OBJECTIVES/GOALS: The aim of this study is to examine the prevalence of communication sources about genetic testing among adult women with a higher risk of cancer in the U.S. and identify factors associated with these communication sources by analyzing the Health Information National Trends Survey (HINTS; 2017-2020) data, a large, nationally representative sample. METHODS/STUDY POPULATION: HINTS aims to gain knowledge about the use of and access to cancer information by the public. Used data was collected between 2017 and 2020 from a sample of adult participants who self-reported as female, aged 18+, having no personal cancer diagnosis, and having a family history of cancer. The primary outcome measure is source of communication about genetic testing. Some categories are the media, family members, or a healthcare professional. Analytical approaches include the Pearsons Chi-squared test and poisson regression model to estimate prevalence ratios and examine the association between sociodemographic characteristics and sources of communication, adjusting for clinical and health belief factors as covariates. RESULTS/ANTICIPATED RESULTS: This study is in progress. It is anticipated that the most overall prevalent method of communication about genetic testing will be via the media. In multivariate models, it is anticipated that women who are younger, Black, have a lower education, have lower income, and no health insurance are more likely to receive communication about genetic testing from a source other than a health professional or not at all. After adjusting for clinical and health belief factors such as co-morbid conditions, having a primary care physician, and general knowledge about genetic testing, there may be some association between the above mentioned sociodemographic factors and receiving communication about genetic testing via a healthcare professional. DISCUSSION/SIGNIFICANCE: Reporting on the association between sociodemographic factors and sources of communication can aid in an intervention design to better promote genetic testing. This can be most beneficial among vulnerable groups like Black women to better understand their own genetic risk of cancer and to make informed decisions about their health.

OBJECTIVES/SPECIFIC AIMS: Improving public health requires effective community-engaged approaches. The Better Together Lebanon County initiative plans to create opportunities for improved health and quality of life by aligning strategies of local organizations, previously working independently. METHODS/STUDY POPULATION: Better Together began with a 1-day summit, convening stakeholders with the goal of coordinating efforts and maximizing resources in the Lebanon community. Key stakeholders were identified using the socioecological model to assist with planning, goal setting, and developing outcomes for this initiative. Representation included community members, hospital systems, restaurants, school administrators, nonprofit organizations (including YMCA, American Heart Association), grocery stores and policy makers such as the mayor, health departments, and state representatives. RESULTS/ANTICIPATED RESULTS: The Better Together summit brought together almost 200 individuals representing 82 local organizations to share ideas and evoke collaboration around decreasing health disparities. Attendees learned about programs within and outside of their communities and volunteered for task forces to propel the community forward. Currently, we have members committed to further this work through Action Teams within the sectors of Physical Activity, Healthy Food Access and Family and Community Engagement. DISCUSSION/SIGNIFICANCE OF IMPACT: Convening individuals from many layers of the community helps to ensure discussions are representative of the overall community voice. It is vital to facilitate effective collaboration that includes networking, identifying assets and areas of improvement, brainstorming solutions and integrating research and best practices to improve the health of a community.

ABSTRACT IMPACT: This work has begun to provide the foundation for better ensuring that translational research funded and supported by our IDeA-CTR grant is more directly addressing community- and stakeholder-authored health priorities. OBJECTIVES/GOALS: In order to effectively engage diverse, societal perspectives, we aimed to determine the relevance and feasibility of purposefully aligning translational research with health priorities adopted by the RI Department of Health, health-focused organizations, and community leaders. METHODS/STUDY POPULATION: Individuals from 27 community organizations in RI were asked, ‘What are your health related goals for your community’ and submitted responses online for 2 weeks. Participants generated 71 goals which they sorted into meaningful clusters and rated for importance and feasibility. Clusters were contrasted with RI health priorities to gauge alignment and saturation. In the next phase of this project, researchers and service users funded by Advance-CTR will be asked in routinely administered surveys how their current work may align with RI health goals and whether their future work can feasibly be connected to those priorities. RESULTS/ANTICIPATED RESULTS: Using Group Concept Mapping software, the 71 health goals identified by community organization representatives were fit into an 8-cluster model. Results suggested highest importance placed on Accessible & Healthy Housing (M=4.12, SD=0.29), Community (M=4.08, SD=0.28), Youth (M=4.04, SD=0.49) and Mental Health (M=4.03, SD=0.46). State agency priorities were found to overlap substantially with clusters defined by community leaders. We expect researchers will rate clusters differently, and find some community-endorsed health goals more relevant to their work than others. Perceived feasibility of tailoring future research to state health goals is expected to vary widely by item and researcher. DISCUSSION/SIGNIFICANCE OF FINDINGS: We intend to: 1) facilitate discussions about successes and challenges of translating community-authored priorities into research, and 2) foster better understanding between researchers and the communities they aim to serve on the role of CTR for addressing health challenges in the state.

OBJECTIVES/GOALS: To assess the impact of FLTCs on CTR on S and F from health professions and basic science academic programs island wide in Puerto Rico. Cycles supported by the Title V Cooperative Project at University of Puerto Rico-Medical Sciences Campus (UPRMSC) and Universidad Central del Caribe (UCC)(Title V). METHODS/STUDY POPULATION: After offering FLTCs in CTR to S and F from UPRMSC and UCC, Title V expanded it to S and F from other institutions island wide in PR. These FLTCs were offered the 2nd semester of 2018 and consisted of 20 hours of interdisciplinary sessions in: introduction to and definition of CTR; preparation of a CTR-presentation; how to interview/share a presentation of a CT researcher and to prepare a research question in CTR. To assess the knowledge of S and F in the above-mentioned skills and their continuation in the 2nd level of CTR training, surveys were administered: pre-test, at the beginning, post-test, sometime during the FLTCs, and satisfaction at the end of the FLTCs. RESULTS/ANTICIPATED RESULTS: Fifty eight (58) S/F from UPRMSC, UCC and 7 other institutions participated. Forty two (42,72%) answered a pre-test and 31/42 (74%) completed the post-test. Results showed that S/F: who correctly defined CTR increased from 7% to 77 %; their ability to identify a CT researcher increased from 10% to 83%. Fifty five percent (55 %) (21/38) S/F that were certified in the FLTCs, answered the satisfaction survey. One hundred percent (100%) indicated that the materials offered contributed in the identification of a CT researcher and a topic in CTR; 100% answered that the FLTCs contributed higher knowledge in and provided new skills in CTR. Moreover, 31/38 (82%) S/F started the 2nd level of training. DISCUSSION/SIGNIFICANCE OF IMPACT: The FLTCs were successful in increasing S/F knowledge of CTR and to further engage in 2nd level of trainings. Title V impact extended island wide, increasing the diversity of represented health professions and science fields among participants. The interventions were deemed to be of high quality.

OBJECTIVES/SPECIFIC AIMS: Determine the effectiveness of a curriculum designed to teach doctoral students to use implementation science theories, models and frameworks in optimizing scientific, social, political, cultural and organizational impact METHODS/STUDY POPULATION: Analysis of Integrated Final Projects across three cohorts of doctoral students (N=30) to identify sub-disciplinary knowledge integration and application. RESULTS/ANTICIPATED RESULTS: Integrated Final Projects indicate that the integration of IS, Program Theory and Research design within semester two yields application of integrated, sub-disciplinary knowledge to research design, identification of mechanisms of action and the address of barriers and facilitators to implementation of findings. Future analysis will be conducted to determine the degree to which dissertations reflect a similar level of sub-disciplinary integration and focus on implementation within the appropriate service setting. DISCUSSION/SIGNIFICANCE OF IMPACT: Training future translational researchers to understand and use implementation science theories, models and frameworks can potentially result in narrowing the science-to-service gap.

OBJECTIVES/GOALS: The goal is to use a participatory design approach involving patients and healthcare providers to create an intervention aiming to improve the transition readiness of youth with sickle cell disease (SCD) when going from pediatric to adult care in Ontario. METHODS/STUDY POPULATION: The study employed a participatory design approach, utilizing co-design and community-consulted design practices. The co-design process involved three design sessions with 7 adult participants (3 with SCD, 3 with SCD working in healthcare, and 1 without SCD but working in healthcare) to actively involve them in designing an intervention that addressed their unmet needs. A thematic analysis of the first design session was conducted to gain insight into their experiences. The community-consulted design included three internal research team sessions to synthesize the participants' insights. Zoom was used for all sessions, and Miro as the online collaboration tool for participatory design activities, resulting in a prototype that reflected the collective input of the target users and the broader community. RESULTS/ANTICIPATED RESULTS: With the thematic analysis, one prominent theme emerged, labeled as 'Barriers to Successful Transition,' which consisted of four subthemes: 1) Lack of Education and Awareness; 2) Constraints in Healthcare Delivery, 3) Managing Multiple Transitions; and 4) Racial Bias in Healthcare. The word 'hospital' emerged as the most frequently mentioned word, following closely were the terms 'school,' 'person,' 'sickle cell disease,' and 'education.' This analysis underscores the crucial involvement of hospitals and healthcare providers in facilitating the transition of youth with SCD. Following the design sessions, the most desirable/feasible intervention was to create an accredited digital educational module for adult healthcare providers specifically focusing on youth transitioning with SCD. DISCUSSION/SIGNIFICANCE: 3,500 people in Ontario have SCD, with an average age of 24 years, where one-third are aged 14 or younger. Youth with SCD face unique challenges, so effective communication and comprehensive care coordination are needed from healthcare providers. The digital module will increase awareness and ultimately improve transition readiness.

OBJECTIVES/GOALS: Degenerative cervical myelopathy (DCM) can lead to pain, disability, and permanent spinal cord impairment. Timely diagnosis and surgical intervention is essential to optimize functional outcomes for patients with CSM. Here, we compared patients who were admitted through clinic versus the emergency department (ED) for surgical management of DCM. METHODS/STUDY POPULATION: Patients aged ≥18 years admitted for surgery for DCM through clinic (elective cohort) were compared to a surgical cohort who were evaluated through the ED (call cohort). Basic demographics included age, gender, race, ethnicity, and insurance payor. Sociodemographic characteristics were estimated using the Social Deprivation Index (SDI) and the Area Deprivation Index (ADI) for the state of California, which were obtained through aggregated Zip Code Tabulation Area (ZCTA). Cervical MRI was reviewed to assess severity of spinal cord compression. Other outcomes included number of motion segments operated on, functional outcome using the Nurick classification, length of stay (LOS), disposition, and 30-day reoperation and readmission rates. RESULTS/ANTICIPATED RESULTS: From 2015 to 2021, 327 DCM patients received surgery (227 Elective Cohort, 100 Call Cohort). Elective cohort was mainly female (48.0 vs 30.0%, p=0.002) and white (72.7 vs 51.0%, p=0.0001). Call cohort was mainly uninsured/covered by Medicare/Medicaid (78.0 vs 67.0%, p=0.04), had higher SDI (68.0 vs 56.2, p=0.0003), ADI (7.9 vs 7.2, p=0.009), and cervical cord compression on MRI (78.0 vs 42.3% Grade III, p DISCUSSION/SIGNIFICANCE: Compared to DCM patients undergoing elective surgery, those admitted through the ED were more likely to be male, non-White, and socioeconomically disadvantaged, as measured by SDI and ADI. Postoperative outcomes were less favorable for these patients, including longer hospital stay, discharge disposition, and less Nurick grading improvement.

Funding for large research initiatives, such as those funded through the National Institutes of Health U mechanism, has increased since 2010; however, there is little published research on how to evaluate the success of such initiatives. Here, we describe the collaborative evaluation planning process undertaken by the Interactions Core of the Collaborating for the Advancement of Interdisciplinary Research in Benign Urology (CAIRIBU) research community, a clinical and translational research initiative funded by the National Institute of Diabetes and Digestive and Kidney Diseases. Evaluation is necessary to measure the impact of our work and to allow for continuous improvement efforts of CAIRIBU activities and initiatives. We developed and implemented an iterative seven-step process that engaged the Interactions Core, NIDDK program staff, and grantees at each step of the planning process. Challenges faced in planning and implementing the evaluation plan included the time burden on investigators to submit new data for evaluations, finite time and resources for evaluation work, and the development of infrastructure for the evaluation plan. We call on funding agencies to include more explicit requirements for evaluation participation from grantees, as well as dedicated funding to support the evaluation process, in future funding opportunity announcements for large research consortia.

OBJECTIVES/GOALS: People experiencing homelessness vs. housed peers have higher rates of substance use disorders as well as increased emergency medical services (EMS) use. However, it is unknown if EMS administers naloxone at different rates to people experiencing homelessness. We address if patient housing status impacts naloxone administration by EMS providers. METHODS/STUDY POPULATION: We conducted a retrospective, cross-sectional analysis of electronic patient care reports (ePCRs) for all 911-incidents attended by the Los Angeles Fire Department (LAFD) during the study period, January to December 2018. Individuals who were medically assessed by the LAFD and who were administered naloxone by LAFD EMS were included. Exclusion criteria was incomplete ePCRs. The primary outcome was prevalence of EMS naloxone administration by housing status in the city of Los Angeles. We used descriptive statistics and a logistic regression model to examine differences in care. RESULTS/ANTICIPATED RESULTS: Naloxone was administered in 2,438 of the 345,190 incidents that occurred during the study period. 608 (25%) incidents involved people experiencing homelessness. Top indications for naloxone administration were similar in both groups: overdose, altered consciousness and cardiac arrest. Of those who received naloxone, people experiencing homelessness were more likely to be male (82% v 67%) and younger (41 v 46 years). People experiencing homelessness were more likely to receive naloxone (OR 2.6, 95% CI 2.4-2.9). People experiencing homelessness received naloxone at a rate of 44 times that of housed peers. A logistic regression model adjusting for gender, age, respiratory depression and transport status showed people experiencing homelessness remained more likely to receive naloxone (OR 2.3, 95% CI 2.0-2.5). DISCUSSION/SIGNIFICANCE: Emergency medical services are more likely to administer naloxone to people experiencing homelessness than housed peers. There is a need to identify bias and factors that impact prehospital care and patient outcomes of people experiencing homelessness. New care pathways for people confronting homelessness and opioid use disorders are needed.

ABSTRACT IMPACT: The goal of this evaluation study is to enhance the ability of the External Review Board to advise the CTSA at UTMB how to improve translational science activities. OBJECTIVES/GOALS: The purpose of this study is to evaluate the work of the External Review Board (EAB) for the Institute for Translational Sciences/CTSA at the University of Texas Medical Branch-Galveston. This evaluation is conducted through the perceptions of professional and community board members. The outcome consists of an inventory of best practices. METHODS/STUDY POPULATION: We collected data by means of semi-structured interviews with all eight member of the EAB. The interviews were conducted via telephone, lasted approximately 30 minutes each, and were audio-recorded with respondents’ permission. Respondents’ identities were held in confidence. The IRB at UTMB reviewed our study. The interviews were transcribed. The data were analyzed by means of an inductively-oriented, grounded theory approach (Charmaz, 2006). Emergent themes led to the formation of a series of best practices. RESULTS/ANTICIPATED RESULTS: Common concerns included the need for more extensive training for new members; circulation of the agenda before the meeting; and the value of more structured main leadership. The members generally agreed that the breakout groups were valuable because they encouraged them to engage in hands-on responses to practical problems. One of the key epistemological findings was the consensus view that the evaluation of the EAB should be an ongoing project, as opposed to a yearly task. This serious approach to evaluation would be conducive to a process analysis of the EAB, since medical, social, economic, and cultural conditions surrounding and influencing translational science are generally in flux (e.g., the COVID-19 pandemic and the various stages in the CTSA grant). Overall, the EAB experience was quite positive for them. DISCUSSION/SIGNIFICANCE OF FINDINGS: The strongest sentiment expressed in the interviews was that the CTSA at UTMB should focus and build on its strength--the science of team science--as opposed to any concerted search for weaknesses that the term “evaluation” occasionally implies.

OBJECTIVES/SPECIFIC AIMS: Chromosome 22q11.2 deletion syndrome (22q) has a prevalence almost as common as Down syndrome. 22q is well known for medical complications, including congenital heart disease and immune dysfunction. However, children with 22q also have borderline cognitive abilities, are at high risk for ADHD and anxiety, and have poor independent living skills (adaptive function). Parenting is one modifiable factor that has been found in typically developing populations to promote independent functioning and protect against the development of anxiety disorders. This study investigates the associations between parenting, anxiety, and adaptive functioning in 22q. METHODS/STUDY POPULATION: Parent-child (ages 4–11) dyads participated in an ongoing study involving observed parenting during challenging tasks plus questionnaires of parenting, child anxiety, and child functioning. In total, 52 dyads [22q=25; typical development (TD)=27] have enrolled to date. Parents completed questionnaires, including the Parenting Styles and Dimensions Questionnaire (PSDQ), Spence Children’s Anxiety Scale, and Adaptive Behavior Assessment System for Children (ABAS-II). PSDQ dimensions of interest included Parental Psychological Control (PPC: the management of child behavior through the manipulation of emotions, expectations, and independence), Authoritative, Authoritarian, and Permissive, and the subscales of these broad dimensions. Scores were compared using t-tests and multiple regression models were used to investigate the relationships between 1-parenting and anxiety and 2-parenting and adaptive function. RESULTS/ANTICIPATED RESULTS: Mean age was 7.8+2.1 years. Full Scale IQ (TD: 112.3 vs. 22q: 82; p<0.001) and ABAS-II Global Adaptive Composite (TD: 102.7 vs. 22q: 69.2; p<0.001) were significantly higher in the TD group. Parents in the 22q group reported higher levels of PSDQ PPC (22q: 2.3 vs. TD: 2.1; p=0.06), specifically overprotection (22q: 3.7 vs. TD: 3.3; p=0.04), and lower Authoritative parenting (22q: 4.1 vs. TD: 4.4; p=0.03), across the subscales. There were no differences in Authoritarian or Permissive parenting. Children with 22q had higher Spence Total Anxiety scores (22q: 62.5 vs. TD: 47.4; p<0.001). Self-reported PPC and group (R2=0.3, F3,48=8.1, p<0.001) predicted child anxiety with a main effect of PPC (β=16, p=0.02). Group tended to moderate the association between PPC and anxiety (β=−17.5, p<0.10), with PPC predicting anxiety for the 22q group (r=0.35, p<0.09), but not the TD group (r=−0.08, ns). At this time, a relationship between PPC and child ABAS-II GAC in 22q (r=−0.14; p=0.5) is not identified. DISCUSSION/SIGNIFICANCE OF IMPACT: Children with 22q are at high risk for anxiety and poor adaptive outcomes. These results suggest that parents of children with 22q use higher levels of PPC, which is correlated with increased child anxiety. These analyses also provide support for parenting interventions to improve anxiety in children with 22q and possibly mitigate the serious mental health risk in this population.

OBJECTIVES/SPECIFIC AIMS: (1) Provide basic brain knowledge about development and resiliency. (2) Develop an understanding of how a mother can impact a child’s brain development. (3) Foster a sense of agency to increase the likelihood that a mother will enact positive changes. (4) Develop the ability to recognize a connection between one’s own behaviors and a child’s development and behaviors. METHODS/STUDY POPULATION: Tested the efficacy of a 4-week intervention program on neurodevelopment for homeless mothers. Mothers (n=4) residing at the Center for the Homeless in South Bend, IN were recruited. Used community partner feedback, weekly surveys, and pre/post tests to look at changes in basic content knowledge, behavioral change, and self-efficacy. RESULTS/ANTICIPATED RESULTS: Preliminary results indicate an increase in knowledge about neurodevelopment, although results on behavioral changes are inconclusive. The program is anticipated to run a second time with a new group of parents residing in the Center for the Homeless to increase sample size. DISCUSSION/SIGNIFICANCE OF IMPACT: Anticipated that the results will add to the existing literature concerning effective interventions in strengthening parenting and neuroscience knowledge in vulnerable populations.

OBJECTIVES/SPECIFIC AIMS: Thionamides are anti-thyroid drugs (ATD) that are commonly used to treat autonomous thyrotoxicosis. Although efficacious, these medications carry a risk of neutropenia or agranulocytosis in a small but finite proportion of the patients who receive them. Some risk factors for thionamide-induced neutropenia have been identified, including body mass index (BMI) and dose, but the role of race and ethnicity in the pathogenesis of this potentially life-threatening side effect is not known. We hypothesize that there will be no effect of race or ethnicity on the change in absolute neutrophil count (ANC) following initiation of thionamide therapy among adult patients with thyrotoxicosis. METHODS/STUDY POPULATION: Data from the electronic medical record at UNM HSC were obtained using a standard database query for the years 2000–2016. Inclusion criteria were the prescription of an ATD, an ANC recorded within 30 days of initiating ATD therapy (pre-ATD), and an ANC recorded between 75 and 365 days after starting an ANC (post-ATD). Patients taking other agents known to cause neutropenia and agranulocytosis, such as clozapine, allopurinol, or chemotherapy, were excluded. Patients were assigned to racial and ethnic groups as follows: Hispanic, non-Hispanic Caucasian (NHC), native American, Black, and Asian. The post-ATD ANC was defined as the nadir ANC observed after the ATD was started. “Delta ANC” was defined as [(post-ATD ANC)−(pre-ATD ANC)]. ANOVA analysis with Bonferroni-adjusted post-hoc testing was performed to examine differences in the mean changes of ANC across ethnic groups. RESULTS/ANTICIPATED RESULTS: In total, 123 adult patients met inclusion and exclusion criteria and were included in the analysis. No significant difference was found between any of the racial groups with regard to age, sex, BMI, pre-ATD ANC, or the pre-ATD to post-ATD ANC interval. The native American group showed a significantly greater post-ATD ANC (not shown) and Delta-ANC as compared with the other groups. Delta ANC Hispanic=−1.4±3.3, Caucasian=−0.6±3.3, Black=−0.9±4.1, Asian=−3.8±4.8, native American=3.6±5.1 (all units per mm3; p<0.001). DISCUSSION/SIGNIFICANCE OF IMPACT: In this cohort of New Mexicans with thyrotoxicosis, native American race was protective against thionamide-induced neutropenia.

OBJECTIVES/GOALS: Contingency management (CM), wherein patients earn prizes for behavior change, is the gold-standard for reducing stimulant misuseand has been shown to improve medication adherence.We aim to describe the feasibility, acceptability, and effectiveness of CM to reduce stimulant use and optimize ART adherence in Women’s HIV primary care. METHODS/STUDY POPULATION: Using the ADAPT-ITT model for adapting evidence-based HIV interventions, we implemented the CoMBostudy at the Ward 86 Women’s Clinic at San Francisco General Hospital. Inclusion criteria are (1) adult age women with HIV, (2) suboptimal ART adherence, (3) stimulant use disorder with goal of reduced-use. Participants receive weekly CM for 12 weeks with escalating incentives for point-of-care urine testing negative for stimulants and positive for tenofovir ART. We use mixed methods to evaluate feasibility and acceptability ofCoMBowith quantitative process measures, sequential explanatory in-depth interviews with participants and staff, and effectiveness by proportion of point-of-care urine tests without stimulants and with tenofovir. RESULTS/ANTICIPATED RESULTS: CoMBoStudy enrollment began in September 2023; n=10 participants have enrolled with an additional n=20 planned.We will report feasibility and acceptability using:1) the number of women with HIV, stimulant use disorder, and suboptimal ART adherence enrolled vs. recruited, 2) the number and proportion of CM sessions attended/missed, 3) cost per participant, and 4) participant-reported facilitators and barriers to CM engagement. We will report preliminary effectiveness based on: 1) proportion of POC tests negative for stimulants, positive for ART, and 2)trend in self-reported stimulant use assessed weekly during CM. DISCUSSION/SIGNIFICANCE: Women with comorbid HIV and stimulant use disorder have demonstrated poor outcomes including reduced ART adherence and faster progression to AIDS. This work aims to expand access to evidence-based treatment for stimulant use disorder for women with HIV and share key opportunities and challenges for doing so in the women’s health HIV primary setting.

OBJECTIVES/SPECIFIC AIMS: This study seeks to test the feasibility and effectiveness of a brief acceptance and commitment therapy (ACT) treatment for chronic pain patients in a primary care clinic METHODS/STUDY POPULATION: Primary care patients aged 18 years and older with at least 1 pain condition for 12 weeks or more in duration will be recruited. Patients will be randomized into (a) ACT intervention or (b) control group. Participants in the ACT arm will attend 1 individual visit with an integrated behavioral health provider, followed by 3 weekly ACT classes and a booster class 2 months later. Control group will receive enhanced primary care that includes patient education handouts informed by cognitive behavioral science. Data analysis will include 1-way analysis of covariance (ANCOVA), multiple regression with bootstrapping. RESULTS/ANTICIPATED RESULTS: The overall hypothesis is that brief ACT treatment reduces physical disability, improves functioning, and reduces medication misuse in chronic pain patients when delivered by an integrated behavioral health provider in primary care. In addition, it is anticipated that improvements in patient functioning will be mediated by patient change in pain acceptance and patient engagement in value-consistent behaviors. DISCUSSION/SIGNIFICANCE OF IMPACT: This pilot study will establish preliminary data about the effectiveness of addressing chronic pain in a generalizable integrated primary care setting. Data will help support a larger trial in the future. Findings have potential to transform the way chronic pain is currently managed in primary care settings, with results that could decrease disability and improve functioning among patients suffering from chronic pain.

OBJECTIVES/SPECIFIC AIMS: The prevalence of kidney stone disease has increased significantly in the United States in the last 2 decades. While several studies have reported that disparities in access to and quality of medical care exist, there is a need for a more thorough investigation of factors that negatively impact patients seeking care specifically for kidney stone disease. We sought to examine whether kidney stone patients received different standard of care in the emergency department (ED) according to their race/ethnicity, gender, age, body mass index, socioeconomic status (SES), and insurance status. METHODS/STUDY POPULATION: We conducted a retrospective study of patients presenting to the ED at Montefiore Medical Center between January 1, 2014 and December 31, 2016. Patients with a diagnosis of nephrolithiasis were identified using ICD-9/10 codes and electronic chart review was used to assess each patient’s ED course as well as to gather sociodemographic information. The primary outcomes of interest were administration of pain medication, prescription of alpha-1 antagonists to facilitate stone passage and whether or not patients received CT scan or ultrasound. Associations of these outcomes with age categories, sex, race/ethnicity, body mass index category, SES and insurance status were examined using multivariate logistic regression models. RESULTS/ANTICIPATED RESULTS: A total of 1200 patients were included in this analysis of which 616 (51%) were women. A large proportion of patients were minorities (40% Hispanic and 15% non-Hispanic African-American), whereas 21% were Caucasian and 24% declined to report race/ethnicity. Patients between the ages of 55–64 and those older than 65 were less likely to receive pain medication compared to younger patients aged <35 years (OR=0.48, 95% CI: 0.27–0.86 and OR=0.46, 95% CI: 0.21–1.00, respectively). Women were less likely than men to undergo any form of diagnostic imaging (OR=0.52, 95% CI: 0.35–0.76) including CT scan (OR=0.50, 95% CI: 0.35–0.72). Similarly, patients in the lowest quintile of SES received less imaging than patients in higher SES categories (OR=0.50; 95% CI: 0.27–0.90). Furthermore, African Americans (both genders) and women were less likely to be prescribed an alpha antagonist medication (e.g., tamsulosin) to facilitate stone passage compared with White patients (OR=0.61, 95% CI 0.36–1.03) and men (OR=0.68, 95% CI: 0.49–0.92), respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: We found that multiple disparities exist among patients presenting to the ED for nephrolithiasis. A more thorough investigation into the causes of these disparities is warranted to limit their impact on patient care.