ABSTRACT IMPACT: This work will inform the ongoing development of adaptive capacity and preparedness of the CTSA Program and other clinical and translational research organizations in their quest of improving processes that drive outcomes and impacts, shaping effective programs and services, and strengthening their emergency readiness and sustainability. OBJECTIVES/GOALS: -Share the progress and preliminary findings of an ‘Adaptive Capacity and Preparedness of CTSA Hubs’ CTSA Working Group; -Improve our awareness and understanding of the efficient and effective changes helping CTSA hubs build robust capacity to address METHODS/STUDY POPULATION: A multi-case study including: - Triangulating multiple sources of information and mixed methods (survey/interviews of research administrators, researchers, evaluators, and other key stakeholders), literature review, document and M&E system information analysis, and expert review; - Describing CTSA hubs’ experiences as related to research implementation, translation, and support during the time of emergency; - Administering a comprehensive survey of the CTSAs addressing their challenges, lessons learned, and practices that work in various program components/areas. Data collection includes aggregate and cross-sectional data, with representation based on CTSA size, maturity, and population density. RESULTS/ANTICIPATED RESULTS: The described approach shows sound promise to investigate and share strategies and best practices for building adaptive capacity and preparedness of CTSAs -- across various scientific sectors, translational research spectrum, and the goals outlined by NCATS for the CTSA program. The anticipated results of this research will include the identified/shared innovative solutions and lessons learned for this rapidly emerging, high-priority clinical and translational science issue. ‘High-quality lessons learned’ are those that represent principles extrapolated from multiple sources and triangulated to increase transferability to new contexts and situations. DISCUSSION/SIGNIFICANCE OF FINDINGS: The project provides useful knowledge and tools to research organizations and stakeholders across multiple disciplines -- for mitigating the impact of the COVID-19 disaster via effective adjusting programs, practices, and processes, and building capacity for future successful, ‘emergency ready and responsive’ research and training.

ABSTRACT IMPACT: Results will inform the design of health information technologies that assess and improve clinicians’ interpersonal communication supporting co-management of care across health institutions. OBJECTIVES/GOALS: Poor communication and co-management of comorbidities during the referral process increase physician workload, patient burden, and safety risks. In this preliminary study, our objective was to understand how consultants’ notes support physician collaboration within and across health care institutions. METHODS/STUDY POPULATION: We reviewed medical records. Accessing the Indiana Network for Patient Care database, consultation notes were randomly selected from four specialties: cardiothoracic surgery, neurology, rheumatology, and oncology. These specialties were identified, in advance, as challenging in interprofessional communication. The notes reviewed were associated with in-person consultations at a medical network in the Midwest from 2016 to 2019, including internal and cross-institutional (i.e., external) referrals. The Quality of Consult Assessment tool was adapted to assess note quality and co-management facilitation. Two researchers reviewed all records independently. A consensus meeting was then held to discuss and resolve discrepancies. RESULTS/ANTICIPATED RESULTS: Medical records of ten patients with comorbidities were reviewed. The mean age was 67 (SD= 12 years); one patient was a child. All consultation notes contained clinical recommendations. Seventy percent of notes referred to explicit consultant responsibilities. Conversely, only one contained explicit responsibilities for referrers. Medical records denoted reliance on support staff to send messages among referrers, consultants, and patients via phone calls and facsimile. The use of fax machines to send medical records to referrers was more prominent after cross-institutional consultations. DISCUSSION/SIGNIFICANCE OF FINDINGS: Clinical documentation supported specialty referrals for transitions of care rather than co-management of care. Accessing medical records across institutions contributed to a lack of clinical context, and workflow inefficiencies, when attempting to co-manage clinical care.

ABSTRACT IMPACT: Investigators in clinical and translational research will be better supported by CTSAs that reduce barriers to the efficient and effective utilization of their program services. OBJECTIVES/GOALS: Evidence from three CTSAs show that investigators do not take advantage of all program services provided. This session will explore the patterns and sources of underutilization by sharing preliminary results from investigators and program managers. METHODS/STUDY POPULATION: Interviews with investigators at all three CTSA sites were conducted in Spring 2020. Investigators who had only used one program service and those who had used multiple program services across a span of three-years (2016 to 2018) were included in the sample. Investigators who had only used REDCap, were excluded. Interviews numbered about six interviews per site. Content analysis helped identify emerging themes and patterns. A survey with program managers at the three CTSA sites will be deployed in January 2021. Program managers across all programs will be included in the sample. Basic descriptive analysis will be used to analyze the data. RESULTS/ANTICIPATED RESULTS: Interviews with investigators at all sites illuminated ways different investigators use, learned about and leveraged services, as well as the barriers they encountered to using cross-program services. Investigators also provided thoughts on ways to address lack of program service use. Survey results are expected to clarify program managers’ knowledge of other program services in their CTSA, programs’ referral processes, and the barriers program managers face when recommending other services to users. DISCUSSION/SIGNIFICANCE OF FINDINGS: When investigators do not take full advantage of all program services provided, investigators are put at risk of having longer, less successful projects. Knowing the sources of underutilization can help curb this trend and effectively address investigator needs throughout the research process.

ABSTRACT IMPACT: This project successfully implemented a promising team science model by introducing and facilitating best practices to develop high functioning teams working to accelerate health innovations from bench to bedside. OBJECTIVES/GOALS: The goal of this project was to improve the team science knowledge, skills, and attitudes of interdisciplinary engineering students (undergraduate and graduate) who were partnered with health professionals to develop technical solutions to translational health challenges during a year-long Engineering Innovation in Health (EIH) program. METHODS/STUDY POPULATION: We adapted, implemented, and evaluated team science training content and approaches in the EIH program at the University of Washington (UW). EIH faculty and the UW Institute of Translational Health Sciences’ (ITHS) Team Science Core co-developed and delivered highly interactive team science training modules and evaluated their impact with biannual surveys. A student cohort was surveyed prior to the implementation of the team science trainings, which served as a baseline. Descriptive statistics were used to summarize student demographics and survey responses within and between years. Median and interquartile range of responses to Likert-type questions were calculated, and Mann-Whitney U Tests (independent samples Wilcoxin Rank Sum Tests) were used to test for differences within and between years. RESULTS/ANTICIPATED RESULTS: During both the baseline and the team training year, student demographics were similar in terms of gender and past experience working in teams. Team training during the first year of implementation was well-received. Post-implementation surveys of students demonstrated measurable improvement in team dynamics, communication, and effectiveness; including, students reporting higher levels of psychological safety and self-efficacy within their teams. Comparisons within the team training year and between the baseline and team training years identified numerous instances in which differences were statistically significant. DISCUSSION/SIGNIFICANCE OF FINDINGS: Tailored team science training in an interdisciplinary EIH program was successful at improving psychological safety and self-efficacy among undergraduate and graduate students and offers a promising model for similar settings and audiences.

ABSTRACT IMPACT: Many who suffer from end-stage organ disease do not qualify for solid organ transplantation because of obesity; however, bariatric surgery offers the potential to render select patients transplant-eligible, and in some cases, may lead to weight loss that is sufficient to reverse end-stage organ disease. OBJECTIVES/GOALS: As obesity prevalence grows, more end-stage organ disease patients will be precluded from transplant. Numerous reports suggest bariatric surgery in end-stage organ disease may help patients achieve weight loss sufficient for transplant listing, though the published data are limited. METHODS/STUDY POPULATION: We performed a systematic review/meta-analysis of studies of bariatric surgery to achieve solid organ transplant listing. RESULTS/ANTICIPATED RESULTS: Among 82 heart failure patients, 40.2% lost sufficient weight for listing, 29.3% were transplanted, and 8.5% had sufficient improvement with weight loss they no longer required transplantation. Among 28 end-stage lung disease patients, 28.6% lost sufficient weight for listing, 7.1% were transplanted, and 14.3% had sufficient improvement following weight loss they no longer required transplant. Among 41 cirrhosis patients, 58.5% lost sufficient weight for listing, 41.5% were transplanted, and 21.9% had sufficient improvement following weight loss they no longer required transplant. Among 288 end-stage/chronic kidney disease patients, 50.3% lost sufficient weight for listing and 29.5% were transplanted. DISCUSSION/SIGNIFICANCE OF FINDINGS: Small sample size and publication bias are limitations; however, bariatric surgery may benefit select end-stage organ disease patients with obesity that precludes transplant candidacy.

ABSTRACT IMPACT: Up to 33% of patients of patients who undergo reconstruction have hostile defects with coexisting soft tissue and osseous defects due to prior radiation, prior failed cranioplasty or concurrent infections we seek to identify optimal strategies for these patients based on the experience of a southeastern tertiary referral center. OBJECTIVES/GOALS: Scalp and calvarial defects in patients may result from a number of etiologies including trauma, burns, tumor resections, infections, osteoradionecrosis, or congenital lesions. Our objective was to retrospectively evaluate the use of alloplastic reconstruction alongside autologous reconstruction for high risk cranial defects. METHODS/STUDY POPULATION: An IRB approved retrospective review of patients who underwent cranioplasty of a hostile site at a Southeastern tertiary referal center between January 2008 and December 2018 was performed. The patients were stratified into three groups based on the type of implant used: autogenous (bone), alloplastic (PEEK, Titanium, PMMA), or mixed (combination of both types of graft). The primary outcome metric was a complication in the year following cranioplasty, identified by flap or bone graft failure, necrosis, or infection. Statistical analysis included t-tests and chi-square tests where appropriate using SPSS. RESULTS/ANTICIPATED RESULTS: There were 43 total cases in this time period; 15 autogenous, 23 alloplastic, and 5 mixed. The purely autogenous group had the highest complication rate (85%) and the alloplastic group had the lowest complication rate (38%). When stratified by specific material used for reconstruction (15 bone, 14 PEEK, 10 titanium, and 5 PMMA), overall complication rate was statistically significant (p=0.009; chi square test) with PEEK implants having the lowest complication rate (21%). The analysis documented an overall complication rate that was statistically different between the three groups (p=0.012). DISCUSSION/SIGNIFICANCE OF FINDINGS: This analysis interestingly found that in the setting of hostile cranial defects, cranioplasties would benefit from the use of prosthetic implants instead of autologous bone grafts, not only for avoidance of donor site morbidity but also for decrease in overall complications.

ABSTRACT IMPACT: Patients living in overcrowded zip codes were at increased risk of contracting severe COVID-19 after controlling for confounding disease and socioeconomic factors OBJECTIVES/GOALS: This study sought to examine whether residences in over-crowded zip codes with higher reported over-crowding represented an independent risk factor for severe COVID-19 infection, defined by presentation to an emergency department. METHODS/STUDY POPULATION: In this zip code tabulated area (ZCTA)-level analysis, we used NYC Department of Health disease surveillance data in March 2020 merged with data from the CDC and ACS to model suspected COVID-19 case rates by zip code over-crowdedness (households with greater than 1 occupant per room, in quartiles). We defined suspected COVID-19 cases as emergency department reported cases of pneumonia and influenza-like illness. Our final model employed a multivariate Poisson regression models with controls for known COVID-19 clinical (prevalence of obesity, coronary artery disease, and smoking) and related socioeconomic risk factors (percentage below federal poverty line, median income by zip-code, percentage White, and proportion of multigenerational households) after accounting for multicollinearity. RESULTS/ANTICIPATED RESULTS: Our analysis examined 39,923 suspected COVID-19 cases across 173 ZCTAs in NYC between March 1 and March 30 2020. We found that, after adjusted analysis, for every quartile increase in defined over-crowdedness, case rates increased by 32.8% (95% CI: 22.7%% to 34.0%, P < 0.001). DISCUSSION/SIGNIFICANCE OF FINDINGS: Over-crowdedness by zip code may be an independent risk factor for severe COVID-19. Social distancing measures such as school closures that increase house-bound populations may inadvertently worsen the risk of COVID-19 contraction in this setting.

ABSTRACT IMPACT: Evaluate the impact that the Kidney Allocation System has had on racial and ethnic disparities in pediatric deceased donor kidney transplant recipients. OBJECTIVES/GOALS: Racial and ethnic minority pediatric transplant candidates have known disparities in access to kidney transplantation. The Kidney Allocation System (KAS), implemented in 2014, was designed in part to alleviate some of these disparities thereby making transplant more equitable. We investigated the effect of KAS on reported disparities. METHODS/STUDY POPULATION: We utilized Scientific Registry of Transplant Recipients (SRTR) data to determine differences in new waitlist registrants, deceased donor (DDKT) and living donor kidney transplants (LDKT), HLA mismatch, and allograft survival among pediatric patients of different racial and ethnic backgrounds. RESULTS/ANTICIPATED RESULTS: Black pediatric patients represented 21.3% of new waitlist registrants pre-KAS and 18.9% post-KAS. Waitlist time increased for pediatric patients of all races post-KAS with the highest increase (131 days) in Asian patients (p < 0.01). The racial distribution of DDKT pre- and post-KAS was unchanged (White 38.4% vs 38.3%, Black 24.5% vs 22.5%, Hispanic 30.6% vs 31.1%, Asian 3.7% vs 4.4%, p = 0.12). The 3-yr graft failure rate is disproportionately worse in Black children compared to other races pre- and post-KAS (White 6.8% vs 5.3%, Black 14% vs 8.7%, Hispanic 8% vs 4.5%, Asian 6.6% vs 6.7%, Other 6.5% vs 2.9%) although there is a trend towards better graft survival in the post-KAS era. Graft survival worsened in Asian children in the post-KAS era (HR 2.34,95% CI 1.05 - 5.25, p=0.038). DISCUSSION/SIGNIFICANCE OF FINDINGS: Racial and ethnic disparities in pediatric ESRD patients have not been ameliorated by KAS. Children of color have longer waitlist time and are more likely to have graft failure. Alarmingly, allograft failure rate increased in Asian patients post-KAS, which merits further evaluation.

ABSTRACT IMPACT: Advanced spatial analysis techniques are used to target a community education intervention for Immigrant and African American women to increase breast cancer screening. OBJECTIVES/GOALS: We are addressing breast cancer screening disparities through the development of the COmmuNity kNowlEdge to aCtion Toolkit (CONNECT). CONNECT implements a mixed-methods approach using GIScience, community education, and social media to mitigate the impact of breast cancer screening disparities for Immigrant African and African American women. METHODS/STUDY POPULATION: We used advanced spatial analysis techniques, Spatially Adaptive Filters (SAF) to reveal mammography screening rates below the state level. SAF create screening maps of This new information allows lay health educators to identify and engage their communities in the Breast Cancer Champions program. We transformed and curated existing cancer educational material into culturally relevant educational training for lay health educators. Lay health educators participate in educational trainings and receive stipends for conducting formal and informal breast cancer education and screening events. RESULTS/ANTICIPATED RESULTS: We have identified four principles for designing culturally relevant education materials.

1. 1. Visual representation of the community in materials

2. 2. Positive Framing

3. 3. Statistics and graphs should be minimal

4. 4. Appropriate reading level and minimizing jargon

Due to COVID-19, our breast cancer champions are engaging with their community in socially responsible ways (i.e., engaging through social media, developing and placing community education flyers, community radio spots). Our social media campaign, which began in October has already attracted over 1000 followers. DISCUSSION/SIGNIFICANCE OF FINDINGS: Despite the disruption of COVID-19, our project continues reduce breast cancer screening disparities. We have developed and created culturally appropriate materials and are currently training Champions. By incorporating an online presence into our community outreach, we are increasing the ways we connect with our community.

ABSTRACT IMPACT: Interventions designed to improve access to healthy food are needed as a mechanism to improve diet quality and ultimately prevent diet-related chronic diseases. OBJECTIVES/GOALS: For people living in food deserts, access to grocery stores is an important consideration toward improving diet quality. The Grocery Access Program (GAP) provided discounted Lyft rides to grocery stores for residents in Baltimore, MD. This study will assess how the GAP impacted access to different food retail stores and healthy food purchases. METHODS/STUDY POPULATION: A mixed methods sequential explanatory design will be used. We collected survey data at baseline and mid-pilot on primary grocery shopping store, frequency of purchasing fruits and vegetables, and frequency of using the discounted Lyft rides for 90 program enrollees. The Healthy Food Availability Index (HFAI), a validated, observation-based instrument, will be used to measure healthy food availability at participants’ primary grocery shopping stores; HFAI scores range from 0-27. We will also compare frequency of self-reported fruit and vegetable purchases before and after GAP participation. Quantitative data analysis using paired sample t-tests and chi square tests will be followed by in-depth interviews with GAP participants; thematic analysis will be used to analyze qualitative data. RESULTS/ANTICIPATED RESULTS: This research is in progress; survey data collection is complete and store-level HFAI data collection will begin soon. We hypothesize that GAP participants will have shopped at stores with higher HFAI scores than non-participants, and that participants will have purchased healthy foods more frequently than they did prior to GAP participation. If these hypotheses are not supported, our qualitative findings will elucidate potential reasons and mechanisms for improving the program. If our hypotheses are supported, it will provide evidence for the GAP as a convenient, low-cost intervention to improve healthy food access for people in low-income communities. DISCUSSION/SIGNIFICANCE OF FINDINGS: Access to healthy foods is an important social determinant of health, and innovative strategies that can facilitate better dietary habits are needed in the area of food access research. Findings from this study could be used to scale up efforts that will foster better food access, healthier diets, and ultimately better health outcomes.

ABSTRACT IMPACT: This study provides a framwork to inform and organize health equity efforts and initiatives at CTSA institutes. OBJECTIVES/GOALS: to map the activities of the Clinical and Translational Science Award (CTSA) Program hubs across the EQ-DI framework, to depict opportunities for interaction between health equity and dissemination & implementation (D&I) science. METHODS/STUDY POPULATION: The EQ-DI framework demonstrates the dynamic interaction between D&I science and health equity. Health equity could be a lens to sensitize and inform D&I planning (through goal-setting and team development), execution (through ‘adaptation’ and D&I strategies), and evaluation (through incorporating health equity in D&I outcome assessment). On the other hand, D&I models, methods, and study designs can operationalize dissemination and implementation of evidence-based interventions to improve equity. Stakeholder engagement is at the center of the framework to inform and direct the sensitization and operationalization cycles. RESULTS/ANTICIPATED RESULTS: We reviewed the activities of Colorado Clinical & Translational Sciences Institute (CCTSI) and University of Rochester Clinical and Translational Science Institute (UR CTSI) to improve health equity and mapped them across the EQ-DI framework. The sensitizing activities included health equity training, eliciting community priorities, and inclusion of health equity as a critical axis in funding mechanisms. The operationalizing activities included D&I methodological training and consultation, collaborative team science, and funding mechanisms to support implementation of health equity EBIs. Community engagement through studios, community liaisons, and consults was a core priority guiding sensitizing and operationalizing activities. DISCUSSION/SIGNIFICANCE OF FINDINGS: The CTSA Program has been a champion for community engagement and translational collaboration to improve individual and population health. CTSA hubs provide infrastructure and resources to facilitate equity-focused D&I.

ABSTRACT IMPACT: Throughout the COVID-19 pandemic, the UTMB Institute for Translational Sciences has sought to answer our communities’ needs for research, for knowledge of research, and involvement in research, while recognizing that meaningful engagement involves understanding all emergent needs and responding to maximize the health and well-being of those we serve. OBJECTIVES/GOALS: ITS community programs responsive to COVID-19 include:

ο Ongoing communication with community and business stakeholders

ο Social media and public health campaigns promoting safe practices, research updates, and testing information

ο Community initiatives to increase testing among vulnerable populations METHODS/STUDY POPULATION: Like sister hubs across the US, the UTMB ITS has brought available resources to bear on addressing COVID-19 through research, medical response, and public health outreach. Community engagement activities have included facilitating communication, particularly by rapidly translating information for multiple audiences and wherever possible and appropriate, providing opportunities for the patient’s voice to inform and guide development of research. We realized the community’s need for trustworthy and reliable information about COVID-19 early in the pandemic. Key partnerships with community members and organizations were critical in enabling us all to be most responsive in meeting these needs. RESULTS/ANTICIPATED RESULTS: ITS community outreach included developing infographics, media notices, and educational materials related to prevention and testing as well as appropriate use of PPE. These efforts resulted in an article in a regional newspaper, which was disseminated widely through social media networks. ITS faculty also engaged doctoral and MPH trainees to support the Health District’s contact tracing effort. We held several events on mental health impacts as well as discussions related to health disparities. Both activities shaped plans for community-based interventions and research. The ITS also hosted a virtual workshop to facilitate discussion around key research questions related to the pandemic. DISCUSSION/SIGNIFICANCE OF FINDINGS: Throughout the pandemic, the ITS has maintained contact with stakeholders. Our roles have been to communicate, disseminate, translate, provide resources, and build bridges. We also listen, share, and provide opportunities for patients and communities to engage in all phases of the research spectrum.

ABSTRACT IMPACT: Leverage community engagement to continue moving translational science and research forward. OBJECTIVES/GOALS: Engaging community in translational research improves innovation and speeds the movement of evidence into practice. Yet, it is unclear how community is engaged across the translational research spectrum or the degree of community-engagement used. We conducted a scoping review to fill this gap. METHODS/STUDY POPULATION: We used the PRISMA model search strategy with a range of databases (e.g., PubMed/Medline, Scopus) to identify articles published between January 2008 and November 2018 (n=167) and eliminated studies that did not use any level of community-engagement (n=102). Studies were coded for translational stage-corresponding to T0 (basic science), T1 (basic science to clinical research in humans; n=6), T2 (clinical efficacy and effectiveness research, n=45), T3 (dissemination and implementation research, n=95), and T4 (population health, n=21) as well as the degree of community engagement from least to most intensive (i.e., outreach, consultation, involvement, collaboration, shared leadership). RESULTS/ANTICIPATED RESULTS: The final number of eligible articles was 65. There was a relatively balanced distribution across levels of community engagement across articles (i.e., outreach, n=14; consultation, n=13; involvement, n=7; collaboration, n=15; shared leadership, n=16). Within these articles, the depth of community engagement varied with higher engagement typically occurring at later stages of translational research (T3 and T4), but more specifically in the dissemination and implementation science stage (T3). However, shared leadership, the most intensive form of engagement, was found in T2, T3, and T4 studies suggesting the value of community-engagement across the translational research spectrum. DISCUSSION/SIGNIFICANCE OF FINDINGS: A strong understanding of how various levels of community engagement are used in translational research, and the outcomes they produce, may to expedite the translation of knowledge into practice and enable practice-based needs to inform policy.

ABSTRACT IMPACT: This study identifies potential areas for community and clinical interventions to improve eye and vision health. OBJECTIVES/GOALS: The ‘All Eyes on Us’ study sought to understand perceptions of and barriers to eye and vision care, of residents over the age of 40 in the Broadway/Slavic Village neighborhood in Cleveland, Ohio. The goal of this study was to identify potential areas for community and clinical interventions to improve eye health. METHODS/STUDY POPULATION: Residents of the Broadway/Slavic Village neighborhood, an ethnically diverse, low socioeconomic status, neighborhood in Cleveland, Ohio were recruited from, and with the assistance of, University Settlement, a nonprofit that has been providing services to the neighborhood since 1926. The project’s Community Advisory Board assisted with the development of a semi-structured interview guide over the course of three meetings. Sixty interviews were completed, 30 with self-identified European Americans and 30 with self-identified African-Americans, all over the age of 40. Two research team members coded the interview transcripts and a thematic analysis was conducted. RESULTS/ANTICIPATED RESULTS: Participants identified barriers to obtaining eye and vision care for themselves as well as perceived barriers for others, including transportation, cost, insurance status, clinic locations, lack of education around eye and vision care, fear, forgetfulness, and priority management. To encourage people to go to the eye doctor more often, participants mentioned strategies related to access issues including lowering the cost of exams, operating on a sliding scale, improving insurance coverage, transportation services, and having mobile units that deployed to specific neighborhoods or senior centers. Additionally, participants suggested education and increasing awareness about the importance of eye and vision care. DISCUSSION/SIGNIFICANCE OF FINDINGS: Participants in this study identified that accessibility to and awareness about eye health and eye care is an issue. Interventions to address both access issues such as location, cost, and insurance as well as those that increase education could increase engagement with eye and vision care.

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.

ABSTRACT IMPACT: Our implementation model translates two evidence-based nutritional and behavioral interventions to lower blood pressure, into a community-based intervention program for seniors receiving congregate meals. OBJECTIVES/GOALS: The Rockefeller University, Clinical Directors Network, and Carter Burden Network received an Administration for Community Living Nutrition Innovation grant to test whether implementation of DASH-concordant meals and health education programs together lower blood pressure among seniors aging in place. METHODS/STUDY POPULATION: n=200, >60 yr, >4 meals/week at CBN; engagement of seniors/stakeholders in planning and conduct; Advisory Committee to facilitate dissemination; menus aligned with Dietary Approaches to Stop Hypertension (DASH) and NYC Department for the Aging nutritional guidelines; interactive sessions for education in nutrition, BP management, medication adherence. Training in use of automated daily home BP monitors (Omron 20). Validated surveys at M0, M1, M3, M6. Taste preference and cost assessed through Meal Satisfaction (Likert scale) and Plate Waste measures. Primary Outcome: Change in Systolic BP (SBP) at Month 1; change in %BP controlled. Secondary: validated cognitive, behavioral, nutritional measures (SF-12, PQH-2), economics; staff/client satisfaction, trends and significant associations. RESULTS/ANTICIPATED RESULTS: n=94, x2 age =73 +/- 8 years, 65% female, 50% White, 32% Black/African American, 4% Asian, 1% American Indian, Alaskan Native, 13% Other, 32% Latino/a, 43% with income <$20,000. Mean SBP at Baseline was 137.87 +18.8 mmHg (range 98-191). Menus were adapted to provide 20% daily DASH requirements at breakfast, 50% at lunch. Participants attended classes in nutrition and medication management and were provided with and trained to use an automated home BP monitor. Meal satisfaction scores dipped briefly then met or exceed pre-DASH levels. Home BP data was downloaded every 2-4 weeks with social/behavioral support. The COVID-19 closures interfered with BP outcome data collection and meal service ceased. Primary outcome: x2 change in SBP at Month 1 = -4.41 mmHg + 18 (n=61) (p=0.713). Significant associations will be reported. DISCUSSION/SIGNIFICANCE OF FINDINGS: Our community-academic research partnership implemented the DASH diet in congregate-meal settings to address uncontrolled hypertension in seniors. COVID-19 interrupted the study, but encouraging trends were observed that may inform refinement to this community-based health intervention for seniors.

ABSTRACT IMPACT: This translational study demonstrates a method for identifying possible mechanisms underlying a highly effective randomized control trial intervention so that a university-public health agency partnership might replicate intervention components in a scalable, feasible, community version of the program. OBJECTIVES/GOALS: The Barbershop Study was a cluster randomized control trial which demonstrated that clinical pharmacist directed care, provided to African American men in community barbershops, significantly improve hypertension control. We sought to understand which components of the intervention the participants and implementers considered most important. METHODS/STUDY POPULATION: Enrollment in the Barbershop Study included 319 men from 52 barbershops across Los Angeles. Two specialty trained clinical pharmacists led the intervention. We performed 32 structured interviews of 20 study participants, 10 barbers, and 2 clinical pharmacists approximately 1 year after the study’s completion. Interviews consisted of 27, 24 and 19 questions for barbers, participants, and pharmacists, respectively. Interviewees were asked about their experience in the study, barriers and facilitators to participation, effective aspects of the intervention, and less helpful components of the design. Interviews were recorded performed by a research assistant uninvolved in the study. Recordings were then transcribed for a qualitative thematic analysis. RESULTS/ANTICIPATED RESULTS: We anticipate facilitators of participant engagement to include the provision of care in the community and integration of services into a regular task (getting their hair cut). Based on prior conceptual models, we also anticipate the provision of care in a trusted setting to be an effective means to enhance participants’ willingness to follow clinical instructions. An anticipated barrier for participants includes the need to go to an offsite pharmacy to pick up their medications. For barbers, we anticipate themes including a desire to help their community, while barriers include potential decreased productivity due to time spent counseling participants. Pharmacists are expected to identify an enhanced sense of importance in their work, while identifying the need to travel as a barrier to the intervention. DISCUSSION/SIGNIFICANCE OF FINDINGS: Insights from this qualitative analysis may assist with adaptation of the highly effective Barbershop intervention, allowing it to be rolled out at scale. If done successfully, achieved reductions in blood pressure may result in reduced health disparities and prevent thousands of strokes, heart attacks and deaths.

ABSTRACT IMPACT: This study will showcase the importance if incorporating patient stakeholders in the development of an interview guide for a women of color with uterine fibroids, an understudied population. OBJECTIVES/GOALS: Black women and Hispanic/Latinas report having greater symptom burden from uterine fibroids (UF), non-cancerous neoplasms, compared to White women. These disparities may be linked to cultural factors resulting in treatment delays. The objective of this study is to provide insights to barriers and facilitators to timely treatment. METHODS/STUDY POPULATION: In partnership with the Fibroid Foundation, a UF advocacy organization, we plan to conduct a virtual community engagement (CE) studio to serve as a first step for a pilot study with a national cohort of Black women and Hispanic/Latinas who receive treatment in the United States for UF. The studios will include a presentation about UF treatment options and a facilitated discussion. The CE team will use past research and constructs from Model of Improvement and Health Belief Model to develop materials for the studio. A qualitative researcher will guide the discussion, a note-taker will take notes, and they will thematically code the notes. The results will be used to create and implement a cross-sectional in-depth qualitative study with a national sample. RESULTS/ANTICIPATED RESULTS: We hypothesize that timely treatment will be impacted by cultural factors, such as health literacy in uterine fibroids and menstruation. We expect that detailed feedback from this national cohort will contribute to greater insight to the experiences of women of color with UF and address barriers and facilitators to treatment. We anticipate the anecdotes will provide information about the influence of culture in seeking treatment for UF. We will utilize this experience to understand the impact of a virtual CE studio in elucidating open discussion among women of color on a challenging and personal topic. DISCUSSION/SIGNIFICANCE OF FINDINGS: Using CE process with advocates and research partners attains a deeper understanding in the development of an interview guide to examine the cultural impact on the treatment of UF for women of color. Understanding cultural barriers and facilitators can help overcome treatments delays in UF along with other gynecological diseases.

ABSTRACT IMPACT: By identifying clear gaps in our knowledge of racial and ethnic disparities in antibiotic-resistant infections, this research is informing the design of (a) community-based interventions and (b) patient-centered research studies that we are currently leading to address these disparities and improve human health. OBJECTIVES/GOALS: Antibiotic resistance (AR) is widely considered to be the next global pandemic. As with COVID-19, the potential for AR to disproportionately impact racial/ethnic minorities is a major concern. Our goal was to identify gaps in knowledge of AR disparities in order to inform the types of interventions that might be most appropriate to address this. METHODS/STUDY POPULATION: We reviewed the literature to examine evidence of racial/ethnic disparities in (a) infections with the most concerning drug-resistant bacteria in the United States, and (b) underlying social-economic or behavioral factors that could contribute to such infections. We searched PubMed and Google Scholar to identify studies published in English between August 1973 - August 2020. We used keywords that included: antibiotic resistance, antibiotic-resistant infections, antibiotic-seeking behavior, prescription/non-prescription antibiotic use, antibiotic education, or health literacy AND race, ethnicity, or socioeconomic status. We screened all abstracts to identify US-based studies that assessed (a) or (b) above. RESULTS/ANTICIPATED RESULTS: We identified 11 studies investigating racial/ethnic disparities for 5 of the 17 drug-resistant bacteria flagged in the CDC’s 2019 Antibiotic Resistance Threats Report. Black, Hispanic, and lower-income individuals were found to be at higher risk of some community-acquired antibiotic-resistant infections. We identified multiple factors that may contribute to disparities in AR-related morbidity and mortality, including reported differences in antibiotic use, higher likelihood of living in crowded/multigenerational homes, more frequent employment in potentially high exposure settings (e.g. slaughterhouses), lower health literacy, and more frequent underlying comorbidities, which increases risks for hospitalization and subsequent acquisition of drug-resistant infections. DISCUSSION/SIGNIFICANCE OF FINDINGS: Given the small number of studies on this topic, educational interventions that aim to raise awareness of this issue must target not only the public but also researchers. Community-based interventions that seek to address disparities in ‘antibiotic resistance literacy’ among minority and underserved groups could be particularly impactful.

ABSTRACT IMPACT: Strengthening investigator and community engagement to improve human health OBJECTIVES/GOALS: Community Engagement is one of the 14 core competencies for CT research defined by the CTSA Education Core Competency Work Group. To meet this, the UMN CTSI created the Community Mentor for Scholars Program with goals to: 1) train Scholars to engage stakeholders; and 2) provide community with formal mentoring training and linkages to researchers at UMN. METHODS/STUDY POPULATION: The CM Program was implemented over 12 months and includes four components. One, Scholars were trained in stakeholder identification and working with a community mentor (CM) through two seminars presented by expert faculty and staff. Two, CMs were identified, recruited, and matched with Scholars through a collaborative effort of our CTSI Education and Community Engagement cores. Three, Scholars and CMs learned about the program from a 2-hour Kick-Off event. Four, CMs and Scholars each completed four online modules developed through an NCATS administrative supplement. Scholar-CM pairs met at least four times to plan and hold a bi-directional ‘Community Conversation’ with an audience of key stakeholders convened by the CM. The CM Program was evaluated through in-person interviews. RESULTS/ANTICIPATED RESULTS: In 2019-2020, CTSI initiated the pilot program with four KL2 Scholar - CM pairs. Two pairs did not complete the program due to time pressures, a parental leave, and the COVID-19 pandemic. Feedback from the two Scholar - CM pairs was positive, specifically:

CMs reported the training modules were useful, resulting in better understanding of CTSI research programs and increased capacity to mentor

Scholars felt the interactions with CMs positively impacted their future research

Mentors supported experiential learning, offered insight on community perspectives, and successfully facilitated community engagement principles. DISCUSSION/SIGNIFICANCE OF FINDINGS: The second cohort launched in late 2020 with inclusion of TL1 Scholars. They will be matched with CMs in spring 2021. After Cohort 2 completion, the program design and materials will be updated based on evaluation results from scholars and mentors and then will be piloted with select CTSAs before sharing across the CTSA consortium.