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Objectives/Goals: Pediatric inguinal hernia (PIH) is a common diagnosis managed by pediatric surgeons. Patients typically present in the outpatient setting for evaluation. However, a subset present emergently with hernia incarceration, which has a higher risks. Our research aims to identify and address disparities in access to care of PIHR. Methods/Study Population: This study has a sequential multi-methods approach. First, we will perform a retrospective cohort study of pediatric patients (ages 0–18) who have undergone PIHR at St Louis Children’s Hospital (SLCH) over the past 5 years (n = 3,421). We will assess the impact of demographic and system-based factors on patient outcomes. Second, we will conduct interviews with caregivers of patients who have undergone PIHR. Qualitative interviews will be coded to prospectively identify themes in barriers and facilitators to accessing care, understanding of disease, and effectiveness of risk factor education by the pediatric care team. Finally, we will analyze the readability index (RI) of patient provided materials to assess the impact of health literacy on access to care and PIHR outcomes. Results/Anticipated Results: We hypothesize that demographic factors and socioeconomic status (SES) impact outcomes in PIHR. We anticipate higher rates of incarceration and emergent presentation of children from low SES and racial/ethnic racial minorities in our dataset, with longer time from initial presentation to definitive repair. Moreover, we anticipate identifying significant barriers to accessing care for non-white patients and patients with low SES, with gaps in understanding about the risk factors, presentation, and management of PIH. Finally, we hypothesize that the RI of our patient provided materials do not match community literacy rates, and there will be opportunities to implement new patient provided materials to improve parental education and communication in the perinatal space. Discussion/Significance of Impact: More than 600 patients undergo PIHR annually at a large tertiary care pediatric hospital, with those who are born premature being at higher risk. Using a mixed-methods approach, we aim to implement targeted interventions to facilitate access to care and improve patient outcomes in PIHR.
Objectives/Goals: This study aims to address mobility disability in the rural South by collecting advanced clinical measures in underserved communities, uncovering relationships between socioeconomic status, mobility, and physical health, providing data to aid clinicians in diagnosis and treatment, and improving healthcare delivery in disadvantaged areas. Methods/Study Population: We will recruit 50 participants aged 65+ years from a diverse range of areas in the rural South. Data collection will occur at community health fairs, employing a community-centered approach. Assessments include mobility measures using portable inertial sensors, physical health assessments: body composition (TANITA BC-568), muscle size analysis (ultrasound), central and peripheral blood pressure. Demographic information: We will analyze relationships between ADI, mobility, and physical health measures. This approach allows for comprehensive health evaluation in participants’ own communities, facilitating trust building and immediate dissemination of health information. The study design enables investigation of socioeconomic impacts on health and mobility in this underserved population. Results/Anticipated Results: Preliminary data from our ongoing community health fairs (n = 172) show promising feasibility for data collection in rural settings. Importantly, initial analyses reveal a significant correlation between higher area deprivation index (ADI) scores and reduced mobility performance, supporting our hypothesis that socioeconomic factors influence physical function. We anticipate further findings, including more detailed relationships between ADI and specific mobility parameters (e.g., gait speed and balance), associations between ADI and poorer physical health measures (e.g., increased arterial stiffness and decreased muscle mass), and interrelationships between mobility impairments and cardiovascular health markers Discussion/Significance of Impact: Building vital relationships with rural communities while uncovering critical links between mobility and physical health. By bridging urban science and rural needs, we are addressing health disparities and informing targeted healthcare strategies. Our findings will improve clinical decision-making and healthcare delivery in underserved areas.
Objectives/Goals: To evaluate equity in utilization of free initial health evaluation (IHE) services among members of a limited health care program, the World Trade Center (WTC) Health Program (Program), to inform intervention development and provide insights for similar healthcare programs. Methods/Study Population: We included Program members who newly enrolled during 2012–2022, and who had an IHE or were alive for ≥ 1 year after enrollment. Program administrative and surveillance data collected from January 2012 to February 2024 were used. We evaluated two outcomes: timely IHE utilization (proportion of members completing an IHE within 6 months of enrollment) and any IHE utilization (proportion completing an IHE by February 2024). We described IHE utilization by enrollment year and various members’ characteristics and conducted multivariable logistic regression models to estimate adjusted odds ratios for IHE utilizations to identify factors related to potential inequities for the two member types: Responders, who performed support services, vs. Survivors, who did not respond but were present in the New York disaster area. Results/Anticipated Results: A total of 27,379 Responders and 30,679 Survivors were included. Responders were 89% male, 70% 45–64 years old at enrollment and 76% White. Survivors were 46% female, 54% 45–64 years old at enrollment, and 57% White. Timely IHE utilizations remained relatively stable (~65%) among Responders across time and increased from 16% among Survivors who enrolled in 2017 to 68% among Survivors who enrolled in 2021. Timely IHE utilization was lower for younger members (enrolled Discussion/Significance of Impact: This study highlights Program achievements and gaps in providing equitable IHE services. Strategies to improve members’ equitable IHE utilization can include: adopt/expand flexible scheduling; increase non-English language capacity and cultural competency; and facilitate transportation/assistance for members with accessibility barriers.
Objectives/Goals: Access to accurate public health information is an essential component to ensuring health equity. We launched our social media channels on Instagram, Facebook, and TikTok to highlight, engage with, and bring culturally tailored and language appropriate health and research information to our target communities. Methods/Study Population: Monitoring engagement patterns with our content on each platform influenced the development of a range of innovative campaigns in both English and Spanish that were informed by our core values of inclusivity, trust-building, ongoing bidirectional communication, and co-creation. These three platforms were chosen to ensure reach and engagement with the different demographics within our target populations. The campaigns included those that provided relevant and accurate health information, highlighted the diversity of our team, uplifted our community partners, and gave voice to our community members. This content included health-related infographics, mini-documentary reels, video essays, interviews, and photos. Results/Anticipated Results: We assessed effectiveness, reach, and engagement based on the robustness of the analytics for each platform. Facebook content, the majority of which is in Spanish, appealed more to older, Latino community members. TikTok content appealed more to younger (under 35), primarily English-speaking community members, while Instagram appealed more to organizational partners and community health workers. A 2023 trendline analysis of average monthly Instagram content reach and interactions indicated a moderate-to-strong relationship between our tailored content and audience engagement. Storytelling techniques consistently outperformed other content types across platforms, and community partner collaboration drastically enhanced our visibility, reach, and further validated our approach. Discussion/Significance of Impact: Social media has become increasingly central to bidirectional information dissemination. Implementing tailored strategies and leveraging storytelling techniques is an effective means of engaging diverse audiences, enhancing public health communication, and building and maintaining trust by providing accurate, accessible information.
Objectives/Goals: The purpose of this study was to explore pharmacists’ and patients’ attitudes, contextual barriers, organizational readiness, and preferences regarding implementation of a mindfulness-based stress reduction (MBSR) program for chronic pain management in the community pharmacy setting in rural Alabama. Methods/Study Population: Pharmacists in independently owned community pharmacies and patients ≥18 treated for chronic pain in the past year in rural Alabama were recruited via purposive and snowball sampling. One-hour virtual semi-structured interviews were conducted by Marketry, a qualitative market research company. Interview questions were guided by the consolidated framework for implementation research (CFIR) and focused on 1) knowledge/awareness; 2) attitudes; 3) barriers/facilitators (e.g., demand, reimbursement); 4) pharmacies’ organizational readiness (e.g., technology, personnel, and culture); and 5) program preferences (content, format) regarding a potential pharmacy-based MBSR program for chronic pain management. Interview transcripts were analyzed using deductive content analysis to identify themes. Results/Anticipated Results: A total of 60 interviews were conducted (n = 30 pharmacists, n = 30 patients). Qualitative data analysis is ongoing and is expected to be completed by December 2024. Interviewee’s responses describing knowledge, attitudes, barriers, facilitators, pharmacies’ organizational readiness, and recommended program elements will be categorized according to the CFIR domains of “inner setting,” “outer setting,” “intervention characteristics,” and “characteristics of individuals.” Domains will be summarized with over-arching themes. Discussion/Significance of Impact: Findings are expected to inform development of a community pharmacy-based MBSR program for chronic pain management. This serves as the first step in building and implementing a sustainable, accessible community pharmacy-based program offering a nonopioid alternative for pain management in the underserved rural Deep South.
Objectives/Goals: This study aimed to identify preferences for nutrient-dense foods with critical nutrients associated with reduced neuroinflammation and perinatal depression risk. Aim two evaluated the acceptability of daily intake and preparation methods of select foods in Black American pregnant and postpartum people living in food apartheid in St. Louis. Methods/Study Population: The study included a mixed-methods sequential explanatory design with data collection at the YWCA of Metro St. Louis during Early Head Start programming with 21 participants living in geographies with low grocery-to-convenience store ratios. We conducted an open-ended online survey to determine participants’ preferences for specific foods with high nutrient density. Food preferences were subjected to nutrient analyses using FoodData Central, and foods with the highest concentrations of critical nutrients associated with reduced neuroinflammation and perinatal depression risk were identified. We presented results during a focus group with participants who completed the survey and evaluated the acceptability of daily intake and preparation methods. Results/Anticipated Results: Preferred food choices with the highest concentrations of critical nutrients associated with reduced neuroinflammation and perinatal depression risk included dark red kidney beans, black beans, pinto beans, black-eyed peas, peanuts, almonds, pistachios, walnuts, pecans, carrots, spinach, red bell pepper, sweet potatoes, and salmon. Participant justifications for low acceptance of daily intake included allergic reactions, “dry” or “slimy” texture, undesirable taste or appearance, absence of cravings, preferring alternatives, complicated preparation methods, and financial tradeoffs. Participant justifications for high acceptance included desirable taste and texture, diverse modification and preparation options, and nutrient composition critical for anemia treatment. Discussion/Significance of Impact: The study identified nutrient-dense food preferences within a sample vulnerable to nutrient-poor alternatives and health consequences. Participant acceptance of nutrient-dense intake was contingent upon recipes fulfilling cravings, acceptance among persons preparing meals, and diverse options to prevent boredom with preparation methods.
Objectives/Goals: Community engagement is critical to promoting equity for those affected by clinical and translational research. Despite its importance, investigators rarely involve community stakeholders in ancillary projects such as secondary analyses. I use a study example to demonstrate how to meaningfully partner with communities in ancillary research. Methods/Study Population: Using data collected in a previous study, the aim of this secondary analysis was to examine whether pregnant women’s reports of social adversity during the third trimester were associated with their infant’s resting cortisol level at 1, 6, and 12 months of age. Community engagement at the study design phase included consultation with an institutional Community Advisory Board (CAB) whose expertise included lived experiences relevant to the context of the study (i.e., social adversity and pregnancy). Community engagement at the analysis and dissemination stage included deeper collaboration with three community research consultants (CRCs) from the CAB; all identified as women of color and mothers with relevant lived experiences. CRCs received compensation for time and effort and an invitation for co-authorship. Results/Anticipated Results: Consultations included written review as well as a live presentation and discussion with the CAB for feedback on the study proposal prior to submission for IRB approval. The focus of discussion was around the use of inclusive terminology and ensuring respectful and equitable representation of all participants in the original study, including those who reported experiences with social adversity during pregnancy. After receiving study approval, statistical analyses were finalized and CRCs actively engaged in discussions with the PI around the interpretation of results. CRCs significantly contributed to the development of solutions-oriented implications for practice, policy, and future research. All CRCs were co-authors on the study manuscript that was published in a top-tier international journal. Discussion/Significance of Impact: Community engagement in ancillary research is feasible and essential. True equitable collaboration requires partnership during all study activities, including critical phases (e.g., developing aims, data analysis). Researchers also should prioritize the use of datasets from studies that incorporated community partnership and engagement.
Objectives/Goals: To facilitate engagement between university researchers and Appalachian Kentucky communities, the UK Rural Research Hub (RRH) promotes Community Engaged Research (CEnR) and academic–community partnerships that have the greatest potential to conduct impactful research to improve health and reduce regional health disparities. Methods/Study Population: Through the UK RRH, a wealth of expertise and a range of services sustain successful CEnR. Hub coordinators provide research consultations, accelerate researchers’ engagement with the community, and facilitate the success of studies through study coordination, assistance with participant recruitment, data collection and interventions, and through dissemination back to the community. Results/Anticipated Results: UK RRH coordinators have supported numerous studies across the region. For example, RRH staff facilitated recruitment of and collected data from 40 Appalachian caregivers of patients with Alzheimer’s disease and related dementias (ADRD) in a study to improve home environments for patient well-being. The study provided pilot data for a successful K23 application. Other examples of supported research include studies to improve cancer screening uptake, self-management of diabetes, and cardiovascular disease risk reduction, resulting in improved care in the community and often providing pilot data leading to larger national grants. Discussion/Significance of Impact: Research addressing the complex health issues that burden Appalachian Kentucky requires community engagement to be successful. The UK RRH is at the heart of successful CEnR that benefits researchers and communities alike.
Objectives/Goals: This study will integrate scientific evidence to create messaging about the modifiable risk factors for Alzheimer’s disease (AD) and examine how culturally tailoring elements in message content, such as text and visualizations in infographic messaging, impacts cognitive processing of AD prevention messages among Black adults. Methods/Study Population: This study is guided by the two-dimensional theory of cultural sensitivity and the elaboration likelihood model (ELM). The two-dimensional theory distinguishes between surface structure (visualizations) and deep structure (text with embedded cultural features) in messaging. The ELM considers how message attributes influence cognitive processing. A 2 × 2 factorial experiment will test the impact of cultural features (surface vs. deep) and message type (text-based vs. infographic) on persuasive outcomes regarding modifying AD risk factors. Black adults will be recruited from local churches and randomly assigned to one of four conditions, after which they will complete post-test measures. Statistical analyses will determine the effects of cultural tailoring and message effects on outcome variables. Results/Anticipated Results: Guided by previous literature (Resnicow et al., 1999; Lazard & Atkinson, 2015; Lam et al., 2022), we hypothesize an interaction effect of cultural tailoring and message type, wherein surface structure infographic messages and deep structure text-based messages will outperform the other two message conditions, resulting in greater cognitive processing and more positive attitudes and behavioral intentions toward modifying AD risk factors. In addition, a research question asks whether there will be differences between surface structure infographic messages and deep structure text-based messages on outcome variables. The study will advance understanding of the effects of cultural sensitivity and visual vs. text-based messaging by integrating these literatures. Discussion/Significance of Impact: This research will contribute to the literature on culturally tailored health messages and persuasive effects of text vs. visual messages. The findings can inform the development of more effective, culturally relevant public health campaigns for AD prevention by reducing risk for AD through modifiable risk factors in diverse populations.
Objectives/Goals: Engaging interest holders in research is increasingly common, and guidelines include creating engagement plans. A detailed plan may be especially helpful when researchers perceive engagement as difficult or less relevant. We tested whether a study’s translational stage or an investigator’s years of research experience affect their perceptions. Methods/Study Population: Since 2019, the Tufts Clinical and Translational Science Institute Pilot Studies Program required applicants to submit plans to engage interest holders. Applicants in three cohorts responded to a survey about this requirement, including perceived difficulty developing an engagement plan, perceived relevance of engagement, and self-reported years of research experience (≤5, 6–10, and ≥10 years). Two raters assigned translational stage(s) of proposed studies: T0 (basic science), T.5 (pre-clinical to initial human studies), and T1 through T4. Separate analyses were conducted when multistage studies were coded as the earliest vs. latest stage and for individual stage vs. groups of stages (T0/T.5/T1 vs. T2/T3/T4). The Fisher’s exact statistical test was used to assess associations between variables. Results/Anticipated Results: Analyses included 67 participants. Developing an engagement plan was perceived as more difficult for studies at earlier translational stages when those studies were coded as the earliest applicable stage. This significant association held both when stages were grouped as T0/T.5/T1 and T2/T3/T4 (P = .03) and when analyzed as a single stage (P = .01); however, when studies were coded as the latest applicable stage, there were no significant associations. Similarly, when multistage studies were coded as the earliest applicable stage, engagement was perceived as less relevant for early-stage studies when grouped (P = .04), but not for individual stages or when studies were coded as the latest applicable stage. No significant association between years of research experience and perceived difficulty was identified. Discussion/Significance of Impact: Results show that investigators conducting early-stage research perceive more difficulty engaging interest holders, aligning with prior qualitative studies. These investigators may need more evidence of the value added to early-stage studies, targeted and practical training, and funder requirements to establish a culture of engagement.
Objectives/Goals: Arterial stiffness is a determinant of vascular health. Older Black females exhibit greater arterial stiffness than White females. Exercise minimizes negative health effects of prolonged exposure to adverse social determinants of health (SDoH). Here, we will assess the role of exercise on race differences in arterial stiffness and SDoH in females. Methods/Study Population: We will recruit 96 postmenopausal females (48 Black, 48 White) from the Birmingham, AL area. Graded exercise tests will be used to define training status (“trained”: VO2max ≥60th percentile, “untrained”: ≤35th percentile). We will assess arterial stiffness via pulse wave velocity (SphygmoCor XCEL). SDoH will include income, education, neighborhood deprivation, racial discrimination, food insecurity, and healthcare access, all measured via corresponding surveys. We will then perform a two-way analysis of variance (race × training status) to assess the differences in arterial stiffness between groups. Through linear regression, we will evaluate the statistical relations between arterial stiffness and race, training status, and SDoH. Results/Anticipated Results: Our central hypothesis is that Black females will have greater arterial stiffness, by way of greater exposure to adverse SDoH, than White females, but that habitual aerobic exercise will attenuate this race difference. Ultimately, we aim to inform future clinical trials related to understanding female-specific cardiovascular disease progression. Discussion/Significance of Impact: Black females face significant exposure to adverse SDoH and have the highest rates of cardiovascular disease in the United States. However, females are still widely underrepresented in relevant research. This will be the first study to examine the roles of aerobic exercise, race, and SDoH in cardiovascular disease risk among females.
Objectives/Goals: To develop a user-friendly tool to simplify the Trillium Drug Program (TDP) application process, addressing barriers for pre-exposure prophylaxis (PrEP) users aged 25 to 64 years. This project may also serve as a scalable model for improving accessibility across other service delivery programs. Methods/Study Population: This study uses the Translational Research Framework to create and refine an online TDP guide. Participants include Ontario residents aged 23 to 64 years. Challenges are identified in the “Understand” phase, while user-driven feedback in the “Act” phase iteratively enhances the tool. Virtual prototyping interviews via Zoom will assess user experience, and error rates will be evaluated by comparing tool suggestions with verified mock scenarios. Twenty participants will test the tool in two iterations: Version 1 from January to February 2025, and Version 2 based on feedback from February to March 2025. Results/Anticipated Results: It is anticipated that participants will encounter fewer barriers to completing the TDP application when using the tool. We expect to see an improvement in user experience by simplifying complex procedures and guiding participants through mock applications with generated scenarios. Data collected from user feedback will highlight specific elements of the tool that require enhancement. Ultimately, we anticipate an increase in successful TDP applications among participants and improvements in accessibility and efficiency of the application process for PrEP users aged 23 to 64 years in Ontario. Discussion/Significance of Impact: The developed tool aims to reduce financial barriers to PrEP access by facilitating successful enrolment in the TDP. The project’s broader impact includes improving health outcomes for underserved communities and contributing to equitable healthcare service delivery.
Objectives/Goals: Community members in North Central Florida who were identified with high mental health burden, through completion of a Health Needs Assessment in our community engagement program, experienced higher rates of health disparities like food insecurity, recent marijuana use, and burden of disease compared to persons with lower mental health burden. Methods/Study Population: Data were collected through HealthStreet, a University of Florida community engagement program to reduce disparities in healthcare and research. Multivariate and logistic regression analyses were conducted to identify differences between community members with high mental health burden (HMHB; reported depression and scored 8–10 on the stress/loneliness scale) and people with low mental health burden (LMHB; no reported depression and scored 1–7 on the stress/loneliness scale) on age, sex, race, food insecurity, trust in research/researchers, recent marijuana use, high blood pressure, and anxiety. Results/Anticipated Results: Among 3,736 CMs, 21.9% (n = 819) were considered to have high mental health burden. They were statistically significantly more likely to be middle-aged (37.9% vs. 31.2% LMHB), food insecure (62.6% vs. 35.2% LMHB), self-reported marijuana use in the past 30 days (29.2% vs. 15.5% LMHB), and experienced anxiety (70.8% vs. 34.4% LMHB). There were no differences by sex or trust. Discussion/Significance of Impact: People with HMHB do in fact have more disparities than people with LMHB but trust in research(ers) is not affected. These disparities contribute to significant distress over the lifespan. HealthStreet has engaged people with higher mental health burden and provided social referrals, which is crucial to reduce disparities and improve outcomes.
Objectives/Goals: The purpose of this study was to document the publicly available literature, measurement tools, secondary data, and expert perspective on the intersectional care gaps and disparities of children with palliative needs in foster care. Methods/Study Population: Four data collection methods determined the frontier of available information on the palliative needs of children in foster care. A literature review assessed the quality and content of published evidence. A catalogue of relevant measures tools and validation results determined what psychometric tools exist for the population, how well they performed in validation studies, and if any incorporated community members in their development. The National Data Archive for Child Abuse and Neglect was consulted to assess whether existing secondary data was fit for purpose. Informal interviews will be conducted with subject matter experts (pediatrics, palliative care, foster care) to determine the legitimacy and urgency of the problem. Results/Anticipated Results: Health inequities among children in foster care and children with medical complexity (CMC) suggest a strong likelihood of unmet palliative care needs for CMC in foster care; however, no literature or data describe the scope and severity, and few insights support development of safe and supportive interventions to meet these needs. No national publicly available datasets include both foster-related case or placement information and diagnosis or service-specific data, including Medicaid data and the Adoption and Foster Care Analysis and Reporting System (AFCARS). No work has been published integrating foster parents or former foster youth input on palliative needs. Participatory action research methodologies with critically ill patients have led to improvements in patient experience and clinical care. Discussion/Significance of Impact: The lack of data, community engagement, and validated measures to identify palliative needs of children in foster care stymie efforts to identify and correct health inequities. Participatory action research is needed to meaningfully engage foster and health care partners to determine what palliative care needs should be prioritized and measured.
Objectives/Goals: The goals of this research are to 1) determine the prevalence of perinatal doula services use in Virginia, with a focus on individuals with substance use disorders (SUD), 2) evaluate awareness of doulas among pregnant and postpartum people with SUD, and 3) assess provider knowledge and interaction with doulas for the care of this population. Methods/Study Population: Both quantitative and qualitative methods will be used to evaluate patient and healthcare provider knowledge regarding doula services and the patient–doula–healthcare provider relationship. Surveys and semi-structured interviews will be administered to doulas, pregnant and postpartum women, and healthcare providers in this mixed-methods approach. Information from the Centers for Medicare and Medicaid Services National Provider Identifier (NPI) Registry, and doula training programs will be utilized to recruit doulas for participation. Paper and online recruitment materials will be posted to engage pregnant and postpartum individuals. Healthcare provider recruitment will occur via the NPI Registry along with contacting physicians’ practices. SAS 9.4 and NVivo will be utilized for analysis. Results/Anticipated Results: This proposed research will be an initial assessment of the current state of doula services utilization, mothers’ knowledge of doulas and their purpose, and healthcare providers’ awareness of and partnership with doulas to provide optimal birthing and postpartum experiences to the pregnant and parenting population with and without SUD. Results from this study will be disseminated to community doulas, pregnant people and mothers with substance use disorders, and relevant healthcare providers to decrease barriers to doula care and advocate for consistent, systematic documentation of doula services in the medical record and in public health surveillance systems. Discussion/Significance of Impact: This study will be the first study to assess doula services utilization in Virginia, with a specific focus on pregnant and postpartum women with substance use disorders. This work will support advocacy for improved data capture and utilization regarding doula services in order to reduce barriers to care and improve perinatal outcomes.
Objectives/Goals: Substantial evidence supports the use of community engagement in CTS. Yet, there is a lack of empirical basis for recommending a particular level of community engagement over others. We aimed to identify associations between level of community involvement and study process outcomes, focusing on procedures to promote enrollment and inclusion. Methods/Study Population: Using manifest content analysis, we analyzed community engagement (CEn) strategies of studies indexed in ClinicalTrials.gov, focusing on studies 1) associated with 20 medical schools located in 8 southern states in the Black Belt, 2) conducted in 2015–2019, and 3) on 7 topics: cancer, depression, anxiety, hypertension, substance use disorder, cardiovascular disease, and HIV/AIDS. Data source was the ClinicalTrials.gov entry and publication for each study. We categorized each study on level of community involvement as described by the study protocol CTSA Consortium Community Engagement Key Function Committee Task Force on the Principles of Community Engagement continuum. Outcomes included recruitment and representativeness. Other codes included funder type, study phase, study status, and time to enrollment. Results/Anticipated Results: Of 890 studies that met inclusion criteria, only 493 had published findings. 286 studies (58%) met enrollment targets. Only 9 studies described any level of CEn (1 outreach, 3 consult, 1 involvement, 3 collaboration, and 1 shared leadership). Time to enrollment for these 9 studies (mean 28.78 mos.) was shorter than for studies without CEn (mean 37.43 months) (n.s.). CEn studies reached significantly higher enrollment (CEn mean = 2395.11, non-CEn mean = 463.93), p Discussion/Significance of Impact: Results demonstrate the substantial effect of CEn on enrollment and inclusion in clinical studies. However, the infinitesimal number of studies that reported CEn did not allow comparisons of level of engagement on the outcomes. Findings highlight ethical questions surrounding the lack of publishing incomplete studies.
Objectives/Goals: To evaluate disparities in diabetes outcomes between Hispanic/Latinx and non-Hispanic participants in a medically tailored meal intervention, assess effect modification by ethnicity/language, and explore cultural factors influencing intervention effectiveness for diverse T2DM populations. Methods/Study Population: This mixed-methods study, part of the Changing Health through Food Support for Diabetes RCT (n = 246), compares standard diabetes care to a 6-month medically tailored meal intervention for T2DM patients with food insecurity. It examines differences in intervention effectiveness among Latinx, Spanish-speaking participants and non-Latinx, English-speaking participants from San Francisco and Alameda counties. Quantitative measures include HbA1c, food security scores, and hospitalization rates. Qualitative interviews explore diabetes management, food access, and cultural factors. Baseline disparities are assessed using t-tests and chi-square analyses, while longitudinal changes are evaluated with mixed-effects models. Thematic analysis of qualitative data identifies emerging patterns. Results/Anticipated Results: We expect to find significant baseline disparities in glycemic control and food security between Latinx- and Spanish-speaking participants compared to their counterparts. The medically tailored meal intervention is anticipated to show differential effectiveness, with potentially smaller improvements among Latinx and Spanish-speaking groups. While we hypothesize that medically tailored meals will lead to improved glycemic control and reduced food insecurity across all groups, the magnitude of improvement may vary. Qualitative data are expected to reveal unique cultural and linguistic barriers contributing to these disparities, as well as insights into the acceptability and cultural appropriateness of the intervention. Discussion/Significance of Impact: This study will inform culturally tailored medically tailored meal interventions for Hispanic/Latinx- and Spanish-speaking populations, addressing disparities in diabetes outcomes and food security. Findings will shape “food is medicine” initiatives and policies to reduce chronic disease burden and health inequities in diverse communities.
Objectives/Goals: As translational researchers, we seek to offer more treatments to more people, more quickly. Essential to this mission, we must demonstrate trustworthiness to establish trusted with those we seek to benefit. Research Jam uses a human-centered design (HCD) research approach to achieve this. Methods/Study Population: HCD is an iterative process that focuses on understanding people’s contexts while designing products and services collaboratively with the people who will interact with and be affected by the research. This generative approach helps participants express tacit and latent knowledge – emotions, needs, and desires that are often challenging to communicate verbally. We work with individuals who have lived experience relevant to the research being conducted and use HCD activities to help people share their thoughts, concerns, and ideas. These activities are highly interactive, promote collaboration, and explore topics with respect and sensitivity. Results/Anticipated Results: At Indiana Clinical and Translational Sciences Institute, we use the AAMC’s principles of trustworthiness. These principles parallel the tenets of HCD research; thus, taking an HCD research approach naturally builds trust between the researcher and participants and offers tangible benefit to the research, the researcher, and those with lived experience who participate. We have ten years of work collaborating with 40 PIs and over 600 participants. Our experiences demonstrate that this approach can create an environment where participants feel comfortable as they share their thoughts, concerns, and ideas which influences the research that could affect their lives. Discussion/Significance of Impact: An HCD approach helps demonstrate a researcher’s trustworthiness with the population being served. This is essential to achieve a lasting impact by discovering the best solutions from the community’s perspective and identifying partners to help implement solutions.
Objectives/Goals: 1. Demonstrate the need to apply principles of community-engaged research to various stages of the research process. 2. Outline the process of using CE Studio(s) to redesign an interview guide for service providers of youth involved in the justice system. Methods/Study Population: Service-providers provide a critical lens with which to view the sexual health needs of justice-involved youth. Minimal research describes the unique perspectives of those who work directly with this vulnerable population to address their sexual health needs. The goal of this project is to outline the process of using CE Studio(s) to redesign an interview guide for service providers. The guide is aimed at gathering insight into the knowledge, access, and use of sexual health services for justice-involved youth. Preparation involves the preplanning phase, including the drafting of the interview guide; engagement consists of recruitment and implementation of the CE Studio; and restructuring will outline the application of feedback and finalization of the interview guide. Results/Anticipated Results: During the preparation phase, the researcher was tasked with (1) developing a visual guide to highlight key points of the research study and (2) providing a draft of the tentative interview guide for review prior to the CE Studio session. For the engagement stage, participants were recruited from listservs, community organizations, and word-of-mouth to participate in a session facilitated by a member of the CE Studio team. Lastly, we anticipate that the restructuring phase will not only allow us to use feedback from the CE Studio session to alter the interview guide but provide insight into potential recruitment strategies for the overarching research project. Discussion/Significance of Impact: Leveraging CE Studios to elicit feedback from service providers will provide unique insight into addressing the sexual health needs of justice-involved youth. We expect that the overall CE Studio process and feedback will be integral in eliciting strong qualitative feedback and shaping the implementation of the overall research project.
Objectives/Goals: Despite significant advancements, adolescent and young adult (AYA) patients with hematologic malignancies continue to have inferior improvement in survival over time compared to their younger and older peers. This project assesses which patient and neighborhood characteristics are associated with clinical trial enrollment in this population. Methods/Study Population: We will perform a retrospective study of individuals, aged 15–39, diagnosed and treated at Children’s Healthcare of Atlanta (CHOA) or Winship Cancer Institute for hematologic malignancies between 2011 and 2023. Our primary exposure variables will be race/ethnicity, the area deprivation index (ADI), and the index of concentration at the extremes (ICE). The primary study outcome will be enrollment in an open frontline therapeutic clinical trial (yes vs. no). Our analyses will estimate the crude and adjusted odds ratio of clinical trial enrollment according to race/ethnicity, ADI, and ICE; these analyses will be adjusted for co-variables of interest (e.g. patient primary language, and insurance provider). As a secondary analysis, we will further subdivide the patients by treatment location and by age tertiles. Results/Anticipated Results: Our study team completed preliminary work looking at institutional clinical trial enrollment in a pediatric-only (Discussion/Significance of Impact: We expect that this study conducted in a large, diverse AYA cohort will reveal key associations about likelihood of clinical trial enrollment. Once these associations are known, we can develop and test interventions –such as augmented social work involvement and assistance with transportation– to mitigate the effect of amenable risk factors.