bluuebunny/crossref_metadata_2025 huggingface dataset:
131 Beyond the Case Study: Advancing Development and Use of the Translational Science Benefits Model (TSBM) Framework through Application Across Diverse CTSA Contexts
Authors: Sperling Jessica , Quenstedt Stella , McClernon Joe
Published: April 2023

OBJECTIVES/GOALS: This project has two linked aims. (1) It seeks to integrate the TSBM into specific practices and processes to advance its integration into translational research and translational science processes. (2) Via this integration, it aims to determine ways to expand the TSBM as a conceptual model. Ultimately, we aim to advance the TSBM framework and use. METHODS/STUDY POPULATION: We developed a process that implemented and integrated the TSBM within three intentionally-distinct processes. First, we expanded the use of the TSBM case study from a focus on research studies to a focus on translational research programs, and specifically workforce development programs. Second, we integrated TSBM domains and indicators into a new Duke CTSA-wide database used to track, monitor, and assess activities and achievements across the CTSA. Third, we embedded TSBM and its indicators into our Pilots projects application and review process as well as ongoing reporting. RESULTS/ANTICIPATED RESULTS: We were able to successfully integrate the TSBM model into the processes indicated in methods, yet this integration identified opportunity to improve the model to enhance its applicability and value. We found the TSBM applies in distinct ways to translational science programs compared to research studies, with added indicators better accommodating TSBM application to programs. To properly integrate TSBM into progress monitoring systems, we found added needs to ensure comprehensibility for a wide array of researchers and program implementers. Across uses, we identified challenge distinguishing between TSBM benefits as demonstrated versus potential and ambiguity in potential as based on time to benefit realization, likelihood of realization, or centrality of a specific project to realization. DISCUSSION/SIGNIFICANCE: Our session contributes significantly to the field of translational research and science through its focus on advancement and implementation of an innovated model in its early stages, including how researchers and translation science entities can incorporate this model into their own work beyond the traditional use of case studies.
136 Evaluating the ten-year progression of the Miami CTSI Mentored Translational Research Scholars (KL2) Program Awards
Authors: Das Rosalina , Diaz Jessica , Avissar Patricia , Dominguez Sheela , Ransford Daru , Fornoni Alessia , Rundek Tatjana , Scott Gwendolyn , Issenberg Barry
Published: April 2023

OBJECTIVES/GOALS: The goal of Miami CTSI’s Mentored Translational Research Scholars (KL2) Program is to identify outstanding early-stage investigators and prepare them to become the next generation of highly skilled independent researchers who translate fundamental knowledge and new technologies from the laboratory to the clinic and to the community. METHODS/STUDY POPULATION: Evaluation of the KL2 program focused on assessing progress in the following areas: 1) scholar productivity during and after graduating from the program; 2) continued engagement of KL2 program graduates in clinical and translational research; scholar productivity during and after graduating from the program; 3) outcomes such as establishing independent research careers, obtaining research funding, and establishing collaborations; and 4) research impact. We used a developmental evaluation approach and benefits-framework model to conduct program evaluation, incorporating both in a program-specific logic model. Bi-annual surveys were used to measure scholar feedback and progress, and utilization of CTSI services. RESULTS/ANTICIPATED RESULTS: Since 2013, the KL2 program has trained 21 scholars,17 of whom have completed training, and four are still in the program. Of the 21 scholars, 52% are female and 38% are underrepresented minorities (URM)–significantly higher than the 12% URM for overall CTSA KL2 scholars. Scholars have 176 total publications related to their KL2 projects and have received $52.4m in total research funding. In addition, 50% of the projects focused on health disparities. Overall, 48% of KL2 scholars have received large subsequent federal awards including three NIH K awards and six NIH R awards. Scholars actively utilized CTSI services during and after graduation. Programmatic enhancements such as adding institutional scholars and using scholar feedback to improve program resources were also implemented. DISCUSSION/SIGNIFICANCE: Miami CTSI’s KL2 program has demonstrated success in fulfilling its program goals. The process and outcome evaluation has provided a better understanding of program performance and progress and has demonstrated alignment with CTSI’s overall goals on addressing health disparities and its commitment to diversity and equity.
141 Translational Barriers, Facilitators, and Benefits of Impactful Research on Health Inequities in the Criminal Justice System
Authors: Volkov Boris B. , Pulley Chris , Shlafer Rebecca
Published: April 2023

OBJECTIVES/GOALS: - Illuminate processes and findings of a translational science case study of impactful research with incarcerated pregnant women and mothers; - Improve our understanding of the translational mechanisms by sharing translational challenges, facilitators, an METHODS/STUDY POPULATION: Utilized the following evaluation methods and tools: - The Retrospective Translational Science Case Study protocol to examine translational path from innovation to policy and practice, barriers and facilitators for that translational movement. - Translational Science Benefits Model (TSBM) Checklist for translational/research impact analysis Triangulated diverse data sources: - Primary data: semi-structured interviews with research partners - Secondary data: researchers’ grant applications, reports, and publications; public stories/news related to their research; scientific publications; organizational/policy documents; and over 50 interviews with 30 stakeholders featured in published sources. RESULTS/ANTICIPATED RESULTS: The research contributed to community and public health, policy/legislative, clinical/medical, and economic benefits, social/institutional change, health equity advocacy, catalyzing research (consequent research studies) and public awareness. Translational research challenges: cultural differences between research and prison system; politics of translating research to policy change; issues of capacity, power, privilege, and opportunity when doing community-engaged research; and science vs. social justice criticism. Facilitators of translation: CTSA support; stakeholder engagement; authentic collaboration; researchers as translation catalysts; and engagement in legislative activities. DISCUSSION/SIGNIFICANCE: The evaluation case study provides useful knowledge about translational impact, challenges, and facilitators of community-based research that moved along the translational continuum and contributed to transformational, systemic changes on the legal, clinical, organizational, and interpersonal levels.
146 A Community Engagement Advisory Board’s 22 Years of Contributions to Translational Research
Authors: Morales-Mirque Sandra , Gore Devyani , Cua Grace , Rusch Dana , Segovia David , Mehta Tara , Atkins Marc ,   CEAB Steering Committee
Published: April 2023

OBJECTIVES/GOALS: CTSIs around the country rely on Community Engagement Advisory Boards (CEABs) to bridge research and communities. The history of this 22-year-old board offers insight on 1) how it was created and has been sustained over time 2) its evolution, and 3) members’views of their contributions to translational research at UIC. METHODS/STUDY POPULATION: As founding members began to step down from this long-standing board, we started to document its history and members’ narratives and perspectives of the work conducted at UIC since its inception. Using an Oral History methodology, we conducted three virtual focus groups with 13 short and long-term members (n=6, n=4, n=3) to learn about changes within CEAB and in members’ roles, and individual semi-structured interviews with three long-standing members to expand on the origin and evolution of CEAB. Focus group data was coded and analyzed. We also extracted data on key events from archived files including grant proposals and CEAB meeting notes. A steering committee of three CEAB members helped guide this process. RESULTS/ANTICIPATED RESULTS: The CEAB was founded at the UIC College of Nursing in 2001 under the Center for Research on Cardiovascular Respiratory Health, with a grant from the National Institutes of Nursing Research (NINR). It was established as college-wide advisory board of community experts to help engage underserved communities and to contribute to research beyond recruitment and retention. In 2009, upon receipt of a Clinical Translational Science award that established the Center for Clinical Translational Science (CCTS), the CEAB became a campus-wide board. Over 30 community organizations and many non-affiliated community members have contributed to translational research at UIC throughout the board’s history. DISCUSSION/SIGNIFICANCE: Over twenty years later, the CEAB continues to help bridge researchers and communities, and to raise awareness about community needs, the importance of cultural relevance, and the inclusion of underserved communities in research. Long-term members have played a key role in providing continuity over the years.
151 A Pragmatic Randomized Trial of Home-based testing for COVID-19 in Rural Native American and Latino Communities: Primary results of the Protecting Our Communities Study
Authors: Webber Eliza , Gregor Charlie , Hassell Laurie , Thompson Matthew , Drain Paul , Ko Linda , Dupuis Virgil , Garza Lorenzo , Lambert Allison , Bishop Sonia , Warne Teresa , Adams Alexandra
Published: April 2023

OBJECTIVES/GOALS: To test the effect of a trusted Community Health Worker (CHW) support model to increase accessibility, feasibility and completion of COVID-19 home-testing in Native American and Latino communities. METHODS/STUDY POPULATION: We conducted a multi-site pragmatic randomized controlled trial among adult Native Americans and Latinos from the Flathead reservation in Montana and Yakima Valley in Washington. Participants were block randomized by site location and age to either an active or passive study arm. Participants in the active arm received assistance with online COVID-19 test kit registration and virtual swabbing support from CHWs, while the passive study arm received the standard-of-care support from the COVID-19 home testing kit vendor. Simple and multivariate logistic regression modeled the association between home-testing distribution mechanism and test completion. Multivariate models included community and sex as covariates. Descriptive feedback was collected in a post-test survey. RESULTS/ANTICIPATED RESULTS: Overall, 63% of the 268 enrolled participants completed COVID-19 tests, and 50% completed tests yielding a valid result. Active arm participants had significantly higher odds of test completion (OR 1.66, 95% CI: [1.01, 2.75], p-value=0.04). Differences were most pronounced among adults ≥60 years, with 84% completing testing kits in the active arm, compared to 58% in the passive arm (p=0.07). Ease of use and not having to leave home were top positive aspects of the home-based test while transporting and mailing samples to lab and long/overwhelming instructions were cited as negative aspects. Most test completers (93%) were satisfied with their experience and 95% found CHW assistance useful. Sample expiration and insufficient identifiers were top causes of non-valid test results. DISCUSSION/SIGNIFICANCE: While test completion rates were low in both study arms, the CHW support led to a higher COVID-19 test completion rate, particularly among older adults. Still, CHW support alone does not fully eliminate testing barriers. Socio-economic differences must be accounted for in future product development for home-based testing to improve health equity.
157 Association Between Structural Racism and Acuity of Illness at Initial Presentation in Pediatric Patients with Solid Tumors
Authors: Cathcart Alexandra , Castellino Sharon M. , Sohn Heeju , DeGroote Nicholas , Mertens Ann , Ji Xu
Published: April 2023

OBJECTIVES/GOALS: Racial/ethnic minoritized children experience poorer cancer outcomes, which may be driven by structural racism. We apply an index that combines segregation and neighborhood vulnerability to a pediatric oncology population and assesses its association with acuity of illness at initial presentation. METHODS/STUDY POPULATION: A retrospective analysis will be performed in a cohort of pediatric patients diagnosed with solid tumors at Children’s Healthcare of Atlanta (CHOA) from 2010-2018 (N=1149). The sample will be linked to a structural racism index (SRI) that has been established in our prior work. We abstract data from medical records to quantify initial acuity of illness based on the need for ICU-level resources. Differences in sociodemographic characteristics will be analyzed by the SRI, using chi-squared, Student t-tests, and ANOVA where appropriate. Logistic regression models will be used to assess the association of the SRI with acuity of illness. RESULTS/ANTICIPATED RESULTS: We anticipate that relevant sociodemographic characteristics (e.g., race/ethnicity, insurance status) differ by the SRI. The CHOA Cancer Registry includes a racially and ethnically diverse group of patients: 63% of the cohort is White, 30% is Black,10% are Other, and 15% are Hispanic/Latino. Furthermore, we anticipate that pediatric patients with solid tumors living in counties with greater levels of structural racism as measured by the SRI experience an increased acuity of illness at initial presentation. DISCUSSION/SIGNIFICANCE: By applying a novel index quantifying structural racism, we will provide new information about the structural barriers patients and families face prior to a pediatric cancer diagnosis. This work will allow us to identify areas for potential interventions in this vulnerable young patient population.
158 Associations Between County Level Poverty and Firearm Injuries in the State of Maryland
Authors: Tiamiyu Khadijah , Byrne James , Hoops Katherine
Published: April 2023

OBJECTIVES/GOALS: The United States is experiencing an epidemic of firearm deaths and injuries. Poverty and other socioeconomic factors have been linked to firearm injuries on the national level. The goal of this study is to examine the relationship between county level poverty and firearm injuries in the State of Maryland. METHODS/STUDY POPULATION: This is a cross sectional study assessing fatal and non-fatal firearm injuries of all ages between 2018-2020 utilizing data from the State of Maryland’s Health Services Cost Review Commission. Our primary analysis will involve calculating injury and mortality rates to assess if fatal and non-fatal firearm injuries are associated with county-level poverty, defined as the percentage of the population living below the federal poverty line. Rates will be calculated by determining county level population within subgroups using the National Historical Geographical Information System database. We will also conduct regression analyses to adjust for confounding variables selected based on evidence from prior research. Some of these variables include age, sex, race, urbanicity, and the social vulnerability index. RESULTS/ANTICIPATED RESULTS: An abundance of prior research has demonstrated differences in firearm injury by age, sex, and race. Prior studies have also shown that poverty is associated with higher rates of firearm-related deaths among youth. Based on that foundational data, we anticipate that regression analyses will demonstrate that counties with higher poverty levels will have higher rates of fatal and non-fatal firearm injuries, even after controlling for other known risk factors. DISCUSSION/SIGNIFICANCE: Findings from this study will contribute to growing evidence on the role of poverty in the burden of firearm injuries and mortality. This will have policy implications regarding the allocation of public health resources and interventions aimed at reducing firearm-related injuries and deaths in Maryland.
160 Biopsychosocial Well-being and Identity: Variation in the Experience of Allostatic Load and Depression by Identity Status Using NHANES 2017-2020 Data
Authors: Bishop Rachael E.
Published: April 2023

OBJECTIVES/GOALS: Chronic stress has vast implications for health. Pathophysiological dysregulation, as evidenced by allostatic load, is associated with increased morbidity and mortality. Health disparities exist in both the incidence and outcomes of chronic stress. This study investigates the intersection of identity, allostatic load, and depression. METHODS/STUDY POPULATION: A nationally representative sample of pre-pandemic health data from the 2017-2020 cycle of the National Health and Nutrition Examination Survey (NHANES) was used to assess variation in depression and allostatic load by identity status. Datasets containing biomarker, mental health, and identity data were merged using Stata. An index of allostatic load was created by generating quartiles for nine biomarkers of cardiovascular (cholesterol, triglycerides, systolic and diastolic blood pressure), metabolic (glucose, body mass index, albumin, creatinine), and immune (c-reactive protein) functioning, and summing the total high risk biomarkers per person. Depression scores were averaged across nine items from the patient health questionnaire, and dichotomous identity variables (e.g., race) were generated. RESULTS/ANTICIPATED RESULTS: People identifying as female (t = 8.25, p < .001) or Black (t = 7.18, p < .001) have higher allostatic load scores, whereas people identifying as White (t = -2.64, p < .01) or Asian (t = -3.80, p < .001) have lower allostatic load scores. People identifying as female (t = 10.76, p < .001), White (t = 2.66, p < .01), or Another/Mixed race (t = 6.23, p < .001) have higher levels of depression, whereas people identifying as Asian (t = 9.17, p < .001) have lower levels of depression. Multiple regression analyses indicate a significant effect of depression on allostatic load when controlling for sociodemographic variables (B = 0.33, SE = 0.05, t = 7.02, p < .001). The identity*depression interaction increases allostatic load for females (B = 0.43, SE = 0.10, t = 4.21, p < .001) and racial/ethnic minority males (B = 0.25, SE = 0.10, t = 2.62, p < .01). DISCUSSION/SIGNIFICANCE: This study highlights differences in the experience of allostatic load and depression based on identity. Depression exerts an independent and moderating effect on allostatic load. Findings have implications for health disparity research, and highlight the dynamic intersection of identity, mental, and physical health in the face of chronic stress.
161 Black and Latino Perspectives on COVID-19 Vaccines: A Mixed-methods Examination
Authors: Cross Fernanda L. , Buyuktur Ayse G. , Wileden Lydia , Platt Jodyn , Morenoff Jeffrey , Valbuena Felix , Bailey Sarah , Israel Barbara , Marsh Erica E. , Aramburu Jasmin , Militzer Maria , Cornwall Tiffany , Esqueda Ana Patricia , Woolford Susan J.
Published: April 2023

OBJECTIVES/GOALS: COVID-19 vaccines were met with both public excitement and concern. Our goal was to understand individual’s attitudes about COVID-19 vaccines within Black and Latino communities deeply impacted by COVID-19, in an effort to highlight their potential similarities and differences. METHODS/STUDY POPULATION: Using a community-based participatory approach, we partnered with 16 leaders from community-based organizations to conduct a mixed-methods study examining the perspectives of Black and Latino communities regarding their vaccine acceptance or hesitancy. We focused on Michigan counties highly impacted by COVID-19 infection and deaths. In 2021, we interviewed 24 Black and 16 Latino residents in English or Spanish. We combined this with survey data on vaccine attitudes and behavior from the Detroit Metro Area Communities Study (n=1,800). This research is part of the NIH Community Engagement Alliance Against COVID-19. RESULTS/ANTICIPATED RESULTS: Qualitative and quantitative analysis highlight that Black participants expressed greater mistrust and hesitance around vaccines and less willingness to get vaccinated, often citing historical mistreatment as a contributing factor. The desire to keep themselves, their families and community safe was cited as the most important factor shaping vaccine decisions among both groups. Trust in information and in science was rated as a stronger reason for vaccination among Latinx participants; however, they also appeared to highlight the issue of vaccine access more often than Black participants. Fear of side effects and risks were equally cited as factors that influenced their vaccine hesitancy. DISCUSSION/SIGNIFICANCE: Despite being labeled as minority communities, these two groups have important differences regarding their perspective of COVID-19 vaccines. Our results suggest that public health interventions must be tailored to address the concerns, differences in attitudes, and beliefs among Blacks and Latinos.
164 Characterizing Aging-Related Health in Women who have Criminal-Legal System Involvement (CHARMS)
Authors: Emerson Amanda , Xinyang Li Frontiers , Williams Brie , Zaller Nickolas , Ramaswamy Megha
Published: April 2023

OBJECTIVES/GOALS: To build a multi-function health profile for older adult (>50 years) women with a history of incarceration; explore group differences by age [45-54, 55-64, 65+], race, and length of incarceration; compare with age-matched control with no history of incarceration; and identify relative contribution of life course risk and asset factors. METHODS/STUDY POPULATION: We will analyze data from the Health and Retirement Survey (HRS) (UMichigan Institute of Social Research). The sample: women >50 years who took the leave-behind psychosocial questionnaire. The sample includes women with history of incarceration (n = 118; 2.93%) and (n = 115; 2.55%), respectively, and in the control n = 4,021 women (2012) and n = 4,114 women (2014). We will use descriptive statistics to profile physical, functional, cognitive, and social health; bivariable tests to compare groups on age-related morbidity, multimorbidity, frailty, and 4-year mortality risk; measure within group differences by age strata and race; estimate GLMs for effects of life course risk on dependent variables in and between groups; and if data permit, test direct mediation by life course risks and indirect by life course assets. RESULTS/ANTICIPATED RESULTS: Our results will characterize health in 4 health domains of women over 50 who have a history of incarceration. In bivariable analysis, we expect significant differences between groups on the dependent variables. Based on previous study using this data set, life course and accumulated stress theory, and our own previous research, we hypothesize that women with incarceration history will have more and earlier cardiovascular disease, stroke, and multimorbidity, higher 4-year mortality risk, and more and earlier cognitive impairment. We anticipate significant contributors to aging-related health outcomes to include childhood challenge and trauma history and, for Black women, perceived racial discrimination. We anticipate education and social support will partially mediate relationships. DISCUSSION/SIGNIFICANCE: The CHARMS findings, based on large-sample, representative, longitudinal HRS survey data, will contribute a profile of multi-function health status, risk, and assets in older women with CLS involvement. The much-needed characterization of aging in the group will set the stage for future interventional study to guide shifts in clinical practice.
177 Education and Its Effects on Barriers to Clinical Trial Participation in Alzheimer’s Disease Studies by Underrepresented Communities
Authors: Ziegler Mallory , Adams Alexandrea , Zhu Jingtao , Case Allison , Argueta Natalie , Regling Ashley , Wilding Gregory , Szigeti Kinga
Published: April 2023

OBJECTIVES/GOALS: Minoritized populations experience a large burden of Alzheimer’s Disease; interventions are often delayed and underrepresented communities’ participation in clinical trial research is low. Lack of information has been proposed as a barrier to clinical research enrollment of minoritized populations. METHODS/STUDY POPULATION: Brain Train, a cluster randomization trial, evaluated the role of education in increasing willingness to participate in research. A 3 segment program was developed whereas segment 3 had two versions: clinical trial education or healthy brain aging video. Brain Train was presented to multicultural communities with participants of at least 50 y/o throughout WNY. The primary outcome measure is evaluating the percent change in responding yes to would you be interested in participating in a clinical trial? before and after segment 3. The secondary outcome measure and exploration of barriers are measured by a Research Attitude Questionnaire. Demographic information such as age, race, gender, socioeconomic status, and educational attainment is collected. The statistical model is a generalized linear mixed model. RESULTS/ANTICIPATED RESULTS: Sixteen sessions with 281 participants were completed to generate the pilot dataset. We see 59.29 % of individuals answered yes before segment 3 and 46.02% answered yes after the educational intervention. Our data shows there is a 13.3% decrease in clinical trial participation interest after the educational intervention. Through our RAQ responses, our data shows significance when it comes to our participants’answers to questions regarding society needing to devote more resources to medical research (p=0.04). Trust emerged as the most significant barrier when it comes to one’s willingness to participate in medical research and clinical trials (p=0.03). DISCUSSION/SIGNIFICANCE: Our preliminary results from the first sixteen events suggest that the power of education is not sufficient to overcome barriers to clinical trial participation for underrepresented communities. Instead, trust appears to be the most significant barrier. Trust building strategies should be explored to answer this research question.
181 Evaluating the Association of Age with Acuity and Severity of Illness at Initial Clinical Presentation in Patients with Leukemia and Lymphoma
Authors: Jain Tarun , Ji Xu , DeGroote Nicholas , Coxhead Cortland , Mertens Ann , Castellino Sharon
Published: April 2023

OBJECTIVES/GOALS: Adolescent and young adult (AYA) patients, diagnosed with cancer between 15 and 39 years of age, often have worse outcomes compared to younger children and older adults. We will characterize age differences in acuity and severity of illness at initial presentation, as a measure for health outcomes, in patients with new diagnoses of leukemia or lymphoma. METHODS/STUDY POPULATION: We will perform a single institution-based, retrospective analysis of a cohort of pediatric oncology patients at Children’s Healthcare of Atlanta (CHOA) who were diagnosed with leukemia or lymphoma from 2010 to 2018. Data will be abstracted from the CHOA medical record and cancer registry. We will construct a severity score, with one point for 1) admission to the Intensive Care Unit (ICU), 2) ICU-level requirements at admission, 3) stage IV or metastatic disease, and 4) white blood cell count over 100,000/microliter. We will associate this score with age at presentation using logistic regression models among patients overall and stratified by disease type. All regression models will adjust for confounders (e.g., health insurance, race and ethnicity, and local-area social vulnerability level). RESULTS/ANTICIPATED RESULTS: Previous literature has shown increased cancer incidence and mortality in AYAs compared to younger children. Therefore, we hypothesize that AYA patients with a new diagnosis of leukemia or lymphoma will have a higher acuity and severity of illness at presentation than younger patients. We conducted a pilot study analyzing acuity and severity of illness by age, race, ethnicity, and insurance status. Bivariate comparisons suggested patients aged 10 and older were as likely as those younger to have a severity score of more than 0 at diagnosis (OR=0.661 , 95% CI 0.43-1.01). However, this result was collapsed across all hematologic malignancies, did not encompass the entire cohort, and did not address possible confounders; we anticipate our estimates will be different taking these factors into account. DISCUSSION/SIGNIFICANCE: Our work will be the first steps in creating a validated tool to understand disease acuity and severity. By using this tool to characterize presentation by disease type and age, we will identify unmet needs prior to an initial diagnosis of cancer. Our findings inform strategies toward narrowing age disparities in outcomes for AYA hematologic cancers.
184 Exploring facility level differences in medication-based treatment of OUD
Authors: Thornton Vera , Chang Yoonhoo , Chaloemtoem Ariya , Hartz Sarah , Mintz Carrie , Ramsey Alex , Bierut Laura
Published: April 2023

OBJECTIVES/GOALS: Medications to treat opioid use disorder (mOUD) are available and can save lives, but are underutilized. We hypothesize that the rate of prescribing varies by treatment facility and these differences will shed light on barriers and facilitators to mOUD utilization. METHODS/STUDY POPULATION: We performed an exploratory analysis in MD Clone, a platform which generates non-identifiable synthesized data based on real patient data in the electronic health record (EHR) of St. Louis based hospitals. Our query included adults aged 18-70 with an OUD diagnosis using ICD-9 of -10 codes (opioid abuse, opioid dependence, opioid poisoning, opioid withdrawal) occurring between 2013 and 2022 along with prescriptions for buprenorphine, methadone, or naloxone within 7 days of the condition being entered in the record. We compared the rate of medication prescription within 7 days across settings and facilities where the patients were seen. We propose to replicate this analysis in actual patient records from the EHR following IRB approval. RESULTS/ANTICIPATED RESULTS: Our synthetic data comprised 24600 patient diagnoses. After filtering for patients seen in the ER or inpatient 16235 patients remained in the data set. Of these, 4376 fell into one of the categories that clearly warrant treatment with medication. Out of 4376 patients with a qualifying OUD related condition, only 815 (18.6%) received a prescription for any of the medications. Rates of prescribing within facilities varied between 67.2% of eligible patients receiving a prescription at a rural location to 0% at some urban centers. We anticipate similar findings from analysis of patient records obtained from the EHR. We will extend our analysis to explore factors which may be driving the wide difference in prescribing to better understand barriers and facilitators to mOUD utilization. DISCUSSION/SIGNIFICANCE: We identify under-utilization with differences across facilities in prescribing mOUD based on preliminary work in synthetic data. If true, this represents a gap in care and opportunity for intervention. By replicating the MD Clone results in patient data from the EHR we will confirm this finding and increase acceptability to clinicians.
191 Hollywood, Health & Society: Infusing Cutting-Edge Science into Popular Media
Authors: Kipke Michele , Rosenthal Erica , Stoddard Laura , Giaccardi Soraya , Orechwa Allison , Wolfe Nicole , Folb Kate
Published: April 2023

OBJECTIVES/GOALS: Partner with the entertainment industry to build trust in science and research, especially among high-disparity and underserved communities, through inclusion of research themes on popular television shows. METHODS/STUDY POPULATION: To date, our partnerships with TV writers have led to inclusion of clinical research storylines on 10 popular TV shows (e.g., Grey’s Anatomy with an audience of 7M). We are now conducting research on show popularity among diverse audiences, and interviewing medical and entertainment experts to understand health priorities and potential entry-points to deliver targeted outreach. We are also analyzing keywords in scripts to assess frequency and sentiment of medical topics in entertainment. Our team also consults with the TV community regarding storylines and public service announcements on health and innovations in medicine. RESULTS/ANTICIPATED RESULTS: We anticipate reporting insights into current and shifting narratives around future-of-medicine topics. Building on work that reached over 64M viewers, more frequent and accurate depictions will likely be related to positive changes in attitudes, behaviors, and trust regarding health and science. The overall goal is to foster attitudes among high-disparity and underserved populations that will increase service utilization and early screenings, foster trust in research and evolving medical technologies, and combat misinformation. DISCUSSION/SIGNIFICANCE: By working with television writers of shows proven to be popular among key audiences, this initiative has the potential to reach millions of viewers in their homes with important and timely information modeling healthy behavior, providing accurate facts, depicting cutting edge research, and emphasizing diversity in medical research.
198 Meta-analysis of Transgender Exclusion from PrEP Clinical Trials
Authors: Lee Jeremiah
Published: April 2023

OBJECTIVES/GOALS: To evaluate access to Pre-Exposure Prophylaxis (PrEP) medications for transgender individuals examining how systemic and sociocultural obstacles play a role. Additionally, analyzing the impact of trans-exclusion in clinical trials investigating PrEP efficacy on the trans-HIV care model. METHODS/STUDY POPULATION: By examining the clinicaltrials.gov database, inclusion and exclusion criteria will be collected for Phase III trials of FTC/TAF (Descovy) and FTC/TDF (Truvada) as PrEP for Human Immunodeficiency Virus (HIV). Secondly, trends of physicians’ prescription of PrEP will be analyzed to track post-approval usage and deduce the acceptance and adherence of PrEP by transgender patients. Thirdly, post-approval marketing strategies of PrEP medications will be documented to see key demographics that biopharmaceutical companies are targeting. Finally, relevant literature about trans healthcare will be analyzed to identify key short fallings to support conclusions and justify recommendations for greater transgender clinical trial enrollment and reformations to current standard practices. RESULTS/ANTICIPATED RESULTS: After a preliminary literature review of published Phase III trials for Descovy and Truvada , there is a marked lack of transgender patient enrollment. Contemporary literature argues that this lag in enrollment has downstream effects on trust and acceptance of PrEP as safe and effective by cohorts in the transgender community. The examination of prescribing information for Descovy and Truvada for PrEP reveals a minimal effort to advise doctors of the increased risk for infection in the transgender demographic. Through continued research, I expect to elaborate on the cross-discipline impacts of trans-exclusion, including increased rates of HIV infection, sociocultural and financial barriers to PrEP, and stigmatizing doctor interactions with transgender patients. DISCUSSION/SIGNIFICANCE: The current trans-HIV treatment paradigm lags behind in its sensitivity and nuance, preventing the most equitable distribution of care. Only with more inclusion of transgender individuals in clinical trials can we hope to promote greater awareness and trust for PrEP as effective for HIV.
205 Perceived Needs and Access to Community-based Dementia Resources in the Rural Deep South
Authors: Hohmann Natalie , Whatley Maggie , Yang Heqin , Cherrington Andrea , Clay Olivio , Pickering Carolyn , Westrick Salisa
Published: April 2023

OBJECTIVES/GOALS: The goal of this project is to investigate dementia caregivers’ needs, barriers to access, and current utilization of community-based dementia-care services in Alabama, and how these vary across rural/urban settings and racial groups. METHODS/STUDY POPULATION: We partnered with Marketry Inc. to recruit and conduct interviews among three groups: dementia caregivers, healthcare providers, and aging services representatives. We recruited caregivers from dementia support groups and aging services in 2 rural and 2 urban Alabama counties. Purposive and snowball sampling was used to recruit healthcare providers and aging services representatives. Interviews were conducted by trained Marketry staff, recorded, and transcribed verbatim. Rapid content analysis was conducted by three investigators using the Social Determinants of Health as a coding framework to assess patterns in barriers and facilitators to utilizing community-based dementia resources. RESULTS/ANTICIPATED RESULTS: We interviewed 5 healthcare providers, 32 caregivers, and 15 aging services representatives. Providers thought that the process of memory loss care is not streamlined and they lack key information necessary to fulfill their role. Caregivers expressed a need for more dementia education, social connection, and access to financial resources. Aging services agencies need more funding and volunteers to sustain community-based dementia services. Dementia resources, like memory clinics, were more available in urban than in rural counties. African-American caregivers mentioned a reluctance to accept outside help for taking care of their loved ones with dementia, potentially due to distrust. DISCUSSION/SIGNIFICANCE: There is a need for more accessible dementia services in rural AL and a need to build service trust and familiarity, especially among African-American caregivers. Future research should develop tools for providers and caregivers to start conversations and increase awareness of service availability.
206 Perceptions of the COIVD-19 Pandemic on Social, Mental, and Physical Health of Native American and Latino Communities
Authors: Warne Teresa , Gregor Charlie , Ko Linda K , Drain Paul K , Perez Georgina , Ahmed Selena , Dupuis Virgil , Garza Lorenzo , Adams Alex
Published: April 2023

OBJECTIVES/GOALS: The COVID-19 pandemic impacted health systems and exposed disparities in access to health care among underserved populations. We examined how the pandemic shaped social, mental, and physical health among Native American and Latino communities in rural and underserved areas. METHODS/STUDY POPULATION: Using Theory of Planned Behavior, Social Cognitive Theory, and Social Contextual Factor frameworks, we developed interview guides to examine perceptions of the COVID-19 pandemic on social, mental, and physical health among community members. Stakeholders of the Confederated Salish and Kootenai Tribes of the Flathead Reservation in Montana and the Hispanic/Latinx population in Yakima Valley in Washington were selected through purposeful community-engagement. A total of six focus group discussions and 30 key informant interviews were administered in both communities. A codebook was developed and deductive coding was applied to informant responses, followed by an inductive, constant comparison approach. The codebook was further refined and inter-rater agreement was completed by three analysts. RESULTS/ANTICIPATED RESULTS: Four themes were highlighted as areas impacted by the COVID-19 pandemic (mental and physical health, family dynamics, and social disruptions) with few differences among geographic areas or between focus group (n=39) and key informant (n=28) participants. Perceived impacts on mental health included increased stress, anxiety, and depression, while pandemic-related lifestyle or family changes impacted physical health. Participants reported changes to family routines and dynamics due to staying home, social distancing, and more frequent interactions inside or limited interactions outside the household respectively. Social distruptions reported included impacts on finances, employment, and household staples, though participants highlighted how many community members stepped up to help those in need. DISCUSSION/SIGNIFICANCE: The COVID-19 pandemic had similar impacts on two geographically distinct underserved communities in Montana and Washington. Understanding the community’s experience with the COVID-19 pandemic is critical to identify strategies to support families, community needs, and mental and physical health in underserved communities.
207 Perceptions of the Vaccinated and Unvaccinated to Inform Translation to Health and Public Health Practice
Authors: Striley Catherine Woodstock , Alday Matthew , Gutter Michael , Rosales Carolina Luz , Cohen Irvin PeDro , Cottler Linda B.
Published: April 2023

OBJECTIVES/GOALS: Translating the science of vaccines to health and public health practice requires understanding how vaccine risks and benefits are understood and applying that knowledge to community translation. During the pandemic the lack of this knowledge became apparent. METHODS/STUDY POPULATION: Through the PACER community engagement special interest group of the ACTS, the University of Florida(UF)/Florida State University and 5 other CTSIs community engagement programs received Center for Disease Control and Prevention funding for the Program to Alleviate National Disparities in Ethnic and Minority Immunizations in the Community (PANDEMIC) to translate vaccinations into the community. At UF, HealthStreet’s Community Health Workers, CTSI Mobile Health Vehicle nurses, and Institute of Food and Agricultural Sciences extension agents collaborated to engage adults throughout the North and Central part of the state on their vaccine status and perceptions and to offer them vaccines. RESULTS/ANTICIPATED RESULTS: Through UF, 4,587 people have been interviewed in community settings using the Survey of Perceptions; 25% (1,125) had not received any COVID-19 vaccine. Among differences in perceptions, those vaccinated versus unvaccinated perceived people to be getting vaccines because they cut down on disease spread (28.9% vs. 15.2%), and perceived people NOT to be getting vaccinated because of misinformation/ignorance (27.1% vs. 11.0%) and political beliefs (16.3% vs. 6.7%). Both vaccinated and not perceived lack of trust as a reason to not get vaccinated (41.3% vs 46.4%). When asked what people were doing instead of vaccination, those vaccinated versus unvaccinated responded that people were doing nothing/very little much more often (40.6% vs. 21.8%) but were less likely to say ’trying to stay healthy’ (9.1% vs. 18.9%). DISCUSSION/SIGNIFICANCE: The science of translating from bench through clinical trials and to common health and public health practice requires knowledge of reasons for successful adoption. This survey adds to knowledge of perceptions towards vaccines that inhibit translation and biases toward the vaccine-hesitant.
208 Pharmacy Students Explore Use of an Electronic Medication Adherence Device
Authors: Darbishire Patricia L
Published: April 2023

OBJECTIVES/GOALS: To examine pharmacy students’ and patients’ perspectives on use of an automatic pill dispenser (APD) and adherence device, and secondly, to identify patient characteristics impacting selection of an APD. This knowledge will assist pharmacists in making appropriate device recommendations that improve medication adherence and effectiveness. METHODS/STUDY POPULATION: One hundred fifty-three pharmacy students participated in a personal APD simulation, living the life as a person taking medication. Students then each identified an actual patient exhibiting medication nonadherence from pharmacy records at their work setting, provided them with an APD free of charge and instructed them on its use. The students later interviewed their patients and reported on their patients’ ability to use the APD, as well as their perspectives (likes and dislikes) on the features of the device. Students identified individual patient characteristics associated with successful use of the APD. This new knowledge will aid these future pharmacists in making recommendations for medication adherence devices for their patients. RESULTS/ANTICIPATED RESULTS: In general, patients perceived more difficulty with use of the 10 APD features than did students. Over half of the patients indicated that the following features were a distinct advantage in adherence: individual medication compartment size, method of loading medications, alarm, flashing light, ability to lock the dispenser, and method of retrieving the medication from the device. Patients felt that the biggest disadvantage was its bulky size and lack of portability. In spite of individual difficulties with use, the research findings showed that persons who are elderly, homebound, have memory problems, take multiple medications and/or have complex regimens are most likely to benefit from the device features and exhibit improved adherence to their prescribed medication regimen. DISCUSSION/SIGNIFICANCE: Medication adherence rates in the U.S are agreed upon to be about 50% - highly relevant to healthcare practitioners since several studies suggest a correlation between adherence and improved health outcomes. Pharmacists must be knowledgeable about non-adherence tools and consider patient characteristics when recommending an adherence aid.
213 Provider-identified barriers to recommending low-intensity treatments for patients awaiting mental health care
Authors: Peipert Allison , Adams Sydney , Lorenzo-Luaces Lorenzo
Published: April 2023

OBJECTIVES/GOALS: Waiting for psychotherapy is a major barrier to care and associated with negative outcomes. Individuals waiting for treatment may be particularly well-suited to receive low-intensity treatments (LITs), but few providers recommend LITs. We investigated provider-identified barriers to recommending LITs for patients on treatment waiting lists. METHODS/STUDY POPULATION: We recruited mental health professionals via social media and professional association listservs to participate in a brief survey. Participants were asked about their current waiting list practices and attitudes towards low-intensity resources for patients waiting for treatment. Participants were prompted to provide additional thoughts on recommending LITs for patients on waiting lists in an open-ended text box. Two members of the research team independently coded responses into themes, resolved discrepancies, and achieved total consensus. RESULTS/ANTICIPATED RESULTS: 141 mental health providers participated in the survey, and 65 (46%) provided a response to the open-ended question. The emerging themes included: Patient Barriers, Research Evidence/Efficacy, Feasibility, Patient Personal Contact, Patient Appropriateness, Liability, Systemic Problems, Trust in Programs, Downplaying Distress, Additional Resources, and Positive Attitudes. Providers were particularly concerned with giving a generalized intervention without having conducted a full evaluation or assessment with a patient. Many providers also reported concerns pertaining to the legal and ethical liability of providing LITs when a patient is not being seen face-to-face by a provider. DISCUSSION/SIGNIFICANCE: Many of the themes we identified parallel those identified in previous literature. Some barriers we identified from our providers, when thinking about integrating LITs on waiting lists, highlight the need for professional guidelines to address legal and ethical liability, as well as billing and reimbursement procedures.