bluuebunny/crossref_metadata_2025 huggingface dataset:
102 Mayo Clinic Rochester, MN Hub Placement Process for Clinical Research Coordinators
Authors: Cassidy Cynthia S. , Monosmith Michelle D.
Published: April 2023

OBJECTIVES/GOALS: Mayo Clinic implemented a CRC Placement Hub to improve hiring experiences for candidates and hiring managers. Candidates apply to a centralized posting. A Placement Coordinator handles administrative and screening responsibilities, allowing hiring managers to focus on selecting best candidates. METHODS/STUDY POPULATION: The CRC Placement Hub was implemented in phases. Initially, first and second interviews were conducted using Zoom and hiring manager utilization of the Hub was voluntary. Positive candidate and hiring manager feedback shifted Hub utilization to the standard practice and hiring managers must request an exception to post separately for unique candidate requirements. The third phase progressed to utilizing the HireVue hiring platform. Qualified candidates are invited to complete an on-Demand interview at their convenience, which hiring managers utilize to select candidates to continue through the interview process. HireVue utilization has decreased time to fill metrics for CRC candidates. RESULTS/ANTICIPATED RESULTS: The intentions for the CRC Placement Hub are to offer a positive hiring experience for candidates and reduce administrative burden for the hiring managers, while maintaining autonomy of hiring decisions. Additional purposes for the Hub are to increase the candidate pool by developing recruitment pipelines and decrease overall timeline to fill an open position. Qualitative and quantitative metrics were established to monitor performance. Metrics depict positive experiences for candidates and hiring managers, and decreased timelines to fill open positions. Candidate pools continue to increase as the Hub Placement Coordinator holds off-campus and online recruitment events. DISCUSSION/SIGNIFICANCE: The CRC Placement Hub provides candidates a positive experience, allowing them to apply to one posting but considered for all open positions. The Hub decreases administrative burden for hiring managers, allowing them to focus on critical aspects of candidate selection and managing clinical research.
108 Pilot Project Awardees Productivity Award Metrics at The Alliance Idea-CTR
Authors: Wojna Valerie , Martanez-Montemayor Michelle , Morou-Bermadez Evangelia , Hill Martin , Ortiz Antonia , Khan Omar A. , Luciano Carlos A. , Cruz-Correa Marcia R.
Published: April 2023

OBJECTIVES/GOALS: Scholarly achievement metrics are essential for academic researchers since they are used for promotion and funding opportunities. Our objective was to create awareness among pilot project PIs about how these scholarly activities are evaluated and about the need for continuous auto-evaluation. METHODS/STUDY POPULATION: NIH-sponsored Clinical & Translational Research (CTR) infrastructure grants are a critical mechanism to increase scholarly activity. The Pilot Project Program Core (PPP) of The Alliance IDeA-CTR created a weighted metrics system to evaluate activities including presentations, publications, promotion, honors, & community service. We used the revised evidence-based medicine pyramid to develop the metric instrument. Pilot project PIs received the metric table and met quarterly with a PPP member to discuss progress. The top PIs were acknowledged during the Alliance Research Day with a platform presentation and a monetary award for research expenses or travel to scientific meetings. RESULTS/ANTICIPATED RESULTS: During our first 2 pilot project calls (2020-2022) the PPP funded 7 one-year pilot projects for ($50,000 each). We had a total of 10 PIs, 2 of the projects were MPI. Seven PIs were early or new stage investigators (ESI/NSI). Using the productivity award metric we had a total of 33 presentations, 10 publications, 12 events of community service, and 2 external grant funding. These are significant outcomes considering the pandemics impact on clinical & translational research. A total of 3 awards were given, one award per year for funding and an overall award. The activity was well received by the PIs who actively participated in the tracking of their scholarly activities using the metric. DISCUSSION/SIGNIFICANCE: Productivity metrics are crucial for the career development of ESI and NSI by raising awareness regarding the importance of scholarly activities in their career. This activity will help them track their productivity in an ongoing manner while becoming independent researchers.
115 The Clinical Research Internship Portal (CRISP): Creating a mechanism for the onboarding and placement of clinical research interns in the Duke University School of Medicine
Authors: McMillan Amanda , Snyder Denise , Hough Holly , Faulk Taryn Cavanaugh , Budinger Susan , Freel Stephanie
Published: April 2023

OBJECTIVES/GOALS: To address investigator frustration and appropriate oversight for student interns performing clinical research activities, we created infrastructure to support matchmaking with clinical research teams and onboarding of student interns, thereby allowing for more meaningful internship experiences with access to clinical research systems. METHODS/STUDY POPULATION: Internship requests may be initiated by a student, an affiliated institution, or an investigator. Requests are triaged accordingly. Affiliation agreements define the parameters for these placements. Unaffiliated institutions may request an agreement by contacting CRISP; otherwise, unaffiliated interns will be classified as visiting scholars with restricted access. If a student is from an affiliated institution, the Clinical Research Internship Portal (CRISP) is used to collect and track information regarding the internship. CRISP provides: Matchmaking for student interns with placements Compilation of onboarding documentation Tools (e.g., learning agreements) for student intern supervisors Professional development workshop series for all student interns RESULTS/ANTICIPATED RESULTS: Launched in 2021, CRISP is a relative newcomer to the Duke research training landscape, but preliminary impact may be measured by the following metrics: Affiliated institutions: 8 agreements in place, 4 pending 25 student interns from 7 institutions placed across 11 departments/institutes 7-session professional development series garnering positive feedback from interns and supervisors Improved access to clinical and research systems aligned with clinical research activities Enhanced oversight and tracking of student interns across Duke enterprise Expansion of program to include internal and external student interns CRISP has engaged invested parties within and outside of Duke to ensure robust oversight of these valuable training opportunities and to create new pathways into our workforce. DISCUSSION/SIGNIFICANCE: Streamlining intern placements has lessened pain points related to including students in our research environment, both for investigators and institutional partners. Future plans include expanding the number of affiliation agreements, creating an interface to quickly triage intern requests, and scaling up the professional development series.
117 The Research Coordinator Support Services (RCSS) and Coordinator Apprentice Program (CAP) at Johns Hopkins University (JHU)
Authors: Zade Daniel , Pagliocchini Andrew , Reichley Rachel , Keyes Anthony
Published: April 2023

OBJECTIVES/GOALS: METHODS/STUDY POPULATION: The duration of the apprenticeship program is 2 years, with promotability to: -Research Program Coordinators -Senior Coordinators. CRCs learn essential clinical research foundations through courses and instructor led training, mentoring, and shadowing of other CRCs, such as: -Good Clinical Practices (GCP) -International Committee on Harmonization guidelines (ICH) -Institutional Review Board (IRB) -Office for Human Research Protections (OHRP) -Shipping Dangerous Goods (DOT/IATA) -REDCap data entry -Clinical Research Management System (CRMS) -Clinical Skills (i.e., vital signs, ECG, and phlebotomy) -CPR (etc.) -EPIC training RESULTS/ANTICIPATED RESULTS: -Over 100 CRCs have been trained since 2012 -Currently more than 40 active studies assigned between 16 CRCs -Over 10,000 hours of clinical trial activity in the past 15 months -The program is moving towards cost neutrality CRCs have gained access to begin DISCUSSION/SIGNIFICANCE:
119 Usability and acceptability of an assistive technology WebAPP for the management of older adults’ functional disabilities in activities of daily living: Primary care physicians’ perspective
Authors: Orellano-Colón Elsa M. , Bonilla Daz Wency L. , Orellano Radamas Revilla , Castro Jesus Mejas , Mercado Joan M. Adorno , Berros Joshua , Cruz Angely , Montenegro Dana , Lima Abiel Roche
Published: April 2023

OBJECTIVES/GOALS: Assistive technology (AT) can improve older adults’ function in daily activities. However, Latinos are among the least likely to use AT. Given that primary health care physicians (PCPs) have low awareness about AT, this study aims to evaluate the usability and acceptability of an AT WebAPP among PCPs to increase older Latinos’ access to AT. METHODS/STUDY POPULATION: A team of an established researcher, a sub-graduate faculty and student, and a graduate student will recruit ten PCPs in Puerto Rico and will interview them to explore their current practice in addressing the functional needs of older Spanish-speaking Latinos. The researchers will then train PCPs in the use of a Spanish evidence-based AT WebAPP developed in one of our earlier studies. PCP participants will use the APP with their older patients for 30 days. At the end of the usage period, the analysis will include a mixed method design, consisting of the simultaneous collection of quantitative data using a validated scale followed by qualitative data through individual interviews. Quantitative data will be analyzed with descriptive statistics and qualitative data with thematic content analysis. RESULTS/ANTICIPATED RESULTS: We expect that the AT WebAPP will be rated as particularly useful and acceptable by the PCPs to increase older Latinos’ access to information about AT that could compensate for their physical function disabilities. We also expect that PCPs will offer recommendations for enhancing the design and usability of the AT WebAPP. DISCUSSION/SIGNIFICANCE: Studying the usability and acceptability of this AT WebAPP among PCPs will advance our understanding of its feasibility in enhancing PCPs AT knowledge and recommendations of AT devices for older adults with disabilities in Puerto Rico and in Latino communities in the continental United States.
120 Using Implementation Science to Develop a TL1 D&I Science Training Implementation Plan
Authors: Daudelin Denise H. , Cabrera Alyssa , Thompson Anna L. , Concannon Thomas W. , Sege Robert , Leary Elizabeth , Rodday Angie Mae
Published: April 2023

OBJECTIVES/GOALS: The training needs of clinical & translational scientists are evolving. Implementation of new curriculum content requires assessment of need, fit with current curriculum, incentives and barriers to implementation. We used implementation science methods to plan the implementation of a dissemination and implementation science training toolkit. METHODS/STUDY POPULATION: The Tufts Clinical & Translational Science (CTS) Graduate Program is the training core of the Tufts CTSI and its associated TL1. To assess barriers and facilitators to implementing the University of Washington’s Dissemination and Implementation (D&I) Science Toolkit for TL1 Programs into the Tufts CTS Graduate Program, we used the Consolidated Framework for Implementation Research (CFIR). We developed an interview guide based on CFIR constructs or categories of factors that might influence implementation of the D&I Toolkit and interviewed 8 stakeholders including leadership, trainees and faculty. We compared D&I Toolkit content to the current curriculum on stakeholder engagement (SE) and research study quality improvement (QI) to identify how the D&I Toolkit could be adapted to fit trainee and program needs. RESULTS/ANTICIPATED RESULTS: Stakeholder interviews and review of the current curriculum identified facilitators and barriers to implementing the D&I Toolkit in the Tufts CTS Graduate Program. The program has a strong SE focus and fosters the use of research study QI methods. Interviews identified student and faculty desire to implement the D&I content yet time constraints and overlap with the current curriculum were identified. The following plan to adapt the D&I Toolkit content to fit contextual factors was developed and executed: 1. Adapt didactic content to fit into a 90-min session. 2. Highlight the synergy between the current SE curriculum and the role of stakeholders in D&I science. 3. Modify course materials to highlight examples of disseminating local research results. 4. Limit the experiential learning component to a SE plan. DISCUSSION/SIGNIFICANCE: TL1 training programs must balance competing demands in selecting curriculum content. The CFIR framework was used to systematically assess implementation barriers by engaging program faculty, students and leaders to identify implementation strategies. This process could be useful when evaluating the addition of other educational content.
122 DIAMOND 2.0: Updating a Pioneering Digital Platform for Study Team Workforce Development
Authors: Eakin Brenda , Samuels Elias , Ellingrod Vicki L.
Published: April 2023

OBJECTIVES/GOALS: There is a critical need to provide quality training for study teams. Materials need to be flexible and available at the learner’s preferred time and format. DIAMOND was developed to provide nimble education offerings that respond to the changing landscape of clinical and translational research. METHODS/STUDY POPULATION: In 2018 four CTSA institutions (the University of Michigan, the Ohio State University, Rochester University, and Tufts University) collaborated to launch the DIAMOND portal. Developed as a CTSA-wide web-based platform, DIAMOND allows members of clinical and translational research teams to widely share and access training and education resources. In 2022 a MICHR-led update of DIAMOND used principles of user centered design to improve the platform. New features include updated search functions to quickly find and sort training materials, tagging training materials to the characteristics of a translational scientist, and development of user controlled customized playlists. RESULTS/ANTICIPATED RESULTS: DIAMOND currently includes 217 training resources developed by 30 CTSA hubs and private industry. The platform has over 600 page views per day from users across the U.S. and internationally. DIAMOND includes an easy-to-use form to upload new materials to the platform. Contributors are asked to include key words and select competency domains and characteristics of a translational scientist that apply to their materials. Other new features include tagging materials to streamline and improve search results, the ability to sort materials by competency domain or characteristics of a translational scientist, and the ability for users to create and share customized, personalized playlists. DISCUSSION/SIGNIFICANCE: DIAMOND is an important tool to support workforce development for study teams. Updates to the flexible digital platform meet the needs and preferences of adult learners and busy health professionals. Lessons learned from the design process and future plans for the platform will be explored.
129 Anatomical Approaches to Treating Obstructive Sleep Apnea in Patients who Fail CPAP: State of the Art Review
Authors: Dijour Phoebe , Turley Mitchell , Shivram Shri Prabha , Sideris Anders , Yazdi Youseph
Published: April 2023

OBJECTIVES/GOALS: The aim of this study was to evaluate current and new anatomical approaches to treating obstructive sleep apnea (OSA) in patients who fail continuous positive airway pressure (CPAP). Understanding the breadth of devices and procedures increases clinical scope of practice and innovator opportunities. METHODS/STUDY POPULATION: A comprehensive review of literature, FDA approvals, patents, and commercially available technologies was undertaken with regards to anatomical approaches for treating OSA. These include experimental therapies, surgical approaches, and non-surgical ablative procedures. Oral appliances, positive airway pressure devices, and therapeutics were excluded. Key search terms included obstructive sleep apnea,’ anatomy,’ surgery,’ devices,’ experimental therapy,’ innovation,’ technology,’ and translational research.’ Publications were limited to the last five years. Innovations were evaluated for relevance to OSA treatment and then assessed in greater depth based on scientific literature. RESULTS/ANTICIPATED RESULTS: Numbers of preclinical and commercially available innovations pertinent to the anatomical treatment of OSA were reported along with clinically relevant outcome metrics. The greatest number of innovations was found in surgical approaches, including soft-tissue removal, orthognathic surgery, and electrical stimulation. Outcome parameters included safety, efficacy, patient compliance, and mean disease alleviation as a ratio of efficacy to compliance. Innovations were grouped by their intended anatomical targets including retrolingual, palatal, oropharyngeal, epiglottic, nasal, and complete concentric collapse, making special note of gaps in the treatment armamentarium. DISCUSSION/SIGNIFICANCE: In the last decade, sleep surgery has trended toward innovative CPAP alternatives. Nerve stimulation and ablative procedures have grown, but some anatomical presentations have been frequently excluded. These developments present opportunities for innovators to fill persistent gaps in treatment.
132 Caregivers Perspectives on Multidisciplinary Clinic Visits for Duchenne and Becker Muscular Dystrophy
Authors: Fawcett Kindann , Haynie Cade , Roby Tiffany , Wagner Ellen , Schrader Rachel , Fischer Ryan , Veerapandiyan Aravindhan
Published: April 2023

OBJECTIVES/GOALS: This study surveyed parents and/or caregivers of children with Duchenne and Becker muscular dystrophy (DBMD) to obtain their perspectives on experiences during multidisciplinary team (MDT) clinic visits. The goal was to improve DBMD care by identifying positive and negative aspects of the visits. METHODS/STUDY POPULATION: Multidisciplinary care models have been widely used in many disciplines, as they provide excellent opportunities for patient-centered care (PCC). Survival of patients with Duchenne muscular dystrophy (DMD) has improved with multidisciplinary care. As the model continues to evolve, additional services and disciplines are added, and exploring parents’ and caregivers’ perspectives on multidisciplinary care for patients with DBMD must be assessed. A survey, via a non-identifiable Redcap link, was emailed to registered parents/caregivers through The Duchenne Registry provided by Parent Project Muscular Dystrophy (PPMD). The survey contained questions concerning the children’s demographics, medical information, knowledge, and perspectives on MDT visits. RESULTS/ANTICIPATED RESULTS: A total of 186 parents/caregivers of DMBD patients responded to the survey. Respondents were white (83.1%), bi/multi-racial (9.3%), African American (1.6%), and other (2.7%). The average travel distance to the care site was 228.37 miles. Most respondents (75%) had their visits within one day, but 25% had visits over ≥2 days. 89.0% of respondents preferred a single MDT meeting with their child’s care providers; 89.4% indicated they had enough time with each provider, 86.1% were satisfied with the MDT care, and 81% said they received enough information prior to the visit. Scheduling difficulties were rare for MDT visits, but common when arranging care with providers not included in the MDTs. DISCUSSION/SIGNIFICANCE: MDT clinic visits enable patients to see multiple caregivers in a single visit. Our study suggests that parents and caregivers of DBMD patients prefer to have MDT visits and are satisfied with the care. This information will support the DBMD community as they continue to advocate for MDT visits.
138 Preschooler Hemoglobin and Ferritin Concentrations Were Not Affected by Parenting and Multiple Micronutrient Supplementation Interventions in Southwest Guatemala
Authors: Kowalski Alysse J
Published: April 2023

OBJECTIVES/GOALS: Micronutrient deficiencies contribute to poor health and childhood development outcomes. The objective of this study was to examine the independent and combined effects of responsive parenting and multiple micronutrient supplementation interventions on preschooler hemoglobin and ferritin concentrations in southwestern Guatemala. METHODS/STUDY POPULATION: We enrolled 387 preschoolers (36-52 months) at nutritional risk (height-for-age z-score < -1) (51% male; 17% indigenous ethnicity) in a double blind, 2 x 2, cluster randomized controlled trial. Participants in the parenting intervention received culturally tailored responsive parenting or nutrition education (control) curriculum, delivered over 6 home visits. Participants in the nutrition supplementation group received daily supplementation with a maize-soy product fortified with 21 micronutrients for 6 months or a control product fortified with vitamin B2 only. Linear mixed models were used to estimate changes in hemoglobin and ferritin from baseline (2015) to endline (2017) in a subsample with blood specimens (n = 218). RESULTS/ANTICIPATED RESULTS: At baseline, 14% of preschoolers were iron deficient and 11% were anemic. Preschooler ferritin significantly increased over time in most arms, with the largest increase in the combined responsive parenting + multiple micronutrient supplementation arm (ferritin = 95.6 (95% CI 46.4, 144.74); rates of change did not differ between study arms (p = 0.16). Preschooler hemoglobin did not change over time. Further analysis will examine the moderation of intervention effects by pre-specified child and household factors. DISCUSSION/SIGNIFICANCE: Increases in preschooler ferritin did not differ between intervention and control arms. There was no effect of the intervention on hemoglobin. Future analyses will examine intervention effects on pre-specified subgroups including baseline micronutrient deficiencies.
139 Reducing Physical Therapy Consults for Patients with High Functional Mobility in the Acute Medical Inpatient Setting: A Difference-in-Differences Analysis
Authors: Martinez Maylyn , Cerasale Matthew , Baig Mahnoor , Dugan Claire , Robinson Marla , Sweis Meghan , Prochaska Micah , Schram Andrew , Greysen Ryan , Meltzer David , Arora Vineet M
Published: April 2023

OBJECTIVES/GOALS: Physical therapy (PT) is key for treating functional decline that inpatients experience but is a constrained resource in hospital settings. The Activity Measure Post-Acute Care (AM-PAC) score is a mobility measurement tool that has been used to define misallocation of PT. We aim to optimize PT referrals using AM-PAC-based clinical decision support . METHODS/STUDY POPULATION: We conducted a prospective study of patients admitted to University of Chicago Medical Center. AM-PAC scores were assessed by nursing staff every 12 hours. Clinical decision support was designed using validated AM-PAC cutoffs (> 18, a predictor of discharge to home). The tool was embedded in hospital medicine note templates, requiring providers to indicate PT referral status based on current AM-PAC scores. The primary outcome, unskilled consult , was defined as PT referral for patients with AM-PAC > 18. Data were collected for one year prior to implementation and one year after implementation for intervention (hospital medicine) and control (general internal medicine) services. Difference in differences analysis was used to assess the association between the intervention and unskilled consults. RESULTS/ANTICIPATED RESULTS: Between October 2018 and March 2021, 18,241 admissions were eligible for the study. Compared to preintervention, there was a lower rate of referral to PT for patients with high AM-PAC mobility scores in the post-intervention period [18.5% vs 16.6%; X2(1) = 7.02; p < 0.01]. In the postintervention time period, the control group experienced a 2.6% increase in unskilled consults while the intervention group experienced a 2.3% decrease, a difference in differences of 4.9% (95% CI -0.07–-0.03 for difference in differences) controlling for age sex, race, LOS, and change in mobility. Compared to preintervention, there was no statistically significant difference in mean change in mobility score post-intervention for either group. DISCUSSION/SIGNIFICANCE: Our results suggest that clinical decision support can decrease unskilled PT consults. Many functionally independent patients can mobilize with nursing or other mobilization staff. Hospitals should consider mobility score-based decision support to prioritize PT for impaired and at-risk patients.
145 A CTS Team Approach to Adapting an Evidence-Based Mindfulness Tool to Increase Trust of Reproductive Healthcare Providers
Authors: Nesbit Tyler S. , Ronke Coker Karen Awura Adjoa , McKune Sarah , Forthun Larry
Published: April 2023

OBJECTIVES/GOALS: The goals of this study are to 1) adapt a mindfulness-based intervention that supports the development of trust-promoting behaviors of OBGYN providers with patients who identify as Black women based on the input of providers and patients, and 2) assess the feasibility of implementation for OBGYN healthcare providers. METHODS/STUDY POPULATION: Goal 1: Focus groups will be conducted with members of the populations of providers and Black women patients in Alachua County, Florida to identify essential intervention content to complement the central component of mindfulness and spiritually based practices. This complementary content will serve to address the institutional and cultural context of the intervention setting. Goal 2: Providers will be recruited to participate in interviews about their perceptions of intervention feasibility. These aspects include recruitment potential, acceptability of the intervention content and delivery, implementation practicality, identification of appropriate outcomes, and identifying strategies to recruit Black women patients to participate in program evaluation. RESULTS/ANTICIPATED RESULTS: Goal 1: We will elicit the perspectives of providers and Black women patients regarding the respective roles and relationship of mindfulness and spirituality to increase trust-promoting behaviors with patients who are Black women. We also anticipate identifying additional content to complement the core intervention components that participants perceive as necessary to develop the knowledge, skills, and behaviors which convey the trustworthiness of providers to patients. Goal 2: We expect to gain key insights into intervention design, implementation, and evaluation feasibility from the perspective of providers. Interview data will be aggregated and qualitatively analyzed for themes pertaining to feasibility. DISCUSSION/SIGNIFICANCE: An intervention that builds on mindfulness and spiritual practice is an innovative approach to improving interpersonal outcomes in provider-patient relationships. By investigating the feasibility of such an intervention, we will gain insight into how to design and deliver a program to increase the trust-promoting behaviors of OBGYN providers.
148 A Feasibility Study for the Implementation of a Hospital-based Violence Intervention Program in the Rural South
Authors: Lovelady Nakita , Curran Geoffrey , Richardson Joseph B. , Wilson Michael , McBain Sacha , Urban Kelly , Washington Taylor , Rohm Laura , Zaller Nickolas
Published: April 2023

OBJECTIVES/GOALS: As hospitals across the nation respond to the need to address community violence, there is a dearth of Hospital-based Violence Intervention Programs (HVIPs) in the South despite having disproportionate rates. This research aims to identify key factors and strategies for implementation of an HVIP among rural patient populations in a southern state. METHODS/STUDY POPULATION: Semi-structured interviews will be conducted with medical providers, social service organizations, and patients transferred from four high-risk rural areas in Arkansas. Data will be analyzed using Framework Analysis, a rapid analysis approach involving framework development, code application, impactful statement identification, and content analysis. Evidence- Based Quality Improvement (EBQI), a group consensus making process, will be conducted to identify key implementation strategies and factors to adapt based interview findings. Priority areas for adaptation will be identified via systematic rating. The EBQI team, including researchers and key rural stakeholders will engage in a series of discussion, vote on final strategies, and develop a guide for future HVIP implementation and pilot testing. RESULTS/ANTICIPATED RESULTS: Findings from this study will result in a prioritized list of barriers and facilitators across sample groups. Factors will be rated by level of importance. Cluster maps will display the relationships among factors. Go and no-go zones will be identified based on importance and feasibility. Implementation strategies will be mapped to barriers and facilitators. DISCUSSION/SIGNIFICANCE: The findings will result in a culturally and geographically relevant HVIP model and package of implementation strategies to test in future hybrid trials (feasibility pilot & multi-site RCT); and shape the future of violence prevention efforts in healthcare settings across the rural South.
149 A Mixed Methods Analysis of Disparities in the Management of Low-Risk Febrile Infants
Authors: Gutman Colleen , Aronson Paul , Lion K. Casey , Fisher Carla , McFarlane Antionette , Bylund Carma , Fernandez Rosemarie
Published: April 2023

OBJECTIVES/GOALS: Febrile infants are a model population for exploring communication, implicit bias, and health disparities in the pediatric emergency department. Using mixed methods, we performed an in-depth analysis of disparities and physician-parent communication, a potentially modifiable driver of inequities. METHODS/STUDY POPULATION: We performed a multicenter cross-sectional study of febrile infants with low-risk for invasive bacterial infection evaluated between 2018-19 across 32 institutions. We performed logistic regression to assess the association between 1) race and ethnicity (Non-Hispanic White [NHW], Non-Hispanic Black [NHB], Hispanic [H], Other Race and/or Ethnicity [O]) and 2) limited English proficiency (LEP) with the standard of care, discharge without lumbar puncture and without antibiotics. We concurrently performed in-depth semi-structured interviews with physicians to explore physician–parent communication and implicit bias in the management decisions for febrile infants. RESULTS/ANTICIPATED RESULTS: Of 3629 low-risk febrile infants, 74.2% received standard of care. NHB, compared to NHW, infants were more likely to receive standard of care (aOR 1.3 [95% CI 1.0-1.7]; aOR H: 1.1 [95% CI 0.9-1.4]; aOR O: 1.0 [95%CI 0.8-1.4]). There was no association between LEP and standard of care (aOR 0.8 [0.61–1.1]). When accounting for documented use of professional interpretation, families with LEP without documented professional interpretation were less likely than families without LEP to receive standard of care (aOR 0.6 [95% CI 0.4–0.9]). Thematic analysis of 13 physician interviews is expected to elucidate aspects of the physician-parent interaction that influence management decisions. DISCUSSION/SIGNIFICANCE: Infant race, ethnicity, and use of professional interpretation, are associated with the management of low-risk febrile infants. Physician behaviors that are influenced by the physician-parent interaction may represent modifiable targets for future interventions to promote health equity.
154 Addressing Institutional and Community barriers to Development and Implementation of Community-engaged Research through Competency-based Academic and Community Training
Authors: Croisant Sharon A. , Hallmark C. Claire , Bohn Krista , Hallberg Lance , Wiseman Lori , Hanley Eleanor , Sommer Lesley
Published: April 2023

OBJECTIVES/GOALS: CEnR plays a crucial role in rapidly translating science to improve health by bridging gaps between research and practice although skills development is critical to enable successful community/academic partnerships. We have developed a curriculum mapped to CEnR domains and competencies that meets the needs of community partners and investigators. METHODS/STUDY POPULATION: We located three comprehensive efforts to identify CEnR domains and competencies that we aligned to develop our curriculum, which we then mapped to these competencies. The first was undertaken by a NCATS Joint Workgroup which identified curricula, resources, tools, strategies, and models for innovative training programs. Using Competency Mapping, they developed a framework for curriculum mapping that included eight domains, each with two to five competencies of knowledge, attitudes, and skills. The second aligned CEnR competencies with online training resources across the CTSA consortium, while the third focused on Dissemination and Implementation training. Informed by a conceptual model to advance health equity, we adapted and integrated these frameworks into a set of six educational modules. RESULTS/ANTICIPATED RESULTS: Although many CEnR training programs have been developed, few curricula are mapped to identified domains and competencies, and fewer still address institutional and community barriers to effective CEnR training. However, many outstanding curricula effectively address these competencies, and our curriculum draws from and builds upon these programs of excellence, including those from our sister CTSA hubs. Our modules serve our local community by educating and empowering faculty, students, and community partners. To date, no CEnR curriculum has been implemented at our institution that meets the needs of all parties who play a significant role in community-engaged research (e.g., IRB members, investigators, and community-based partners). This curriculum thus fills an important gap in our workforce training. DISCUSSION/SIGNIFICANCE: This educational program is designed to educate and empower investigators, trainees, students, and community partners to engage in effective CEnR that promotes community projects and fosters relationships and trust. Following evaluation, we will offer the curriculum for use by others interested in using or adapting it for their own programming.
155 An Assessment of Gender-Affirming Language within Patient Encounter Notes
Authors: Bindman Jay , Sevelius Jae
Published: April 2023

OBJECTIVES/GOALS: Transgender, non-binary, and gender expansive (TGE) patients experience significant barriers to high-quality care including limited provider expertise and pathologization within health documentation. This study aimed to evaluate the use of gender-affirming language within free text medical notes of TGE patients. METHODS/STUDY POPULATION: We conducted a qualitative analysis of free text medical notes in adult (> age 18 years) TGE patients seen in inpatient and outpatient medicine and general surgery clinics between January 2019 and January 2022 at three independent health systems in San Francisco. TGE patients were identified based on self-identified gender identity, sex assignment at birth, and legal sex. We conducted a thematic analysis to assess use of gender-affirming language, including self-identified pronouns, chosen names, gendered and gender-neutral descriptors, sex-related traits, and pathologizing language. RESULTS/ANTICIPATED RESULTS: Within pilot data, we found inconsistent use of gender-affirming language within notes, with pronounced variability within the history of present illness, the clinical one liner, and the problem list. Within one liners, many did not include patient-identified pronouns (81%), omitted chosen names (53%), and utilized gendered language that was misaligned with patient self-identified gender identity (27%) - frequently including the use of outdated terms i.e. female-to-male and transsexual. Many problem lists included gender-related care, with some describing hormonal and surgical interventions and others utilizing language to pathologize trangender status. DISCUSSION/SIGNIFICANCE: Our study identifies gaps in the use of gender-affirming language in medical notes. Of particular significance in the era of open notes wherein patients can view their medical records, our study offers a framework for assessing and increasing gender-affirming language use within free text medical notes that can be applied across health systems.
156 Approaches to disseminating a community engagement tool through capacity building
Authors: Zimmerman Emily B. , Rafie Carlin , Biney-Amissah Theodora , Lee Samantha
Published: April 2023

OBJECTIVES/GOALS: Despite the importance of stakeholder engagement in research, there remains a critical need for methods that facilitate the engagement of diverse stakeholders throughout the research process. We describe dissemination and capacity building for the SEED Method, which was created to involve stakeholders in the research development process. METHODS/STUDY POPULATION: In order to raise greater awareness of the SEED Method and to build capacity among research teams, we received funding from the Patient-Centered Outcomes Research Institute (PCORI) for a 2-year project to implement a plan of outreach, training, interactive learning, and technical assistance, as well as an innovative partnership with the Extension Foundation. Tools created for this project include an internet site providing tools and materials, live and on-demand webinars, training videos, SEED materials, a blog, and an interactive course/toolkit. In addition, we created a monthly learning collaborative and provided direct technical assistance to teams using the SEED Method in their research engagement projects. We evaluated user satisfaction with the tools and support provided through online surveys. RESULTS/ANTICIPATED RESULTS: We highlight the routes to reaching potential users and diverse approaches to capacity building, including multi-media training materials, interactive learning sessions, and customized technical assistance. As a result of outreach and capacity building, there are currently 13 research teams using the SEED Method to engage stakeholders in research development across various topics. We link this result to the dissemination and capacity building strategies utilized and the paths through which teams learned about the SEED Method. We also look at how the teams are using the method in terms of project goals and approaches to adapting the SEED Toolkit. DISCUSSION/SIGNIFICANCE: The use of PHR continues to increase, and with it the emergence of new approaches to involve patients, stakeholders, and communities. Innovations in engagement need to reach potential users and build capacity among researchers and communities.
159 Bearing a higher burden: Black and Latinx community perspectives on the Impact of COVID-19
Authors: Cross Fernanda L. , Buyuktur Ayse G. , Woolford Susan J. , Williamson Susie , Bailey Sarah , Ledon Charo , Ramakrishnan Arthi , Marsh Erica E. , Israel Barbara , Aramburu Jasmin , Militzer Maria , Cornwall Tiffany , Esqueda Ana Patricia , Platt Jodyn
Published: April 2023

OBJECTIVES/GOALS: During earlier periods of the pandemic, Black and Latinx populations in Michigan have suffered higher rates of infection, hospitalization, and deaths when compared to Whites. We conducted this study to understand how Black and Latinx residents perceived this disproportionate burden. METHODS/STUDY POPULATION: In 2021, 40 semi-structured interviews were conducted virtually in English or Spanish with Black (n=24) and Latinx (n=16) residents in Michigan areas highly impacted by COVID-19: Genesee, Kent, Washtenaw, and Wayne counties. Using a Community-Based Participatory Research (CBPR) approach, we partnered with leaders from 15 community-based organizations and health and human service agencies to develop research questions, an interview protocol, and to interpret the data. We used the data analysis software Dedoose (ver 4.12) for inductive coding (IRR=0.81). This study is a part of the NIH Community Engagement Alliance (CEAL) Against COVID-19 initiative. RESULTS/ANTICIPATED RESULTS: Participants described the significant impact of the pandemic in terms of physical and mental health, job security, and the sheer number of deaths among loved ones. They attributed the impact to comorbidities and social determinants of health disparities exacerbated by the pandemic, including income, housing, access to healthcare, as well as systemic racism. They noted being overrepresented among frontline workers with higher exposure to COVID-19, limited or misinformation about the virus, language barriers, and difficulty with social distancing. Cultural norms that promote being in close proximity, such as intergenerational households, and loss of trusted community leaders were also noted. DISCUSSION/SIGNIFICANCE: Findings reflect the needs of Black and Latinx community members in Michigan and the discussions they feel are important to highlight. We must work strategically with partners and the community to provide transparency and effective leadership, and prioritize addressing systemic disparities in SDoH.
169 COPD Care for Patients in Rural Clinics: A Mixed Methods Evaluation
Authors: Baldomero Arianne K. , Wilson Talitha , Kunisaki Ken M. , Wendt Chris H. , Bangerter Ann , Dudley R. Adams
Published: April 2023

OBJECTIVES/GOALS: To assess barriers and recommendations for improving delivery of care for chronic obstructive pulmonary disease (COPD) in rural clinics, we assessed COPD care metrics and obtained perspectives of primary care providers (PCPs) who practice in rural clinics. METHODS/STUDY POPULATION: Quantitative retrospective analysis of patients with COPD using VA data. We included patients whose primary care clinic is located in a rural VA Midwest Health Care Network (HCN) facility and quantified binary measures for receipt of: spirometry, pulmonary specialty care, and optimal inhaler therapy (regimen with LAMA or LABA monotherapy) Qualitative semi-structured individual interviews of PCPs (physicians, nurse practitioners, and physician assistants) whose clinics are located in a rural VA Midwest HCN facility. We elicited perceived barriers to and recommendations for receiving spirometry, pulmonary specialty care, and optimal inhaler therapy from PCPs. RESULTS/ANTICIPATED RESULTS: 6,350 rural patients had a new diagnosis of COPD in 2016-2019. 48.4% had spirometry, 14.4% had pulmonary encounters, and among patients who were prescribed long-acting inhaler therapy, 48.8% received optimal inhaler regimens. Rural PCPs (n=14) highlighted lack of access to spirometry, pulmonary specialty care, and clinic staff support in local clinics and suggested: 1) leveraging the expertise of pharmacists in COPD management and 2) improving access to resources, including use of telehealth technologies. DISCUSSION/SIGNIFICANCE: Less than 50% of rural COPD patients received recommended diagnostic testing and therapy. Resource limitations in rural clinics were the main barrier. The main recommendation was to leverage pharmacists’ expertise in COPD care. These findings provide a pathway forward to improving rural COPD care.
171 COVID-19 Vaccine Uptake in Latinx Sexual and Gender Minorities in South Florida
Authors: Scott Dalton , Metheny Nicholas , Behar-Zusman Victoria
Published: April 2023

OBJECTIVES/GOALS: Intersecting marginalized identities and multimorbidity elevate Latinx sexual and gender minority (SGM) risk for severe COVID-19, making vaccination critically important for this group. This study provides some of the first data on strategies for improving vaccination efforts in this community. METHODS/STUDY POPULATION: Data come from the Latinx SGM substudies of the NIH-funded Florida Community Engaged Alliance against COVID-19 Health Disparities (FL-CEAL), recruited between April 2021-August 2022 (n=215). Descriptive statistics and univariate analyses informed a multivariable logistic regression model with a dichotomous outcome variable for respondents who received at least one COVID-19 vaccine dose. Covariates included, gender, education, poverty, immigration status, an index of six COVID-19-related challenges, and dominant COVID-19 strain. Dichotomous measures of trust in six information sources (e.g., doctors, community organizations, social media) were also included. RESULTS/ANTICIPATED RESULTS: 182 respondents (85%) had received one or more vaccines. Key findings of statistical significance associated with vaccination from the adjusted model include White race (p=0.028), college degree attainment (p=0.006), high trust in community organizations (p=0.022), and the dominant variant at the time of survey (p DISCUSSION/SIGNIFICANCE: In a departure from non-SGM Latinx samples, high trust in community organizations was significantly associated with vaccine uptake. This highlights the importance of LGBT organizations to Latinx SGM and suggests messaging regarding vaccination via these organizations may be especially effective.
175 Development of an mHealth Functionality Focused Body Image Intervention for Latinx Women
Authors: Munguia Sarah Johnson , Forbush Kelsie T.
Published: April 2023

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