groups, there was also confusion around specific terms and an identified need to develop a common language and clarify terms among all those involved in the research process. More specifically, terms such as community, culture, community of focus, community partners, accessible, and convenient were identified as needing further definition or clarification. Through the focus groups, we learned the valuable lesson that it cannot be assumed broad terms or even seemingly specific ones will be interpreted the same by everyone or have the same meaning in different contexts. Therefore, it needs to be very clear what these terms mean and who or what they represent. Finally, the community stakeholders emphasized throughout both focus groups the importance of making sure that the HLCR Assessment Tool unpack and explicitly emphasize how the research process can align and should align with community needs, communication structures, influencers, and assets. Some factors community stakeholders suggested be considered were: (1) Where the researcher is in the research process; (2) How community members prefer to communicate with each other; (3) Stigma/biases (e.g., class) that may be pervasive in a particular community; (4) Identification of key community influencers/gatekeepers; (5) Learning about a community’s assets along with their needs. DISCUSSION/SIGNIFICANCE OF IMPACT: Currently, there is dearth of resources focused on increasing diverse engagement in clinical and translational research, and consequently, research teams have little or no knowledge or support for how or when to engage community partners in clinical or translational research. The goal of this project is to help fill that gap with a tool to guide clinical and translational research teams in assessing the health literacy and culturally responsive components of their research projects to improve recruitment of diverse populations. Feedback on the first iteration of the HLCR Assessment Tool helped us identify the priorities for community stakeholders and better understand their concerns and needs around engagement with academic partners in clinical and translational research. This understanding will help us enhance the relevance and usefulness of the HLCR Assessment Tool so that clinical and translational science researchers more effectively engage with community partners and help ensure the community’s needs are better aligned with. Therefore, developing and pilot testing this tool can offer a significant opportunity for clinical and translational sciences institutions to enable their researchers and their teams to teams better understand, anticipate, and adapt to the cultural and health literacy needs of diverse populations. More specifically, this tool can: (1) Help clinicians develop the patient-centered communication skills needed to facilitate more frequent and meaningful engagement of potential research participants during medical visits to truly make every healthcare encounter an opportunity for research. (2) Help clinical and translational sciences institutes identify additional service support clinical research teams will need access to in order to effectively recruit diverse communities, that are not currently not supported [e.g., translation services by certified translators, access to bilingual/bicultural research staff at all level (i.e., study coordinators, research assistants, etc.), etc.].