Clinical trials have provided evidence for determining treatment effectiveness. However, clinical trial participants have been underrepresented by diverse and special population groups (e.g., younger and older adults, different races/ethnicities), contributing to disparities in our understanding of diseases and treatments in all those affected. Addressing these disparities in clinical trial participation would be critical to achieving health equity in the USA and beyond. To assess enrollment inclusivity in clinical research at a large academic medical center in the southeast, we used administrative information to develop a snapshot of clinical research participation by age, sex, race, ethnicity, and rurality that was accessible to the public. We compared research enrollment statistics with relevant geographic benchmarks (county, state, and national) from the 2020 US Census. Comparisons revealed 1) over-participation by females relative to county, state, and national benchmarks; 2) under-representation of Black/African Americans relative to county, but higher relative to state and national, levels; and 3) underrepresentation of Hispanic/Latino and Asian groups. The ISP Snapshot has promoted accountability and transparency in this institution’s efforts toward health equity. The process has highlighted the need to update and standardize use of outdated categories (e.g., binary gender, rural status) that limit accurate reporting.

OBJECTIVES/SPECIFIC AIMS: Compared to others, African-Americans (AA) have a higher prevalence of hypertension. Although, hypertension control has been well studied in clinical settings, a significant number of AA patients have uncontrolled hypertension. We conducted a qualitative study on CVD risk perceptions, knowledge, and behaviors among hypertensive AA in the South Bronx, NY. METHODS/STUDY POPULATION: Hypertensive AA participants, 18 years and older were recruited at a community-based hospital clinic. Focus groups with open-ended questions on CVD knowledge, perception, and behaviors was conducted. Responses were transcribed and transcript was analyzed using open code method. Concepts were formulated, which were then categorized into dominant themes. The sample size was based on the saturation point related to emerging common themes. RESULTS/ANTICIPATED RESULTS: There were 21 patients participated in 3 focus group sessions. The median age was 59 years; BMI median of 31.5 kg/m2; 76% were female. In total, 57% had controlled BP and 67% were diagnosed with diabetes mellitus; 8 themes emerged of which unhealthy diet was dominant. Participants acknowledged eating fried foods and meat seasoned with salt contributed to their hypertension. Their food choices were based on family tradition and economical cost more than nutritional value. DISCUSSION/SIGNIFICANCE OF IMPACT: This study reveals that inner city hypertensive AA patients have misperceptions, gaps in knowledge, and barriers to healthy behaviors. We propose to partner with them using shared decision making to raise awareness, knowledge and change in behaviors to prevent CVD in community settings.

OBJECTIVES/GOALS: Our objective is to assess whether street race is a stronger predictor of sleep quality and sleep hours than self-reported race. We also seek to understand whether the association between race and sleep quality/hours can be explained by experiences of microaggressions. METHODS/STUDY POPULATION: This study uses data from the National Couples’ Health and Time Study (NCHAT), a population-representative sample of 20–60 year-olds (N=3,642) who were married or cohabiting during 2020-2021 when the COVID-19 pandemic disproportionately negatively impacted racial and ethnic minorities in the U.S. (Boserup et al., Yip et al.). During this time, incidents of racial trauma increased (Tessler et al.). Using NCHAT data we examine whether street race is a stronger predictor of sleep quality and sleep hours than self-reported race. We also seek to understand whether the association between race and sleep quality/hours can be explained by experiences of microaggressions. RESULTS/ANTICIPATED RESULTS: Results show that microaggressions mediate the link between identifying as Black and being perceived as Black or Asian and sleep quality/hours. Identifying as Black and being perceived as Black or Asian, compared with non-Latinx White respondents, is associated with more frequent microaggressions. More microaggressions are associated with poorer sleep quality and fewer sleep hours. Asian street race is a marginally better predictor of microaggressions than self-reported race. In all models, microaggressions are associated with poorer sleep quality and less sleep hours. DISCUSSION/SIGNIFICANCE: With a growing non-white population, the wellbeing of our future generations is in everyone’s best interest. Poor sleep increases the risk of cardiovascular disease, diabetes, obesity, and cancer. The United States spends $93 billion in excess medical care costs due to health disparities.

OBJECTIVES/GOALS: We aim to determine whether non-neuronal, non-synaptic glutamate signaling mechanisms can be targeted to produce highly specific, narrow changes in brain function that would benefit CNS disorders. To do this, we investigated cognitive changes produced through manipulating the activity of the astrocytic glutamate release mechanism system xc-. METHODS/STUDY POPULATION: System xc- (Sxc) activity was eliminated by mutating the gene Slc7a11 through pronuclear injection of zinc-finger nucleases into Sprague Dawley rat embryos to create a line of rats lacking Sxc (MSxc rats). To confirm a lack of Sxc activity, we verified that tissue from MSxc rats had a complete lack of xCT, which is the regulatory subunit of Sxc that is encoded by Slc7a11. We also verified that astrocyte cultures generated from MSxc tissue lacked cystine-evoked glutamate release. Next, we measured development (body weight), CNS regulation of metabolism, and other indicators of generalized, non-specific brain function as well as behaviors that are reliant on executive function, such as cognitive flexibility, impulse control, decision-making, and response inhibition. RESULTS/ANTICIPATED RESULTS: Eliminating Sxc was not lethal and did not impair development or produce widespread changes in brain function as is commonly observed when deleting other glutamate mechanisms. MSxc rats did not differ from wildtype in growth rate, central regulation of metabolism as reflected by absolute or diurnal changes in core body temperature, locomotor activity in a familiar or novel environment, or simple forms of cognition such as novel object recognition, or operant responding (food and cocaine-reinforced). In contrast, behaviors that rely on executive function were impaired. MSxc rats displayed deficits in cocaine reinstatement and attentional set-shifting. We anticipate MSxc rats to also show impairments in decision-making in the rat gambling task and response inhibition in the stop-signal reaction time task. DISCUSSION/SIGNIFICANCE: Eliminating Sxc activity in rats produced deficits in behaviors reliant on executive function without impacting development or simple brain function. These results highlight the potential of targeting Sxc to enhance cognition without generating therapeutically limiting adverse effects resulting from non-specific changes in brain function.

OBJECTIVES/GOALS: Youth and Families Determined to Succeed (YFDS), a non-profit organization in Hennepin County, MN, provides programs to address health disparities and increase health equity in diverse families. The objective of this capacity building community engaged research study was to identify factors and opportunities to expand YFDS. METHODS/STUDY POPULATION: A community partnered participatory research framework using 3 community engaged (CE) studies was conducted. This structured research process involves a facilitated discussion with a presentation on YFDS programming and a guided discussion with YFDS stakeholders. The theoretical foundation included constructs from the Model of Improvement and Health Belief Model. A trained qualitative research team led the discussion, took detailed notes, and used traditional content analysis to thematically code the notes (n = 29 pages). The studios were not audio recorded for confidentiality. Preliminary findings were presented to YFDS leadership with plans to present the results to YFDS stakeholders and families. RESULTS/ANTICIPATED RESULTS: A total of 16 YFDS past and current members participated in the studios. The average age was 42.5 years with 69% female and 75% black participants. The main themes were YFDS programming, outreach, and partnership. Participants mentioned YFDS youth “gained confidence”, found an additional family, and suggested ways to increase outreach and partnerships. Participants suggested YFDS increase their social media presence, create multicultural programing, partner with faith based organizations and schools, and determine new ways to evaluate health, social, and athletic gains. DISCUSSION/SIGNIFICANCE OF IMPACT: YFDS has positively impacted the lives of their families. With the use of CE studios, we have the opportunity to hear the voices of the members impacted that is necessary for capacity building community engaged research. We were able to find factors that made YFDS successful and suggestions to better improve and to increase positive wellness gains.

OBJECTIVES/SPECIFIC AIMS: In the US, 60-90% of adults have experienced emotional trauma-- defined as an event or series of events (such as abuse, loss, or chronic stressors) that negatively affect health. Trauma exposure is strongly associated with proportional increases in chronic diseases, behavioral health disorders, and risky behaviors. These negative sequelae disproportionately affect ethnic minorities and urban, underserved populations. Physicians and healthcare providers can play important roles in intervention or re-traumatization of victims. However, current standard medical training does not include trauma or Trauma Informed Care (TIC). We aimed to examine the knowledge, attitudes, perceived skills, and behaviors of internal medicine residents regarding managing patients with histories of trauma, as well as residents’ desires for additional training in trauma informed care. METHODS/STUDY POPULATION: We conducted an online survey of residents enrolled in 4 internal medicine programs in Baltimore, Maryland to assess the following behaviors: recognizing, screening, managing, and referring patients with trauma histories. The questionnaire was based on PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey) and addressed residents’ knowledge, attitudes, self-assessed preparedness, and close personal experiences with trauma. Nonparametric tests (Kruskal-Wallis, Fisher’s exact, and Wilcoxon rank sum) were used for analysis. RESULTS/ANTICIPATED RESULTS: Of the 168 residents who responded to the survey (54% response rate), 44% were female, 55% White, 28% Asian, 4% Black and 13.2% unknown/other. Knowledge and preparedness were very limited. 83% percent of respondents underestimated trauma prevalence; 31.7% felt inadequately prepared to appropriately respond to positive disclosures. 59.5% reported they seldom asked about trauma in the past 6 months, and 8.8% never asked. Factors significantly associated with higher frequency of screening patients include greater perceived preparedness to identify, respond to, and refer patients (p =.0001 −.012); familiarity with referral resources (p=.005); comfort in discussing trauma with patients (p =.003); and perceived faculty (p =.001) and workplace support (p =.038). 68.7% had previous training on some trauma-related topics in medical school, and 42.2% did in residency; 91.8% wished for additional training on trauma and trauma informed care. Differences among genders, races, years in training, and program sites were minimal. DISCUSSION/SIGNIFICANCE OF IMPACT: Internal medicine residents in Baltimore had very limited knowledge about trauma prevalence and risks for comorbidities. Although most residents feel TIC is relevant to clinical practice, they feel unprepared to identify, respond to, manage, and refer patients with histories of trauma. Our results support the need for integration of trauma and Trauma Informed Care training into graduate medical education for internal medicine residents.

OBJECTIVES/GOALS: Fragile X-associated tremor/ataxia syndrome (FXTAS) is a devastating rare neurological disorder that negatively impacts movement and cognition. To date, there are no effective pharmacological treatments for FXTAS. Our goal was to develop a cell culture model of FXTAS to investigate promising therapeutics. METHODS/STUDY POPULATION: To establish mitochondrial dysfunction, normal human cell lines and human-induced pluripotent cells were treated with multiple concentrations of glucose/ glucose oxidase (GluOx) at 2,12, and 24 hour time points to induce varying intensities of oxidative stress. The degrees of oxidative stress were measured by apoptosis and mitochondrial reactive oxygen species (ROS) production. Curcumin and MSKE compounds effective against oxidative damage in mitochondria were used to rescue glucose oxidase-induced oxidative damage in both cell lines. To test the ability of these drugs to restore mitochondrial health, cell viability and cellular superoxide production were assessed by propidium iodide and the MitoSox fluorescence assay, respectively. RESULTS/ANTICIPATED RESULTS: We anticipated that GluOx at varying concentrations and time points would proportionally increase levels of apoptosis and mitochondrial ROS, reflective of mitochondrial damage, with the most severe dysfunction occurring at a dose of 25 nM and the longest duration of 24-hr exposure. Administration of MSKE in concentrations ranging from 10-8 to 10-5 M in half log increments, did not reverse the oxidative defects induced in the cell lines. However, curcumin concentrations increased cell viability at the 2, 12, and 24 hour time period. Results indicate that the research design should be modified by increasing the concentration of both glucose and MSKE to provide a reliable test of the hypothesis. DISCUSSION/SIGNIFICANCE: These studies illustrate the usefulness of this in vitro model to test novel therapeutics in neuronal FXTAS models and expand the discovery of mitochondrial markers for the syndrome.

Objectives/Goals: Although eHealth tools like websites, apps, and wearables are widely available, underserved groups often do not benefit equally. This gap is due to usability challenges and overlooked structural, physical, and psychosocial barriers. Additionally, high costs and licensing issues make these tools hard to sustain and share. Methods/Study Population: This case study presents lessons learned over eight years of designing and disseminating a user-centered educational website on human papillomavirus (HPV) and the HPV vaccine for Hmong parents and teens (Hmong Promoting Vaccines, www.hmonghpv.com [http://www.hmonghpv.com]), a community-based participatory research project. Results/Anticipated Results: Our community-driven approach revealed four key principles for creating and sustaining culturally tailored eHealth tools for underserved groups: * Engage stakeholders like community members, legal teams, and developers early and keep them involved. * Discuss dissemination and sustainability goals from the start. * Explore commercialization options, balancing sustainability with protection for underserved groups. * Identify and use academic resources to discuss commercialization, ownership, copyright, and intellectual property of such eHealth interventions. Discussion/Significance of Impact: The Hmong Promoting Vaccines case study highlights the need for an inclusive approach to designing sustainable eHealth tools for underserved communities. Early stakeholder engagement, careful planning for dissemination, and balancing commercialization with protection can reduce health disparities and create fairer digital solutions.

OBJECTIVES/GOALS: The Rockefeller University CCTS, Clinical Directors Network (CDN), and Carter Burden Network (CBN) received a DHHS-Administration for Community Living Nutrition Innovation grant to test whether implementation of DASH-concordant meals and a program to enhance self-efficacy, could lower blood pressure among seniors aging in place. METHODS/STUDY POPULATION: CEnR-Nav model to engage stakeholders, enroll seniors age >60 yr., eating 4 meals a week at 2 CBN congregate meal sites; Advisory Committee to facilitate dissemination; menus aligned with Dietary Approaches to Stop Hypertension (DASH) and New York City Department for the Aging (DFTA) nutritional guidelines; interactive sessions for education (nutrition, blood pressure, medication adherence); Omron 10 home BP devices for daily home monitoring. Plate Waste and Meal Satisfaction (Likert scale) to assess taste preference and cost impact. Outcomes: Primary: Change in Systolic BP at Month 1; change in percent with controlled blood pressure. Secondary: change in validated measures of cognitive (e.g. SF-12, PHQ-2), behavioral (Home BP monitoring), nutritional (food frequency) variables, satisfaction, costs. RESULTS/ANTICIPATED RESULTS: Menu alignment required multiple iterations. Plate Waste and Menu Satisfaction tools were developed. Site 1 enrollment began June 2019; educational sessions and home BP monitors and training were provided. Baseline mean blood pressure (Site 1) was 138/79 +20.5; (range: 7% hypertensive crisis, 36% stage 2 hypertension, 22% stage 1 hypertension, 22% elevated, and 13% normal). DASH-aligned meals began October 2019; Meal satisfaction declined briefly, chefs adjusted menus, and meal satisfaction rose to pre-intervention levels. Site 2 enrollment is ongoing; dietary intervention will start in 2020. Primary outcome data (change in BP) will be complete in March 2020. Secondary outcome data on social and behavioral impact of the interventions will also be presented. DISCUSSION/SIGNIFICANCE OF IMPACT: We leveraged our community-academic research partnership to conduct research addressing uncontrolled hypertension, an urgent unmet health need among seniors. The DASH Implementation Study can inform the broader aging services and healthcare community of the potential for congregate nutrition programs to improve cardiovascular health outcomes.

OBJECTIVES/SPECIFIC AIMS: The Wake Forest Clinical and Translational Science Institute (CTSI) put in place a KL2 program in 2007 and introduced an 18-month Translational Research Academy (TRA) in 2010. The TRA provides education and leadership development training, research support services, mentoring, and networking opportunities to 15-20 early-career clinical and translational researchers, including those receiving KL2 awards. The KL2 and TRA programs make up the Mentored-Career Development Core that is administered by the Wake Forest CTSA Education Program. Over the years, the program administrators have collected feedback from the graduates on what they liked and did not like about the programs. However, a comprehensive evaluation to understand the impact of the trainings on helping scholars advance their research and their research careers was not conducted. The purpose of this evaluation was to assess if and how the KL2 and TRA programs are helping scholars advance their research and career in research. METHODS/STUDY POPULATION: Semi-structured phone interviews were conducted with 11 selected CTSI scholars from both KL2 and TRA programs. The interviews focused on 4 key areas: expectations coming into the program, role the program played in their career development over time, what else could/should have program done to support them and their research, and which of the other CTSI services were valuable in their career development. RESULTS/ANTICIPATED RESULTS: Even though scholars joined the program as an early-career researcher, the amount of experience in research they had varied and so did their areas of interest. The participants in the program also included both clinician and basic researchers. Scholars came into the program with different level of expectations and drive to use this program as a platform to lift their research careers. The conversations during these interviews gave an insight on career trajectories that the scholars have taken before and after joining the academy. For example, among the scholars that had graduated from the programs, 5 of the 6 had received a career development award, all 6 had their own grants to support their research, 3 had received professional promotions, and all 6 have an administrative leadership role they play, in addition to focusing on their research career. The information on where the scholars were at the beginning and the pathway they have taken to get to where they are now allowed us to better understand what aspects of the program was most valuable. The scholars noted that sessions around grant writing and developing specific aims were very helpful. Among the services provided, having a grant editor support was something that everyone noted as the most important service to them, even after leaving the program. DISCUSSION/SIGNIFICANCE OF IMPACT: The impact of the interviews and candid feedback provided by the scholars have been immensely valuable to program administrators to really understand the impact the program (and which components specifically) is having for the scholars. Looking at the career trajectories of the scholars, it was noted that scholars coming in to the academy with some experience doing research and ability to continue engaging in research benefited the most from what the program had to offer. Scholars that were still very early in their research career gained knowledge but were not always able to apply it because they were not working towards a grant at the time. Using the data on career trajectories, recommendations for improving the program, and other CTSI services that were most valuable, the program administrators decided to redesign the curriculum. The new version of the program is now tailored for scholars who have research experience and are working towards a career development grant such as a K or R. This will allow them to have a curriculum that is more intense and hands-on with an expectation that the scholars will submit the application towards the end of the program. A separate program is being developed for early-career researchers who are still setting their foot into t field to provide them basic research competencies through ad hoc courses and seminars.

OBJECTIVES/GOALS: The COVID-19 pandemic disrupted established social support networks (faith-based, community, family, friends), resulting in unprecedented health-related, financial, and employment challenges among African Americans (AAs). This study explores the psychosocial influences of the pandemic on the health and wellness of AAs. METHODS/STUDY POPULATION: The FAITH! (Fostering African-American Improvement in Total Health!) Program, an academic-community partnership with AA churches, shifted focus to COVID-19 prevention in AA communities. Funded by the Mayo Clinic Center for Clinical and Translation Sciences, this cross-sectional study recruited AA adults from FAITH!-affiliated churches and social media to complete a survey exploring the personal impact of the pandemic from hardships (e.g., food and housing insecurity, paying utilities) on healthy lifestyle (HL). The primary outcome was difficulty maintaining a HL during the pandemic. Logistic regression (odds ratios and associated 95% confidence intervals (CIs)) was used to examine the associations between difficulty maintaining a HL and factors including COVID-19 hardships and mental health. RESULTS/ANTICIPATED RESULTS: Participants (N=169, 71.4% female, 41.4% essential workers) had a mean age [SD] of 49.4 [14.9] years. Over half (91/169, 54%) reported difficulty maintaining a HL. Those reporting unemployment (OR 2.3; 95% CI [1.2,4.4]; p=0.008), difficulty paying rent (OR 4.1; 95% CI [2.1,8.6]; p<0.001), or food/utilities (OR 5.5; 95% CI [2.7,11.5]; p<0.001) all had greater odds of difficulty maintaining a HL. High stress (≥5/10, scale 1-10) was associated with difficulty maintaining a HL (OR 4.1; 95% CI [2.1,8.5]; p<0.001) compared to AAs with low stress. Negative mental health (depression (OR 3.4; 95% CI [1.0,13.7]; p<0.001), anger (OR 2.5; 95% CI [0.5,18.9]; p=0.005), and nervousness (OR 4.1; 95% CI [1.1,19.5]; p=0.003) was associated with difficulty maintaining a HL compared to AAs with positive mental health. DISCUSSION/SIGNIFICANCE: Our study findings revealed that COVID-19 hardships, stress, and negative mental health impacted the ability of AAs to maintain a HL. These issues should be considered in the design and implementation of community-based health programs to promote healthy living during future public health emergencies.

OBJECTIVES/SPECIFIC AIMS: Gender affirmation is a critical aspect of the health and well-being of transgender individuals. For many transgender people, this includes changing one’s physical appearance to align with one’s felt gender. Some gender-affirming body modifications require medical interventions such as hormone therapies and surgeries. Other modifications, such as tucking to create a flat-appearing lower pelvis and binding to create a flat-appearing chest, require no external intervention. The published literature is slowly growing on the health effects of gender affirming medical interventions; however, other body modifications are understudied. As part of our needs assessment of the transgender community, we sought to understand the frequency and health impact of binding and tucking. METHODS/STUDY POPULATION: A quantitative online survey was developed based on qualitative interviews with 20 community-based key informants. The survey was available online, in English, for 6 months. Eligible participants were 18 years of age or older, lived in the Baltimore metropolitan area, and identified as transgender and/or a sex different from what was assigned on their original birth certificate. RESULTS/ANTICIPATED RESULTS: 139 participants provided complete data: 45% were assigned male at birth (AMAB) and 55% were assigned female at birth (AFAB). In total, 54% were Black, 40% White, and 9% Latinx. Of AFAB participants, 80% had bound their chest tissue. Of those who had bound, 51% bound 7 days/week, 62% bound 8+ hours per day, and 68% were concerned about the health effects of binding. The most common symptoms associated with binding were back pain (65%), shortness of breath (48.6%), bad posture (32%), chest pain (30%), and light-headedness (30%). Of AMAB participants, 71% had ever tucked, 85% of those tucked 7 days per week, 79% tucked 8+ hours per day, and 50% were concerned about the health effects of tucking. Most common symptoms included itching (28%), rash (21%), testicular pain (17%), penile pain (14%), and skin infections (12%). DISCUSSION/SIGNIFICANCE OF IMPACT: The majority of transgender participants used binding or tucking for gender-affirming body modification and at least half of them have concerns about associated health effects. Clinicians should ask transgender patients about binding and tucking behaviors and assess for common symptoms. More research is needed to better understand the benefits and risks of gender-affirming binding and tucking behaviors.

Objectives/Goals: Our pilot study tests the hypothesis that a hospital-based oral health education and referral program will increase patient knowledge of the importance of oral health, engagement with dental health services, and create a reproducible model to improve access and utilization of routine oral health care services and treatments. Methods/Study Population: Participants recruited for this study will include a pool of eligible patients at an urban university affiliated teaching hospital, 18 years or older, who upon initial screening, reported having not seen a dentist within the past 12 months. Enrolled participants also reported having some form of dental insurance coverage. Our project plans to recruit fifty hospitalized patients from ten inpatient units. Once consented and enrolled, participants will receive a brief education on oral health and be assisted in scheduling a dental appointment with one of the providers from our dental referral network. The dental referral network will consist of local dental providers who agree to treat our study participants. Tracking of ongoing participant dental care engagement will be tracked over a six-month period. Results/Anticipated Results: We anticipate no issue recruiting the 50 planned hospitalized patients. One, the eligible hospitalized patient pool is large, two, data from previous study indicates that a large percentage (~57%) of hospitalized patients at our facility are not receiving adequate dental services and supports. We anticipated that the number of participants who attend their post-discharge dental appointments will be less than 70%. This number reflects averaged rate of missed dental appointments among other populations and considers that our population may have more barriers to appointment attendance. Due to the high prevalence of unmet dental needs among our study population, we anticipate that providers will report patients were seen for many standard dental procedures (cleanings, extractions, fillings, etc.) Discussion/Significance of Impact: The results of this study demonstrate the feasibility of 1) developing and maintaining a dental provider network and 2) utilizing hospital-based teams to promote inpatient engaging with regular oral hygiene and dental appointments. These results show how inpatients visits provide a valuable opportunity to engage adults with unmet dental needs.

OBJECTIVES/GOALS: To investigate nursing homes (NHs) acquired by private equity (PE) firms and estimate the effect of PE NH acquisitions on NH care quality for NH residents and whether PE NH acquisitions exacerbate racial inequities in quality of care. METHODS/STUDY POPULATION: My research estimates the causal effect of NH PE acquisitions on NH access and quality of care for NH residents and whether acquisitions exacerbate racial disparities in NH care for about 115 PE-owned NHs in the US, measuring the quality of care at the facility survey year level, and using an array of NH-level data sources. I identified 115 PE-owned NHs (treatment group) and 665 non-PE-owned NHs between 2003 and 2010, using the Online Survey Certification and Reporting database to obtain facility characteristics. I compare facility characteristics (e.g., payer mix, staffing levels, and quality measures such as pressure ulcers, unexpected weight loss, acuity, and health deficiencies). I will then test whether effects differ by race, with hypotheses informed by Public Health Critical Race Praxis approach. RESULTS/ANTICIPATED RESULTS: Preliminary results show that staffing levels differ between PE and non-PE-owned NHs in a way that aligns with a shift in focus toward the Medicare population i.e. short stays. We also find that deficiencies increased in PE-owned NHs compared to non-PE-owned NHs. We expect that PE acquisitions may lead to slightly widening racial disparities in NH care quality. Results may show that PE-owned NHs have a higher share of low-rated, high-BIPOC facilities. In weak markets, PE-owned NHs may have a higher share of BIPOC residents compared to highly competitive markets. This is because PE managers may prioritize cost over quality by cutting services. However, since quality measures are self-reported, except for measures related to deficiencies, this predicted lower quality of care may not be evident in observed data. DISCUSSION/SIGNIFICANCE: Understanding how PE ownership impacts nursing home care quality for long-stay residents, especially those funded by Medicaid, can help develop intervention strategies to effectively mitigate racial inequities in NH care, as Medicaid funded NH residents are more likely to be Black, Indigenous, and people of color.

ABSTRACT IMPACT: Our implementation model translates two evidence-based nutritional and behavioral interventions to lower blood pressure, into a community-based intervention program for seniors receiving congregate meals. OBJECTIVES/GOALS: The Rockefeller University, Clinical Directors Network, and Carter Burden Network received an Administration for Community Living Nutrition Innovation grant to test whether implementation of DASH-concordant meals and health education programs together lower blood pressure among seniors aging in place. METHODS/STUDY POPULATION: n=200, >60 yr, >4 meals/week at CBN; engagement of seniors/stakeholders in planning and conduct; Advisory Committee to facilitate dissemination; menus aligned with Dietary Approaches to Stop Hypertension (DASH) and NYC Department for the Aging nutritional guidelines; interactive sessions for education in nutrition, BP management, medication adherence. Training in use of automated daily home BP monitors (Omron 20). Validated surveys at M0, M1, M3, M6. Taste preference and cost assessed through Meal Satisfaction (Likert scale) and Plate Waste measures. Primary Outcome: Change in Systolic BP (SBP) at Month 1; change in %BP controlled. Secondary: validated cognitive, behavioral, nutritional measures (SF-12, PQH-2), economics; staff/client satisfaction, trends and significant associations. RESULTS/ANTICIPATED RESULTS: n=94, x2 age =73 +/- 8 years, 65% female, 50% White, 32% Black/African American, 4% Asian, 1% American Indian, Alaskan Native, 13% Other, 32% Latino/a, 43% with income <$20,000. Mean SBP at Baseline was 137.87 +18.8 mmHg (range 98-191). Menus were adapted to provide 20% daily DASH requirements at breakfast, 50% at lunch. Participants attended classes in nutrition and medication management and were provided with and trained to use an automated home BP monitor. Meal satisfaction scores dipped briefly then met or exceed pre-DASH levels. Home BP data was downloaded every 2-4 weeks with social/behavioral support. The COVID-19 closures interfered with BP outcome data collection and meal service ceased. Primary outcome: x2 change in SBP at Month 1 = -4.41 mmHg + 18 (n=61) (p=0.713). Significant associations will be reported. DISCUSSION/SIGNIFICANCE OF FINDINGS: Our community-academic research partnership implemented the DASH diet in congregate-meal settings to address uncontrolled hypertension in seniors. COVID-19 interrupted the study, but encouraging trends were observed that may inform refinement to this community-based health intervention for seniors.

OBJECTIVES/SPECIFIC AIMS: This presentation will highlight the framework and domains of the monitoring and evaluation (M&E) System Checklist created in response to the need for practical guidelines and intended to improve the quality, efficiency, and consistency of monitoring and evaluation of the clinical and translational work. The recently published NCATS Strategic Plan (2016; p. 18) presents the following objectives and guidelines that implicitly suggest the need for sound M&E: “Objective 4-1: Continually assess and optimize internal business practices” and “Objective 4-2: Ensure all scientific programs and operational activities are conducted in a rigorous, robust and data-driven manner.” Given the complexity of clinical and translational work and associated monitoring/evaluation processes and the dearth of practical tools in the CTR evaluation area, the need for such a checklist is clear. A “checklist” (a detailed list of items/steps required, things to be done, or points to be considered) is a type of informational job aid used to improve performance, reduce failure, deal with complexity, and ensure consistency and completeness in carrying out work. Checklists are popular in many fields—due to their brevity, concreteness, order, implicit (and sometimes explicit) mandate to do things right, and expectation for a checklist’s being grounded in good practices and/or strong theory. A notable example is the famed WHO Surgical Safety Checklist (2008). The proposed M&E Checklist has been developed based on the author’s extensive experience in internal evaluation, checklist development and use, and working with the Clinical and Translational Sciences Awards (CTSAs)—as the UMN CTSI M&E Director, ACTS Evaluation SIG Chair, and a Co-Lead of the Evaluators Working Group within the NCATS CTSA Common Metrics Initiative. Although there is no “golden” algorithm that will totally suit every organization, the M&E checklist provides useful guidelines for building M&E. The Checklist presents the key concepts and important issues in M&E development and implementation. It also incorporates a synthesis of 3 grounded frameworks: King and Volkov’s Framework for Building Evaluation Capacity (2005), Simister’s Framework for Developing M&E Systems for Complex Organizations (2009), and the award-winning CDC Framework for Program Evaluation in Public Health (1999). For the purposes of the proposed Checklist, an M&E system (or framework/approach) is understood as “a series of policies, practices and processes that enable the systematic and effective collection, analysis and use of monitoring and evaluation information” (Simister, 2009; p. 1). A well-designed M&E system ensures a consistent approach to the collection, analysis, and use of information, while allowing considerable scope for different parts of an organization to develop and apply their own solutions in response to their particular situations. The M&E Checklist structured around 3 key domains (adapted from the Volkov and King ECB Checklist, 2007): (1) M&E/organizational context: taking advantage of the internal and external organizational context, administrative culture, and decision-making processes. (2) M&E structures: creating structures—mechanisms within the organization—that enable the M&E development and use. (3) M&E resources: making M&E resources available and used. For each domain, the Checklist has a number of associated categories and activities. Specifically, the checklist adopts and adapts the following useful steps from Simister’s approach: “Define the scope and purpose,” “Perform a situational analysis,” “Consult with relevant stakeholders,” “Identify the key levels and focus areas,” and “Integrate the M&E system horizontally and vertically,” as well as the CDC Framework’s steps “Engage stakeholders,” “Focus the M&E Design,” and “Ensure use and share lessons learned.”With slight modification, the organizations can also utilize the Checklist as a rubric/assessment tool to gauge the status of their M&E capacity. METHODS/STUDY POPULATION: A case study of methodological/implementation tool development. There are no human subjects in this study, thus, Study Population is not applicable to this study. This study is not subject to IRB review. RESULTS/ANTICIPATED RESULTS: The proposed checklist approach shows sound promise to not only impact individual programs and their M&E systems but to also enhance internal evaluation capacity, critical thinking, learning, strategic management, and improvement within clinical and translational science organizations. DISCUSSION/SIGNIFICANCE OF IMPACT: The ultimate goal and impact of the proposed checklist is to help ensure that organizations and their M&E teams consistently follow a few critical steps and thereby maximize the quality, efficiency, and consistency of monitoring and evaluation of the clinical and translational work. The checklist’s impact is significant in that it fills the current gap in the practice, literature, and methodology and provides practical guidance for CTR (and other) organizations and programs striving to improve the quantity and quality of evaluation.

References

Centers for Disease Control and Prevention (CDC). Framework for program evaluation in public health. MMWR 1999; 48 (no. RR-11).

King JA, Volkov B. A framework for building evaluation capacity based on the experiences of three organizations. CURA Reporter 2005; 35(3): 10–16.

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