Early in the COVID-19 pandemic, the World Health Organization stressed the importance of daily clinical assessments of infected patients, yet current approaches frequently consider cross-sectional timepoints, cumulative summary measures, or time-to-event analyses. Statistical methods are available that make use of the rich information content of longitudinal assessments. We demonstrate the use of a multistate transition model to assess the dynamic nature of COVID-19-associated critical illness using daily evaluations of COVID-19 patients from 9 academic hospitals. We describe the accessibility and utility of methods that consider the clinical trajectory of critically ill COVID-19 patients.

OBJECTIVES/GOALS: The present study investigated contextual factors linking rural Black American mens experiences of racial discrimination to their COVID vaccine hesitancy. Specifically, we investigated two potential mediators of the link between racial discrimination and COVID vaccine hesitancy: (1) medical mistrust, and (2) COVID conspiratorial beliefs. METHODS/STUDY POPULATION: Hypotheses were tested using structural equation modeling with 7 waves of data from 504 Black American men participating in a longitudinal study of risk behavior and substance use during young adulthood. At baseline, mens mean age was ~20. Data were collected before and during the COVID pandemic. The COVID pandemic began after Wave 4 data had been collected. A series of 3 online surveys, at 3-month intervals, were conducted to examine acute COVID-related stressors and impacts. RESULTS/ANTICIPATED RESULTS: The dual mediation model fit the data as follows: χ2(7) = 19.00, p < .008; χ2/ df = 2.71; RMSEA = 0.06; CFI = 0.95; SRMR= 0.04. Results indicated that racial discrimination was directly associated with increases in COVID conspiratorial beliefs (B = .14, p<.05) and medical mistrust (B = .22, p<.001). COVID conspiratorial beliefs was directly associated with increases in COVID vaccine hesitancy (B = .11, p<.05). Indirect effects were detected whereby racial discrimination was associated with increases COVID vaccine hesitancy indirectly via increases in COVID conspiratorial beliefs (B = 0.016; 95% CI [0.001, 0.048]). DISCUSSION/SIGNIFICANCE: Investigating race-related factors in the context of vaccine hesitancy is a novel area of inquiry that could facilitate the development of targeted interventions for Black Americans to increase their vaccine uptake. Future research is needed to more thoroughly examine the relationship between racial discrimination and conspiratorial beliefs.

OBJECTIVES/GOALS: Last year, we reported on storytelling events highlighting the experiences of Black biomedical professionals. The goal of this continuation study was to put Black Voices into action through a companion curriculum, instructional materials, and facilitated meaningful discussions around racial justice. METHODS/STUDY POPULATION: We developed instructional materials and pilot-implemented the curriculum in a 250-student Healthcare Leadership class. Prior to viewing the video, participants were asked to provide a definition of diversity, inclusion, and equity. Afterwards, the students reflected and suggested changes to the definition. Throughout the class, instructors facilitated group discussions about the role of diversity. As a culminating activity, students submitted a written reflection summarizing their understanding of the role of diversity, inclusion, and equity in healthcare. RESULTS/ANTICIPATED RESULTS: Instructional materials included videos, a facilitators guide, a reflection worksheet, and online course modules. The facilitators guide included an overview of best practices in the facilitation of group discussions, common rules groups can establish for open dialogue, and discussion questions specific to the Black Voices videos. In-class and lab discussions brought up several prominent metaphors for diversity and inclusion. For example, students first defined diversity as pieces of the puzzle that somehow fit together, but later surmised that the pieces do not need to fit, or be from the same puzzle. DISCUSSION/SIGNIFICANCE: Our pilot showed that participants experienced the power of storytelling, particularly for amplifying Black voices, gained a vehicle to expand awareness and consciousness of diversity, equity, and inclusion, and identified plans to promote and facilitate stories of race, equity, and diversity.

OBJECTIVES/GOALS: In spite of significant growth in undergraduate research, there is little accessible RCR training material targeting this group. The goal of this project was to develop level appropriate RCR materials and test them for effectiveness of teaching basic knowledge of RCR. It was developed cognizant of the type of learning preferred by this group. METHODS/STUDY POPULATION: Todays undergraduate students are digital natives accustomed to using on-line resources for learning and value the ability to work independently. An asynchronous, online series of eight RCR modules were developed using PowerPoint. Audio instruction was overlaid over the presentations and uploaded to YouTube. Each module includes quiz at the end that must be completed with a 90% score in order to continue and students can retake each quiz until correct. Case studies, a plagiarism game, and additional resources such as infographics created by the Office of Research Integrity were included. 275 first year undergraduates completed the pilot and the on-line retrospective pre-post assessment that included 28 Likert scale items and two open-ended questions that were analyzed with RapidMiner. RESULTS/ANTICIPATED RESULTS: Participants rated their ability prior to and after the course to recognize the roles/responsibilities of a mentor, maintain and organize data records, recognize what constitutes research misconduct and multiple types of plagiarism, define ethics of authorship and the types of peer review, recognize responsible handling of human and animal subjects and to define collaborative research. Responses were analyzed using t-Tests and all items showed a significant increase. Students reported between a 28% and 50% increase in knowledge in each topic and gains in understanding where to report RCR violations. Text analysis using RapidMiner provided developers with suggestions on how to enhance the project. Students reported finding the course concise and easy to understand and valued the included case studies. DISCUSSION/SIGNIFICANCE: This study demonstrated that RCR materials developed specifically for todays undergraduate students, presented an easily accessible format, effectively conveys the basics of RCR. The on-line, asynchronous format made it accessible to those for whom in person course is not possible. This model fills the gap in RCR training for early researchers.

Low-accruing clinical trials delay translation of research breakthroughs into the clinic, expose participants to risk without providing meaningful clinical insight, increase the cost of therapies, and waste limited resources. By tracking patient accrual, Clinical and Translational Science Awards hubs can identify at-risk studies and provide them the support needed to reach recruitment goals and maintain financial solvency. However, tracking accrual has proved challenging because relevant patient- and protocol-level data often reside in siloed systems. To address this fragmentation, in September 2020 the South Carolina Clinical and Translational Research Institute, with an academic home at the Medical University of South Carolina, implemented a clinical trial management system (CTMS), with its access to patient-level data, and incorporated it into its Research Integrated Network of Systems (RINS), which links study-level data across disparate systems relevant to clinical research. Within the first year of CTMS implementation, 324 protocols were funneled through CTMS/RINS, with more than 2600 participants enrolled. Integrated data from CTMS/RINS have enabled near-real-time assessment of patient accrual and accelerated reimbursement from industry sponsors. For institutions with bioinformatics or programming capacity, the CTMS/RINS integration provides a powerful model for tracking and improving clinical trial efficiency, compliance, and cost-effectiveness.

OBJECTIVES/GOALS: Uterine fibroids (UF), non-cancerous myometrial neoplasms, affect 11 million women in the US. In qualitative research, experiences of Black women (BW) and Latinas (HL) with UF are understudied. UF etiology is poorly understood, and most symptoms are focused on decreasing UF symptoms. This study will showcase a translational approach in studying UF. METHODS/STUDY POPULATION: A community-engaged research process will be used throughout the study. We have a partnership with the Fibroid Foundation (FF), a UF advocacy organization. For our first aim, we have held community-engagement (CE) studios to provide insight for best practices in creating and implementing culturally appropriate studies with ethnoracially diverse women regarding topics of UF. Our CE studios set the foundation for the second aim, which will be in-depth interviews assessing the sociocultural impacts among pre-menopausal BW and HL with UF. The women will be recruited through the FFs social media platform. To address lack of treatment options in UF, we will be focusing on JAK 2/3 pathway. We will be performing immunofluorescence on tissue microarrays on over 100 patient samples with extensive clinical and survey data. RESULTS/ANTICIPATED RESULTS: We held two CE studios, one with BW with UF and another with HL without UF. These participants were chosen as patient stakeholders. One theme from the CE studio was that both groups mentioned a cultural impact around menstrual health and UF discussions. The participant stakeholders provided insight to other influences in their journey that will be used to develop the interview guide questions for Aim 2. We expect the individual interviews to show similar experiences as our CE studio experiences. We anticipate more in-depth conversations about the sociocultural and ethnoracial factors impacting UF treatment. For Aim 3, we hypothesize that there will be increased JAK 2/3 expression in UF of patients with higher sympton burden and larger fibroid volume. DISCUSSION/SIGNIFICANCE: Implementing a community-engaged research framework provides a foundation for qualitative and translational gynecologic research in BW and HL. This project will contribute insight to their UF experience. There is a lack of innovative treatments, and we have access to valuable patient tissue and data that can be used for potential molecular targets.

The coronavirus disease 2019 (COVID-19) pandemic requires urgent implementation of effective community-engaged strategies to enhance education, awareness, and inclusion of underserved communities in prevention, mitigation, and treatment efforts. The Texas Community-Engagement Alliance Consortium was established with support from the United States’ National Institutes of Health (NIH) to conduct community-engaged projects in selected geographic locations with a high proportion of medically underserved minority groups with a disproportionate burden of COVID-19 disease and hospitalizations. The purpose of this paper is to describe the development of the Consortium. The Consortium organized seven projects with focused activities to address COVID-19 clinical and vaccine trials in highly affected counties, as well as critical statewide efforts. Five Texas counties (Bexar, Dallas, Harris, Hidalgo, and Tarrant) were chosen by NIH because of high concentrations of underserved minority communities, existing community infrastructure, ongoing efforts against COVID-19, and disproportionate burden of COVID-19. Policies and practices can contribute to disparities in COVID-19 risk, morbidity, and mortality. Community engagement is an essential element for effective public health strategies in medically underserved minority areas. Working with partners, the Consortium will use community engagement strategies to address COVID-19 disparities.

OBJECTIVES/GOALS: The purpose of this study is to evaluate average pain scores in patients with Hidradenitis Suppurativa (HS) and determine if racial disparities influence HS-related pain management. METHODS/STUDY POPULATION: We surveyed 3,140 adult patients about demographics, HS, pain levels, medical history, and health-related quality of life. Among respondents (N=162), pain scores (0-10) were grouped as high (8+, N=54) and low (<7, N=108). We used logistic regression to calculate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). RESULTS/ANTICIPATED RESULTS: Respondents were female (88.9%), Black race (59.4%), with a median age of 36 (IQR 25-42) and a mean pain score of 7 (IQR 5-8). Half (48.2%) of respondents disagreed or strongly disagreed with, “I am satisfied with how my pain related to HS is being managed by my doctors.” Independent risk factors for high pain included Black race (aOR=7.95, 95% CI 3.11-20.26), history of prescribed pain medications (aOR=2.37, 95% CI 1.06-5.30), and former/current tobacco use (aOR=4.12, 95% CI 1.76-9.64). DISCUSSION/SIGNIFICANCE: The preliminary data support the hypothesis that race influences HS-related pain. In addition, less education, a history of prescription pain medication use, and tobacco use are all independent risk factors contributing to higher pain scores in patients with HS. Further analysis will be conducted to evaluate racial influences on pain management.

There are numerous examples of translational science innovations addressing challenges in the translational process, accelerating progress along the translational spectrum, and generating solutions relevant to a wide range of human health needs. Examining these successes through an education lens can identify core principles and effective practices that lead to successful translational outcomes. The National Center for Advancing Translational Sciences (NCATS) is identifying and teaching these core principles and practices to a broad audience via online courses in translational science which teach from case studies of NCATS-led or supported research initiatives. In this paper, we share our approach to the design of these courses and offer a detailed description of our initial course, which focused on a preclinical drug discovery and development project spanning academic and government settings. Course participants were from a variety of career stages and institutions. Participants rated the course high in overall value to them and in providing a unique window into the translational science process. We share our model for course development as well as initial findings from the course evaluation with the goal of continuing to stimulate development of novel education activities teaching foundational principles in translational science to a broad audience.

OBJECTIVES/GOALS: To describe and evaluate an innovative university-community vaccination and food access model for minority, immigrant, and underserved individuals experiencing food insecurity during a global pandemic. METHODS/STUDY POPULATION: The Purdue University Center for Health Equity and Innovation (CHEqI) partnered with the two largest food banks in the Midwest and Walgreens to offer free COVID-19 and Flu vaccinations alongside food distribution. Goals included addressing food insecurity, increasing vaccine access, and decreasing vaccine hesitancy. CHEqI acquired funding, recruited volunteers and interpreters, assessed interest and addressed vaccine hesitancy. Food bank/pantry partners distributed food and provided access to clientele and marketing assistance. Walgreens procured, administered, and documented vaccinations. The Model accommodated drive-through and indoor processes. Unidentifiable observational and self-report data were collected. Descriptive statistics were computed to characterize program outcomes. RESULTS/ANTICIPATED RESULTS: A total of 11 vaccination events occurred between June and October 2021 at three food bank/pantry locations. Of these 11 events, nine (82%) were drive-through and two (18%) took place indoors, eight (72%) offered COVID-19 vaccinations only, and three (27%) offered both COVID-19 and Flu vaccinations. Food was distributed to a total of 5,108 families and 416 vaccines (314 COVID, 102 Flu) were administered. Of the 396 individuals who received at least one vaccine, 20 (5%) received both a COVID and Flu vaccine. Of the 386 individuals who received at least one vaccine and reported their sex, 194 (50%) identified as female and the average age of those who received at least one vaccine was 45 years old. Of those who reported race (N = 228) or ethnicity (N = 253), 43% identified as Black or African American and 53% identified as LatinX. DISCUSSION/SIGNIFICANCE: Findings offer an innovative vaccination and food access model for diverse individuals experiencing food insecurity during a global pandemic. By drawing on cost effective, accessible, and culturally contextualized practices to optimize the reach and quality of vaccination services we can improve access barriers and mitigate health disparities.

OBJECTIVES/GOALS: Health inequities represent complex structural and systematic processes that lead to disparate outcomes for populations or subgroups within populations. This project aims to improve the available structural and systematic approaches to the study of such inequities at the population level. METHODS/STUDY POPULATION: Using examples from diabetes research, two critical factors that may impact the validity or utility of health equity models will be examined; and proposed methodological approaches to offsetting potentially resulting biases will be offered. The factors include: (1) inequitably missing and misclassified data in large datasets and (2) the presumed positioning of socially constructed variables such as race, ethnicity, and gender within modeled structural and systematic mechanisms. This examination intersects theories and praxis in epidemiological modeling and health equity promotion with the goal of advancing rigorous, equity-focused epidemiological methods. RESULTS/ANTICIPATED RESULTS: Inequitably missing and misclassified data are generally expected to obscure inequities. Treatment of missing or misclassified data as informative measures of inequity is expected to partially offset this bias. The implicitly modeled components of socially constructed variables are expected to be non-uniform across structural and systematic mechanisms of inequity. Models that apply these variables as informatively heterogeneous constructs, using multi-phase analyses to test modeling assumptions and to assess intersectionality, may provide better context about the mechanisms by which inequity has been distributed and, perhaps, by which equity may be achieved. DISCUSSION/SIGNIFICANCE: Equitable epidemiological methods are essential to the advancement of evidence-based health equity on the population level. Potential structural or systematic inequities in large-scale datasets and traditional data analyses should be thoughtfully reviewed through a health equity lens.

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

OBJECTIVES/GOALS: We were interested in health equity research for each CTSA-affiliated institution, specifically focusing on cross department and cross-campus co-authorship. We conducted a bibliometric analysis of our CTSA-funded papers relating to diversity and inclusion to identify cross department and cross-campus collaborations. METHODS/STUDY POPULATION: We worked with our CTSAs Racial Justice, Diversity, Equity and Inclusion Task Force to conduct an environmental scan of diversity and inclusion research across our CTSA partner institutions. Using the Scopus database, searches were constructed to identify and retrieve the variety of affiliations for each of the CTSA authors, a health equity/health disparities search hedge, and all of our CTSA grant numbers. We limited the dates from the beginning of our CTSA in 2008-November 2021. We used PubMed to retrieve all MeSH terms for the articles. We used Excel to analyze the data, Python and NCBIs Entrez Programming Utilities to analyze MeSH terms, and VOSviewer to produce the visualizations. RESULTS/ANTICIPATED RESULTS: The results of this search yielded 94 articles overall. We broke these up into subsets (not mutually exclusive) to represent five of the researcher groups across our CTSA. We analyzed the overall dataset for citation count, normalized citation count, CTSA average authors, gender trends, and co-term analysis. We also developed cross department co-authorship maps and cross-institutional/group co-authorship maps. DISCUSSION/SIGNIFICANCE: This poster will demonstrate both the current areas where cross-departmental and cross-institutional collaboration exists among our CTSA authors, as well as identify potential existing areas for collaboration to occur. These findings may determine areas our CTSA can support to improve institutional performance in addressing health equity.

OBJECTIVES/GOALS: Observational studies suggest unequal effects of COVID-19 on the population of the U.S. distinguished by race and ethnicity. Our primary research question: what are the demographic differences among patients identified with concurrent ischemic stroke and COVID-19 positivity? METHODS/STUDY POPULATION: The National Covid Cohort Collaboration (N3C) data was used to identify patients with concurrent COVID-19 and stroke, operationally defined as those with a COVID diagnosis and inpatient admission for ischemic stroke 1 week before or 6 weeks after their COVID diagnosis. The data was further age restricted (18-65 years) and a categorical variable was created representing payer plans (Medicaid, Medicare, Other insurance). Data on patients race/ethnicity, comorbidities, treatments administered (Remdesivir and ECMO) and insurance information was analyzed using various exploratory data methods and visualizations. Logistic regression was implemented to model the relationship between variables (dependent/independent) in the cohorts. Model complexity was analyzed using the F test of significance. RESULTS/ANTICIPATED RESULTS: Taken as a whole, the data contained over 7 billion rows and around 6.4 million persons (~ 2.15 million of whom were COVID+). The main cohort of individuals with concurrent COVID positivity and ischemic stroke made up around 0.29% of the original COVID+ group, and the payer plan sub-cohort consists of around 29.26% of our main cohort. Black/African American (AA) and the Hispanic/Latino any Race have younger distributions (median ~ 65 years), while the White Non-Hispanic group has the oldest distribution (median ~ 70 years). Black/AA had the highest average number of comorbidities per patient (4.49), compared to white non-Hispanic (3.39) and Asian non-Hispanic (2.59). In our analysis, Medicaid patients had lower odds of obtaining ECMO (p < .01), there was no significant difference in Remdesivir treatment. DISCUSSION/SIGNIFICANCE: We found the N3C data to be useful in studying a distinct group of patients, and exploring COVID-19 and ischemic stroke treatment across patients’ race/ethnicity identities and insurance status. Our exploratory analysis provides a foundation for further insight into demographic trends and discrepancies in apportionment of treatment.

OBJECTIVES/GOALS: To engage community partners in full spectrum of translational sciences participants will: 1. Develop community-based research projects. 2. Evaluate pilot awards submitted to the Community Advisory Board for funding. 3. Actively participate in the research cores at the CTSC METHODS/STUDY POPULATION: The Academy workshop curriculum supports an in-depth examination of the translational research process, introduction to the CTSC Community Advisory Board; as well as to community based participatory research; grant evaluation process, and the need for active community involvement in various cores, and clinical trials. Workshops presented by tenured professionals and community leaders with multi-media out of class assignments. Scheduled sessions were 1 hour, and 15 minutes. Exams given post class session with a mean score of 22.8/30 for session 1 and a mean score of 23.80/30 for session 2. RESULTS/ANTICIPATED RESULTS: The Community Research Academy (CRA) has thus far held for two sessions. Of the 45 enrollees, 20 completed the entire program. Of those, ten have joined the CAB board; and three have actively participated in the pilot award review process. One of the CRA graduates will be publishing her photo novella assignment in Health Affairs. One person changed careers,: and several people have taken all the classes for a second time. Many participants originally came from our faith-based connections. Now word of mouth is expanding the program. DISCUSSION/SIGNIFICANCE: Community engagement ensures that the fresh voices of diverse populations are involved in translational science. Their input ultimately leads to creating novel clinical innovations; such community-driven ingenuity which addresses the deeply felt needs of those communities.

Identifying and disseminating actionable intelligence is a challenging task that requires thoughtful planning. The National Center for Advancing Translational Sciences instituted the Common Metrics Initiative with the goal of evaluating the Clinical and Translational Science Awards (CTSA) Programs using a standard set of metrics. Initially managed by Tufts University, the Center for Leading Innovation and Collaboration (CLIC) at the University of Rochester began leading this initiative in 2017. In directing this work, CLIC created a framework for communicating and disseminating data insights. Insights to Inspire emerged from the need to share strategies and lessons learned to improve metric performance at the local level to a network of 60+ academic research institutions. Insights to Inspire employs a mixed methods approach for translating data into actionable intelligence. A series of blogs, webinars, and webcasts were designed to communicate metric-specific strategies used by individual sites to the broader CTSA consortium. A dissemination plan to expand the reach beyond metric stakeholders utilized focused communications including social media channels, network newsletters, and presentations at national meetings. This framework serves as a blueprint for other national evaluation programs interested in a systematic approach to using data insights for continuous improvement.