OBJECTIVES/GOALS: In a previous genome-wide association study of European Americans, rs12772424, a variant in the gene encoding transcription factor 7-like 2 (TCF7L2), was shown to have a SNP-BMI interaction association with bipolar disorder (BD). The objective of this study was to replicate this finding in an African American (AA) sample. METHODS/STUDY POPULATION: Using a sample of 659 controls and 323 BD cases from the Genetic Association Information (GAIN) Study of BD, we conducted analyses to assess association between BD and the interaction of BMI with genetic variation in TCF7L2. For this study we identified 4572 single nucleotide polymorphisms (SNPs) in a 1Mb region around the candidate SNP rs1272424. Based on variants identified in the prior analysis of the larger European American dataset we selected SNPs for analysis in the AA data. This allowed for a smaller AA sample, and still maintained adequate power for statistical significance. RESULTS/ANTICIPATED RESULTS: We anticipate observing an effect of TCF7L2 variation on the relationship between BD and BMI in the AA data. We also anticipate that combining results from the European and African American patients may help narrow down potentially functional variants in TCF7L2 that influence the association between BD and BMI. DISCUSSION/SIGNIFICANCE OF IMPACT: Psychiatric genetics studies lack ancestral diversity among participants, decreasing their generalizability, and possibly increasing health disparities, especially for diseases like BD, which is often misdiagnosed and untreated in AAs. This work propels us towards understanding the genetics of BD and obesity in this underrepresented population.

ABSTRACT IMPACT: We review our strategy to use live community events on Facebook to share health and clinical research information and share further steps to increase engagement. OBJECTIVES/GOALS: To describe the use of live community events to enhance communication about clinical and health research through a Facebook platform (MN Research Link) with diverse social media users. The project identified variables associated with video engagement and strategic implications. METHODS/STUDY POPULATION: From June 2019 to November 2020 we streamed 31 events on the MN Research Link Facebook public page. Events highlighted different investigators’ clinical and health research in the areas of mental health, health and wellness, chronic diseases and immunology/infectious diseases. Facebook analytics were used to determine the number of views, total minutes viewed, average video watch time, and audience retention. Engagement score was calculated as the total number of interactions (likes, shares, and comments) divided by total number of followers (N=1437), expressed as a percentage RESULTS/ANTICIPATED RESULTS: Events averaged 24secs/16 min (SD=0.4). A mean of 1.61 (SD=1.28) followers viewed the events live but an average of 417.52 (SD=793.50) followers viewed after the event posted. The average engagement score was 1.1%. Mean total minutes viewed for all 31 videos was 253.5 (SD= 437.6). Viewers spent an average of 17 seconds (SD=0.01) watching each piece of video content. On average 28 followers viewed the events for at least 1-minute event (SD= 48.7). Audience retention at the halfway point for each video was 15.74% (SD=0.19). DISCUSSION/SIGNIFICANCE OF FINDINGS: Results suggest that novel approaches are necessary for active engagement. Promotion of live events is recommended to increase participation and length of engagement. Prior length of engagement (average 17 seconds), suggests refining video introduction will increase engagement.

Objectives/Goals: To assess the impact of the MATCH Program on mentees and mentors over the years, we have surveyed both groups on the effectiveness of the mentorship process, how the MATCH program influenced mentees’ future career plans, and their ongoing interest in clinical research. Methods/Study Population: To evaluate impact on mentees and mentors in the most recent cycle, we fielded two program evaluation surveys, for mentors and mentees. The surveys were distributed and collected using Qualtrics in May 2024. The mentee survey collected data on relationship with mentors, quality of mentorship, future career/education plans, and self-assessment of the program impact. The mentor survey collected data on relationship with mentees, mentees’ engagement, and a self-assessment of the program impact. Qualitative analysis was conducted to determine key themes expressed by participants. The responses were compared to assess the effectiveness of the mentoring relationship from both parties. Results/Anticipated Results: Respondents included 15/20 (75%) mentees and 15/20 (75%) mentors. All mentees (100%) and mentors (100%) stated they would like to continue their relationship outside of the program. The majority of mentees 13/15 (87%) and mentors 13/25 (87%) also viewed their mentee/mentor relationship to be excellent or good. Most mentors 10/15 (67%) stated it was their first time serving as a mentor for the program. Mentees also found their experience in the program very beneficial with 6/15 (40%) stating that MATCH changed their career plans. In addition, most mentees 14/15 (93%) indicated that they are community college or four-year college/university bound. Most mentees 11/15 (73%) indicated an interest in pursuing a health or medical career. Also, 10/15 (67%) mentees stated an interest in pursuing a career in research. Discussion/Significance of Impact: Both mentees and mentors have benefited from the program’s daisy chain mentoring and the program has helped facilitate a potential lifelong mentorship between mentees and mentors. The program also demonstrates promise of developing a pre-health pathway for historically underrepresented students in STEM.

OBJECTIVES/GOALS: To assess barriers and recommendations for improving delivery of care for chronic obstructive pulmonary disease (COPD) in rural clinics, we assessed COPD care metrics and obtained perspectives of primary care providers (PCPs) who practice in rural clinics. METHODS/STUDY POPULATION: Quantitative retrospective analysis of patients with COPD using VA data. We included patients whose primary care clinic is located in a rural VA Midwest Health Care Network (HCN) facility and quantified binary measures for receipt of: spirometry, pulmonary specialty care, and optimal inhaler therapy (regimen with LAMA or LABA monotherapy) Qualitative semi-structured individual interviews of PCPs (physicians, nurse practitioners, and physician assistants) whose clinics are located in a rural VA Midwest HCN facility. We elicited perceived barriers to and recommendations for receiving spirometry, pulmonary specialty care, and optimal inhaler therapy from PCPs. RESULTS/ANTICIPATED RESULTS: 6,350 rural patients had a new diagnosis of COPD in 2016-2019. 48.4% had spirometry, 14.4% had pulmonary encounters, and among patients who were prescribed long-acting inhaler therapy, 48.8% received optimal inhaler regimens. Rural PCPs (n=14) highlighted lack of access to spirometry, pulmonary specialty care, and clinic staff support in local clinics and suggested: 1) leveraging the expertise of pharmacists in COPD management and 2) improving access to resources, including use of telehealth technologies. DISCUSSION/SIGNIFICANCE: Less than 50% of rural COPD patients received recommended diagnostic testing and therapy. Resource limitations in rural clinics were the main barrier. The main recommendation was to leverage pharmacists’ expertise in COPD care. These findings provide a pathway forward to improving rural COPD care.

OBJECTIVES/SPECIFIC AIMS: Develop a plain language informed consent template that met IRB and regulatory requirements. Evaluate the effectiveness of the template at improving the readability of informed consents. Field test the informed consent with low health literacy. METHODS/STUDY POPULATION: We conducted a retrospective analysis of over 200 UAMS IRB approved, investigator initiated informed consents from 2013 to 2015 to determine the readability before intervention. The mean grade level readabilities were derived from the results of 3 readability formulas (Flesch-Kincaid, SMOG, and Fry) using open-source readability tools. A plain language informed consent template that meets IRB and regulatory requirements was developed, adhering to health literacy best practices for written communication. The template was made available to investigators as an optional resource, and IRB committees were trained on use of the template. In addition, a focus group will be conducted to qualitatively assess understandability of the template with study participants identified as having inadequate health literacy. Data analysis will include readability assessment of IRB approved informed consents post intervention with and without use of the plain language template, as well as qualitative feedback from focus group participants. RESULTS/ANTICIPATED RESULTS: The retrospective analysis revealed a mean readability of 10th grade for IRB approved informed consents from 2013 to 2015 (n=217). The readability of the developed plain language template was 5th grade. Preliminary post-intervention results show adoption of the template by investigators (n=16) resulted in informed consents with a mean readability of 7th grade (range 6–9th grade), compared to a mean of 10th grade (range 7–11th grade) for the comparator (“no adoption” group, n=24). Data collection will continue through May 2017. The focus group is forthcoming and results will be included in the poster. DISCUSSION/SIGNIFICANCE OF IMPACT: Low health literacy is common in individuals with healthcare disparities and can limit their participation in clinical research. Few studies have examined interventions to address this barrier to research. Preliminary results of this study support the utilization of a plain language informed consent template in investigator-initiated research. Moreover, this study demonstrates the importance of stakeholder engagement among CTSA leadership, health literacy experts, the institutional review board, investigators, and research subjects in the development and testing of this intervention to make informed consents “understandable to the subject” while containing all required elements.

OBJECTIVES/GOALS: In line with NCATS funding requirements, the Michigan Institute for Clinical and Health Research (MICHR) established a continuous quality improvement (CQI) process and used the process to guide the implementation of a benchmarking project to evaluate and set goals for MICHR’s production of Clinical and Translational Science manuscripts. METHODS/STUDY POPULATION: We aimed to increase the number of Clinical and Translational Science papers MICHR produces and to set a reasonable goal for improvement. Benchmarking was used to obtain a baseline and inform the identification of a reasonable goal for improvement. 11 Peer institutions were identified with similar funding levels. 1,225 Publications from 2022 for all 12 CTSAs were obtained from NIH Reporter. All publications were reviewed by title to identify probable CTS content. Two staff reviewers confirmed a total of 108 CTS publications across all CTSAs, and coded each paper to characterize the theoretical approach, method (quantitative and/or qualitative), analytic method and topic. All publications that were selected for benchmarking were also tracked and compared using Altmetrics for Institutions and Overton platforms. RESULTS/ANTICIPATED RESULTS: A total of 108 CTS publications were produced by 12 benchmarked CTSAs in 2022; of those, 70% (77) regarded research infrastructure, 37% (41) regarded research methods, and 15% (16) regarded clinical care. Over half, 53% (58), of the benchmarked papers are empirical research papers; of those, 67% (39) used quantitative methods, 28% (16) used qualitative methods, and 5% (3) used mixed methods. A clear majority of the benchmarked papers, 70% (76), provided only descriptive analyses, 18% (19) provided inferential analyses, and 12% (13) provided predictive analyses. We identified an opportunity to produce more manuscripts with descriptive analyses of research infrastructure. In the long-term, we saw an opportunity to produce predictive analyses of translational initiatives designed to impact clinical care. DISCUSSION/SIGNIFICANCE: The benchmarking results helped MICHR identify goals for its production of Clinical and Translational Science to fill gaps in the field. Expanding the scope of this benchmarking project might achieve greater interrater reliability using larger representative sets of publications drawn from institutions across the CTSA Consortium.

ABSTRACT IMPACT: Points to strategies to de-implement ineffective, harmful, or unproven practices, lowering burden and cost of healthcare, using evidence-based recommendations on low value care. OBJECTIVES/GOALS: Ineffective, harmful, or unproven practices add burden and cost of healthcare. In national efforts to de-implement low value care (LVC), Choosing Wisely ®campaign generated 25 recommendations through the American Academy of Nursing (CW AAN). Our study described nurse-awareness of CW AAN recommendations as requisite toward de-implementing LVC. METHODS/STUDY POPULATION: A multi-stakeholder state action coalition led the project to achieve the Institute of Medicine Future of Nursing goals by describing nurse awareness of CW AAN recommendations. The survey was the first among nursing professionals. Use of human subjects was approved at the lead university. Registered Nurse contact information was obtained from the state Board of Nursing of a large mid-South state. Qualtrics ®surveys patterned after the CW survey of physicians’ awareness were administered online by the state Center for Nursing Workforce Studies. Content experts developed 2 surveys’‘ one for Registered Nurses (RNs) and one for Advance Practice Registered Nurses (APRNs)’‘ to account for differences in scope of practice. Surveys assessed current knowledge and perception of the Choosing Wisely ®AAN campaign. RESULTS/ANTICIPATED RESULTS: Over six weeks, 374 nurses participated (295 RNs and 79 APRNs). About half of each group indicated that unnecessary nursing care was a ‘somewhat serious problem.’ Only 21% of RNs and 26% of APRNs were aware of Choosing Wisely ®AAN recommendations. Participants identified reasons for the prevalence of low value care in practice as being concerns about malpractice issues, lack of time with patients for meaningful discussion, ‘just to be safe,’ and patients insisting on getting the test or procedure. For the RN group, cost of LVC was rarely discussed; in the APRN group, cost was frequently discussed. Of the APRNs who were aware of CW, 90% believe the recommendations were helpful. When asked for LVC de-implementation suggestions, 78% said EBP recommendations would be effective; at the same time, 20% had low knowledge of EBP. DISCUSSION/SIGNIFICANCE OF FINDINGS: RNs and APRNs reported low awareness of CW AAN advice. While representative, sample size limits generalization. De-implementation in learning health systems will include socioecological strategies focused on provider awareness and confidence, patient preference, cost, strength of evidence, and safe work culture to diffuse fear of litigation.

The Expanded Program for Immunization Consortium – Human Immunology Project Consortium study aims to employ systems biology to identify and characterize vaccine-induced biomarkers that predict immunogenicity in newborns. Key to this effort is the establishment of the Data Management Core (DMC) to provide reliable data and bioinformatic infrastructure for centralized curation, storage, and analysis of multiple de-identified “omic” datasets. The DMC established a cloud-based architecture using Amazon Web Services to track, store, and share data according to National Institutes of Health standards. The DMC tracks biological samples during collection, shipping, and processing while capturing sample metadata and associated clinical data. Multi-omic datasets are stored in access-controlled Amazon Simple Storage Service (S3) for data security and file version control. All data undergo quality control processes at the generating site followed by DMC validation for quality assurance. The DMC maintains a controlled computing environment for data analysis and integration. Upon publication, the DMC deposits finalized datasets to public repositories. The DMC architecture provides resources and scientific expertise to accelerate translational discovery. Robust operations allow rapid sharing of results across the project team. Maintenance of data quality standards and public data deposition will further benefit the scientific community.

The success of clinical research studies depends on effective recruitment and retention of study participants, yet only a small fraction of patients engage in research studies, even in academic health systems. Increasing awareness of research opportunities and facilitating connections with clinical research study teams would help to improve the success of research programs. In this Special Communications, we describe the creation and evolution of and tools used for the My Research Partners Concierge Service (MRPcs) of an academic health system. The MRPcs provides a centralized point of contact or hub for patients and community members, as well as clinical research organizations and academic partners, who have research-related questions or interests. The MRPcs helps to connect the users of the service with relevant research study teams, personnel, or resources to facilitate their engagement in a clinical research program. Our experience with the MRPcs informs our recommendation that peer institutions organize similar research service hubs for their clinical research programs to help increase awareness of and participation in clinical research by the public and to help increase the success of research programs at fulfilling their ultimate goal of improving the health of their population.

The hidden curriculum (HC), or implicit norms and values within a field or institution, affects faculty at all career stages. This study surveyed affiliates of a junior faculty training program (n = 12) to assess the importance of HC topics for junior faculty, mentors, and institutional leaders. For non-diverse junior faculty and their mentors, work-life balance, research logistics, and resilience were key HC topics. Coping with bias and assertive communication were emphasized for diverse junior faculty and mentors. Institutional norms and vision were essential for leaders, while networking was important for all groups. Future research should explore HC needs and potential interventions.

Objectives/Goals: The University of Minnesota’s two-year TL1 program provides flexible and individualized education and training for a diverse cohort of scholars committed to pursuing impactful careers in clinical and translational science (CTS). The program aims to strengthen the nation’s biomedical workforce by developing scientists skilled in clinical and translational research. Methods/Study Population: The TL1 program recruits PhD candidates and postdoctoral fellows from a wide variety of graduate programs in colleges and departments across the University. To date, we have trained 26 predoctoral and 9 postdoctoral Scholars in 3 cohorts. Scholars represent dozens of disciplines and the full translational spectrum. These interdisciplinary cohorts are in a unique position to realize the fundamental characteristics of a translational scientist. Entrance/exit surveys and exit interviews provide program leadership with information for quality improvement and areas scholars believe contribute the most to their education and training in CTS. Results/Anticipated Results: Entrance/exit surveys indicated Scholar-perceived benefits of training in an interdisciplinary program, including growth in translational scientist characteristics (e.g., Boundary Crosser, Team Player). Exit interviews showed Scholars appreciated the cohort model bringing together trainees from many different research areas. They valued exposure to varied perspectives, talking through challenges and solutions with each other, and learning others shared similar issues. They valued the Scholar community they developed. Several felt siloed in their careers before the program and reported that TL1 participation connected them to others outside their own area of focus, expanded their knowledge about different research methods and revealed more pathways for translation. Discussion/Significance of Impact: Recruiting and training a diverse interdisciplinary cohort of pre- and postdoctoral TL1 Scholars promoted synergy in translational research, science skills and competencies, and transformed the perspectives of Scholars’ views on the importance of interdisciplinary collaboration to accelerate science.

OBJECTIVES/GOALS: Intersecting marginalized identities and multimorbidity elevate Latinx sexual and gender minority (SGM) risk for severe COVID-19, making vaccination critically important for this group. This study provides some of the first data on strategies for improving vaccination efforts in this community. METHODS/STUDY POPULATION: Data come from the Latinx SGM substudies of the NIH-funded Florida Community Engaged Alliance against COVID-19 Health Disparities (FL-CEAL), recruited between April 2021-August 2022 (n=215). Descriptive statistics and univariate analyses informed a multivariable logistic regression model with a dichotomous outcome variable for respondents who received at least one COVID-19 vaccine dose. Covariates included, gender, education, poverty, immigration status, an index of six COVID-19-related challenges, and dominant COVID-19 strain. Dichotomous measures of trust in six information sources (e.g., doctors, community organizations, social media) were also included. RESULTS/ANTICIPATED RESULTS: 182 respondents (85%) had received one or more vaccines. Key findings of statistical significance associated with vaccination from the adjusted model include White race (p=0.028), college degree attainment (p=0.006), high trust in community organizations (p=0.022), and the dominant variant at the time of survey (p DISCUSSION/SIGNIFICANCE: In a departure from non-SGM Latinx samples, high trust in community organizations was significantly associated with vaccine uptake. This highlights the importance of LGBT organizations to Latinx SGM and suggests messaging regarding vaccination via these organizations may be especially effective.

OBJECTIVES/SPECIFIC AIMS: The purpose of this descriptive study is to explore knowledge, attitudes, and behaviors related to genetics and genetic research in a sample of persons of African descent. METHODS/STUDY POPULATION: Data were generated using a cross-sectional survey design. A nonprobability sample of 272 persons of African descent, ages 18 and older, were recruited from the Washington, DC metropolitan area through public advertisement and word-of-mouth. Participants had diverse backgrounds with most born in the United States (93%), female (71%), some college or above education (57%), household income under $40,000 (54%), and some with a reported disability (38%). Before survey recruitment and administration, this study was reviewed and approved by the Howard University Institutional Review Board. RESULTS/ANTICIPATED RESULTS: The majority (79.8%) of the participants considered themselves as having a “fair” to “good” knowledge of genetics. The sample had a 2.24 (SD=77) mean score on the 5-item genetics knowledge questionnaire with total possible mean scores ranging from 0 (no correct responses) to 5 (all correct responses). Most (53.3%) participants believe it is important for persons of African descent to participate in genetic research. However, almost one-half (46.7%) felt that information from genetic research can be used to discriminate against minorities. In terms of behaviors, 83.4% of the participants never had genetic testing conducted. However, an overwhelming majority reported that they would be willing to participate in a genetic research project specifically for detection of risk factors such as cancer (87%), diabetes (89.3%), Alzheimer disease (88.6%), and alcohol use disorder (75%). DISCUSSION/SIGNIFICANCE OF IMPACT: This investigation suggests that persons of African descent generally view participation in genetic research as important and are willing to have their genetic profile analyzed to detect susceptibility to certain diseases. However, ethical issues, such as misuse of genetic research to discriminate against minorities, remain a prominent concern. Further studies are needed to illuminate KABEs and to help identify the role these factors may play in this population’s willingness to participate in testing and research. Such information could provide invaluable insight to the development and implementation of more ethical and culturally competence strategies for recruiting minority participants into genetic research.

OBJECTIVES/GOALS:

• To improve and expand health and research literacy throughout Indiana by sharing health-focused resources and research outcomes.

• To encourage and increase health research participation throughout Indiana by promoting health research opportunities, including clinical studies.

METHODS/STUDY POPULATION:

• Discover and understand community concerns and barriers to good health and clinical research participation by providing a platform for individuals and communities to share their voices.

• Educate Indiana residents on the importance of participating in health research.

• Engage with the community to meet them where they are (online) and continue to build relationships throughout the state.

• Promote healthy living for Indiana residents by sharing health education and resources from existing state health organizations and initiatives.

• Develop and maintain the largest statewide database of research volunteers.

RESULTS/ANTICIPATED RESULTS:

• The anticipated results from this program include engagement of all populations and all communities throughout the state in conversation and education around good health and health research, as well as participation in health research across the CTSI’s partner organizations. Large-scale growth is expected in both the online community and consented volunteer registry is expected to include and engage racially and ethnically diverse populations, as well as special health populations, such as representatives of rural communities, aged, rare disease survivors, and transgender individuals.

DISCUSSION/SIGNIFICANCE OF IMPACT:

• Thorough this work, the Indiana CTSI has developed a unique program, educating the public about health research and opportunities to participate, while simultaneously supporting research departments with marketing promotion of their efforts, and a ready statewide volunteer community.

OBJECTIVES/GOALS: To evaluate the FAITH! (Fostering African-American Improvement in Total Health) App mHealth lifestyle intervention by using post-intervention feedback obtained from participants in our intervention pilot study. METHODS/STUDY POPULATION: We used qualitative methods (focus groups) to elicit post-intervention feedback. Participants who completed the pilot study were recruited to one of two focus groups. Semi-structured focus groups were conducted to explore participants’ views on the app functionality, utility and satisfaction as well as its impact on healthy lifestyle change. Sessions were audio-recorded, transcribed verbatim and qualitative data were analyzed by systematic text condensation thematic analysis. RESULTS/ANTICIPATED RESULTS: Nine individuals participated (N = 4 and N = 5) in each of the two focus groups. Their mean age was 47.9 years (SD 12.1), 67% were women, and all had at least an education level of some college. Six overarching themes emerged from the data: (1) overall impression, (2) content usefulness (3) formatting, (4) implementation, (5) impact and (6) suggestions for improvement. Underpinning the themes was a high level of agreement that the intervention facilitated healthy behavioral change through cultural tailoring, multimedia education modules and social networking. Among the suggestions for improvement were streamlining of app self-monitoring features, personalization based on individual’s cardiovascular risk and attentiveness to nuanced cultural perspectives. DISCUSSION/SIGNIFICANCE OF IMPACT: This formative evaluation found the FAITH! App mHealth lifestyle intervention had high reported satisfaction and impact on the health-promoting behaviors of African-Americans, thereby improving their overall cardiovascular health. The findings provide further support for the acceptability of mHealth interventions among African-Americans. CONFLICT OF INTEREST DESCRIPTION: None.

OBJECTIVES/SPECIFIC AIMS: Increased right atrial pressure is known to be a predictor of poor outcomes after LVAD implantation. Whether resolution of right heart congestion prior to LVAD implantation is associated with more favorable outcomes is not well understood. METHODS/STUDY POPULATION: We analyzed LVAD recipients from our institution from 1/1/2015 to 2/28/2018. We excluded patients bridged to LVAD with ECMO support. Patients with admission right atrial pressure (RAPadmit) and implant RAP (RAPimplant) ≥ 14 mmHg were defined as having persistent congestion, while patients with RAPadmit ≥ 14 mmHg and RAPimplant < 14 mmHg were defined as having resolved congestion. Baseline characteristics between groups were compared using the Chi-square and unpaired t-tests. Time to death or RVAD was compared between groups using Cox proportional hazards models. RESULTS/ANTICIPATED RESULTS: Of 57 LVAD recipients with RAPadmit ≥ 14 mmHg, 14 (25%) had persistent congestion at the time of LVAD implantation. While there were no statistically significant differences between groups, patients with persistent congestion were more likely to be INTERMACS profile 1 (21.4% vs 9.5%), less likely to have a destination therapy device strategy (28.6% vs 34.9%), less likely to have moderate or severe right ventricular (RV) dysfunction (64.3% vs 83.7%), and had similar RAPadmit (20.4 mmHg vs 18.9 mmHg) compared to patients with resolved congestion. Median follow up was 307 days. Patients with persistent congestion had a higher frequency of death or RVAD implantation compared to those with resolved congestion (50% vs 14%, HR 3.75, 95% CI 1.25–11.25, p=0.02). DISCUSSION/SIGNIFICANCE OF IMPACT: Among patients with elevated RAP at admission, patients with persistently elevated RAP at the time of LVAD implantation had worse outcomes than patients who were able to be decongested prior to surgery. These data support optimization of RV filling pressures prior to LVAD surgery.

OBJECTIVES/SPECIFIC AIMS: The study investigated whether adults diagnosed with epilepsy or migraine (a neurological disorder with common features to epilepsy) are at increased risk for developing substance abuse disorders following diagnosis compared to (presumably healthy) adults with lower extremity fracture (LEF). METHODS/STUDY POPULATION: A retrospective cohort analysis was conducted using a subset of surveillance data of hospital admissions, emergency department visits and outpatient visits in South Carolina, USA from January 1, 2000 through December 31, 2011. Individuals aged 18 years or older were identified using the International Classification of Disease, 9th Revision Clinical modification (ICD-9) with a diagnosis of epilepsy (epilepsy-cohort 1; n = 78,547; 52.7% female, mean age [SD] 51.3 years [19.2]), migraine (migraine-cohort 2; n = 121,155; 81.5% female, mean age [SD] 40.0 years [14.5]), or LEF (control cohort; n = 73,911; 55.4% female, mean age [SD] 48.7 years [18.7]). Individuals with substance abuse or dependence diagnosis following epilepsy, migraine, or LEF were identified with ICD-9 codes. Cox proportional hazard regression analyses modelled the time to substance abuse diagnosis comparing epilepsy to LEF and comparing migraine to LEF. RESULTS/ANTICIPATED RESULTS: Adjusting for insurance payer, age and sex, adults with epilepsy are diagnosed with substance abuse disorders at 2.5 times the rate of those with LEF [HR 2.54 (2.43, 2.67)] and adults with migraine are diagnosed with substance abuse disorders at 1.10 times the rate of those with LEF [HR 1.10 (1.04, 1.16)]. An interaction between exposure and insurance payer was found with hazard ratios comparing epilepsy to LEF of 4.56, 3.60, and 1.94 within the commercial payer, uninsured and Medicaid strata, respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: Compared to adults with LEF, adults with epilepsy had a substantially higher hazard of subsequent substance abuse, while adults with migraine showed a small, but still significant, increased hazard of subsequent substance abuse.

OBJECTIVES/GOALS: Nutrition plays an imperative role in the management of Duchenne and Becker Muscular Dystrophy, but guidelines for nutrition counseling are absent. This study was designed to gain insight into provider experiences with nutritional services to find solutions for future counseling. METHODS/STUDY POPULATION: In this prospective, observational exploratory study, semi structured interviews were conducted at Certified Duchenne Care Centers (CDCCs) to gain insight on providers experiences with nutritional services and to identify barriers and solutions to nutrition education/care/counseling at CDCCs. Interviews were video recorded and then transcribed for themes. Overarching themes gave insight for a quantitative survey to be sent out, assessing all members on the multidisciplinary team perceptions, confidence, barriers, and solutions to providing nutritional care to Duchenne and Becker patients. RESULTS/ANTICIPATED RESULTS: We anticipate this study will provide novel data and key information from providers regarding nutrition education /care/counseling efforts in the multidisciplinary care of neuromuscular diseases. DISCUSSION/SIGNIFICANCE: Results will demonstrate the need for higher standards and more specific recommendations in nutritional services at CDCCs, while providing a framework for referrals, continuing education opportunities, and increasing providers’ confidence and abilities to provide sound nutritional advice.