OBJECTIVES/GOALS: Despite its critical importance in reproductive health, access to abortion care continues to be impeded by laws grounded in religious, political, or other ideologies. We will characterize abortion attitudes among US men who live in areas with restrictive abortion laws using qualitative methods. METHODS/STUDY POPULATION: We will use a semi-structured interview guide to elicit men’s attitudes about abortion, characterized within moral, legal, religious, political, and other domains. Inclusion criteria include English-speaking cisgender men, ages 18 to 65 who live in states with the most restrictive abortion laws as defined by the Guttmacher Institute. We will recruit participants through Facebook ads and interviews will continue until theoretic sufficiency. Using an inductive thematic analysis approach, transcripts will be coded for emergent themes by two researchers independently in QRS NVivo 12.0, with concurrent refinement of themes as interviews are completed. RESULTS/ANTICIPATED RESULTS: We will elucidate emergent themes regarding men’s abortion attitudes which could include how men think of abortion as a medical, moral, or personal reality, why they do or do not support abortion provision, among many other possibilities. We anticipate that researchers can use the data obtained from this study to begin to build a conceptual framework of abortion attitudes among US men who lives in restrictive states. DISCUSSION/SIGNIFICANCE OF IMPACT: This study will fill an important gap in the literature by qualitatively characterizing abortion attitudes among a population that has political influence on abortion access. Results can inform policy and advocacy campaigns aimed at shifting public abortion attitudes towards increased acceptance.

OBJECTIVES/GOALS: Learners will:

• Identify social structures that serve as root causes of health disparities

• Critically evaluate the ways in which racism, culture, and power perpetuate disparity

• Use critical reflection to shape their research and advocate for institutional change

METHODS/STUDY POPULATION: The Integrated Translational Health Research Institute of Virginia (iTHRIV) Health Equity curriculum provides a lens for participants to view health disparities, social structures that create and perpetuate disparities, and the path to a more equitable future. This longitudinal workforce curriculum incorporates the principles of critical race theory (CRT), including: race as a social construct, structural determinism, intersectionality, and the social construction of knowledge. Learners gain practical experience through facilitated group discussions and critical reflection of their own work including research question design, recruitment, dissemination, and enhancing the faculty pipeline. RESULTS/ANTICIPATED RESULTS: To measure the impact of the curriculum, we will evaluate learners’ participation in mentoring activities for persons from underrepresented backgrounds; participation in local and national diversity and inclusion efforts; engagement in community-based research; ability to account for implicit bias and power imbalances in their research design, including in recruitment and retention; and share research findings with community members and research participants. Evaluation strategies will include quantitative and qualitative methodologies. DISCUSSION/SIGNIFICANCE OF IMPACT: There is growing recognition of the impact of racism on the development and perpetuation of health disparities. Public health critical race praxis (an adaptation of CRT) is emerging as a theoretical framework to empower researchers to challenge the status quo in order to achieve health equity.

OBJECTIVES/GOALS: There is increased recognition that patients and community members are critical to creating impactful research. To this end the UCLA CTSI Community Engagement & Research Program modified an established multidisciplinary team science communication module to train academic-community research teams. METHODS/STUDY POPULATION: Community partners who have had previous experience in participatory research provided input such as limiting the emphases of individual academic introductions to group icebreakers (to level the playing field), reduced academic jargon to lay language, reducing the amount of text to key principles, and changed academic team scenarios for the team activity to represent community-academic teams. Academic partners articulated institutional barriers to integrating community into institutional systems. Iterative testing and modifications occurred through pilots with eleven teams (49 individuals). RESULTS/ANTICIPATED RESULTS: Embedding community partners in team science training involved creating a level playing field with less emphasis on academic credentials, using lay language in the didactic sessions and ensuring accessibility in all aspects of the training. An example of modifications: communication scenarios were read out loud by participants, which community partners felt were not inclusive of potential varying literacy levels and all partners may not feel comfortable reading aloud in a group setting. The vignettes were replaced with short videos of the scenarios with audio recordings. Several modifications were made the training’s team activity of the training module. DISCUSSION/SIGNIFICANCE OF IMPACT: Traditional academic team science training required significant modifications for an academic/community-partnered team to allow for optimal collaboration, inclusion, and strategically reduce the power dynamics that can naturally occur. Long-term followup to assess their effectiveness is needed.

OBJECTIVES/GOALS: To describe how the Community Engagement (CE) Program at the Michigan Institute for Clinical & Health Research (MICHR), a Clinical & Translational Science Award (CTSA) site at the University of Michigan, is adopting human-centered design (HCD) to advance the science of community engagement in translational research and CE’s programmatic efforts. METHODS/STUDY POPULATION: The MICHR CE Program supports academic-community partnerships to transform translational research across the state of Michigan. As the team aims to better engage partners to help guide the direction of their work, CE is collaborating with MICHR’s Design and Innovation Core to incorporate human-centered design (HCD). HCD is an approach that prioritizes the needs, values, and perspectives of direct users during the creation of a new product or service. The MICHR team created interactive HCD activities for two statewide retreats to elicit feedback from community and academic members on ways to enhance community-engaged research (CEnR). Retreat participants worked on a variety of problems, such as barriers to partnering and defining impact for CEnR. These activities generated authentic, contextual, and multi-view data captured in various artifacts for systematic analysis. RESULTS/ANTICIPATED RESULTS: In the first retreat, a HCD activity had participants reflect on their own barriers to partnering in research and potential solutions. In the second retreat, an HCD activity facilitated participants interviewing each other on their views of the impact in CEnR. Results from the first activity identified a set of common barriers to CEnR, some related to partnership formation, communication, and partner equity, among others. These led the CE Program to specific programmatic efforts, such as designing a statewide partnership platform, hiring a communication program manager, and sponsoring community partners to join national conferences. The second retreat activity produced rich data to identify overlaps between different perspectives to inform how impact can be defined and measured in CEnR. DISCUSSION/SIGNIFICANCE OF IMPACT: HCD activities provide means to include community and academic members in the science of CEnR. They allow systematic ways to gather information directly from the diverse set of current or prospective partners of community engagement programs about their needs, experiences, and values, which can be translated to programmatic innovation.

OBJECTIVES/GOALS: The extent that Clinical and Translational Science Award (CTSA) programs offer resources accessible online for training in community-engaged research (CEnR) core competencies is unknown. This study cataloged CEnR resources accessible online from CTSAs and mapped resources to CEnR core competencies. METHODS/STUDY POPULATION: Eight domains of CEnR core competencies were identified: knowledge/perceptions of CEnR; personal traits necessary for CEnR; knowledge of/relationships with communities; training for performing CEnR; CEnR methods; program evaluation; resource sharing and communication; and dissemination and advocacy. A systematic review of CEnR resources accessible online from CTSAs was conducted between July 2018 and May 2019. Resource content was independently reviewed by two reviewers and scored for inclusion of each domain of CEnR core competencies. Domain scores across all resources and inter-rater reliability in scoring domains were assessed using descriptive statistics and Cohen’s kappa coefficients. RESULTS/ANTICIPATED RESULTS: Overall, 214 resources available from 24 CTSAs were eligible for full review. Scoring discrepancies for at least one domain within a resource initially occurred in 51% of resources. “CEnR methods” (50.5%; 108 of 214) and “Knowledge of/relationships with the community” (40.2%; 86 of 214) were most frequently addressed and “Program evaluation” (12.1%; 26 of 214) and “Dissemination and advocacy” (11.2%; 24 of 214) were least frequently addressed domains. Additionally, challenges were noted in navigating CTSA websites to access CEnR resources, and CEnR competency nomenclature was not standardized. DISCUSSION/SIGNIFICANCE OF IMPACT: Our findings guide CEnR stakeholders to identify CEnR resources accessible online and gaps to address in CEnR resource development. Standardized nomenclature for CEnR competencies is needed for effective CEnR resource classification. Uniform organization of CTSA websites may maximize navigability. CONFLICT OF INTEREST DESCRIPTION: In addition to the funding information listed previously (see above), within the last three years, R.J. Piasecki has been employed as: Project Coordinator, CEnR Online Learning Project, Johns Hopkins University School of Nursing (Current) Temporary Employee (Doctoral Student Intern), Michigan State University Institute for Health Policy (Current) Clinical RN, Intrastaff at the Johns Hopkins Health System (Past) Research Data Analysis Assistant, Maryland Institute for Emergency Medical Services (Past - contracted)

OBJECTIVES/GOALS: Kidney transplant is superior to dialysis for the treatment of end-stage kidney disease, but accessing transplant requires high patient engagement. We sought to develop a group counseling intervention with patients and their social support members using an evidence-based, stakeholder-engaged approach. METHODS/STUDY POPULATION: We employed an Intervention Mapping approach to incorporate qualitative data from stakeholders on barriers to accessing kidney transplant. Data were collected from 13 focus groups of African American (AA) and white adult kidney transplant candidates and their social support networks in Minnesota and Georgia. We completed this process through (1) qualitative data collection, (2) utilizing data and intervention mapping methods to develop a conceptual framework to describe associations between behavioral determinants and desired outcomes, and (3) using these products to identify evidence-based approaches to modify behavioral determinants through a theory based intervention. RESULTS/ANTICIPATED RESULTS: Participants describe experiences of overwhelm, isolation, helplessness, and difficulty communicating. In addition, AA participants expressed distrust in the medical system. We systematically incorporated these themes into a conceptual model of behavior change that identifies determinants of necessary actions to obtain transplant, including knowledge, self-efficacy, reduced decisional conflict, and perception of social support. Evidence-based methods to modify these determinants, such as modeling, goal-setting, and mobilizing social support, were incorporated into the design of a group education and counseling intervention with an individualized risk calculator. DISCUSSION/SIGNIFICANCE OF IMPACT: Intervention mapping allows for behavior change theories to be incorporated into counseling sessions with patients and their social support networks. This approach translates qualitative data into an evidence-based intervention which will be piloted in a randomized controlled trial (RCT) to determine feasibility for a larger RCT.

OBJECTIVES/GOALS: Data were collected or abstracted from a wide variety of sources related to health and health care needs to determine the current health status of the Galveston community including:

• Demographics

• Social Determinants of Health

• Health Care Access and Insurance Status

• Poverty and Socio-Economic Indicators Impacting Health

• Health Behaviors

• Chronic Disease

• Communicable Disease

• Birth Outcomes

• Mortality

• Cancer

• Data on Services Provided at UTMB

• Data on Services Provided through the Galveston County Health District

• Data on Services Provided through the St. Vincent’s House Clinics, student-led clinics operated at a local non-profit organization

• Previous Galveston County Community Health Needs Assessment

• Identifying Gaps in Services

• Prevention Quality Indicator Data

METHODS/STUDY POPULATION: In addition to collection and analysis of secondary data, we also interviewed key stakeholders to solicit their input and recommendations. We met with leadership from St. Vincent’s House regarding current services provided, perceived issues and concerns, and needs for improvements. We met with leaders from UTMB’s academic enterprise to discuss the operation of our current student-led clinics as well as ways in which clinical practice experiences might be expanded and included more formally in the student curricula should the clinical capacity of St. Vincent’s House also be significantly expanded. This would increase the number of services that could be offered at St. Vincent’s and greatly increase the capacity for enrolling patients without relying on faculty volunteers to staff the clinics. We also met with UTMB leaders in a position to provide insight to issues that bridge the UTMB practice arena and public health and with Community Health leaders from the Galveston County Health District and Teen Health Clinics. Information Services leadership and Institute for Translational Science informatics faculty and staff were instrumental in determining what data could be abstracted from the Electronic Medical Record (without patient identifiers) to determine the specific need for services at St. Vincent’s. RESULTS/ANTICIPATED RESULTS: The City of Galveston has a population just under 50,000. Since 2010, the proportion of elderly has increased, and the proportion of families with younger children has decreased. Poverty is high at 22.3% for all people, and especially high for children at 32.1%. Poverty disproportionately affects racial and ethnic minorities, with 36.5% of the Black population living below the poverty level, compared to 25.5% Hispanic, 30.5% Asian, and 14.7% White. Home ownership is decreasing, and median rent costs have sharply increased. The percentage without health insurance is considerable, driven by educational attainment, age, and race. In 2017, >40% of renters spent more than 35% of their income on housing. Upwards of 2,650 reported not having access to a vehicle for transportation. While residents of Galveston County as a whole are less impoverished, those that are impoverished share marked similarities. Lower educational attainment, in particular failure to complete high school or obtain a college degree, are correlated with race. Lower educational attainment then is highly predictive of poverty and low income. The income inequality ratio, i.e., the greater division between the top and bottom ends of the income spectrum in Galveston County is higher than in Texas or the nation and has increased every year but one since 2010. Issues of concern for Galveston County include obesity, Type II diabetes, and disability. These are exacerbated by built and social environment issues such as food insecurity, limited access to healthy foods, and food deserts in some neighborhoods. Pre-term birth rates are higher in Galveston than in the state or nation, and approximately 40% of women do not receive prenatal care until the 2nd or 3rd trimester or receive no prenatal care at all. 8.4% of births are low-birth weight. Marked disparities by race and ethnicity exist for each of these indicators. Age-adjusted death rates for all-cause mortality are higher in Galveston County than they are in Texas or the United States. Perhaps of most concern are the rates of death from septicemia, which are nearly triple that of the U.S. and nearly double that of the state, and cancer. Cancer incidence is not particularly remarkable, however, cancer age-adjusted mortality rates for many specific cancers well exceed state rates. DISCUSSION/SIGNIFICANCE OF IMPACT: With a clearer picture of the medical and other needs impacting health or health care access for our community, all stakeholders and experts can provide more detailed recommendations about prioritizing care and especially, preventive care—much of which could conceivably be provided in St. Vincent’s House clinics. Opportunities exist for enhanced practice and education opportunities for UTMB students from all schools. Preventive Care and Population Health practices can be brought to bear in novel practice settings that could serve as models for provision of integrated services. Social and other services provided by non-profit organizations can be coordinated and streamlined. It is our hope that the considerable data presented herein will enable stakeholders to begin to prioritize issues and to make some evidence-based decisions about the next steps in this process. Throughout the interview and data collection process, all stakeholders have expressed both enthusiasm and hope at the prospect of re-visioning how they can contribute to a process that will improve how we as a community care for our most vulnerable members. CONFLICT OF INTEREST DESCRIPTION: The authors have no conflicts of interest to disclose.

OBJECTIVES/GOALS: Heart failure and depression are important public health problems. Depression has been identified as an independent risk factor for increased cardiovascular morbidities. It is estimated that 1 out of every 5 patients living with heart failure suffer from depression. (Kop, W. J.) Studies have found that Hispanic patients have a higher rate of heart failure than non-Hispanic whites. Current guidelines recommend that proper screening tools must be used to identify and manage major depression disorder in HF patients, however many of these patients go unrecognized in the medical setting. The prevalence, management, and outcomes of depression among PuertoRican Hispanics living with heart failure is unknown. Objective: The purpose of this study is to evaluate the relationship between heart failure and depression in Hispanics with heart failure METHODS/STUDY POPULATION: To this end, we will perform a secondary analysis of data from the PR CardiovascularSurveillance Study (PRCSS). We will extract personal data from 4,461 medical records of patients admitted with heart failure (ICD-9 Codes 428) at 21 hospitals in Puerto Rico, during the years 2007, 2009 and 2011. For statistical methods, we will implement chi-square and t-tests at a significance level of 0.05 RESULTS/ANTICIPATED RESULTS: We expect to see older aged women with higher NYHA and pro-BNP levels to be associatedwith diagnosis of major depression disorder and worse in-hospital outcomes DISCUSSION/SIGNIFICANCE OF IMPACT: With this study, we would like to raise awareness about depression in patients with heart failure, and its role in improving patient outcomes. Moreover, we would like to determine if there are gender-specific health disparities among Puerto Rican Hispanics with heart failure

OBJECTIVES/GOALS: Patient online portal (POP) allows patients to access electronic health records (EHRs) and have efficient communication with their clinicians. We assessed disparities in access to POP by families with different SES and its impact on asthma research which is little known in the literature. METHODS/STUDY POPULATION: A randomized controlled trial testing the efficacy of an EHRs-based clinical decision support (CDS) system was conducted at a pediatric primary care setting of Mayo Clinic. Asthma Control Test (ACT) questionnaire was administered to parents every 3 months through phone or email for this study after consenting, and reminders were sent to unanswered subjects through the POP. SES was measured by HOUSES (in quartiles), a validated individual-level SES index based on housing features (the higher HOUSES, the higher SES).The association of HOUSES with availability of POP access and missing ACT score rate was assessed. RESULTS/ANTICIPATED RESULTS: The mean age of 184 participants was 9.0 years (57% male) and parents of 152 (83%) children had POP. Only 68% of children from lowest HOUSES (Q1) had access to POP (vs. 74% (Q2), 88% (Q3), and 92% (Q4; highest SES); p = .02). ACT score was completed by 144 (78%), 150 (82%), 171 (94%), and 164 (95%) at each intervention conducted every 3 months with a total of 61 (33%) missing at least once. Overall, children whose parents had access to POP had a lower missing rate in ACT score at all interventions during the study; 16% (those with access to POP) vs. 47% (those without), 13% vs. 44%, 3% vs. 16%, and 1% vs. 23% for 1st, 2nd, 3rd, and 4th intervention, respectively (p < .007 for all). DISCUSSION/SIGNIFICANCE OF IMPACT: There are significant disparities in access to POP by SES defined by HOUSES which impact availability of ACT score resulting in a systematic bias in asthma research and potentially widening disparities in asthma care. CONFLICT OF INTEREST DESCRIPTION: NA.

OBJECTIVES/GOALS: Total hip replacement (THR) improves function for those with arthritis, but not all patients have equal access to this elective procedure. To better geographically target healthcare resources, we explored whether geographic socioeconomic disadvantage is associated with incidence of elective THR. METHODS/STUDY POPULATION: We performed a cross-sectional analysis of data in the state of Maryland from 2013-2019. We categorized 5-digit zipcodes into national quartiles of socioeconomic disadvantage using the Area Deprivation Index (ADI). For each zipcode, we calculated the THR incidence rate using Maryland Health Services Cost Review Commission (HSCRC) inpatient and outpatient data in those age 65 years and older. We included only elective THRs. We analyzed the association between a zipcode’s disadvantage quartile and THR incidence rate using multivariate linear regression, correcting for differences across zipcodes in gender, race, and ethnicity distributions, and distance to the nearest hospital performing THRs. RESULTS/ANTICIPATED RESULTS: We analyzed 414 zipcodes with overall average THR rate of 370.8 per 100,000 persons >65yo per year. Relative to zipcodes in the least socioeconomically disadvantaged quartile, those in the second-least disadvantaged had 82.2 fewer THRs per 100,000 persons >65yo per year, those in the second-most disadvantaged had 144.2 fewer, and those in the most disadvantaged had 207.4 fewer (all p65yo per year, those in the second-most disadvantaged had 136.2 fewer, and those in the most disadvantaged had 182.9 fewer (all p <.05). DISCUSSION/SIGNIFICANCE OF IMPACT: More socioeconomically disadvantaged areas have significantly lower rates of elective THR, independent of differences in demographics and hospital proximity. These findings show how disparities can affect access and outcomes, and should inform targeting of community-level education and intervention.

OBJECTIVES/GOALS: 1. Understand the association between patient perceptions of care measured by the Interpersonal Processes of Care (IPC) Survey and glycemic control, appointment no-shows/cancellations and medication adherence in patients with type II diabetes. 2. Determine how these relationships differ by race for non-Hispanic White and Black patients. METHODS/STUDY POPULATION: This is a cross-sectional study of a random sample of 100 White and 100 Black Type II diabetic patients followed in Duke primary care clinics and prescribed antihyperglycemic medication. We will recruit through email and phone calls. Enrolled patients will complete the Interpersonal Processes of Care Short Form and Extent of Medication Adherence survey to measure patient perceptions of care (predictor) and medication adherence (secondary outcome). No show appointments and cancellations (secondary outcomes) and most recent hemoglobin A1c (primary outcome) will be collected from the Electronic Medical Record. We will also collect basic demographic information, insurance status, financial security, significant co-morbidities, and number and type (subcutaneous vs oral) of antihyperglycemic medications. RESULTS/ANTICIPATED RESULTS: -The study is powered to detect a 0.6% difference in HbA1c, our primary outcome, between high and low scorers on the Interpersonal Processes of Care subdomains. -We expect that higher patient scores in the positive domains of the IPC survey and lower DISCUSSION/SIGNIFICANCE OF IMPACT: This study will provide information to develop and implement targeted interventions to reduce racial and ethnic disparities in patients with Type II diabetes. We hope to gain information on potentially modifiable factors in patient-provider interactions that can be intervened upon to improve prevention and long-term outcomes in these populations.

OBJECTIVES/GOALS: The overall goal of the Community-Engaged Research Core, supported by the Penn State Clinical and Translational Science Institute, is to invest in opportunities that promote collaboration between researchers and communities. Research in which community members are participating in the research process will more likely lead to reducing health disparities when compared to more traditional approaches. This abstract describes a community research day that brought researchers and community-based organizational leaders together to discuss critical areas of research. We aim to highlight a successful approach for how to work with a community, particularly one that has been distrustful of research, to facilitate and support collaborations between academic researchers and community-based organizational leaders (CBOs). Community-based organizational leaders are often the most knowledgeable individuals when it comes to identifying and discerning the needs and research priorities of their communities and they are generally in the best positions to help build greater trust between academic researchers and communities. METHODS/STUDY POPULATION: A Community Research Day Steering Committee was formed in the spring of 2018 and consisted of 10 community-based organizational leaders from Harrisburg, Pennsylvania, two Penn State University staff, and one Penn State University faculty member. The Steering Committee’s purpose was to design, plan, and execute an event (Better Together: Community Driven Awareness) in which community-organizational leaders and faculty researchers came together to discuss possible research collaborations to improve community health. The Steering Committee participated in bi-monthly planning meetings leading up to the event, Better Together: Community-Driven Awareness. During these planning meetings, members determined that mental health and nutrition were two critical areas deserving of more attention from research within their geographical community. Organizations were asked to identify sub-categories within mental health and nutrition that they saw as most relevant to their communities. The sub-categories that they selected became the theme topics for round table discussions at the main event. This information was also used to determine which academic researchers to invite to the event, based on scientific expertise. In addition to selecting these topics for table discussions, the Steering Committee provided advice on the agenda and program materials. The agenda for Better Together: Community-Driven Awareness featured a presentation from a successful collaboration between a faculty member and a community-based organization whose project was centered around suicide prevention in the school system. After the presentation, researchers and CBOs sat at round tables for facilitated discussions about their table’s theme. The facilitated discussions fostered new relationships and led to collaborations outside of the event. Following the round-table discussions, there was a presentation about funding and next steps. Lastly, feedback forms were given to each attendee to assess their experience of the event and to better understand what to improve upon for the future. RESULTS/ANTICIPATED RESULTS: Following the Community-Driven Awareness event, the Community-Engaged Research Core at Penn State released a call for proposals for planning grants to be awarded to faculty/community-based organization teams. These grants were intended to build capacity for externally-funded research that seeks to address important community-identified research questions. The internal grants support meetings to discuss mutual interests, develop research questions, identify leaders, conduct literature reviews, and collect pilot data. A team must have included, at a minimum, one Penn State faculty researcher and one community-based organizational leader as co-principal investigators. In the proposal, the team was asked to describe its preliminary research question, the work to be accomplished during the planning period, anticipated outcome(s) and deliverables, and preliminary ideas for seeking future external funding. A two-page narrative briefly described how the team members’ expertise/experience/constituencies would address the specified research question. In addition, the team provided a budget and budget justification. Planning grants ranged from $500-$5,000. Funds were allocated for a 6-12 month period. After the call was sent out, seven proposals were submitted and three were selected for external funding. Proposal topics included: * Exploring the Mechanism of Engagement in HIV Testing, Prevention, and Care Among African American and Hispanic/Latino Men who Have Sex with Men * Educator Translation of a Universal Social-Emotional Learning Program in School Practice * Growing Nutritious Communities: Gardening to increase access to and knowledge about fresh fruits and vegetables among residents in South Harrisburg, Hall Manor community. DISCUSSION/SIGNIFICANCE OF IMPACT: There are several academic institutions that have implemented similar events whose goal is to bring together academic researchers and community-based organizational leaders. To our knowledge, this is one of a few examples of an event that was developed from the ground up by a committee comprised mostly of community organization leaders. The community leaders guided the decisions made in all phases of the event design from determining the research themes to providing input on program materials. Additionally, our Steering Committee garnered the interest and attendance from over 20 community participating organizations, which attests to their commitment and dedication to seeing this event through from beginning to end. The feedback received from the event was overwhelmingly positive. Both academic researchers and community-based organizational leaders expressed their appreciation for an event that brought both parties together in a space where they felt comfortable to share ideas and knowledge. When asked how we could improve this event in the future, most attendees shared that they wanted more time and more opportunities to connect. One limitation of the event noted by attendees was that attendees were not able to sign up for the round table discussions themselves but were placed strategically at them by our Steering Committee. Therefore, at our next event, attendees will be able to select their tables and determine which themed topic they prefer to participate in. Lastly, we are considering how to best summarize the ideas that are generated from these round table discussions in a way that can be shared with the larger group and in a way that might foster collaborations outside of the event.

OBJECTIVES/GOALS: This social justice-oriented, multi-method study aims to gain an understanding of the unique sources of stress and resilience impacting Black women in Milwaukee. As clinical researchers, it is imperative that we understand the mechanisms underlying the relationship between marginalized identities and substantial health disparities. METHODS/STUDY POPULATION: Participants were Black women, diverse in age, income, and sexual orientation to emphasize an intersectional approach (current N = 87 of 160). Our interdisciplinary team collected two interrelated data types: narrative and survey. Participants completed a 1.5-hour life story interview in which they were asked to share stories from their lives, their backgrounds, plans for the future, forces that shaped their stories, and how their identities have influenced their experiences. Interviews were done one-on-one and conducted by Black women interviewers. They were also asked to complete an online survey protocol including measures of stress, trauma, microaggressions, coping, and well-being. Transcribed life story interviews will be coded utilizing grounded theory, an intensive qualitative analysis method. RESULTS/ANTICIPATED RESULTS: The presentation will focus on the unique methodological approach, which emphasizes community empowerment through collaboration and cultural competency. Data collection is still in progress, but initial relationships between key variables will be discussed. It is anticipated that greater frequency and appraisal of microaggressions will significantly predict higher reported stress, anxiety, and depression. Within-group diversity will be examined as well. Relevant themes emerging from grounded theory will also be presented. Results will directly inform community outreach aimed at improving the lives of Black women. DISCUSSION/SIGNIFICANCE OF IMPACT: This study sheds light on unique, identity-related stressors believed to contribute to mental and physical health disparities. It also builds on current theories, filling voids in the research literature by taking a psychosocial perspective, emphasizing the voices of participants, and channeling the findings to specific programs in the community.

OBJECTIVES/GOALS: Examining the impact of the Building Capacity for Research and Action (BCRA) Award created by the Community Engagement (CE) Program at the Michigan Institute for Clinical & Health Research (MICHR)--a Clinical & Translational Science Award (CTSA) site at the University of Michigan--in partnership with Community Based Organization Partners (CBOP). METHODS/STUDY POPULATION: The BCRA is a funding mechanism that supports new community-engaged research (CEnR) partnerships and projects that address community-identified health needs in Flint, Michigan. BCRA projects are required to be Flint-based and inclusive of both community and academic partners. A study section consisting of 10 MICHR-affiliated faculty and community partners reviewed proposals and made funding decisions. Funded teams were trained on Institutional Review Board (IRB) and reporting requirements by CE staff. MICHR provides support to BCRA-funded teams through monthly email correspondence with the CE Flint connector, budget review, mediation, regulatory assurance of IRB and the National Center for Advancing Translational Science (NCATS) requirements, coordinating six-month and final reporting, and hosting an annual stakeholder meet and greet. RESULTS/ANTICIPATED RESULTS: In 2017, the BCRA Award submitted its first request for proposals. It received 20 applications in 2018, and selected eight awardees, providing them with a total of $60,000 in funding. Four received $5,000 for partnership development and another four received $10,000 for their research projects. The BCRA Award received 16 applications in 2019, expanding its academic pool to include the University of Chicago, U-M Flint, Michigan State University, and Michigan State University-Flint in addition to the University of Michigan. Five recipients were selected and received a total of $45,000 in funding. One was awarded $5,000 for partnership development and another four were awarded $10,000 for their research projects. MICHR has invested over $100,000 in Flint through this mechanism, which was renewed in 2019. DISCUSSION/SIGNIFICANCE OF IMPACT: Each awardee presented at the annual stakeholder meet and greet. They showcased their projects with a brief overview and spoke about their expectations, lessons learned, partnership strengths and challenges, translational issues, and proposed next steps for subsequent grants, publications.

OBJECTIVES/GOALS: The goal of this project was to inform four chronic disease initiatives, working together on the team Connections IN Health, and counties in Indiana on certain areas of need to assist them in collaborative planning. The chronic diseases focused on include diabetes, cardiovascular disease, stroke, asthma, lung cancer and obesity. METHODS/STUDY POPULATION: Chronic disease health outcomes and social determinants of health indicators were identified in all 92 Indiana counties. Counties were compared by composite z scores in a matrix to determine the 23 counties with the poorest health statistics for diabetes, cardiovascular disease, stroke, asthma, lung cancer, obesity and life expectancy. Qualitative data were used to identify local health coalitions that have the capacity and desire to work with Connections IN Health to improve these health outcomes. With input from partners, the counties were narrowed to 10 that were identified as those with the most need in the specific areas of chronic disease that the initiatives focus on. The team will begin listening sessions with two of these counties to identify strategic partnerships, funding sources, and evidence-based programs to address community-identified health priorities. RESULTS/ANTICIPATED RESULTS: The 23 counties with the poorest health outcomes related to chronic disease and factors were Blackford, Clark, Clay, Fayette, Fulton, Grant, Greene, Howard, Jay, Jennings, Knox, Lake, LaPorte, Madison, Marion, Pike, Scott, Starke, Sullivan, Vanderburgh, Vermillion, Vigo, and Washington. There was significant overlap in low z score rankings for individual health and social determinants of health measures among these 23 counties. The following 10 counties were selected for focus in the next five years based on partner input: Blackford, Clay, Grant, Jennings, Lake, Madison, Marion, Starke, Vermillion, and Washington. The Connections IN Health team has initiated listening sessions in Grant and Vermillion Counties (with data for presentation at the ACTS meeting). DISCUSSION/SIGNIFICANCE OF IMPACT: This mixed methods approach using existing data and partner input on county capacity/readiness directed Connections IN Health to counties with the most need for coalition efforts. Engagement within each county will inform next steps (e.g., capacity building, partnership development, applications for funding, implementation of evidence-based programs) and specific health focus area(s).

OBJECTIVES/GOALS: People engaging in high-risk substance use or experiencing food insecurity or housing instability are at increased risk to develop end-stage kidney disease. This study will examine associations between these risk factors, patient indicators of socioeconomic position, and hospitalization rates and quality of life after initiation of hemodialysis. METHODS/STUDY POPULATION: The proposed study will leverage a prospective cohort design. We will enroll a convenience sample of 330 participants from the same large dialysis organization. Participants will complete measures of socioeconomic position (age, gender, race, ethnicity, education, income, occupation and community poverty); substance use; food insecurity; housing instability; and quality of life at baseline. We will follow participants for 6 months and extract hospitalization counts from the dialysis facility medical record. RESULTS/ANTICIPATED RESULTS: We will generate risk scores (low, medium, high) from measures of substance use, food insecurity and housing instability. We will conduct multiple logistic regression to generate odds ratios comparing risk group membership by indicators of socioeconomic position. We anticipate that low or medium-risk groups will differ from high risk groups by indicators of socioeconomic position. We will conduct Poisson regression to generate incidence rate ratios for 6-month hospitalization rates comparing low or medium-risk and high-risk groups. Lastly, we will conduct multiple linear regression to generate beta coefficients for changes in quality of life scores comparing low or medium-risk and high-risk groups. We anticipate that high-risk groups will have higher hospitalization rates and lower quality of life scores. DISCUSSION/SIGNIFICANCE OF IMPACT: As the prevalence of end-stage kidney disease continues to increase, there is a need for tertiary prevention interventions that reduce costly inpatient utilization and improve health-related quality of life. The proposed study will lay groundwork for the development of interventions to improve patient outcomes and reduce Medicare spending.

OBJECTIVES/GOALS: This project aims to ensure that the age ranges of participants in OHSU studies for specific diseases match the demographics of the populations the diseases occur in, as mandated by the new NIH Inclusion of Individuals Across the Lifespan as Participants in Research Involving Human Subjects policy. METHODS/STUDY POPULATION: This study involves retrospective and prospective data. The retrospective phase (“Look Back”), reviewed all investigator-initiated OHSU studies between 2017 and 2018 with prospective consent that were disease related (N = 63). Age range per IRB protocol and per subject enrollment were graphically compared to disease demographics to determine if study age ranges were a “match” or “mismatch” to disease demographics (0 = mismatch, 1 = partial match, 2 = full match). This data will inform the upcoming prospective phase of the study, when the study team will reach out to primary investigators of enrolling studies with education and resources, and track whether this reduces demographic “mismatch.” RESULTS/ANTICIPATED RESULTS: Of the studies, 51 were evaluated in the “Look Back” analysis. 40 studies were full matches for age inclusion matching disease demographics (78%), 40 for disease prevalence range (78%), and 38 for enrolling subjects within the disease demographic range (74%). Studies received the lowest scores in enrolling subjects that match disease prevalence, with 19 earning full points (37%) and 17 earning 0 points (33%). Limitations include difficulty in finding and applying disease demographic and prevalence ranges. In addition, in this data, 12 of the original 63 total studies could not be scored because no subjects had been enrolled or prevalence ranges were not in line with clinical expertise. DISCUSSION/SIGNIFICANCE OF IMPACT: This study highlights that many trials exclude older subjects at the upper age ranges. Future analysis of the prospective phase of the study will allow us to assist research teams in closing these gaps and will determine the Policy’s impact on the recruitment of older adults into research.

OBJECTIVES/GOALS: Inflammatory bowel diseases (IBD) are most often diagnosed in adolescence and young adulthood, affecting 10 in 100,000 pediatric patients in the US and Canada. Adolescents with IBD are vulnerable to poorer outcomes and higher health costs, partially attributable to disruptions in the continuity of care in the transition from pediatric to adult care settings. There is currently no consensus among providers about the timing of initiation and completion of the transition process for adolescents and young adults with IBD, and access to structured pediatric transition readiness programs are lacking, with a paucity of research to evaluate relevant clinical outcomes in such existing programs. While prior studies have primarily examined barriers and facilitators of successful transitions from the provider perspective, only few studies have systematically examined such factors from the patient and caregiver perspective. We wish to better understand the experience of living with IBD for adolescents and young adults, as well as their parents, to understand barriers and facilitators of successful transitions in care. Ultimately, we wish to articulate best practices in this domain in order to create and evaluate a transitions program for patients and parents at the Mount Sinai IBD Center. METHODS/STUDY POPULATION: We are recruiting 15-25 patient-parent dyads to complete our study. At recruitment, we collect baseline quantitative metrics from patients pertaining to demographics, disease characteristics, transition-readiness, self-efficacy, resilience, disease-specific health knowledge, and health literacy. From parents, we collect demographic information, concordance metrics (e.g. how parents perceive their children’s resilience, self-efficacy), parenting style questionnaires, and others. These data are used to understand the characteristics of the young adults and parents within our sample to ensure that the results of our study will be generalizable to a diverse range of patients and families. We then train our patient-parent dyads in Photovoice, the primary method of our study. Photovoice is a community based participatory research (CBPR) methodology used in health education and other fields. The method employs photography for participants to capture their experiences living with IBD, or being a parent to a child with IBD. We then interview all participants about the photos using a standard script employed in Photovoice. All surveys are transcribed and coded for thematic analysis. Based on our findings, we hope to determine phenotypes of patient-parent dyads who are likely undergo successful transitions as well as those at higher risk, understand competencies necessary for successful transitions, and create a comprehensive transitions program for the IBD Center that can be applied with all patients undergoing transitions from pediatric to adult GI care. RESULTS/ANTICIPATED RESULTS: We currently have 26 patients and 25 parents (1 pair of siblings) aged 14-25 enrolled in the study. We hypothesize that adolescents with higher baseline resilience, efficacy, disease-specific health knowledge, and less active disease will have more successful transitions than adolescents with lower scores on these metrics. Similarly, we predict that adolescents with lower baseline resilience, self-efficacy, disease-specific health knowledge and more active disease will be ideal candidates for a more robust transition-readiness program. Further, we hypothesize that children of more authoritarian parents will be less prepared for transition than those with assertive parents. We are currently in the process of conducting patient/parent interviews, and have collected 6 interviews thus far. We will begin the qualitative coding process once we have four interviews from each cohort. Themes emerging thus far involve: medication management, psychiatric co-morbidity, social support, direct communication with doctors, the role of surgery, school absences, travel, and others. DISCUSSION/SIGNIFICANCE OF IMPACT: Transition-readiness is defined as a series of skills in the realms of knowledge, information gathering, self-management, and decision-making that must be mastered by a patient in preparation for a healthcare transition, such as that from pediatric to adult IBD care. It has been shown that many clinicians who rely on subjective measures such as perceived health literacy overestimate transition readiness in their IBD patients. Many pediatric gastroenterologists who use more objective measures rely on a validated self-report questionnaire, the Transition Readiness Assessment Questionnaire (TRAQ) to assess readiness for transition and to facilitate discussions around the skills necessary to transition, including appointment keeping, tracking health issues, managing medications, talking with providers, and managing daily activities. However, the TRAQ has been shown to be limited in its ability to predict transition readiness independently of age, and ignores both provider and family perspectives. Given the critical role of parents in medical decision making, and the differential emphasis of the caregiver role in pediatric versus adult IBD care paradigms, it is vitally important to identify barriers to transition as well as differences in perspectives between adolescents living with IBD and their parents. Our study is the first to employ Photovoice, a method that ‘gives a voice to the voiceless’ in the gastroenterology space, in order to understand the needs that adolescents and young adults themselves perceive as critical in promoting transition-readiness. We include parents in this inquiry in order to understand how parental perceptions of their children’s transition-readiness promote or stifle successful transitions and independent disease self-management. We will ultimately use this data to create a Transitions program to evaluate in our center for adolescents with IBD and their parents.

OBJECTIVES/GOALS: Youth experience worse health and behavioral outcomes the longer they are in the juvenile justice system. This study examines whether age at entry and length of time in a specialty juvenile court program predicts citations, bench warrants, and running away among sex-trafficked girls. METHODS/STUDY POPULATION: Domestic minor sex trafficking (DMST) is exploitation and abuse of children for commercial sexual purposes in exchange for money or other goods/services. Historically, the response to DMST has been punitive, resulting in youth being cited and detained for offenses like prostitution. The specialty court offers enhanced physical/mental health services to trafficked youth. Data come from case files in the specialty court for program participants from 2012-2014 (N = 184). Descriptive, bivariate, and Poisson regression analyses were performed to examine risk profile measures: bench warrants, citations, running away, and foster placements. RESULTS/ANTICIPATED RESULTS: All were (cis)female, 74% were African-American, 96%, US citizens, with average age of 16. Participants lived in approximately 4.5 group homes or foster placements prior to program entry; 56% of youth had run away. Youth also averaged nearly two bench warrants before specialty court participation. Bivariate analysis indicates older age at entry into juvenile court was associated with fewer episodes of running away (p<.02) and new citations (p<.001). Poisson regression estimated older age at entry into the juvenile justice system was associated with fewer bench warrants, citations, foster placements, but not running away while in the program. Additionally, longer duration between time at first citation and entry into the program was associated with fewer bench warrants, running away, and citations. DISCUSSION/SIGNIFICANCE OF IMPACT: Younger girls may be particularly vulnerable to trafficking and recidivism without early and persistent intervention. Youth experiencing sex trafficking need to be diverted away from juvenile justice to comprehensive trauma informed services.

OBJECTIVES/GOALS: Access to pediatric subspecialty care varies by sociodemographic factors. Providers for gender diverse youth (GDY) are rare, and GDY face health disparities, stigma, and discrimination. We examined the association between GDY access to medical and mental health care and rurality, race, parental education, and other GDY-specific factors. METHODS/STUDY POPULATION: We surveyed parents of GDY (<18 years old) across the United States. Participants were recruited through online communities and listserves specific to parents of GDY. We determined associations between access to gender-specific medical or mental health providers and rurality, race, parental education, as well as other GDY-specific factors including age, time since telling their parent their gender identity, parent-adolescent communication, parent stress, and gender identity using chi-square or Fisher’s exact tests. We calculated adjusted odds ratios using logistic regression models. RESULTS/ANTICIPATED RESULTS: We surveyed 166 parents and caregivers from 31 states. The majority (73.2%) identified as white, 66.5% had earned a bachelor’s degree or higher, and 7.6% lived in a zip code designated rural by the Federal Office of Rural Health Policy. We found no evidence of association between reported GDY access to medical or mental health care and race, parental education, or rurality. We did find a significant univariate association between access to mental health care and feminine (either female or transfeminine/transfemale) gender identity (p = 0.033, OR 2.60, 95% CI 1.06 – 6.36). After controlling for parent-adolescent communication in a backwards elimination logistic regression model, it was no longer significant (p = 0.137, OR 2.05, 95% CI 0.80 – 5.25). DISCUSSION/SIGNIFICANCE OF IMPACT: Despite rurality, race, and parental education impacting access to pediatric subspecialty care, we failed to find these associations among GDY accessing gender care. There is a need to better understand structural and societal barriers to care for this population including the impact of stigma and discrimination.