The purpose of this clinical improvement project was to instill a streamlined process of identifying social determinants of health (SDOH) in our clinic’s diverse patient population and provide resources that address these barriers to health and well-being. At each clinic visit, patients self-identified SDOH through an easy-to-use Social Assessment Form. Using an online database, Community Relay (CR), providers had access to location-based community resources. In addition to accomplishing the above-mentioned goals, we were left with a more well-rounded understanding of our patients. Unique struggles were identified and barriers to care were revealed, allowing for more patient-centered medical care.

OBJECTIVES/SPECIFIC AIMS: The aim of this study was to determining how interruptions affect the triage process. METHODS/STUDY POPULATION: Prospective, observational study, where 118 triage interviews were observed. RESULTS/ANTICIPATED RESULTS: In total, 57% of triage interviews were interrupted. The most common interruption was by other nurses; however, 7% of the interruptions were by the triage nurse themselves. When an interruption occurred during the triage process, 67% of the time the triage nurse would stop the triage assessment and attend to the interrupter. In the interrupted interviews, 17% of the entire triage time was dedicated to addressing interruptions. Some interruptions (ie, additionally staff entering to conduct ECG) had a positive impact by expediting care during the triage process; where other interruptions delayed patient care. DISCUSSION/SIGNIFICANCE OF IMPACT: Interruptions increased the total triage time and contributed to patient treatment delays, as well as led to errors in nursing assessment. Understanding the classifications of triage interruptions and the impact on patient outcomes will allow researchers to develop interventions to mitigate the impact of these interruptions.

Objectives/Goals: This study illuminates the efforts of a Clinical and Translational Science Award (CTSA) Hub to share stories of its aspirations, challenges, successes, opportunities, and impact when pursuing its complex goals, and how storytelling contributes to the narrative of the translational science work (via storytelling strategies, products, and benefits). Methods/Study Population: We utilized an environmental scan of a CTSA Hub (University of Minnesota Clinical and Translational Science Institute (CTSI)), including case study vignettes of its storytelling practices and products. We triangulated data from diverse data sources: grant applications, reports, and publications; public stories/news related to CTSI activities and impact; scientific publications; organizational/policy documents; and interviews with CTSI stakeholders featured in published sources. Results/Anticipated Results: TS storytelling uses and strategies include communicating the essence of research translation, promoting program utilization, engaging community, reporting to stakeholders, and evaluating for accountability, learning, and improvement. Storytelling challenges include complexity of translation; balancing the scientific rigor with an engaging narrative; identifying appropriate stories that resonate with diverse stakeholders and are at an appropriate level of maturity; and building capacity using storytelling. Facilitators include supportive infrastructure to integrate stories; leadership endorsement of storytelling as a valuable strategy; capable cross-functional teams of communicators, administrators, and researchers to facilitate the integration of data into storytelling. Discussion/Significance of Impact: The environmental scan provides evidence and lessons learned on leveraging storytelling as a useful tool for communicating CTS goals, actions, and findings, engaging stakeholders, building a narrative around scientific discoveries, evaluating and improving programs, and addressing health disparities in translational science.

OBJECTIVES/GOALS: We describe here the implementation of a pilot Quality Improvement (QI) program in clinical research processes in order to facilitate translation from bench to community. This presentation will also discuss challenges encountered by the research teams during the implementation of QI activities. METHODS/STUDY POPULATION: Miami CTSI collaborated with University of Kansas’ CTSA to test the implementation of a QI program for clinical research processes. The program has a duration of 1 year and consists of multi-modal training and coaching sessions with different research teams. Six teams comprising of Principal investigators, clinical coordinators, and regulatory specialists participated in the program based in applied clinical microsystem theory science. Team coaches and teams worked together to assess current processes, test new and improved processes, and standardize and disseminate applicable best practices of the QI program. RESULTS/ANTICIPATED RESULTS: The implementation of QI activities in large clinical research settings poses numerous challenges for the research team. We will present survey results from the coaching sessions and follow on feedback from the different teams involved in the program to implement the QI activities. We will describe the modifications and adjustments made to the original conceptual framework of QI program in order for it to be applicable and feasible for the settings of the University of Miami. We will provide recommendations for other academic clinical research centers that are considering implementing a QI program. DISCUSSION/SIGNIFICANCE OF IMPACT: The successful adaptation of a QI process to implement in academic clinical research settings relies on early engagement of the institution leadership, careful selection of team members, as well as developing communication skills to enhance team dynamics as a clinical research unit.

OBJECTIVES/SPECIFIC AIMS: We aimed to explore the impact of leadership training on student’s abilities to work in interprofessional research teams successfully. The Translational Research Design and Interprofessional Skills Development Course (shortened, Interprofessional Research Design) brings together students from different disciplines (science & medicine) and education tracks (PhD, MD, MD/PhD training) in a seven-week course to learn interprofessional collaborative skills and leadership styles that support success in translational research environments, while undertaking a research grant writing project. Part of the course involves a two-day leadership training workshop (12 hours) with the goal of understanding leadership styles and how to develop productive working relationships with team members to help students work more effectively in high-performance, interprofessional team environments. The course incorporates personality testing to develop self-awareness, with various exercises meant to build empathy, as well as knowledge of project management and effective leadership. METHODS/STUDY POPULATION: Nine teams of 32 students (23 MD; 9 Ph.D.) who took part in the Interprofessional Research Design course in 2017 and 2018 were required to write a reflective essay at the end of the course. We used an inductive thematic analysis to evaluate the essays. Reflective essays were coded openly by one study member. Codes were rationalized; then codes were collaboratively developed into themes by the study authors. We identified issues of integration between student groups that functioned well together and those that did not. Reflective writing responses were grouped into overall positive experiences and negative experiences. RESULTS/ANTICIPATED RESULTS: Seven of the nine teams collectively described their experiences positively. Themes related to positive team experience were “empathizing with group members”, “sophisticated communication” and “collaborative workflow/styles.” We found that those who had a positive experience utilized knowledge and skills learned during leadership training to better understand and communicate with their teammates leading to a more collaborative and dynamic workflow. These groups had higher degrees of communication both between their task assignments and within task completion periods. They also showed more awareness of others’ needs in work and communication styles. For those that had a negative experience, themes were related to “basic communication”, “poor integration” and “theory-practice gap of leadership training.” Those who struggled showed much less in- and between-task communication and showed an inability to address the personal needs of other members in communication and workflow (while still often being able to identify them). DISCUSSION/SIGNIFICANCE OF IMPACT: These findings demonstrate the usefulness of leadership training that facilitates student self-awareness and empathy, as well as effective communication, leading to collaborative high-functioning interprofessional teams. Further work incorporating conflict management and exercises to overcome the theory/practice gap of leadership and teamwork training are recommended.

OBJECTIVES/GOALS: Understand how prepubescent TGD children experience pediatric care with a dual purpose of informing clinical practice and presenting alternative methods for research with children. Centering their perspectives is critical to improving care for this age group, ultimately improving TGD health. METHODS/STUDY POPULATION: A participatory arts-based study involving drawing, photo elicitation, and narrative interviews with prepubescent TGD children (n=15) in the Pacific Northwest. Participants will make photos and draw a picture of their most recent pediatric visit. Participants guide the analysis and interpretation of their artwork, informing subsequent interviews. Interviews are coded and interpreted using inductive thematic analysis at the semantic level, and verified by participants and near-peer community partners. The combination of multiple data sources that represent both stimuli and verifiers of perceptions provide methodological triangulation. RESULTS/ANTICIPATED RESULTS: Early pilot data with community partners suggest that TGD children do not feel sufficiently supported in pediatric settings, which impacts their sense of safety and agency in the clinical context. Findings will inform changes to clinical practice to improve gender affirmation for prepubescent children, positively impact child-caregiver relationships, and ultimately improve health care and wellbeing for TGD people. Observations related to the implementation of novel methodologies will inform future research practices intended to include younger children as active agents in the knowledge production process. DISCUSSION/SIGNIFICANCE: There are missed opportunities to positively impact children’s health and caregiver-child relationships when gender affirming care is overlooked in the pediatric context. This study provides first-hand multi-media perspectives to inform improvements in prepubescent gender affirming pediatric care.

OBJECTIVES/GOALS: The research project aimed to understand the perceived effectiveness of research recruitment methods, including informatics tool utilization, so that best practices can be established and outcomes measured longitudinally. METHODS/STUDY POPULATION: The mixed-methods study was conducted by the Oregon Clinical and Translational Science Institute, the CTSA at Oregon Health and Sciences University. A survey, clinical trial accrual data, and interviews were used to assess the study aims. The survey asked about utilization and value of specific recruitment tools and methods. Accrual data was obtained from the clinical trial management system and analyzed using parameters from the CTSA “Accrual Metric”. The metric was calculated for clinical trials enrolling during 2017. Interviews were conducted with researchers identified by the survey and over or under-enrolled accrual data, and inquired about recruitment facilitators and barriers. RESULTS/ANTICIPATED RESULTS: The most frequently mentioned facilitator of recruitment was direct patient contact, either in the healthcare setting (58.4% of survey respondents) or through patient outreach (32%). A lack of resources was considered a key barrier (21% of survey respondents) and a stated need (27%). Interview data expanded on these findings, as 23% of interviewees indicated a collaborative culture, which includes clinic integration, was key to recruitment success. Additionally, 20% of interviewees identified resources (i.e. funding, staff, time) as their greatest need. Notably, 13% of studies with an accrual ratio of “0” had frequent staff turnover. DISCUSSION/SIGNIFICANCE OF IMPACT: This approach allowed for a uniquely targeted analysis of accrual facilitators and barriers. Use of the CTSA accrual metric identified high-value interview respondents and will allow for investigation into additional accrual questions, such as the impact of funding sources and departmental factors.

OBJECTIVES/GOALS: Alabama has the 3rd highest maternal mortality ratio in the U.S., with more than 50% of deaths occurring postpartum. There is little evidence on the prevalence or equity of postpartum care use in Alabama. This mixed methods study examines relationships between patient and provider factors and access to, use of, and racial disparities in postpartum care. METHODS/STUDY POPULATION: I will use a sequential explanatory mixed methods design. In the quantitative phase I will analyze an integrated electronic health record and human resource dataset to identify patient and provider factors that have a relationship with receipt of at least one postpartum visit within 12 weeks of delivery in a cross-sectional, retrospective cohort of 30,000 obstetric patients in Alabama. In the qualitative phase I will describe the postpartum experiences of obstetric patients who identify as Black or African American who received or did not receive at least one postpartum visit within 12 weeks of childbirth. In the integration phase I will draw synthesized conclusions about how the results of both phases describe predictors of and barriers and facilitators to postpartum care for Black birthing people in Alabama. RESULTS/ANTICIPATED RESULTS: I will identify relationships between patient factors (e.g., race, racial concordance with primary provider, insurance status, age, parity, type of delivery, Area Deprivation Index, presence of a chronic condition or severe morbidity) and patient receipt of postpartum care. I will also explore whether health care provider factors (e.g., race, racial concordance with the patient, age, gender, provider type, years of experience) predict patient receipt of postpartum care in this retrospective cohort. In the qualitative phase, I will explore the experiences and perceptions of birthing people who identify as Black or African-American that help explain the relationships between patient and provider factors and receipt of postpartum care identified in the quantitative phase. DISCUSSION/SIGNIFICANCE: More than 50% of maternal death occurs after childbirth. Postpartum care is critical to birthing people’s survival, especially in states with high maternal mortality. This study will fill a gap in knowledge about factors that have a relationship with equitable postpartum care in Alabama.

OBJECTIVES/SPECIFIC AIMS: Island communities face greater environmental risks creating challenges in their populations. A community and participatory qualitative research method aiming to understand community perspectives regarding the ecology and environmental risks of the island of Culebra was performed to develop a community-centered Information and Communications Technology (ICT) intervention (an app). The island of Culebra, a municipality from the archipelago of Puerto Rico is located 17 miles from the eastern coast of Puerto Rico’s main island. This ICT—termed mZAP (Zonas, Acción & Protección)—is part of a Translational Biomedical doctoral degree dissertation housed at the University of Rochester’s Clinical Translational Science Institute (CTSI) Informatics Core funded by an NIH Clinical Translational Science Award (CTSA). In September 2017, the island of Culebra faced 2 major category hurricanes 2 weeks apart. Hurricane Irma and Hurricane Maria devastated homes, schools, health clinics, and local businesses, disrupting an already-fragile ecological balance on the island. METHODS/STUDY POPULATION: These 2 storms catastrophically affected the archipelago of Puerto Rico. Culebra’s geographically isolated location, along with the inefficient response from authorities, exacerbated the stressors caused by these natural disasters, increasing the gap of social determinants of health, including the lack of potable water. Leveraging a community engagement partnership established before the hurricanes by the mZAP participatory research, which naturally halted once the hurricanes hit a new humanitarian objective formed to deliver aid. Along with another NIH funded RCMI Translational Research Network, or RTRN institution (University of Puerto Rico, Medical Science Campus) students and faculty, The Puerto Rico Testsite for Exploring Contamination Threats Program (PROTECT) an NIEHS Funded Grant, and the National Guard, a “people to people” approach was established to ascertain needs and an opportunity to meet those needs. A people-to-people approach brings humanitarian needs, identified directly by the community to the people who need it most; without intermediaries and bureaucratic delays that typically occur during catastrophes. RESULTS/ANTICIPATED RESULTS: The consumption of potable water in plastic bottles and subsequent accumulation of plastic material has proven to be collateral damage of a vulnerable water distribution system creating another environmental hazard on the island of Culebra. Therefore, this humanitarian partnership, worked to delivered community and family sized water filters, providing a safe environmental alternative to drinkable water for the island. The success of this approach, People to People for Puerto Rico (#p2p4PUR), demonstrated the power of genuine community engagement—arising from a previous clinical research partnership—and true established commitment with members of the community. DISCUSSION/SIGNIFICANCE OF IMPACT: Research partnerships can (and should, when needed) lead to humanitarian partnerships that extend beyond research objectives. Research may subsequently be adapted based on new realities associated with natural disasters and the altered nature of existing partnerships, allowing for a rapid response to communities need. Further, #p2p4PUR was not only able to channel a partnership humanitarian response but also created an opportunity to reflect on how the commitment between members of society and academia (researchers) can create beneficial bilateral relationships, always putting the community needs first. The resulting shared experience elevates community interest and engagement with researchers, and helps researchers see communities as true partners, rather than—simply—research subjects.

ABSTRACT IMPACT: This study provides a framwork to inform and organize health equity efforts and initiatives at CTSA institutes. OBJECTIVES/GOALS: to map the activities of the Clinical and Translational Science Award (CTSA) Program hubs across the EQ-DI framework, to depict opportunities for interaction between health equity and dissemination & implementation (D&I) science. METHODS/STUDY POPULATION: The EQ-DI framework demonstrates the dynamic interaction between D&I science and health equity. Health equity could be a lens to sensitize and inform D&I planning (through goal-setting and team development), execution (through ‘adaptation’ and D&I strategies), and evaluation (through incorporating health equity in D&I outcome assessment). On the other hand, D&I models, methods, and study designs can operationalize dissemination and implementation of evidence-based interventions to improve equity. Stakeholder engagement is at the center of the framework to inform and direct the sensitization and operationalization cycles. RESULTS/ANTICIPATED RESULTS: We reviewed the activities of Colorado Clinical & Translational Sciences Institute (CCTSI) and University of Rochester Clinical and Translational Science Institute (UR CTSI) to improve health equity and mapped them across the EQ-DI framework. The sensitizing activities included health equity training, eliciting community priorities, and inclusion of health equity as a critical axis in funding mechanisms. The operationalizing activities included D&I methodological training and consultation, collaborative team science, and funding mechanisms to support implementation of health equity EBIs. Community engagement through studios, community liaisons, and consults was a core priority guiding sensitizing and operationalizing activities. DISCUSSION/SIGNIFICANCE OF FINDINGS: The CTSA Program has been a champion for community engagement and translational collaboration to improve individual and population health. CTSA hubs provide infrastructure and resources to facilitate equity-focused D&I.

OBJECTIVES/SPECIFIC AIMS: Learning Objectives of this session: Identify possible reasons for misdiagnosis of bipolar patients of African ancestry by reviewing differences in symptom presentation between African American (AA) and European American (EA) bipolar individuals. Introduction: Bipolar disorder is a chronic mental illness with a prevalence rate up to 5.5% of the US population and is associated with substantial personal and economic morbidity/mortality. Misdiagnosis is common in bipolar disorder, which can impact treatment and outcome. Misdiagnosis disproportionally affects racial/ethnic minorities; in particular, AAs are often misdiagnosed with schizophrenia. There is interest in better understanding the contribution of differential illness presentation and/or racial bias to misdiagnosis. METHODS/STUDY POPULATION: Patients and Methods Utilizing the Genetic Association Information Network (GAIN) public database, this study compared clinical phenomenology between bipolar patients of African Versus European ancestry (AA=415 vs. EA=1001). The semi-structured Diagnostic Interview for Genetic Studies (DIGS) was utilized to evaluate individual symptom endorsement contributing to diagnostic confirmation. A χ2 test was used to compare group differences in DIGS harvested mania and psychosis sections, and overview of psychiatric medications. RESULTS/ANTICIPATED RESULTS: Results: The symptom of auditory hallucination was significantly more endorsed in AA bipolar patients than EA bipolar patients (57.9% AA vs. 36.1% EA, p≤0.0001). Conversely, the symptom of elevated or euphoric mood was significantly less endorsed in AA bipolar patients than in EA patients (94.6% AA vs. 97.5% EA, p=0.027). AA, in comparison to EA bipolar patients, had a significantly higher prevalence of lifetime exposure to haloperidol (36.9% AA vs. 29.4% EA, p=0.017) and fluphenazine (12.3% AA vs. 6.7% EA, p=0.004). In contrast, AA, in comparison to EA bipolar patients, had a significantly lower prevalence rate of lifetime exposure to lithium (52.5% AA vs. 74.2% EA, p<0.0001), and lamotrigine (13.7% AA vs. 35.6% EA, p<0.0001). DISCUSSION/SIGNIFICANCE OF IMPACT: Conclusion: The higher rate of psychotic symptom endorsement and lower rate of core manic symptom endorsement represent differential illness presentation that may contribute to misdiagnosis in African-American bipolar patients. The higher rate of high potency typical antipsychotic treatment and lower rate of classic mood stabilizing treatment may also contribute poorer bipolar treatment outcome. While structured diagnostic interviews are the gold standard in diagnostic confirmation, this study is limited by lack of knowledge of clinician/expert interviewer interpretation of symptom endorsement which may contribute to symptom misattribution and misdiagnosis. Incorporation of additional African American participants in research is a critical future direction to further delineate symptom presentation and diagnosis to serve as validation for these results.

OBJECTIVES/GOALS: We have developed a community engagement model that embraces several core values: bi-directional, co-equal, co-created, inclusive, culturally centered, and trust. Our promotoras de salud and community health workers (CHWs) facilitate listening sessions to understand the most pressing health needs and concerns as perceived by the community. METHODS/STUDY POPULATION: Our Southern California CTSI Community Engagement team includes promotoras de salud and community health workers who are trusted individuals within our targeted communities–Latino and Black populations in South and the Eastside of Los Angeles. Listening sessions identify the community’s perceived health needs and concerns, and our team in turn delivers a workshop series that addresses those concerns. Workshops are co-developed by community members, offered in English and Spanish, and delivered both virtually and in-person in community venues. Workshop topics have included mental health, depression, anxiety in children; child development and autism; COVID-19 testing, variants, and vaccines; monkeypox; and a primer on understanding clinical research. RESULTS/ANTICIPATED RESULTS: In 2022, we held 49 workshops that delivered evidence-based information including how to access needed resources. We had a total of 1212 participants, 60% of whom were returning, meaning they had attended at least one prior workshop. An evaluation of the workshop program demonstrated that our promotoras de salud and community health workers are trusted by the community and that workshops are meeting community needs. 677 surveys were completed by participants, 87.5% of whom were female. 85% of respondents stated that they will use the information they learned in their daily life, and 90% said they would attend another workshop. Feedback from the evaluation will inform future workshop format and topics. DISCUSSION/SIGNIFICANCE: Academic-community partnerships are key to advancing health equity, especially in diverse and under-resourced communities. This is one model of community engagement, which includes promotoras de salud and CHWs that was designed to build trust, empower individuals through education, and to address the health needs as defined by the community.

ABSTRACT IMPACT: Throughout the COVID-19 pandemic, the UTMB Institute for Translational Sciences has sought to answer our communities’ needs for research, for knowledge of research, and involvement in research, while recognizing that meaningful engagement involves understanding all emergent needs and responding to maximize the health and well-being of those we serve. OBJECTIVES/GOALS: ITS community programs responsive to COVID-19 include:

ο Ongoing communication with community and business stakeholders

ο Social media and public health campaigns promoting safe practices, research updates, and testing information

ο Community initiatives to increase testing among vulnerable populations METHODS/STUDY POPULATION: Like sister hubs across the US, the UTMB ITS has brought available resources to bear on addressing COVID-19 through research, medical response, and public health outreach. Community engagement activities have included facilitating communication, particularly by rapidly translating information for multiple audiences and wherever possible and appropriate, providing opportunities for the patient’s voice to inform and guide development of research. We realized the community’s need for trustworthy and reliable information about COVID-19 early in the pandemic. Key partnerships with community members and organizations were critical in enabling us all to be most responsive in meeting these needs. RESULTS/ANTICIPATED RESULTS: ITS community outreach included developing infographics, media notices, and educational materials related to prevention and testing as well as appropriate use of PPE. These efforts resulted in an article in a regional newspaper, which was disseminated widely through social media networks. ITS faculty also engaged doctoral and MPH trainees to support the Health District’s contact tracing effort. We held several events on mental health impacts as well as discussions related to health disparities. Both activities shaped plans for community-based interventions and research. The ITS also hosted a virtual workshop to facilitate discussion around key research questions related to the pandemic. DISCUSSION/SIGNIFICANCE OF FINDINGS: Throughout the pandemic, the ITS has maintained contact with stakeholders. Our roles have been to communicate, disseminate, translate, provide resources, and build bridges. We also listen, share, and provide opportunities for patients and communities to engage in all phases of the research spectrum.

OBJECTIVES/SPECIFIC AIMS: Alabama (AL) experienced a 145% increase in its Latino population between 2000 and 2010; making it the state with the second fastest growing Latino population in the United States (US) during that time. Adolescent Latinas in the US and in AL are disproportionately affected by sexual health disparities as evidenced by the disproportionate burden of HIV, STIs and early pregnancy compared with their non-Hispanic, White counterparts. Empirical data with adult Latinas in the southeast suggest significant barriers to sexual healthcare access. However, to our knowledge, no other researchers have examined barriers and facilitators to sexual healthcare access for this subpopulation. Therefore, the purpose of this study is to examine adolescent Latinas’ sexual healthcare needs through in-depth qualitative interviews. These qualitative interviews (phase 1 of a 3-phase study) will inform the development of community-driven, theory-based, culturally-relevant, multi-level intervention strategies to reduce sexual health disparities and increase sexual healthcare access for this group. Community-based participatory research (CBPR), which ensures equitable participation of stakeholder groups through partnerships, and the socioecological model of health, which conceptualizes the individual as nested within a set of social structures, provide the philosophical and theoretical frameworks for the work. METHODS/STUDY POPULATION: Between January and March of 2017, we will conduct 30 qualitative interviews with eligible adolescents who: self-identify as Latina, are between 15 and 19 years old, have been in the US for over 5 years, and live west AL. We will use venue-based, purposeful convenience sampling to recruit participants. We will manage and analyze the data with the qualitative software NVivo 10. We will use a multi-step, consensus-based process to code and analyze the interviews in the language in which they were conducted (ie, Spanish or English). We will maintain detailed audit trails during the analysis process and seek an inter-rater reliability of 0.85. RESULTS/ANTICIPATED RESULTS: We expect to identify barriers and facilitators to sexual healthcare services at distinct levels of the socioecological model of health. Study results and implications for practice in clinical settings will be discussed in detail. DISCUSSION/SIGNIFICANCE OF IMPACT: The proposed research is significant because (1) the state of AL experienced a dramatic increase in its Latino/a population over the last 15 years and adolescent Latinas in AL are disproportionately affected by sexual health disparities; (2) to our knowledge, this will be the first study to examine the multi-level factors associated with sexual healthcare access for adolescent Latinas in the South and inform intervention strategies to promote sexual healthcare access in this population; (3) the work will be conducted under the philosophical lens of CBPR such that community members will be involved in every step of the research process, resulting in culturally relevant intervention strategies.

OBJECTIVES/SPECIFIC AIMS: Our primary objective was to understand the relationship between incident or recent stressful events and adherence to HIV care in the context of other person, environment, and HIV-specific stressors in a sample of Black women living with HIV (WLWH). METHODS/STUDY POPULATION: Thirty in-depth interviews were conducted with Black women living with HIV who receive care at an academic HIV primary care clinic in the Southern region of the United States to elicit stressful events influencing adherence to HIV care. Semi-structured interview guides were used to facilitate discussion regarding stressful events and adherence to HIV care. Interviews were audiotaped and transcribed verbatim. Transcripts were independently coded using a theme-based approach by two experienced coders, findings were compared, and discrepancies were resolved by discussion. RESULTS/ANTICIPATED RESULTS: Participants described frequently experiencing incident stressful events including death or serious illness of a close friend or family member, and relationship, financial, and employment difficulties. Furthermore, participants reported experiencing traumatic events such as sexual and physical abuse during childhood and adolescents. While experiencing traumatic events such as sexual and physical abuse during childhood and adolescence may be distressing, these events did not influence adherence to HIV care. However, incident stressful events as defined above did influence adherence to HIV care for some participants, but not for others. For participants who reported that stressful events did not influence adherence to HIV care, factors such as personal motivation, access to social support, and adaptive coping strategies facilitated their engagement in care. DISCUSSION/SIGNIFICANCE OF IMPACT: Experiencing stressful events, incident or traumatic, is common among Black WLWH and have the potential to negatively influence adherence to HIV care. Thus, Interventions aimed at identifying and addressing stress, social support, and coping are essential to improve adherence to HIV care behaviors.

OBJECTIVES/GOALS: Vascular cognitive impairment (VCI) is the leading cause of dementia behind Alzheimers Disease (AD) and is often the result of brain hypoxia. Diets rich in polyunsaturated fatty acids (PUFAs) can lower cognitive decline and AD incidence in human patients. Therefore, our goal is to determine the mechanisms that PUFAs influence in a mouse model of VCI. METHODS/STUDY POPULATION: We hypothesize that hypoxia promotes endothelial P-tau accumulation and vasotrophic uncoupling, impairing endothelial integrity. Additionally, we believe that a preventative PUFA-enriched diet blocks this uncoupling and subsequently prevents/delays neurovascular dysfunction and cognitive decline. Male and female mice will be administered a control or novel PUFA-enriched dietary intervention 1 month prior to hypoxic injury using the bilateral carotid artery stenosis model. Mice will continue their diet and be assessed for cerebral blood flow, cognitive function, and motor function at 1- & 3-month time points. Following euthanasia, tissue samples from deep cortical regions and microvasculature will be examined for endothelial- & neuronal-specific P-tau accumulation, inflammation, and cell death. RESULTS/ANTICIPATED RESULTS: Preliminary data in our lab indicates that hypoxia leads to a two-fold increase in endothelial P-tau accumulation and lowered mature BDNF (mBDNF) in brain microvascular endothelial cells (BMECs) compared to controls. Further, BMECs cultured in media with the PUFA docasahexaenoic acid (DHA) had lowered P-tau and increased mBDNF after hypoxia compared to controls. Based on this data and past research, we anticipate that mice on the PUFA-enriched diet will have enhanced cognitive and motor function alongside improved cerebral blood flow compared to controls. Also, we expect that mice on our PUFA-enriched diet will have lowered tau pathology, cell death, and neuroinflammation alongside increased blood brain barrier integrity and altered fatty acid composition in brain and vascular tissue samples. DISCUSSION/SIGNIFICANCE: An AHA Presidential Advisory identified cognitive function as modifiable through the management of cardiovascular risk factors, like diet. However, the mechanisms underlying the benefits of PUFA-enriched diets are unknown. Successful completion of these studies will provide insight into the vaso-neuronal protective effects of PUFAs in VCI.

Objectives/Goals: Campylobacter is a foodborne pathogen, causing gastroenteritis in humans. Untreated infections can cause colorectal cancer. With rising antibiotic resistance, alternative therapies like E. coli Nissle 1917 (EcN) are urgently needed to control infections in humans. Our study aims to evaluate the effect of EcN supernatant on C. jejuni in vitro. Methods/Study Population: The efficacy of EcN CFS on the growth of C. jejuni was evaluated in LB and minimal media (M63) using agar-well diffusion assay. We also evaluated the impact of these supernatants on the biofilm formation and pre-formed biofilms, as well as on the adhesion, invasion, and survival of C. jejuni in human colorectal adenocarcinoma cells. Additionally, we examined the effects of EcN CFS on the expression of genes associated with virulence factors, biofilm production, and quorum sensing of C. jejuni using real-time polymerase chain reaction. Each of the experiments was repeated at least twice, and the results were evaluated using two-way analysis of variance. Results/Anticipated Results: Our results showed that EcN supernatants grown in both LB and M63 media exhibited a high zone of growth inhibition of Campylobacter in agar media. The EcN CFS significantly inhibited C. jejuni growth when co-cultured in liquid media. The supernatants also demonstrated a significant reduction of pre-formed biofilms by up to 82% and inhibited biofilm formation by 75%. Pretreatment of HT-29 MTX human intestinal cells with EcN supernatants led to a significant (p Discussion/Significance of Impact: Our study demonstrates that E. coli Nissle 1917 cell-free supernatant significantly inhibits C. jejuni growth and virulence. This suggests that EcN-derived bioactive compounds could be promising antibiotic alternatives to combat C. jejuni infections. This study will bridge the gap between basic and translational research.

OBJECTIVES/SPECIFIC AIMS: Community engagement is a commonly used term, but is complex in both meaning and application. In order to help academic institutions and administrators develop infrastructure to promote and support community engagement and to help investigators work productively with communities, this analysis discusses the major components of community engagement in research on both the institutional and individual project levels as well as the interplay between them. METHODS/STUDY POPULATION: A literature synthesis conducted by a community engagement in research committee at 1 CTSA institution that examined the myriad factors related to effective community engagement in research identified across multiple disciplines was used to distill the major factors identified, assesses the interplay of the identified factors, and produce a conceptual model to help administrators and investigators apply best practices in engaging communities in clinical and translational research. RESULTS/ANTICIPATED RESULTS: This work takes a concept—community engagement in research—that is often stated and discussed, but is highly complex and challenging to implement—and identifies and discusses the multiple, interrelated factors germane to it. The model illustrates that while community engagement in research is implemented in the context of individual projects, a deep and continual interplay between individual projects and the goals, capacity, and policies of research institutions is needed for rigorous, ethical, and effective community engagement. DISCUSSION/SIGNIFICANCE OF IMPACT: Results are presented through a conceptual framework which displays the major components needed for rigorous, ethical, and effective community engagement in clinical and translational research. In addition, the conceptual framework presented will provide assistance to those developing approaches to measure and evaluate institutional readiness for community engagement in research as well as the effectiveness of individual community engagement efforts.

OBJECTIVES/GOALS: Breast cancer survivors who experience psychological and physical symptoms after treatment ends have an increased risk for comorbid disease development, reduced quality of life, and premature mortality. However, survivors in satisfying marriages report lower stress and better health than those in dissatisfying marriages. METHODS/STUDY POPULATION: Research is needed to identify how survivors’ marriages provide these health benefits across the cancer continuum. Including both survivors and their partners’ perspectives can identify key pathways connecting relationships to better health. This study examined survivors’ and their partners’ psychological, physical, and relational health. Breast cancer survivors (stage 0-III) and their partners (n=34 individuals, 17 couples) completed a baseline online survey followed by a 7-day diary study with three ecological momentary assessments across the day. Questionnaires assessed their cancer-related communication, relationship distress, and psychological and physical symptoms. RESULTS/ANTICIPATED RESULTS: Survivors reported poorer sleep quality and greater fatigue than their partners. Survivors also reported disclosing more thoughts, feelings, and information about cancer compared to their partners. For both survivors and partners, feeling more satisfied with each other’s cancer-related discussions and reporting lower relational distress correlated with fewer physical symptoms, sleep problems, fatigue, and psychological distress. DISCUSSION/SIGNIFICANCE: For both survivors and their partners, feeling more satisfied with how often they talked about survivorship and the cancer experience was associated with better psychological and physical health. This research demonstrates the health benefits and importance of open communication for both survivors and their partners across the cancer continuum.