OBJECTIVES/GOALS: Identify ways surveys capture the needs of researchers and community partners (CPs) to build a supportive community-engaged research (CEnR) infrastructure Identify strategies to match existing CEnR researchers and CPs who are interested in future CEnR projects Address educational needs of CPs and researchers for sustainable partnerships METHODS/STUDY POPULATION: The Penn State Community Health Equity & Engagement Research (CHEER) Initiative team developed and implemented surveys to capture the unique interests of Penn State researchers and community partners (CPs) in an effort to build a supportive community-engaged research (CEnR) infrastructure. CPs and researchers were identified from the Penn State Clinical and Translational Science CEnR Core, prior engagement in research studies, and through tracking systems of individuals interested in research. The researcher and CP surveys ascertained detailed information of existing CEnR projects and interests in future community-academic partnerships. These results guided six workshops including an Introduction to Community-Engaged Research, Community-Facing Grant Writing, and Research Ethics Training for CPs. RESULTS/ANTICIPATED RESULTS: A total of 99 PSU researchers and 119 community partners (CPs) throughout PA communities completed the baseline surveys. From the data collected, the CHEER Initiative cataloged over 100 CEnR projects, researcher interests, resources/support needed to jumpstart future CEnR projects, types of CPs, PA regions represented by CPs and researchers, and training resources needed to prepare CPs to engage in research efforts. Heat maps illuminating researcher/CP engagement were generated from survey results. While CEnR research projects spanned all 67 PA counties, several studies were in concentrated areas, and thus allow for opportunities to target CEnR outreach in less engaged areas. Data analysis from follow-up surveys will continue to serve as a foundation to best support existing and future CEnR projects. DISCUSSION/SIGNIFICANCE: The CHEER Initiative’s purpose is to reduce health disparities and increase wellness throughout underrepresented PA communities by promoting community-engaged research (CEnR). Surveys used to capture both CEnR interests of Penn State researchers and community partners built a successful and sustainable infrastructure for meeting this goal.

OBJECTIVES/GOALS: To build a multi-function health profile for older adult (>50 years) women with a history of incarceration; explore group differences by age [45-54, 55-64, 65+], race, and length of incarceration; compare with age-matched control with no history of incarceration; and identify relative contribution of life course risk and asset factors. METHODS/STUDY POPULATION: We will analyze data from the Health and Retirement Survey (HRS) (UMichigan Institute of Social Research). The sample: women >50 years who took the leave-behind psychosocial questionnaire. The sample includes women with history of incarceration (n = 118; 2.93%) and (n = 115; 2.55%), respectively, and in the control n = 4,021 women (2012) and n = 4,114 women (2014). We will use descriptive statistics to profile physical, functional, cognitive, and social health; bivariable tests to compare groups on age-related morbidity, multimorbidity, frailty, and 4-year mortality risk; measure within group differences by age strata and race; estimate GLMs for effects of life course risk on dependent variables in and between groups; and if data permit, test direct mediation by life course risks and indirect by life course assets. RESULTS/ANTICIPATED RESULTS: Our results will characterize health in 4 health domains of women over 50 who have a history of incarceration. In bivariable analysis, we expect significant differences between groups on the dependent variables. Based on previous study using this data set, life course and accumulated stress theory, and our own previous research, we hypothesize that women with incarceration history will have more and earlier cardiovascular disease, stroke, and multimorbidity, higher 4-year mortality risk, and more and earlier cognitive impairment. We anticipate significant contributors to aging-related health outcomes to include childhood challenge and trauma history and, for Black women, perceived racial discrimination. We anticipate education and social support will partially mediate relationships. DISCUSSION/SIGNIFICANCE: The CHARMS findings, based on large-sample, representative, longitudinal HRS survey data, will contribute a profile of multi-function health status, risk, and assets in older women with CLS involvement. The much-needed characterization of aging in the group will set the stage for future interventional study to guide shifts in clinical practice.

OBJECTIVES/GOALS: The Colorado Immersion Training in Community Engagement (CIT) provides experiential training in community-based participatory research (CBPR). We summarized evaluations from the first ten years on program outcomes and lessons learned to inform future programming and the field of community research. METHODS/STUDY POPULATION: CIT is a six-month program that includes didactic sessions, group readings and reflections and a one week immersion experience in a Colorado community experiencing health disparities. The Evaluation Center - University of Colorado Denver provides external evaluation services to the Colorado Clinical and Translational Science Institute (CCTSI). Evaluators used three primary methods to collect data to evaluate the program; Document review, interviews, and surveys. Evaluation data were analyzed using the framework of CBPR Principles and the CBPR conceptual logic model to understand potential shifts in researchers’ thinking and actions, as well as to identify the potential for longer-term impact. RESULTS/ANTICIPATED RESULTS: As of 2020, CIT trained 122 researchers. 25 CIT alumni went on to receive 33 CCTSI Pilot Grants. Out of these 33 grants, an additional $8,723,000 of external grant funding was awarded to continue projects. Community Research Liaisons are a crucial component of the program through their efforts to bridge academic researchers and communities. Survey results indicated that community partners reported high levels of satisfactions with the program and shared stories about the impact they have seen in their community. Common challenges for researchers remain 1) protected time and institutional value and, 2) funding opportunities. DISCUSSION/SIGNIFICANCE: CIT has grown CBPR researchers. Similar programs should consider contributing factors: establishing institutional value and funding for CBPR initiatives with protected time for developing and maintaining community relationships. CIT offers a crucial connection between academia and community.

OBJECTIVES/GOALS: Describe the community of Norther Dauphin County, PA and increase awareness of this community’s health related needs. Establish partnerships between Penn State faculty and Northern Dauphin County community-based organizations to develop an optimal approach to address identified health related needs. METHODS/STUDY POPULATION: Northern Dauphin is located in the rural Northern Tier of Dauphin County, PA and has roughly 30,000 residents within 272 square miles. Of those residents, approximately 1 in 4 families live below the poverty level. Although over 6,000 residents receive Medical Assistance (MA), only one local provider accepts MA covered patients. Residents have limited access to health care due to the rurality of the area when paired with a lack of public transportation. The Penn State Clinical and Translational Science Institute (CTSI) Community Engaged Research Core (CERC) has partnered with Northern Dauphin County community- based organizations to explore the needs of community members and how partnerships with Penn State Faculty could help to address the community needs. RESULTS/ANTICIPATED RESULTS: A Community Advisory Board (CAB) of leaders (e.g., school officials, business owners) was created to identify community needs. After an initial workshop with the CAB, an assessment was created and distributed to the larger community to identify the top community health needs. Details from the assessment were then used to prioritize the themes for the Community Driven Research Day (CDRD). The CERC team identified Penn State University faculty with research interests related to these prioritized themes. The faculty identified and community leaders were then invited to the CDRD. The agenda for the event included an introduction to Community Engaged Research, a presentation from a researcher and community partner working together, round table discussions based on the themes selected, and an overview of pilot grants. DISCUSSION/SIGNIFICANCE: The CDRD will facilitate partnerships between the Penn State faculty and local community leaders to help effectively move forward addressing the community’s health needs. The PSU CTSI will offer pilot grants to formalize and strengthen these partnerships and conduct community engaged research initiatives to discover optimal ways to address them.

OBJECTIVES/GOALS: The Community Engagement Forum (CEF), a quarterly series hosted by the Colorado Clinical and Translational Science Institute (CCTSI) and the ACCORDS Education program, provides seminars from leading academic and community research partners. Our goal is to share the process and outcomes so others may implement a similar forum in their institution. METHODS/STUDY POPULATION: In 2019, CCTSI and the ACCORDS Education Program partnered to offer a forum to exchange best practices for investigators and study teams conducting community-engaged research. Each forum features presenters from community and academic partnerships. Initially this series was offered in-person; during the COVID-19 Pandemic the Forum moved online. At registration we collect data on current position, school/department or organization, and how they heard about the forum. Post session evaluations are also collected. Various topics have been covered including: community engagement foundations, creating advisory boards, responding appropriately to community needs in a pandemic, data equity, and community dissemination. RESULTS/ANTICIPATED RESULTS: Between October 2019 and October 2022, we hosted twelve Community Engagement Forums. A total of 442 people have attended the forums, with the School of Medicine having the highest representation. Among attendees, university research staff are the highest represented position in attendance, with 115 attendees over the 12 forums. 133 people have completed evaluation questions since the start of the forum series. High percentages of agreement were seen from the question, will you use this information to make adjustments/improvements or continue the conversation . Additionally, most respondents agreed that the presentations were useful to their current or future work. DISCUSSION/SIGNIFICANCE: The CEF series has filled a gap for desired resources related to best practices for community-engaged research. CCTSI CE&HC and ACCORDS Education have created a learning community for investigators and study teams to share lessons learned and provide opportunities for trouble-shooting research ideas as they arise.

OBJECTIVES/GOALS: Describe the pipeline of training, coaching, and council opportunities through the Partnerships of Academicians and Communities for Translation (PACT) and how it enhances Community-Based Participatory Research (CBPR) practices and increases community participation and capacity. METHODS/STUDY POPULATION: We conceptualized a pipeline for building capacity for community-based participatory research (CBPR). Key components include Colorado Immersion Training in Community Engagement which introduces academic investigators to specific geographic and demographic communities in Colorado, Partnership Development grants that fund time to building relationships between research and community, Joint Pilot Grants to provide subsequent funding for collaborative research, and the PACT, consisting of Community Research Liaisons (CRLs) and Community and Academic Council Members. RESULTS/ANTICIPATED RESULTS: The pilot grants program was created in 2008; to date has awarded 138 partnerships. In response to academic and community needs, our core developed CIT in 2010. 16 CIT Participants received Partnership Development pilot grant funding, six of whom went on to receive Joint Pilot funding, and an additional 8 who started with a Joint Pilot award. There have been 24 Partnership Development awardees who received subsequent Joint Pilot funding. Ten CIT participants have either become a PACT council member, pilot grants reviewer, or PACT trainer or coach. There has been one person to complete the entire pipeline from CIT, pilot grant awardee, to PACT council member. DISCUSSION/SIGNIFICANCE: The pipeline is a strong foundation for engaging with academic and community researchers who aim to improve CBPR in Colorado. Our signature programs, CIT and Pilot Grants, are unique opportunities to increase community engagement across sectors and improve research practices.

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

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

OBJECTIVES/GOALS: Uterine fibroids (UF) are a significant public health concern with a lifetime prevalence of over 70% in all women, however Black/African American women (BW) are disproportionately affected by UF, and Hispanic/Latinas (HL) mostly understudied. Our goal is to investigate sociocultural influences on menstrual and UF experiences of BW and HL with UF. METHODS/STUDY POPULATION: We have taken a community engaged research approach and partnered with the Fibroid Foundation, a patient UF advocacy group. Following IRB approval, the study was advertised on the Fibroid Foundation’s various social media platforms, such as Instagram. Screening began on October 25, 2022, the screening survey included participants’ contact information, preferred time of contact, time zone, and confirming identifying as a BW and/or HL diagnosed with UF. Ensuring eligibility, we plan to conduct semi-structured interviews for participants. The interviews will be conducted via phone or video call based on participant preference. The interviews will be sent for transcription to an external HIPAA compliant vendor then analyze the interviews for a priori and new themes using traditional content analysis. RESULTS/ANTICIPATED RESULTS: As of November 13, 2022, over 200 participants have completed the screening survey with a total of 133 (66.5%) being eligible to participate. The demographics are the following: 109 (82%) Black women, 14 (10.5%) Latinas, 4 (3%) Afro-Latinas, and 6 (4.5%) did not disclose ethnoracial identity. The participants were sent a consent form and will be interviewed. We anticipate achieving our goal of interviewing a minimum of 60 women for this study. Based on our previous research, we expect to find sociocultural influences leading to negative experiences of menstruation that affect access to care for UF. We also expect women will lack sufficient and accurate information regarding menstrual symptoms and UF. We additionally anticipate seeing delays in UF diagnosis. DISCUSSION/SIGNIFICANCE: There is a need to discuss sociocultural influences around menstruation as negative perceptions lead to delayed diagnosis of UF and can be translated to other gynecological diseases, such as endometriosis and endometrial and ovarian cancer. This suite of female-specific conditions all share increased disparity in historically minoritized women.

OBJECTIVES/GOALS: Responsive infant feeding (RIF) promotes healthy dietary patterns and infant weight gain. Research is needed to assist caregivers recognize infant hunger/satiety cues and overcome barriers to using RIF. The Learning Early Infant Feeding Cues (LEIFc) intervention was designed to fill this gap by using a validated coaching approach to promote RIF. METHODS/STUDY POPULATION: Guided by the Obesity-Related Behavioral Intervention Trials (ORBIT) model, this proof-of-concept study tests the feasibility and fidelity of the LEIFc intervention in mother-infant dyads (N=25). Study visits from the 3rd trimester of pregnancy to 4 months postpartum (PP) are conducted in family homes. Use of RIF via subjective (survey) and objective (video) measures is collected at 1 and 4 months PP. Prenatally written and video material on infant feeding and infant hunger/satiety cues is provided. At 2 and 3 months PP, coaching during a feeding session is provided by a trained interventionist using the SS-OO-PP-RR (super, Setting the Stage, Observation & Opportunities, Problem Solving & Planning, Reflection & Review) approach. Qualitative data on LEIFc are provided by the interventionist and participants. RESULTS/ANTICIPATED RESULTS: To date 25 dyads have been enrolled and 4 have completed all study visits. Preliminary analyses showed that subjective measure of awareness of infant cues increased post intervention (pre, M=4.38 vs post, M=4.63). LEIFc has been well accepted by participants including use of the SS-OO-PP-RR approach. Data suggests refinement to LEIFc is needed to include breastfeeding and mental health support as well as a longer duration of intervention through at least 6 months PP. An experienced interventionist is key to success of the research. All lost to follow-up (n=7) have occurred before the first PP visit suggesting that at study visit closer to birth is needed. Enrollment will continue through December 2022 and data collection through April 2023. DISCUSSION/SIGNIFICANCE: After refinement, the LEIFc intervention will be tested in a pilot RCT. The long-term goal is to implement LEIFc in the curricula of federally funded maternal-child home visiting programs who serve vulnerable populations; those that often have infant feeding practices that do not align with recommendations and are less likely to use RIF.

OBJECTIVES/GOALS: Over 50 million people in the U.S. have an eating disorder (EDs), and body dissatisfaction is a key precursor to EDs. The current study seeks to culturally adapt an evidence-based positive body image program administered through a mobile-phone application for use with Latinx women. METHODS/STUDY POPULATION: The positive body image program centers around body functionality, which in contrast to appearance-based body image, emphasizes the body’s capabilities, including physical capacities, health and internal processes, senses, creative endeavors, self-care, and communication with others. Latinx women aged 18-25 years-old (n =15) will be recruited to participate in focus groups and individual qualitative interviews. Interviews will examine how Latinx women relate to the concepts of positive body image and body functionality. Participants will also provide feedback on the application design and program content. RESULTS/ANTICIPATED RESULTS: Results will elucidate how Latinx women relate to their body and can be used to inform our understanding of Latinx women’s positive body image. Results will also inform what components of the intervention need to be tailored to be more relevant for use in this population. Information from the interviews will be used to explore adaptations to create a more acceptable and effective intervention prior to testing the efficacy of the program. DISCUSSION/SIGNIFICANCE: Most evidence-based body image programs are not developed with culturally sensitive programming in mind. Thus, culturally adapting an evidence-based positive body image program that could be widely disseminated through a mobile-application could address body image concerns in Latinx women.

OBJECTIVES/GOALS: Rising rates of youth obesity, diabetes, depression, and anxiety necessitate programs that address physical and mental health concurrently. We describe a feasibility study for DiscoverU, an afterschool mentoring program that integrates multiple aspects of health including social emotional learning, physical activity, and mindful eating. METHODS/STUDY POPULATION: Trained college students mentored middle and high school students in a Midwestern school district. DiscoverU was delivered 2 hours, 2 days/week for 8 weeks. Based on self-determination theory, DiscoverU was designed to meet National Afterschool Association healthy eating and physical activity and social emotional learning standards. We assessed feasibility with participant attendance (middle, high school, and college students) and acceptability through qualitative data from participants and relevant stakeholders regarding facilitators/barriers to program implementation. We observed indicators of mentoring, lesson fidelity, and assessed physical activity using accelerometry. Pre-post surveys measured self-realization, self-regulation, mindful eating, and physical activity self-efficacy. RESULTS/ANTICIPATED RESULTS: We expect DiscoverU to be feasible and well accepted. We anticipate attendance will be similar or higher than that of other afterschool programs in the district. From focus groups we expect to hear a variety of factors that facilitate/prevent program engagement and learn about the acceptability of specific lessons. We expect to gain insight on processes and procedures from school stakeholders that will inform the sustainability of DiscoverU. We expect program fidelity to be high and mentoring skills to improve over the course of the program. We anticipate the majority of participants will meet National Afterschool Alliance physical activity guidelines. Preliminary outcomes of self-determination, self-regulation, mindful eating, and physical activity self-efficacy are expected to improve over the program. DISCUSSION/SIGNIFICANCE: Findings will help determine the readiness of DiscoverU to be scaled to other schools. A subsequent randomized effectiveness study will evaluate DiscoverU’s impact on intervention mechanisms (e.g., self-determination, self-efficacy) as well as on physical activity, diet, weight, and depression/anxiety symptomology.

OBJECTIVES/GOALS: Minoritized populations experience a large burden of Alzheimer’s Disease; interventions are often delayed and underrepresented communities’ participation in clinical trial research is low. Lack of information has been proposed as a barrier to clinical research enrollment of minoritized populations. METHODS/STUDY POPULATION: Brain Train, a cluster randomization trial, evaluated the role of education in increasing willingness to participate in research. A 3 segment program was developed whereas segment 3 had two versions: clinical trial education or healthy brain aging video. Brain Train was presented to multicultural communities with participants of at least 50 y/o throughout WNY. The primary outcome measure is evaluating the percent change in responding yes to would you be interested in participating in a clinical trial? before and after segment 3. The secondary outcome measure and exploration of barriers are measured by a Research Attitude Questionnaire. Demographic information such as age, race, gender, socioeconomic status, and educational attainment is collected. The statistical model is a generalized linear mixed model. RESULTS/ANTICIPATED RESULTS: Sixteen sessions with 281 participants were completed to generate the pilot dataset. We see 59.29 % of individuals answered yes before segment 3 and 46.02% answered yes after the educational intervention. Our data shows there is a 13.3% decrease in clinical trial participation interest after the educational intervention. Through our RAQ responses, our data shows significance when it comes to our participants’answers to questions regarding society needing to devote more resources to medical research (p=0.04). Trust emerged as the most significant barrier when it comes to one’s willingness to participate in medical research and clinical trials (p=0.03). DISCUSSION/SIGNIFICANCE: Our preliminary results from the first sixteen events suggest that the power of education is not sufficient to overcome barriers to clinical trial participation for underrepresented communities. Instead, trust appears to be the most significant barrier. Trust building strategies should be explored to answer this research question.

OBJECTIVES/GOALS: Premature birth and its complications are among the largest contributions to infant death within the US. The rates of premature birth and infant death are significantly higher among African Americans. Therefore, there is an urgent need to understand the biological and social drivers of this health disparities to improve birth outcomes. METHODS/STUDY POPULATION: This is a retrospective cohort study of premature infants (< 28 weeks estimated gestational age, birth weight < 1500g) born within 2018 and 2021 to mothers who identify as either African American, or White/Caucasian Non-Hispanic and are cared for at Saint Louis Children’s Hospital Neonatal Intensive Care Unit. EPIC collected data will include maternal and fetal factors and social determinants of health (SDOH). ICD-9, ICD-10 codes for primary outcomes include grade 3-4 Interventricular Hemorrhage, moderate-severe Bronchopulmonary Dysplasia, Stage 2+ Necrotizing Enterocolitis, and moderate-severe Retinopathy of Prematurity. Will develop a composite variable score using the SDOH for risk/no risk using that for each disease outcome and mortality. Will use Chi-square test or T-test to compare groups. RESULTS/ANTICIPATED RESULTS: We are currently in the data collection phase of the study, but we anticipate seeing an increase in risk of all-cause morbidity as well as all-cause mortality for infants born to Black mothers compared to infants born to White mothers. We anticipate higher levels of disadvantage (increased area deprivation scores) and lower access to the goods and services deemed necessary for appropriate care of Black mothers and subsequent relation to outcomes for their infants. DISCUSSION/SIGNIFICANCE: Following analysis and assessment of that analysis we will discuss these findings and the impact on the general population and the needs for improvement and implementation of interventions upstream in the care of the vulnerable and special mother-baby-dyad population.

OBJECTIVES/GOALS: Recruiting under-resourced, rural nursing home (NH) staff to clinical research has proven especially difficult during COVID-19. The goal for this study was to leverage an existing group of NH providers to seek their opinions on the development of a novel person-centered risk management intervention for residents with dementia. METHODS/STUDY POPULATION: This study used community engagement studios (CES) to connect and engage with community experts (NH staff and leaders) attending, or in close vicinity to, a NH provider conference in Denver, Colorado July 25-30, 2022. Led by an experienced moderator and an assistant moderator using a semi-structured discussion guide, two CES were completed with 14 community experts. Community experts took part in a 90-minute facilitated and recorded discussion to gain their perspectives on the DIGNITY (Decision-making in aging and dementia for autonomy) study procedures and instruments along with recommendations for how to improve the acceptability, feasibility, and likelihood of intervention success. The local IRB determined this study to not be human research. RESULTS/ANTICIPATED RESULTS: Community experts most often identified as white/Caucasian (64%) females (93%) holding jobs in NHs as direct-care nurse/nursing aide (n=5), nurse supervisor/director (n=4), other NH leadership (n=3), nursing aide union organizers (n=2), and state surveyor (n=1). The primary outcomes of the CES were suggestions that could be used to adapt the elements of the study design. Following CESs, transcripts were reviewed and summarized on a rapid feedback table. The study team made changes to five of the six intervention elements based on expert feedback. Most experts (79%) agreed that the DIGNITY intervention was acceptable, appropriate, and feasible to implement in the NH community. DISCUSSION/SIGNIFICANCE: This study highlighted the voices of NH staff and leaders that is often underrepresented in research development and provides critical information for how to adapt a novel intervention for future testing in rural NH communities. Results also support the usefulness of CES as a method to develop practical interventions in NH communities.

OBJECTIVES/GOALS: Adolescent and young adult (AYA) patients, diagnosed with cancer between 15 and 39 years of age, often have worse outcomes compared to younger children and older adults. We will characterize age differences in acuity and severity of illness at initial presentation, as a measure for health outcomes, in patients with new diagnoses of leukemia or lymphoma. METHODS/STUDY POPULATION: We will perform a single institution-based, retrospective analysis of a cohort of pediatric oncology patients at Children’s Healthcare of Atlanta (CHOA) who were diagnosed with leukemia or lymphoma from 2010 to 2018. Data will be abstracted from the CHOA medical record and cancer registry. We will construct a severity score, with one point for 1) admission to the Intensive Care Unit (ICU), 2) ICU-level requirements at admission, 3) stage IV or metastatic disease, and 4) white blood cell count over 100,000/microliter. We will associate this score with age at presentation using logistic regression models among patients overall and stratified by disease type. All regression models will adjust for confounders (e.g., health insurance, race and ethnicity, and local-area social vulnerability level). RESULTS/ANTICIPATED RESULTS: Previous literature has shown increased cancer incidence and mortality in AYAs compared to younger children. Therefore, we hypothesize that AYA patients with a new diagnosis of leukemia or lymphoma will have a higher acuity and severity of illness at presentation than younger patients. We conducted a pilot study analyzing acuity and severity of illness by age, race, ethnicity, and insurance status. Bivariate comparisons suggested patients aged 10 and older were as likely as those younger to have a severity score of more than 0 at diagnosis (OR=0.661 , 95% CI 0.43-1.01). However, this result was collapsed across all hematologic malignancies, did not encompass the entire cohort, and did not address possible confounders; we anticipate our estimates will be different taking these factors into account. DISCUSSION/SIGNIFICANCE: Our work will be the first steps in creating a validated tool to understand disease acuity and severity. By using this tool to characterize presentation by disease type and age, we will identify unmet needs prior to an initial diagnosis of cancer. Our findings inform strategies toward narrowing age disparities in outcomes for AYA hematologic cancers.

OBJECTIVES/GOALS: This project examines the initial feasibility, acceptability, and appropriateness of using population-health data and geospatial information systems (GIS) technology to guide opioid overdose prevention in a Black community facing increasing racial inequities in fatal overdose since 2016. METHODS/STUDY POPULATION: We applied a mixed-methods approach, using GIS to examine hot spots of fatal opioid overdose among Black, adult decedents in St. Louis City and County, Missouri, derived from cause-of-death data from the Medical Examiner’s Offices from 2016-2021 (N = 1,612). Hot spot analysis was conducting using the Getis-Ord Gi* statistic. We then conducted a focus group with community-based providers in Black neighborhoods (N = 8) to assess the acceptability and appropriateness of mapping overdose data and to determine the utility of GIS for guiding decision-making in outreach activities aimed at overdose prevention. The focus group was recorded and transcribed for analysis to extract themes. RESULTS/ANTICIPATED RESULTS: Among 340 census tracts in the St. Louis region, 41 were statistically significant hot spots, indicating high clustering of fatal overdose. All hot spots were clustered together in North St. Louis, an area characterized by high racial and income segregation. Focus group participants reported potential pitfalls of GIS, including data inaccuracy for Black individuals and unwanted attention in hot spot areas (e.g., increased policing). Potential benefits included improved care coordination between organizations, assessing effectiveness of outreach interventions, and improving community-level awareness. Hyper-local neighborhood rather than regional maps were perceived as useful for outreach. DISCUSSION/SIGNIFICANCE: Artifacts of structural racism that drive Black opioid overdose deaths limit the utility of GIS to guide outreach in communities facing this systemic disinvestment. However, neighborhood-level GIS may serve as a tool for communities to build awareness and collaboration toward overdose prevention.

OBJECTIVES/GOALS: By establishing a youth-centric web-app as a central hub of information and inspiration in an attempt to engage a young demographic, this project aims to increase community awareness and reduce misconceptions surrounding clinical trials, in hopes of fairly representing marginalized communities among future clinical trial participants. METHODS/STUDY POPULATION: We designed a children’s web-app to host a collection of child-friendly educational materials (such as picture books, games, and age-appropriate articles about advances in clinical research) explaining clinical research and its process. An emphasis was put on ensuring the web-app and its contents were understandable and appealing to children. The effectiveness of this tool will be tested through a focus group study. Children ages 7-10 will be given a preliminary survey measuring their knowledge and opinions about clinical research, and then given time to explore the web-app. Afterwards, they will be given a secondary survey to gauge their acquired knowledge from the website and asked about their opinion on the design and usability of the web-app and its materials, as well as how likely they were to revisit the site. RESULTS/ANTICIPATED RESULTS: We anticipate a very positive response from the children regarding the design and usability of the web-app and its materials. By using an adolescent-focused design methodology at every step of the design process, we will ensure that all materials are attractive and engaging to our younger target audience. Exposing children to accessible information about clinical trials at a young age allows us to build their trust in the research process prior to the possible internalization and acceptance of cultural misconceptions. Over time, we hope to see a change in attitudes toward clinical research as well as increased participation, whether from under-represented groups or a younger demographic, and positively contribute to T3 and onwards in the translational continuum. DISCUSSION/SIGNIFICANCE: In a rapidly changing world, the best approach to making change is through targeting the younger demographic, the leaders of tomorrow. Our project will allow adolescents to foster a more well-rounded opinion of clinical research, increasing their participation and better paving a more positively received future for translational science as a whole.

OBJECTIVES/GOALS: Medications to treat opioid use disorder (mOUD) are available and can save lives, but are underutilized. We hypothesize that the rate of prescribing varies by treatment facility and these differences will shed light on barriers and facilitators to mOUD utilization. METHODS/STUDY POPULATION: We performed an exploratory analysis in MD Clone, a platform which generates non-identifiable synthesized data based on real patient data in the electronic health record (EHR) of St. Louis based hospitals. Our query included adults aged 18-70 with an OUD diagnosis using ICD-9 of -10 codes (opioid abuse, opioid dependence, opioid poisoning, opioid withdrawal) occurring between 2013 and 2022 along with prescriptions for buprenorphine, methadone, or naloxone within 7 days of the condition being entered in the record. We compared the rate of medication prescription within 7 days across settings and facilities where the patients were seen. We propose to replicate this analysis in actual patient records from the EHR following IRB approval. RESULTS/ANTICIPATED RESULTS: Our synthetic data comprised 24600 patient diagnoses. After filtering for patients seen in the ER or inpatient 16235 patients remained in the data set. Of these, 4376 fell into one of the categories that clearly warrant treatment with medication. Out of 4376 patients with a qualifying OUD related condition, only 815 (18.6%) received a prescription for any of the medications. Rates of prescribing within facilities varied between 67.2% of eligible patients receiving a prescription at a rural location to 0% at some urban centers. We anticipate similar findings from analysis of patient records obtained from the EHR. We will extend our analysis to explore factors which may be driving the wide difference in prescribing to better understand barriers and facilitators to mOUD utilization. DISCUSSION/SIGNIFICANCE: We identify under-utilization with differences across facilities in prescribing mOUD based on preliminary work in synthetic data. If true, this represents a gap in care and opportunity for intervention. By replicating the MD Clone results in patient data from the EHR we will confirm this finding and increase acceptability to clinicians.

OBJECTIVES/GOALS: The purpose of this mixed methods project was to gain a comprehensive understanding and generate data on factors, including stress and inflammatory biomarkers, that may negatively impact glycemic levels in children aged 8-12 years with type 1 diabetes (T1D) from underrepresented backgrounds. METHODS/STUDY POPULATION: This study employed a two-phase sequential QUAN -> qual mixed methods design. Children and their parents were recruited from a pediatric endocrinology clinic in the southeastern United States. In phase 1 (n=34), we used quantitative methods to measure perceived stress, diabetes distress, cortisol, inflammation (IL-1b, IL-2; IL-6; IL-8; TNF-a; CRP), and glycemic level (HbA1c). Both children and their parent/guardian completed surveys, and children provided salivary and blood samples to measure cortisol and inflammatory markers. Phase 2 qualitative interviews in a subset (n=20) of children and parent/guardians from phase 1 are ongoing; preliminary findings will be included in the presentation. RESULTS/ANTICIPATED RESULTS: Mean age of children was 10.47 (sd=1.44), 67.6% were male, and 41.2% were black. HbA1c ranged from 6.8%-15% and only 2 (5.8%) children met ADA recommendations for HbA1c of 7% or less. HbA1c was associated with child reports of perceived stress (r = .403, p < .05), but not parent reports of child perceived stress (r = -.011, p > .05). Parent reports of perceived stress and diabetes distress in children were not significantly associated with child self-report of perceived stress (r = .11, p > .05) or diabetes distress (r = .018, p > .05). Exploratory models with PROCESS suggest that cortisol slope and IL-8 moderate the relationship between child’s perceived stress and glycemic control. DISCUSSION/SIGNIFICANCE: Stressors are emerging that are unique to this population and may help highlight disparities in care. While the study is ongoing, findings may help health professionals identify and mitigate stressors in children with T1D to help maintain optimal glycemic levels.