The role of housing in providing a welfare asset has been widely explored. With the growth in home ownership between 1979 and 2008 and erosion of the welfare state, housing wealth has become part of the welfare mix in the UK. Here, we present analysis of housing outcomes, as measured in the UK Household Longitudinal Survey (UKHLS), among people who identify as lesbian, gay, or bisexual in Great Britain. This shows that lesbian, gay, and bisexual (LGB) people have poorer housing outcomes than heterosexual counterparts: they are less likely to be homeowners; more likely to be private renters; and more likely to be social renters. With growing intergenerational inequalities in access to home ownership, we argue that, as openly LGB (and broader trans and queer) people being on average younger than the rest of the population, this could lead to LGB people, as a group, being excluded from asset-based welfare in the future as they age.

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

OBJECTIVES/GOALS: Test the effects of a community health worker supported model to deliver home-based COVID-19 testing in the Yakima Valley (Washington) and Flathead Reservation (Montana) METHODS/STUDY POPULATION: A pragmatic, randomized controlled clinical trial evaluating the effects of a community health worker supported model to deliver home-based COVID-19 testing in the Yakima Valley (Washington) and Flathead Reservation (Montana) vs. a modified direct-to-consumer. 400 participants will be enrolled, 200 from each community. Outcomes include comparing the number of completed testing kits as well as the number of testing kits with successful (detected vs not-detected) results. RESULTS/ANTICIPATED RESULTS: The poster presents preliminary results from 191 participants, blinded to study assignment. To date, 53% of enrolled participants returned a sample for testing and 39% received a usable (detected or not-detected) result. Our populations experienced a high-rate (16%) of sample errors, required 28 replacement kits and had 20 participants randomized to the control arm receive the intervention to ensure participants received testing during the pandemic. DISCUSSION/SIGNIFICANCE: Home-based testing models are build for those who are proficient in verbal and written English, have high tech. literacy and continuous access to internet. For home-based testing to have similar success rates as white Americans, cultural and demographic differences and disparities will need to be accounted for in development and implementation.

In Indonesia, management practices that reduce soil fertility could be limiting cocoa (Theobroma cacao L.) production. To address this, we investigated the effects of fertilizers and organic amendments comprising different combinations of NPK + urea, dolomite, and manure-based compost on soil properties and cocoa productivity. We extended an existing field experiment in South Sulawesi, Indonesia, to assess these treatments’ effects on cocoa trees from the age of 2.9 years to 7.4 years. The treatments were first applied 5 months after planting and subsequently twice a year. Soil analyses were performed before planting, after 3 years, and finally after 7 years. Productivity was assessed yearly between the age of 3.5 and 7.4 years. The highest yields were obtained from the plots receiving compost, although the yield benefits diminished over time. Inorganic fertilizer alone doubled the yield compared to the control, while the yields with compost and compost + fertilizer were three times that of the control. With dolomite alone, the yield cumulated over 4 years was 41% higher than the control. The positive effect of compost on cocoa yields can potentially be attributed to (1) physical changes increasing soil water availability, (2) the chemical improvement of nutrient availability, and (3) biologically, by promoting the activity of beneficial organisms. The application of dolomite increased soil pH, Ca, and Mg contents. Soil organic carbon greatly declined in the composted treatments, even though 10 kg of compost was applied per tree per year, probably because of the low C:N ratio of the compost. Future studies should assess different fertilizer formulations and combinations with organic inputs and explore the mechanisms by which compost promotes cocoa productivity.

A central function of health technology assessment (HTA) agencies is the production of HTA reports to support evidence-informed policy and decision making. HTA agencies are interested in understanding the mechanisms of HTA impact, which can be understood as the influence or impact of HTA report findings on decision making at various levels of the health system. The members of the International Network of Agencies for HTA (INAHTA) meet at their annual Congress where impact story sharing is one important activity. This paper summarizes four stories of HTA impact that were finalists for the David Hailey Award for Best Impact Story.

The methods to measure impact include: document review; claims analysis and review of reimbursement status; citation analysis; qualitative evaluation of stakeholders’ views; and review of media response. HTA agency staff also observed changes in government activities and priorities based on the HTA. Impact assessment can provide information to improve the HTA process, for example, the value of patient and clinician engagement in the HTA process to better define the assessment question and literature reviews in a more holistic and balanced way.

HTA reports produced by publicly funded HTA agencies are valued by health systems around the globe as they support decision making regarding the appropriate use, pricing, reimbursement, and disinvestment of health technologies. HTAs can also have a positive impact on information sharing between different levels of government and across stakeholder groups. These stories show how HTA can have a significant impact, irrespective of the health system and health technology being assessed.

Radiocarbon assays of sediments from Lake Shelby, US Gulf Coast, exhibit substantial 14C deficiencies of 9.3% and 4.7% for the limnic sapropel and associated fresh-water clams Rangia cuneata, respectively. Measured radiocarbon dates from the sapropel and clams require corrections of 785 ± 80 and 365 ± 90 14C yr (1σ), respectively, in order to achieve consistency with the radiocarbon time scale. Lake sediments of the US Gulf Coast serve as unique repositories of pre-historic hurricane strikes. Previously unrecognized radiocarbon deficiencies likely render compromised chronologies of the paleo-hurricane records, and erroneous estimates of return period and landfall probability that are derived from the storm chronologies. The recalculated severe hurricane chronologies suggest that the annual landfall probabilities of the last millennium on the US Gulf Coast are equal to, or higher than, the preceding three millennia.