bluuebunny/crossref_metadata_2025 huggingface dataset:
180 Enhancing Engagement of Nursing Home Staff and Leaders in Intervention Development
Authors: Behrens Liza L. , Kowalchik Kalei , Miller Miriam , Murray Andrea , Boltz Marie , Kraschnewski Jennifer
Published: April 2023

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.
182 Examining the Feasibility and Acceptability of Data-Driven Outreach Using Geographic Information Systems to Address Racial Disparities in Fatal Opioid Overdose
Authors: Banks Devin E. , Paschke Maria E. , Winograd Rachel P.
Published: April 2023

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.
183 Explaining Research to Children and Adolescents
Authors: Johnson Tesheia , Black Sundae , Smith Brian , Krystal John , Sevier Brian , Aly Fatima , Kumpf Brandon , Grover Krystal , Solod Alexander
Published: April 2023

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.
186 Exploring stress and inflammation in young children with type 1 diabetes
Authors: Davis Sara L. , Jaser Sarah S. , Ivankova Nataliya , Oates Gabriela , Kaulfers Anne-Marie , Rice Marti
Published: April 2023

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.
187 Exploring the role of maternal exposure to violence in post-partum weight retention among WIC program participants in Puerto Rico
Authors: Mancebo Lorelle R. Lopez , Valle Moro Yari , Colon Maria Kallis , Rivera Maribel Campos
Published: April 2023

OBJECTIVES/GOALS: Evaluate if exposure to violence is associated with post-partum weight retention among WIC participants, which can lead to overweight/obesity due to metabolic adaptations associated to new adapted weight. If confirmed, it would highlight the need for revision of screening for violence exposure as social determinant of health among participants. METHODS/STUDY POPULATION: Nested cohort study among women enrolled in the Baby Act Trial (BAT) who have been enrolled to the active study phase and completed the Accountable Health Communities Health Related Social Needs survey from the Centers for Medicare & Medicaid services as the source of evidence of exposure to violence. BAT recruitment engaged women in their third trimester who were active participants of the Puerto Rico Women, Infants and Children Program (PRWIC), and planned to enroll their infant in the program. Anthropometric measures were documented at the following time points: prior to pregnancy, at delivery, and 12 months post-partum. Of the 530 women recruited to the study, 291 have completed study measures for inclusion into this exploratory analysis from this ongoing trial. RESULTS/ANTICIPATED RESULTS: A Total of 301 participants have met the criteria for inclusion in this preliminary analysis. Mean age among mothers was 26.5 years (SD 5.3), 46.6% had High School level education attainment or less, and 43.3% were actively working at the time of recruitment. Twelve percent of participants had BMI above 35 at 6 months post-partum, while the prevalence of violence exposure was reported as follows for each type of encounter: 3.3% responded yes to physical violence by friends of family, 9.7% reported exposure to insults or inappropriate treatment by any person including family or friends, 2% having been threatened by anyone including family or friends, 6.3% reported having been yelled/cursed at or insulted by anyone including family or friends. Even more concerning is that 7.5% reported severe social vulnerability. DISCUSSION/SIGNIFICANCE: Results reveals importance of providing integrated care in social assistance program. Participants belongs to vulnerable population with social determinants of health that affect the health care they receive. It shows that providing nutritional assistance it’s not enough to being healthy because other components also play a role in overall health.
192 Identifying and Describing Hybrid or Fully Remote Research in Washington, Wyoming, Alaska, Montana and Idaho
Authors: Duenas Devan , Gregor Charlie , Melvin Ann , Perez Gigi , Porter Katie , Saelens Brian , Goss Chris
Published: April 2023

OBJECTIVES/GOALS: The Institute of Translational Health Science (ITHS)Remote Technologies for Research Reference Center (REMOTECH) aims to ease the use of remote technologies in research, addressing barriers to research participation related to in-person and onsite assessments METHODS/STUDY POPULATION: We engaged with stakeholders in our CTSA catchment area to understand the use and impact of remote research: implementation practices, participant acceptability, and impact on accrual. This environmental scan consisted of three parts: (1) Facilitated discussion groups with clinical trial regulatory and implementation experts regarding 10 key areas of research operations using composite case studies of research using remote technologies; (2) Semi-structured interviews with research teams who have successfully implemented remote technologies, querying about specific technologies, expected and actual barriers, and impact on the study population; and (3) A survey distributed to 900+ faculty and staff identifying prevalence of hybrid or fully remote research and describing specific remote technologies. RESULTS/ANTICIPATED RESULTS: Discussion group preliminary findings show experts recommended prioritizing the assessment of value and burden for both research participants and the research team, that equity and diversity should not be sacrificed to accommodate cost and efficiency, and the importance of evaluating the impact of implementing remote technologies on data collection and analysis. Seventeen of 30 interviews are complete, mid-point analysis shows researchers wanting formal best practices and training in remote research, desire increasing diversity through remote options, and expressing concerns about participant burden. 46% of survey respondents report implementation barriers, including participant burden and confusing regulatory pathways. 17% thought remote technologies were not appropriate for their studies. DISCUSSION/SIGNIFICANCE: We plan to leverage a multidisciplinary team to address the identified barriers and disseminate through a public remote technology information portal. Coding and further analysis is underway, including additional interviews targeting researchers working with adolescents and older adults with an increased focus on equity and diversity.
194 Introducing the new Justice, Equity, Diversity, and Inclusion special interest group
Authors: Enders Felicity , Wurth Rachel , Orellana Minerva , Menser Terri
Published: April 2023

OBJECTIVES/GOALS: The Association for Clinical and Translational Science (ACTS) offers important inter-institutional communities through Special Interest Groups (SIGs). New to the SIG ecosystem is the Justice, Equity, Diversity, and Inclusion (JEDI) SIG. METHODS/STUDY POPULATION: Formed in 2022, the JEDI SIG is a growing community of individuals seeking to develop papers and products relating to improving health equity and workforce diversity within the Translational Science Community. Within this context, diversity is broadly defined to include groups at a negative power differential within US society. RESULTS/ANTICIPATED RESULTS: Comprised of 54 individuals spanning 29 institutions as of our first meeting in October 2022, the JEDI SIG is a welcoming group for ACTS members looking to make a difference. We have developed working groups to develop SIG-directed projects, and we look forward to expanding our activities in the future. DISCUSSION/SIGNIFICANCE: In this poster we will share key information about the new JEDI SIG including monthly meeting times, current activities, and ideas for future work.
196 Measuring the Impact of Community Engagement Brokers through Qualitative Interviews
Authors: Piechowski Patricia , Claxton Gina , Spencer Nicola ’Nicki’ , Vasile Elizabeth , Zender Robynn
Published: April 2023

OBJECTIVES/GOALS: As the clinical and translational research enterprise evolves toward addressing health equity and the science of translational science, the CE Brokers are exploring new avenues for impacting the CTSA consortium. METHODS/STUDY POPULATION: Since 2013, managers of Community Engagement (CE) programs across the NCATS CTSA institutes have met monthly to build connections, share knowledge, and advocate for the boundary spanner role. As the clinical and translational research enterprise evolves toward addressing health equity and the science of translational science, the CE Brokers are exploring new avenues for impacting the CTSA consortium. The CE Brokers are composed of 140 individuals from 58 CTSA-associated institutions, and have a long history that has fostered rich, trusting relationships. The growth and strength of this group has primed it to pivot with the new NCATS direction to contribute meaningfully to the science of community engagement and continue the work of improving health equity within the communities we serve. RESULTS/ANTICIPATED RESULTS: In 2022; we surveyed its members about their roles and responsibilities; the ways the network has contributed to their hub’s adoption and development of best practices and innovations; resources and lessons learned; the creation of opportunities for members to collaboratively conduct and disseminate original research; and research on the science of CE. Grounding ourselves in this initial data, we have developed interview questions to take the inquiry further, by gathering qualitative data on the impact of the group: How the Brokers group impacted them personally and professionally; How the Brokers impacted the work of their CTSA; In three words, describe the group; How could the CE Brokers contribute to the science of community engagement? DISCUSSION/SIGNIFICANCE: Together, we will identify themes supported by quotes to inform how the CE Broker group is most effectively moving the CTSAs’ mission forward and how it can be improved. These will be shared at the Translational Science Meeting, 2023.
203 Patient Engagement in Diabetes Care: Missed Appointments Among Adults Living with Type 2 Diabetes
Authors: Sun Chun-An , Perrin Nancy , Maruthur Nisa , Renda Susan , Levin Scott , Han Hae-Ra
Published: April 2023

OBJECTIVES/GOALS: Missed appointments (MAs) negatively impact the health outcomes of adults living with type 2 diabetes mellitus (T2DM), causing disruptions in clinic operation and added financial cost to healthcare providers and systems. This study aimed to identify risk factors for MAs in both in-person and telehealth settings among adults living with T2DM. METHODS/STUDY POPULATION: Using a sequential multi-method design guided by the modified Quality-Caring Model, the quantitative phase of this study used electronic health records (EHR) data in Calendar Years 2019 and 2020 with 7,276 encounters made by 2,235 patients with T2DM from four diabetes clinics within a tertiary academic medical center in Baltimore, MD. Multivariable random effect logistic regression were used to examine the association between MAs and included predictors (i.e., patient characteristics [e.g., age, race, health status], health provider factors [e.g., types of provider], and health system factors [e.g., scheduling lag]). Based on the results of the quantitative phase, a purposive sample of 23 adults with T2DM and 10 providers were then interviewed individually via phone or zoom. RESULTS/ANTICIPATED RESULTS: The EHR data found that the following variables decreased the odds of MAs: having an activated patient portal account, patients with age over 46 or with white race. Telehealth was associated with 50% decreased odds of MAs during COVID (after 3/23/2020). On the other hand, longer scheduling lag increased the odds of MAs. Qualitative interviews revealed that MAs were often related to social needs, such as lack of/limited health-related transportation and its associated financial burden. Telehealth helped break these barriers for some adults with T2DM, but technical challenges in telehealth persisted for those with low digital health literacy and people who did not have a digital device and/or with unstable internet connection. Providers worried that these challenges might undermine the quality of diabetes care. DISCUSSION/SIGNIFICANCE: Disparities in MAs by age and race were noted, which might reflect the impact of unmeasured social needs in EHR. Perceived convenient telehealth may reduce MAs in T2DM care. However, the persistent technical challenges of telehealth should be addressed to optimize the quality of diabetes care and to promote care continuity for underserved populations.
204 Patients without health insurance and experiencing food insecurity are more likely to suffer from anxiety and depression–a cross-sectional study at a Milwaukee student-run free clinic
Authors: Thareja Suma Keerthi , Samudrala Santhosi , Thareja Suma K. , Marting Spenser , Davies William , Rayes Ramsey , Balfour Marie , Corujo-Ramirez Ana Mia , Lundh Rebecca , Young Staci A.
Published: April 2023

OBJECTIVES/GOALS: At the Saturday Clinic for the Uninsured (SCU), a Milwaukee student-run free clinic affiliated with the Medical College of Wisconsin, we screened patients for food insecurity and evaluated associations of food security status with nine separate social determinants of health (SDOH) needs and eight chronic medical conditions influenced by diet. METHODS/STUDY POPULATION: This cross-sectional study took place from October 2021-April 2022 at SCU, which only sees uninsured patients. We added the USDA six-item food insecurity form to the clinic’s larger SDOH survey, which screens for medication financing, housing stability, energy assistance, legal issues, educational/work opportunities, substance use, mental health, health insurance options, and dental care needs. We then completed chart review for demographic, diagnostic, lab, and medication information pertaining to obesity, hypertension, diabetes, dyslipidemia, chronic kidney disease (CKD), gastroesophageal reflux disease (GERD), anxiety, and depression. We conducted descriptive statistics on demographics and measured associations using both Kendall’s tau correlation and odds ratios from binomial regression. RESULTS/ANTICIPATED RESULTS: Of the 157 patients seen during this time, most were middle-aged (mean age = 49.4 years ± 14.5 years), female (n = 98, 62.4%), Black or African American (n = 66, 42%) and resided in Milwaukee County (n = 144, 92.9%). 22 (16%) screened as food insecure and had greater odds and positively correlated with needing resources for medication financing (OR = 7.28, I2 = 0.33), housing (OR = 129.99, I2 = 0.28), energy assistance (OR = 3.94,I2= 0.2), mental health (OR = 4.54, I2= 0.28), insurance (OR = 2.86, I2= 0.18), and dental care (OR=3.65,I2= 0.28), but not legal concerns, education/work opportunities, or substance use. Food insecure patients had higher odds and positively correlated with having anxiety (OR = 3.26,I2= 0.23) or depression (OR = 2.88,I2= 0.19), but not obesity, hypertension, diabetes, dyslipidemia, CKD, or GERD. DISCUSSION/SIGNIFICANCE: Patients without health insurance and experiencing food insecurity were more likely to have multiple SDOH needs and mental health diagnoses. Risk factors separate from food security status may explain associations with other chronic medical conditions, including uninsured status, socioeconomic status, eating behaviors, or food accessibility.
210 Preliminary Validation of the Arabic Global Neuropsychological Assessment
Authors: Strohmeier Andy , Olson Lauren , Almukhtar Riam , Szigeti Kinga , Schretlen David , Cadzow Renee , Benedict Ralph
Published: April 2023

OBJECTIVES/GOALS: Language is the main barrier to equitable access of neuropsychological resources. In our preliminary study, using an Arabic translation of the Global Neuropsychological Assessment (GNA), we assessed 27 Arabic-speaking participants and compared them to English-speaking controls. Our goal was to assess the Arabic GNA’s validity and feasibility. METHODS/STUDY POPULATION: The Global Neuropsychological Assessment (GNA) is a brief 15-minute assessment of cognition. 27 Arabic-speaking participants were recruited and assessed with the GNA and an Arabic translation of the Montreal Cognitive Assessment (MoCA) by community health workers (CHWs). 17 English-speaking participants GNA data were gleaned from a previous validation study and compared to the Arabic sample via independent samples t-tests. Correlations between the GNA sub-tests and Arabic-translated MoCA are reported in the Arabic-speaking sample. RESULTS/ANTICIPATED RESULTS: ): Independent samples t-tests revealed that Arabic and English-speaking groups significantly differed on education (Arabic: M = 10.3, SD = 3.4, English: M = 15.4, SD = 2.43 t(41) = 6.2, p < .05) but not age (p > .05). A one-way ANCOVA model controlling for education revealed that Arabic and English-speaking groups were not significantly different in any GNA subtest (all p’s > .05) except for the perceptual comparison task (Arabic: M = 22.4, SD = 6.9, English: M = 38.4, SD = 9.9, p < .05). Arabic GNA subtests correlated with each other as expected. Logical memory delayed recall was modestly correlated with the MoCA total score (r = .386, p < .05). DISCUSSION/SIGNIFICANCE: Our preliminary results suggest that the Arabic translation of the GNA is suitable for assessment of Arabic-speaking individuals. Brief educable assessments like the Arabic GNA are essential to meet the needs of these English new language populations and reduce the need for live translations that reduce the reliability of assessment.
212 Proof of Concept: An EHR-fueled Risk Surveillance Tool for Managing Care Delivery Equity in Hospitalized African Americans with Congestive Heart Failure
Authors: Williams Tremaine B , Crump Alisha , Garza Maryam Y. , Parker Nadia , Simmons Simeon , Lipchitz Riley , Sexton Kevin Wayne
Published: April 2023

OBJECTIVES/GOALS: 1) Characterize racial differences in congestive heart failure care delivery. 2) Examine the extent to which specific clinical roles were associated with improved care outcomes (i.e., hospitalizations, readmissions, days between readmissions, and charges) of African Americans (AA) with CHF. METHODS/STUDY POPULATION: EMR data was extracted from the Arkansas Clinical Data Repository (AR-CDR) on patients (ages 18-105) who received care between January 1, 2014 and December 31, 2021. Variables included age, sex, race, ethnicity, rurality, clinical diagnosis, morbidities, medical history, medications, heart failure phenotypes, and care delivery team composition. Binomial logistic regression ascertained the effects of these variables on patient’s care outcomes. A Mann Whitney-U test identified racial differences in outcomes. Psychometrically, classical test theory and item response theory assessed items for the risk surveillance tool. RESULTS/ANTICIPATED RESULTS: The study identified 5,962 CHF patients who generated 80,921 care encounters. The results revealed the disproportionate impact of CHF prevalence, hospitalizations, and readmissions on AAs. AAs had a significantly higher number of hospitalizations (i.e., 50% more) than Caucasians. Specific clinical roles (i.e., MDs, RNs, Care Managers) were consistently associated with 30% or greater decrease in odds of hospitalization and readmission, even when stratified by heart failure phenotype. Classical test theory results (e.g., Cronbach’s alpha; 0.88) indicated the set of items on the risk surveillance tool accurately reflect a patient risk for improved outcomes. DISCUSSION/SIGNIFICANCE: The findings stimulate the need for 1) EHR-based tools that manage care delivery equity and 2) investigations of specific clinical roles in risk stratifying and operationalizing the care plans of AAs, advancing formal access-to-care frameworks by ensuring access to clinical roles that are associated with improved outcomes.
216 Relationships Between Self-Perceived Risk of HIV, Behavioral Risk of HIV, and Self-Reported Pre-Exposure Prophylaxis (PrEP) Utilization Among Young Men Who Have Sex with Men of Color at Risk for HIV Infection: Findings From a Prospective Cohort Study
Authors: Warus Jonathan , Hidalgo Marco A. , Wong Carolyn , Olson-Kennedy Johanna
Published: April 2023

OBJECTIVES/GOALS: To improve our delivery of HIV prevention services by evaluating associations between self-perceived risk of HIV, objective risk for HIV based on sexual risk, and self-reported lifetime PrEP use. This will expand our current understanding of an essential component of decision making for PrEP uptake in young men who have sex with men (YMSM). METHODS/STUDY POPULATION: The population consists of participants in the Healthy Young Men (HYM) observational cohort study (16-24-year-old YMSM of color at risk for HIV in Los Angeles). Secondary analysis was conducted using an existing data set to test associations between self-perceived risk of HIV, behavioral sexual risk, and self-report of lifetime PrEP use at baseline. RESULTS/ANTICIPATED RESULTS: The HYM cohort consists of 397 HIV-negative young men who have sex with men from Los Angeles; 21% identify as African American/Black, 59% as Latinx, and 20% as multiethnic. Of these participants, 90% were aware of PrEP and 86% were eligible for PrEP according to CDC behavioral risk criteria; however, only 23% had ever been prescribed PrEP. We hypothesize that those who have utilized PrEP will report higher self-perceived risk of HIV infection and will have stronger correlation between self-perceived and objective risk for HIV. Associations will be tested using appropriate chi-square tests. DISCUSSION/SIGNIFICANCE: Self-perceived risk of HIV is proposed as a strong predictor of engagement in HIV prevention. This has been widely understudied in youth in the context of accessing PrEP. A better understanding of the role of self-perceived risk is essential to create and improve interventions to increase PrEP uptake as well as to improve PrEP service delivery for youth.
221 Factors Influencing COVID-19 Testing among American Indians and Latinos in Two Rural Agricultural Communities: A Qualitative Study
Authors: Rensburg Dillon van , Perez Georgina , Adams Alex , Warne Teresa , Quigley Thomas , Garza Lorenzo , Dupuis Virgil , Drain Paul K , Ko Linda K
Published: April 2023

OBJECTIVES/GOALS: Despite efforts to improve COVID-19 health outcomes through testing and vaccination, SARS-CoV-2 has exacerbated health disparities in underserved populations. Through this study we examined socio-contextual factors impacting decisions to test for COVID-19 among Native Americans in the Flathead Reservation and Hispanics in the Yakima Valley. METHODS/STUDY POPULATION: A series of 28 key informant interviews and 6 focus groups (N=39 focus group participants) were completed with community and tribal leaders using an interview guide informed by the Theory of Planned Behavior, Social Cognitive Theory, and the Social Contextual Factor Frameworks. The interview guide was designed to examine the socio-contextual factors impacting decisions to test for COVID-19 among Native Americans and Hispanics in the Northwest. A codebook was developed to apply deductive coding to informant responses, followed by an inductive, constant comparison approach. Three analysts met to refine the codebook and conduct inter-rater agreement. RESULTS/ANTICIPATED RESULTS: Five themes (social, cultural, health, religious and political factors) were identified that impacted testing for COVID-19. For social factors, participants discussed the influence of families and friends and unfair employment practices influencing decisions to test. Cultural factors included deep rooted distrust for the government and historical trauma. Health factors participants reported included the importance of testing to save lives, distrust for medical system, and health communications around COVID-19 affecting decisions to test. There was some interaction between religious and political factors. While participants mentioned beliefs in putting things in God’s hands, some decisions to test seemed to be affected by their political views. DISCUSSION/SIGNIFICANCE: Several socio-cultural factors influence decisions to test for COVID-19. Understanding the community’s perception of COVID-19 testing is critical for successful implementation of preventive strategies.
226 The Feasibility and Acceptability of Perturbation-Based Balance to Older Adults in Rural Communities
Authors: Whitten Justin , Tarabochia Dawn , Grocke Michelle , Graham David
Published: April 2023

OBJECTIVES/GOALS: Older adults in rural communities are at an elevated risk of falling. Perturbation-Based Balance Training (PBT) is a highly effective fall prevention paradigm but its feasibility in the community is unknown. The purpose of this study was to determine the feasibility and acceptability of PBT to older adults and local clinicians in rural communities. METHODS/STUDY POPULATION: 19 older adults (60+ years) were recruited from communities in rural Montana to take part in a PBT program. The PBT program was implemented using a bespoke portable PBT treadmill developed by our research team and validated against commercial PBT treadmills. To increase ecological validity, the program was implemented by local clinicians. The PBT program lasted 6 weeks, with 1 session per week, participants received up to 35 trip perturbations per session. The feasibility and acceptability of PBT to participants and clinicians was assessed within the Theoretical Framework of Acceptability, prospectively and retrospectively via interviews and surveys, and concurrently via field notes. RESULTS/ANTICIPATED RESULTS: Data analysis is ongoing and will be complete by the time of presentation. Preliminary results suggest the portable PBT program was generally acceptable to older adults and local clinicians. Perceived effectiveness was generally positive and increased balance awareness and low burden are emerging as common themes. Local clinicians indicated the burden of implementing PBT was low, PBT fit within their views on fall prevention, and had a high level of perceived effectiveness. There appear to be a few limitations to feasibility, which are primarily related to the weight and transportation of the treadmill. We are currently working to refine the treadmill and lower its weight and are developing a grant with local clinicians and extension agents that would facilitate transportation to a broader network of communities. DISCUSSION/SIGNIFICANCE: Our preliminary findings suggest PBT is feasible in rural communities and accepted by older adults. Increased balance and fall awareness and low burden are emerging as important factors in the feasibility and acceptability of PBT. This study provides a foundation for future studies to translate other PBT modalities from the lab to the community.
235 Use of Community Review Boards to Evaluate the Utility of the ICF Navigator - A Browser-based Tool to Create Plain-Language Informed Consent Forms
Authors: Spencer Nicola , Bona Jonathan , Brochhausen Mathias , Caballero Alison , Gan Jennifer M. , Kemp Aaron S. , Miner Skye , Utecht Joseph , Whorton Justin , James Laura
Published: April 2023

OBJECTIVES/GOALS: To evaluate the clarity of plain-language informed consent forms (ICF) created using a browser-based tool called the ICF Navigator, we solicited feedback from two community review boards (CRB) to ensure the resulting ICF met the informational needs of all potential participants, including those with limited health literacy skills. METHODS/STUDY POPULATION: Community-engaged research highlights the importance of involving community members in the planning and execution of translational research projects. Virtual discussions were held to elicit feedback from two separate CRBs on the understandability of an ICF that was generated using an online, browser-based tool that we designed to aid researchers in the creation of plain-language ICFs. CRBs included representation of diverse communities from across the state of Arkansas, including individuals who may have limited health literacy skills, those with and without prior experience participating in clinical research projects, members living in rural and urban settings, and those whose race or ethnicity have been traditionally underrepresented among clinical research participants. RESULTS/ANTICIPATED RESULTS: CRB feedback was used to inform actionable improvements to the tool, such as removing content redundancies and embedding tips to guide researchers on how best to optimize the clarity and understandability of resulting ICFs. Program refinements in response to the feedback have been implemented and will be evaluated in another round of CRB discussions in early 2023. Feedback from this follow-up CRB session will also be presented in addition to a discussion of how the feedback was used to improve the online tool, which will ultimately be available for free use by other institutions. DISCUSSION/SIGNIFICANCE: The use of community feedback to optimize the functionality of the ICF Navigator demonstrates the value of CRBs for ensuring that ICFs are culturally salient and readily understandable by all potential research participants, particularly those who may have limited health literacy skills, thereby promoting more equitable opportunities for all.
239 What Happens After Surgery? Postoperative High-Risk prescribing in Patients with Chronic Opioid Use
Authors: Sharif Limi , Gunaseelan Vidhya , Lagisetty Pooja , Bicket Mark , Waljee Jennifer , Englesbe Michael , Brummett Chad
Published: April 2023

OBJECTIVES/GOALS: Patients on chronic opioids face gaps in transitions of care in the time following surgery, increasing the risk for adverse events, specifically high-risk opioid prescribing. The objective of this study is to determine how rates of high-risk prescribing differ between patients with public and private insurance. METHODS/STUDY POPULATION: A retrospective cohort study of 1,435 adult patients with preoperative chronic opioid use on Medicaid or commercial insurance who underwent surgery between November 2017 and February 2021. Patients were identified using the Michigan Surgical Quality Collaborative (MSQC) database, a collection of perioperative data from 70 hospitals across the state of Michigan. Data from the MSQC were merged with Michigan’s prescription drug monitoring program to provide additional information on pre- and postoperative opioid prescribing. Multivariable logistic regression was used to assess high-risk prescribing by the presence of a preoperative usual prescriber and insurance type. RESULTS/ANTICIPATED RESULTS: Overall, 22.7% of patients on private insurance and 23.6% of patients on Medicaid fulfilled criteria for new, postoperative high-risk prescribing. Among criteria for high-risk prescribing, multiple prescribers was the most significant contributor (private insurance: 17.4%, Medicaid: 18.9%). Patients on Medicaid insurance did not have increased odds of new postoperative high-risk prescribing (OR = 1.067, 95% CI: 0.813-1.402). While fewer patients on Medicaid had a preoperative usual prescriber (86.9% and 90.9% respectively, p = 0.015), there was no significant difference between the two insurance types in baseline rates of high-risk prescribing prior to surgery (private insurance: 43.4%, Medicaid: 46.0%, p = 0.352). DISCUSSION/SIGNIFICANCE: While we do not observe disparities in high-risk prescribing between insurance types, rates of high-risk prescribing postoperatively are high across payer types. Further studies to determine the factors driving rates of high-risk opioid prescribing among patients with chronic opioid use are needed to identify areas for future intervention.
243 Why are Somali refugees not utilizing mental healthcare? Identifying barriers impacting mental healthcare utilization among Somali Refugees
Authors: Dadi Dunia , Mason Susan , Areba Eunice
Published: April 2023

OBJECTIVES/GOALS: We seek to describe the challenges to mental healthcare access and utilization among Somali refugees in Minnesota. The objectives of this study are 1) to characterize beliefs and attitudes about mental illness and 2) identify barriers, either personally experienced or perceived, to utilizing mental health services among Somali refugees. METHODS/STUDY POPULATION: Mental health challenges are of particular concern among Somali refugees, who have been found to have rates of PTSD as high as 50%. However, Somali refugees are reported to underutilize mental healthcare. We will recruit 20-25 Somali refugee women and men, who are 18 years or older and reside in the Twin Cities, to participate in one on one interviews. Participants will be asked about their perception of barriers to mental healthcare services, and their beliefs about mental illness and treatment. We will transcribe the interviews, code them, and identify key themes. A community advisory board will be directly involved in the research design, recruitment, interview instrument development, interpretation of findings, and dissemination of project materials as part of our community engagement protocol. RESULTS/ANTICIPATED RESULTS: When completed we expect to identify mental health beliefs and barriers to mental healthcare utilization. The long-term goal of this work is to reduce the substantial mental health morbidity among Somali refugees. Common barriers to research participation that we expect are mistrust, financial constraints, fear of unintended outcomes, stigma about participating in research, and fear of deportation or concern of immigration status. We plan to address these barriers by hiring bilingual Somali recruiter/interviewer, translating study materials, reassuring confidentiality of participant’s information, providing a $50 incentive, and implementing community advisory board’s input on study design and recruitment sites. DISCUSSION/SIGNIFICANCE: Translational Impact: Findings from interviews will be disseminated and evaluated by members of the community and providers. Recommendations based on our findings can be applied in mental healthcare practice to reduce identified barriers. Community dissemination can also promote the destigmatization of mental healthcare in the Somali community.
244 “I am interested!”: Lessons Learned from the All IN for Health/Indiana CTSI Health Advisory Board
Authors: Sotto-Santiago Sylk , Wiehe Sarah , Claxton Gina , Delp Lindsey , Hudson Brenda , Moe Sharon
Published: April 2023

OBJECTIVES/GOALS: All IN for Health’s Advisory Board is an active board providing advice on strategic directions, feedback, contributing ideas, and accountability. Most recently, the HAB had 4 openings. A call to our community of over 13,000 individuals was published. We received 488 applications. We share the lessons in motivations and interests shared respondents. METHODS/STUDY POPULATION: Four hundred eighty-eight individuals submitted applications for participation in the All IN for Health Advisory Board. The call went out to the All IN for Health volunteer research network comprised of community members across the state.The call mentioned a nominal compensation of $50/hour, and time commitment of a 2-hour board meetings via video conferencing every 3 months. The application process included the following questions: 1. What lived experiences and/or personal interests have motivated you to be involved in All IN for Health? 2. Please explain why you are interested in being an All IN for Health Advisory Board member? RESULTS/ANTICIPATED RESULTS: We organize the findings in two categories: Motivation and Interests. The motivation category refers to individual’s motivation to be part of the All IN for Health initiative. Interest category referred to individual’s specific interest in participating in the All IN for Health Advisory Board. Individuals were motivated to participate based on (1) family or friend diagnosis, (2) personal diagnosis, (3) roles as caregivers, (4) desire to impact change and advocacy, (5) role as health professional, and (6) previous participation in research. Interests followed similar themes with additional categories of sharing their experience, previous research and board experience, as well as a desire to educate future generations of researchers. DISCUSSION/SIGNIFICANCE: We share the narratives honoring individual stories for the top three motivations and interest. This information can be used for recruitment to boards, research participation, and healthcare advocacy, and highlights importance of sharing successes and challenges to the processes of forming and sustaining effective boards.
246 Motivators and Barriers to COVID-19 vaccination among Native American and Latino Communities
Authors: Ko Linda , Truong Lina , Adams Alexandra , Bishop Sonia , Dupuis Virgil , Garza Lorenzo , Quigley Thomas , Gregor Charlie , Webber Eliza
Published: April 2023

OBJECTIVES/GOALS: COVID-19 disproportionately impacts rural communities of color. Socioeconomic status, occupation and chronic illnesses lead to worse COVID-19 outcomes. This study identifies motivators and barriers of COVID-19 vaccine uptake in the Latino and Flathead Reservation agricultural communities. METHODS/STUDY POPULATION: Thirty key informant interviews and 6 focus groups (N=39 focus group participants) were conducted with community and tribal leaders using an interview guide informed by the Theory of Planned Behavior, Social Cognitive Theory, and the Social Contextual Factor Frameworks. The interview guide was designed to understand the motivators and barriers of COVID-19 vaccine uptake. The Community Advisory Board, community investigators and community health workers from the community reviewed and revised the guide. A codebook applied deductive coding to informant responses, followed by an inductive, constant comparison approach. Three analysts met to refine the codebook and conduct inter-rater agreement. RESULTS/ANTICIPATED RESULTS: Participants from Flathead reservations and Yakima frequently noted a desire to protect one’s self, family and elders. This significant motivator encouraged individuals to receive the COVID-19 vaccine, despite sincere vaccine concerns and government rollout. Barriers included concerns regarding rumored, serious or rare side effects, speed of vaccine development and misinformation. Key differences exist between both communities. Yakima participants noted religious concerns and ID requirements as major barriers. Flathead reservation participants noted distrust and historical trauma of the U.S. government and issues with access (e.g. transportation, technology). DISCUSSION/SIGNIFICANCE: The pandemic disproportionately impacts vulnerable communities in agricultural settings. Participants in both communities felt vaccine availability had outpaced uptake. Clearly, culturally sensitive education and respectful communication would be key in addressing vaccine concerns and improving vaccine uptake.