ABSTRACT IMPACT: This poster will demonstrate how input from a CTSI Community Advisory Board was used to develop a large, annual dissemination event focused on health disparities, health equity, and community engagement. OBJECTIVES/GOALS: The NYU Langone Annual Health Disparities Symposium began in response to the NYU-H+H CTSI’s Community Advisory Board, which expressed a desire to 1) learn about health disparities research at NYU, H+H, and beyond; 2) build connections and interdisciplinary collaborations; 3) support bidirectional dissemination between community and researchers. METHODS/STUDY POPULATION: The annual symposium, a collaboration between NYU Langone’s CTSI, Department of Population Health, Office of Diversity Affairs, and the NYU-CUNY Prevention Research Center, features a keynote, a series of rapid-fire talks, panels on current controversies in population health and the work of the Community Engagement Cores of NYC-based CTSAs, and poster sessions. Each year the event is focused around a specific theme, with the 2020 theme being ‘Research Into Action’. Audience members include faculty, staff, students, health care providers, community health workers, and representatives from community-based organizations, health care facilities, and the NYC Department of Health and Mental Hygiene. For the very first time, the event was held virtually days and CME/CNE credits were provided free of cost. RESULTS/ANTICIPATED RESULTS: The conference explored how institutions have turned research into action, and speakers addressed the ways in which COVID-19 has highlighted structural inequities that have existed across time. 585 attendees participated in the event, with 63 claiming an average of 7.8 hours of continuing education credits. 46 individuals completed the post-event evaluation, with 95% agreeing/strongly agreeing that the symposium increased their awareness of health disparities research taking place at NYU, H+H, and beyond, 91% agreeing/strongly agreeing that they are likely to apply the information learned to their own work, and 91% agreeing/strongly agreeing that the symposium increased their interest in health disparities research. 86% were very/extremely satisfied with the quality of the meeting overall. DISCUSSION/SIGNIFICANCE OF FINDINGS: The 2020 event had the greatest proportion of health care provider attendees (24%), likely due to the opportunity to earn CME/CNE credits. Attendance also grew over the years, from 150 in 2015 to 585 in 2020. This increase is likely due to increased awareness of the event, as well as well as virtual the format, which made it more convenient for attendees.

ABSTRACT IMPACT: This work provides context from the patient perspective on the impact of hospital policies on their birthing experiencing during the first peak of the pandemic. OBJECTIVES/GOALS: The goal of this study was to report the intrapartum care experiences from people giving birth during the COVID-19 pandemic in the United States. Place of birth included hospital, birth center and home births. METHODS/STUDY POPULATION: Studies that involved patient-related data collection are hindered by pandemic-related changes in clinical practices and research policies. Our aim was to assess patient experience during a pandemic, we explored data collection via a large online community of pregnant women. We asked if women who birthed during COVID-19 changed their birth setting and if they experienced less respectful care, more pressure to undergo induction and/or cesarean birth and newborn separation. We also wanted to explore whether there were differences in the care experience depending on the race of the woman. Open ended questions on care experiences were included and content analysis conducted. Bivariate analysis was conducted comparing those from high versus less COVID-19 impacted areas and by race (White/Black self-identifying). RESULTS/ANTICIPATED RESULTS: The mean age was 31.5 years (SD = 5.0), 80.7% identified as White, 85.0% married, and 85.3% privately insured (N=388). Bivariate unadjusted analyses comparing high vs. low impact COVID-19 states, 22.3% considered changing their place of birth versus 12.7% in less impacted areas (p<.05): no difference pressure for induction/cesarean based on region. In bivariate unadjusted analysis comparing White and Black people, Black people had higher odds of pressure for cesarean or induction compared to White (OR 10.3, 95% CI 2.2 to 48.6, p=.0003). Black people had lower respect scores vs. White (68.7 vs. 72.3 p<.01) and higher odds of preterm birth 3.7 (1.1 to 12.4, p=0.04). Content analysis themes were institutional policies, changes in care, hospital staff interactions, sub-par care, support during birth and mental health. DISCUSSION/SIGNIFICANCE OF FINDINGS: The analysis demonstrated differences among participants from highly versus less impacted COVID-19 states. Disparities persisted with Black women reporting lower respect, pressure for interventions and more preterm birth when compared to White participants. Limitations include use of a convenience sample and self-reported data.

ABSTRACT IMPACT: Understanding the women community leaders’ sense of relational and financial empowerment in the social entrepreneurship context will be key to developing a sustainable pathway to scale-up community-based HPV self-sampling programs in low resource settings. OBJECTIVES/GOALS: The Hope Project, a social entrepreneurship (SE) near Lima, Peru, trains women leaders (Hope Ladies) to promote human papillomavirus (HPV) self-sampling in their communities. This study aims to evaluate the Hope Ladies’ own relational/financial empowerment after participating in the program. METHODS/STUDY POPULATION: The Hope Ladies participated in semi-structured in-depth interviews (n= 9) and 8-question 5-point Likert-scale survey (n=16) that evaluated their relational/financial empowerment after participating in the social entrepreneurship. The interview and the survey questions were developed using validated empowerment frameworks, indicators, and theory, respectively: 1) Kabeer’s conceptual framework, 2) International Center for Research on Women (ICRW), and 3) Relational Leadership Theory (RLT). Direct content analysis was used to deductively evaluate the interviews with predetermined codes and categories of empowerment. Descriptive statistics were used to analyze the survey results. RESULTS/ANTICIPATED RESULTS: All reported experiencing empowerment in the SE. Interviews: The codes were mapped onto 3 categories/9 sub-categories: 1) voicing confidence (willingness to challenge social/gender norms); 2) social resources (new skills, knowledge, self-efficacy, access to networks, role models); 3) financial gains (helpful but not the primary motivation to continue as Hope Ladies, and not enough to override traditional household roles/priorities). Survey: 75% indicated an increase in social contacts, confidence in discussing reproductive topics (75%), comfort with medical facilities (44%), ability to help the community (62.5%), and ability to make household purchasing decisions (36%) since joining the program. DISCUSSION/SIGNIFICANCE OF FINDINGS: The Hope Ladies’ experience in this SE demonstrated the complex relationship between various domains of empowerment (e.g., relational/financial). More studies are needed to elucidate the relationship between empowerment and worker retention/performance to inform scale-up of HPV self-sampling SE’s.

ABSTRACT IMPACT: This work will contribute to the understanding of challenges and best practices for navigating the research review process for collaborative community-engaged research. OBJECTIVES/GOALS: The aim of this scoping review is to comprehensively identify the challenges that researchers, community partners, and the Institutional Review Board (IRB) face, in order to develop best practices to guide future community-engaged research (CEnR). METHODS/STUDY POPULATION: Community-engaged research (CEnR) encompasses all research practices in which traditional researchers collaborate with community partners to identify health disparities that affect the community. CEnR aims to empower communities and prevent exploitative research practices on vulnerable populations. Though many goals of CEnR align with that of the Institutional Review Board (IRB) to protect human research subjects from unethical harm, researchers and community members conducting CEnR are often met with challenges when getting research approval. The search strategy included all publications pertaining to challenges in IRB approval and process for studies in the spectrum in community-engaged research. Systematic searches in PubMed Central and PsycINFO were conducted. RESULTS/ANTICIPATED RESULTS: The search strategy produced 748 publications from peer-reviewed journals. We included 118 publications that met our initial inclusion/exclusion criteria from the search strategy in our analysis. Preliminary results show that common challenges include lack understanding of the duo role of community members as researchers and participants, informed consent language barriers, and lack of understanding community-based participatory research. Best practices when working with the IRB include fostering an environment for open communication with the IRB early in the research process, understanding timeline constraints from both researcher and community agencies and supporting the role of community members as research staff. DISCUSSION/SIGNIFICANCE OF FINDINGS: Community-engaged research efforts are advantageous in empowering and providing agency for community members to address important health concerns within their communities. To prevent the exploitation of vulnerable and underserved populations, more research should engage in collaborative community-based partnerships.

ABSTRACT IMPACT: Working alongside news staff as community partners is feasible for community engagement to co-create a post-hurricane health assessment and connect it to our academic health center’s disaster response capacity. OBJECTIVES/GOALS: Successful academic-community partnership in post-disaster response depends on shared understanding of impact. Community newspapers could provide valuable insight into health needs and inform strategic recovery plans. Our objective was to determine methodological feasibility of using newspaper stories to identify post-disaster needs. METHODS/STUDY POPULATION: Community-Based Participatory Research principles were applied to engage newspaper staff and conduct qualitative analysis of stories published in the weekly Port Aransas South Jetty newspaper, serving this small rural coastal community. Using directed content analysis, the team derived and validated constructs from Maslow’s Hierarchy of Needs and Phases of Disaster models to create a codebook. Scientists and newspaper staff examined the codebook for congruency regarding interpretation and themes. With copyright permission to access online newspaper files, NVivo software was used to search for Hurricane Harvey-related terms (e.g., ‘Harvey, tropical storm, flood, damage, volunteer’). Stories from 3 days post-Harvey to 6 months post-Harvey were examined and again at anniversary date. RESULTS/ANTICIPATED RESULTS: The weekly South Jetty newspaper was published continuously from August 31, 2017, through the date our study ended, February 22, 2018. Analysis showed themes of the storm and community response to disaster at multiple levels. Harvey caused catastrophic flooding, destruction, on par with 2005 Hurricane Katrina as the costliest storm on record. In Port Aransas, 130 mph winds and a 12-foot storm surge damaged 90% of the buildings. Stories reflected Phases of Response: Pre-disaster, Impact, Heroic, Honeymoon, Disillusionment, and initial phases of Reconstruction and Maslow’s Hierarchy of Needs. Story: ‘It’s not just the physical part of Port Aransas that was hurt by the hurricane. Harvey also wounded the town’s collective psyche. We’ve wept for our losses, then counted our blessings, then wept for our losses again.’ DISCUSSION/SIGNIFICANCE OF FINDINGS: Newspapers were a rich source of post-disaster data. Text and pictures were poignant. Thematic analysis identified stages of recovery. Working alongside news staff as community partners is feasible for community engagement to co-create a post-hurricane health assessment and connect it to our academic health center’s disaster response capacity.

ABSTRACT IMPACT: Congregations’ support for social, emotional, mental and spiritual wellness is foundational to human health and their community knowledge and presence can improve resilience and health in socially vulnerable neighborhoods. OBJECTIVES/GOALS: The Indiana CTSI Monon Collaborative is listening and understanding the most pressing health issues in the community and are working together to design and deliver community health solutions. We worked with our community ambassador to launch a health and wellness learning community for ten congregations seeking to build a health-connector network. METHODS/STUDY POPULATION: Study team used qualitative (interviews, focus groups, listening sessions, learning management system, participatory-design research) and quantitative (surveys) data collection methods in the development and ongoing implementation of the learning community. Study Population: Based on initial assessment of health and social vulnerability data within the Marion County neighborhoods in Indianapolis, community ambassador engaged congregations in more vulnerable neighborhoods to seek participation in learning community. Ten congregations signed a covenant of participation; learning community includes 10 clergy and 8 health advocates. RESULTS/ANTICIPATED RESULTS: Since the inception of the Learning Community in May 2020, we have developed a better understanding of the assets and barriers of LC participants around health and well-being. Through ongoing virtual gatherings (facilitated by community ambassador Good to the Soul), sharing of resources through our online modules on Canvas (LMS), and synthesis of data captured throughout our time together, LC participants have developed SMART goals which will inform priority setting for congregations to assist them in identifying the resources and connections necessary to drive forward solutions together as they seek out funding opportunities to support health improvement. DISCUSSION/SIGNIFICANCE OF FINDINGS: The learning community has provided a space and structure for congregations to align around a shared goal focused on health and wellness. Through regular gatherings we were able to connect people, organizations, and systems who were all eager to learn and work across boundaries leading to greater resilience in vulnerable communities.

ABSTRACT IMPACT: Understanding the needs and barriers or facilitators to participation in research, especially among minority communities is critical not only for COVID-19 research but also for future clinical and translational research and health disparities studies. OBJECTIVES/GOALS: The overall goal of this project is to enhance education, awareness, access, and inclusion of underserved communities across Florida in COVID-19 research, especially among Black and Hispanic minority groups that are disproportionately affected by COVID-19. METHODS/STUDY POPULATION: Through strategic partnership among five academic institutions and community-based organizations across the state of Florida, the FL-CEAL team will implement focus groups and surveys in minority communities in Florida to gauge the awareness and understanding of COVID-19, and the barriers and facilitators for participation in COVID-19 research studies. These communities include but are not limited to Latinx and Black populations in South and Central Florida, and Black communities in North Florida. The outcomes will help shape strategies for outreach and dissemination activities and minority recruitment plans to promote participation of minorities into vaccine and therapeutic trials. RESULTS/ANTICIPATED RESULTS: An estimated 75-125 participants will be recruited for focus groups. Four focus groups with minority communities have been conducted and the results are being analyzed. A common Community-Based Needs Assessment survey is being finalized and will be deployed across the 11 states that are part of the national CEAL consortium. Community Health Workers are being engaged to support outreach and dissemination to educate targeted communities on COVID-19 research and the importance of participation in COVID trials. To date, 243 CHWs and 880 community members have been engaged. Minority participation in COVID-19 vaccine trials at University of Miami has been higher than the national average. DISCUSSION/SIGNIFICANCE OF FINDINGS: The FL-CEAL Alliance has successfully demonstrated a coordinated effort to engage minority communities affected by COVID. Through strategic geographic partnerships, FL-CEAL will positively impact minority communities throughout the state that has one of the most diverse populations in the nation.

ABSTRACT IMPACT: The mobilization of a CTSA-sponsored team with multi-disciplinary translational science expertise enabled the university to provide a range of T1-T4 expertise to a large, complex school district that resulted in permanent learning and data science infrastructure. OBJECTIVES/GOALS: The Clinical Translational Science Institute (CTSI) formed a multidisciplinary science team to provide expertise in support of the re-opening of in-person learning in the second-largest U.S. school district during the COVID-19 pandemic. METHODS/STUDY POPULATION: The assembled interdisciplinary science team provided expertise in epidemiology, machine learning, causal inference and agent-based modeling, data and improvement science, biostatistics, clinical and laboratory medicine, health education, community engagement, and experience in outbreak investigation and management. The team included TL1 pre and postdoctoral fellows and mobilized scientists from multiple professional schools and T1-T4 stages of translational research. RESULTS/ANTICIPATED RESULTS: Tangible outcomes achieved using this team approach included the development of practical metrics for use in the school community, a learning process, the integration of preventive design elements into a testing and tracing program, and targeted and data-driven health education. The team, for example, generated new data displays for community engagement and collaborated with the school district in their use to visualize, learn from, and act on variation across a 700 square mile region. DISCUSSION/SIGNIFICANCE OF FINDINGS: Novel translational methods can be used to establish a learning environment and data science infrastructure that complements efforts of public health agencies to aid schools in the COVID-19 pandemic. These new capabilities apply to COVID-19 testing and vaccines and can be mobilized for future population health challenges faced by school districts.

ABSTRACT IMPACT: This abstract presents a generalizable process to evaluate, and act on, community advisory board perceptions of collaboration effectiveness to improve clinical and translational research network function. OBJECTIVES/GOALS: Community advisory boards (CAB) play an important role in facilitating relevant and externally valid, clinical and translational research (CTR). The objective of this presentation is to describe a participatory process to derive collaboration metrics that can be used to assess CAB effectiveness. METHODS/STUDY POPULATION: During the 4th and 5th years of the Great Plains IDeA CTR award, we used a mixed-methods approach that included CAB (1) discussions related to the need to assess collaboration effectiveness, (2) review of the validated Wilder Collaboration Inventory to identify factors that, if maximized, would improve a sense of team science and enhance productivity, (3) planning for assessment frequency and follow-up processes, and (4) review of collaboration data to determine necessary actions for improvement. Qualitative data were gathered across components of the mixed-methods approach. Quantitative data were collected and reviewed by the CAB (n=11 members) during the 1st quarter of award year 5. RESULTS/ANTICIPATED RESULTS: CAB members expressed an interest in assessing collaboration effectiveness, identified important factors to assess, and agreed that annual assessment and follow-up would be appropriate. Key factors identified and assessed (5-point agreement scale--higher score reflects stronger agreement) were 1) mutual respect/trust (m=4.2); 2) appropriate cross section of members (m=3.6); 3) a shared stake in the process and outcomes (m=3.9); 4) flexibility in decision-making/collaboration (m=4.1); 5) roles and policy guidelines (m=3.6); 6) open communication (m=3.9); 7) goal achievement (m=4.0); 8) shared vision (m=4.0); and 9) skilled leadership (m=4.4). DISCUSSION/SIGNIFICANCE OF FINDINGS: CAB reflection on the initial collaboration assessment resulted in developing plans to broaden membership and clarify roles and policy guidelines related to CAB participation. There was strong consensus related to the utility of this assessment approach.

ABSTRACT IMPACT: Using network analysis and a systems science lens, UTMB’s Institute for Translational Sciences is able to quantify the evolution of REACH (its Community-Campus Partnership) as measured by the creation of new partnerships among member entities, promoting the translation and sharing of ideas and resources, and formalization of relationships among members. OBJECTIVES/GOALS: o Present how network analysis and systems science can inform evaluation of community-campus partnerships o Describe results from our experience with evaluating the REACH coalition o Summarize lessons-learned and likely improvements we are considering for our methodology METHODS/STUDY POPULATION: In 2016, we administered a network survey to core members of the Research, Education, and Community Health (REACH) coalition. The survey captured attributes about each organization, including size, populations served, etc. The survey also captured data on the relationships among these organizations, including joint meeting attendance, joint event planning, shared tangible resources, shared information, and formal legal agreements between organizations. These data were analyzed using network analysis methods. The survey was again repeated in 2018, and comparisons were made to evaluate how the network structure had evolved from 2016 to 2018. RESULTS/ANTICIPATED RESULTS: Joint meeting attendance was high in both 2016 and 2018; however, there was evidence of increased sharing of information and tangible resources in 2018. We also observed an increase in joint event planning among partnering agencies. Most strikingly, we observed that the number of formalized agreements (in the form of Memoranda of Understanding or more formalized contracts) between agencies more than doubled between 2016 and 2018. By measuring the evolution of our network of partners, we are able to document the evolution of a community-campus partnership over time. DISCUSSION/SIGNIFICANCE OF FINDINGS: Over the course of 2 years, the coalition signaled an increase in deeper collaborations beyond simply meeting together. The use of network analysis demonstrated utility and provided another dimension for evaluating the development of teams, partnerships, and coalitions.

ABSTRACT IMPACT: These findings identify a new way in which the COVID-19 pandemic exacerbates racial/ethnic health disparities, and will thus direct future research to explore potentially avoidable hospitalizations, as well as direct health policy to improve the value of this specific aspect of care without further widening the disparity. OBJECTIVES/GOALS: Racial and ethnic disparities in potentially avoidable hospitalizations predate COVID-19. In order to identify and address healthcare disparities exacerbated by the pandemic, we examined whether and to what extent the pandemic affected numbers of potentially avoidable hospitalizations by race and ethnicity. METHODS/STUDY POPULATION: This single-center pre-post study of 904 patients at UCLA included all patients admitted to an internal medicine service for an ambulatory care sensitive condition (ACSC) between March-August of 2020 (post) and March-August of 2019 (pre). We measured the change in number of potentially avoidable hospitalizations (defined per the Agency for Healthcare Research and Quality guidelines) stratified by race and ethnicity. We calculated 95% CIs for the number of potentially avoidable hospitalizations using a cluster bootstrap procedure, clustering at the level of patients. We inverted the bootstrap CIs to calculate p-values for overall changes within racial/ethnic groups as well as differential changes between groups. Patients with missing or unspecified racial/ethnic data were excluded (n=1,003; 7.8%). RESULTS/ANTICIPATED RESULTS: Between March 1 and August 31, 2020, 347 out of 4,838 hospitalizations (7.2%) were potentially avoidable, compared to 557 out of 6,248 (8.9%) during the same 6-months of 2019. Reductions in potentially avoidable hospitalizations among Non-Hispanic White (-50.3%; 95% CI, -60.9 - -41.2; p<0.001) and Latinx (-32.3%; 95% CI, -59.8 - -12.2%, p<0.001) patients were statistically significant, whereas reductions among African American (-8.0%; 95% CI, -39.9 - +16.2) and Asian (-16.1%; 95% CI, -75.7 - +20.4) patients were not statistically different from 0%. The relative differences in magnitudes of reduction were only statistically significant between African American and non-Hispanic White patients (-50.3% v. -8.0%; 95% CI as above; p=0.015). DISCUSSION/SIGNIFICANCE OF FINDINGS: Racial disparities in potentially avoidable hospitalizations increased during the COVID-19 pandemic at this large urban health system. Healthcare leaders, researchers, and policy makers should focus on efforts to prevent a post-pandemic resurgence of low-value hospitalizations in ways that do not further widen disparities.

ABSTRACT IMPACT: This poster will demonstrate how a community issue from a CTSI Community Advisory Board member organization initiated a collaborative, community-engaged project to identify priority areas of concern and culturally appropriate mitigation strategies. OBJECTIVES/GOALS: Little is known about the health and psychosocial impact of construction on older adults living near construction sites. We applied a mixed methods approach to identify evidence-based strategies to mitigate community prioritized health and psychosocial concerns related to long-term construction on older adults in NYC’s Manhattan Chinatown. METHODS/STUDY POPULATION: In Chinatown, where approximately 20% of its residents are seniors, many are poor, have a disability, and experience ambulatory difficulties. We used a mixed methods approach including: 1) a high level scoping review of the published literature on the health impact of long-term construction for older adults; 2) key informant interviews with stakeholders; and 3) a two-part community-engaged modified Delphi process to identify priority topic areas related to construction and older adults and evidence-informed, culturally-relevant mitigation strategies. Using priority areas identified through the modified Delphi process, we conducted a literature review on the health and psychosocial impact of construction on older adults. RESULTS/ANTICIPATED RESULTS: We identified five priority topics: construction site emissions; noise; outdoor nocturnal lighting; neighborhood changes; and relocation. Long-term construction is associated with environmental and psychosocial consequences with greater negative impacts on vulnerable populations. Current NYC mitigation policies are based on general population and need revisions to consider impacts for the most vulnerable, e.g. older adults and children, to mitigate adverse health outcomes. Findings were shared with City Council members and resulted in enacting specific recommended mitigation strategies, e.g. double paned windows, etc. Seniors are highly susceptible to the effects of air pollution, noise, and environmental changes, with exposure associated with higher morbidity, mortality, and social isolation. DISCUSSION/SIGNIFICANCE OF FINDINGS: Long-term construction may pose serious health implications for seniors residing near construction sites. Standards and guidelines for the general population may not protect them. Community-driven coalitions, like community-academic partnerships, can successfully advance community priorities and inform strategies to protect the elderly.

ABSTRACT IMPACT: The broad goal of this investigation is to inform the development of culturally sensitive HIV prevention strategies to reduce specific challenges pertaining to PrEP uptake and utilization for Latino men. OBJECTIVES/GOALS: HIV is a significant public health concern affecting Latinos in the U.S. Daily use of pre-exposure prophylaxis (PrEP) effectively prevents HIV infection and has the potential to curb HIV epidemics. The objective of this study is to examine how sociocultural variables impact PrEP-related services among HIV-negative Latinxs. METHODS/STUDY POPULATION: The current study is a mixed-method investigation. Participants will include Latinx adult patients seeking services at an HIV community clinic. Approximately 150 participants will be recruited for the study. Participants who are eligible will complete sociocultural, mental health and PrEP-related measures. For the applied aim, community stakeholders will be recruited who serve the Latinx community. Upon completion of data collection, the data analytic plan is as follows: Aim 1, to establish the relationship between each sociocultural variable and PrEP uptake/utilization, preliminary analyses (i.e., correlations and regression analyses considering co-variates) will be conducted. Aim 2, grounded theory techniques will be conducted to establish community-informed practices to increase the use of PrEP. RESULTS/ANTICIPATED RESULTS: Relatively little is known about cultural factors that may impede PrEP uptake among Latinx MSM. Several researchers have identified specific factors such as language, acculturation, familismo, and similar cultural norms as significant barriers to care (Page et al., 2017). It is expected that each of these variables will contribute significant variance to willingness to use PrEP. Specifically, negative relationships are expected between fatalism and machismo and lower stages on the PrEP Contemplation Ladder. Comparably, a negative relationship is expected between the Hispanic acculturation subscale and lower stages on the PrEP Contemplation Ladder. It is however, hypothesized that there will be a positive relationship between familism and the non-Hispanic acculturation sub-scale. DISCUSSION/SIGNIFICANCE OF FINDINGS: Despite important advances in health to prevent HIV infection, HIV rates among Latinx MSM continue to rise. This investigation will have the potential to inform the development of culturally sensitive prevention strategies. By collecting qualitative data from key community stakeholders, this project will also directly inform a CBPR prevention.

ABSTRACT IMPACT: This study will be used to culturally tailor interventions to reduce maternal and infant health disparities in a Marshallese community. OBJECTIVES/GOALS: Inadequate prenatal care is associated with adverse birth outcomes including preterm births, low birth weight infants, and neonatal mortality. Marshallese Pacific Islanders are less likely to receive early and consistent prenatal care compared to other racial/ethnic groups and are thus at a higher risk for maternal and infant health disparities. METHODS/STUDY POPULATION: This article used a qualitative comparative analysis method to compare and contrast the perceived barriers to prenatal care for the prospective of Marshallese mothers and Maternal Health Care Providers (MHCPs). RESULTS/ANTICIPATED RESULTS: Marshallese mothers and MHCPs identified the same structural barriers to prenatal care: health insurance, transportation, and language. The socio-cultural barriers to prenatal care were depicted quite differently by Marshallese mothers verses MHCPs. DISCUSSION/SIGNIFICANCE OF FINDINGS: While the description of structural barriers were consistent among Marshallese mothers and MHCPs, the socio-cultural barriers and the value assigned to those barriers was quite different. Understanding the perspectives from both lenses is an important step towards addressing the barriers to prenatal care among Marshallese.

ABSTRACT IMPACT: Analyzing the types of technical assistance (basic, targeted or intensive) provided by the Opioid Response Network (ORN) to unique and hard-to-reach populations (UHRP) informs addiction health services and translational research by identifying technical assistance needs in these populations which may require a higher level of intensity. OBJECTIVES/GOALS: To improve ORN dissemination and implementation efforts, the project classifies TA requests into one of three categories: basic, targeted, and intensive. This TA Framework assists the ORN project team in understanding the level of TA required in the delivery of evidence-based practices to address opioids with communities with respect to UHRP. METHODS/STUDY POPULATION: TA requests from April 1, 2019, to April 1, 2020, were selected. The ORN classifies TA requests in one of three categories: basic (dissemination & brief consultation), targeted (services to enhance readiness and capacity), and intensive (full incorporation of innovation considering context, culture, and linguistics) (Fixsen, et. al., 2009; Becker, et al., 2020). Unique and hard-to-reach populations (UHRP) are defined based on physical location (i.e., remote or isolated), social position, or other vulnerabilities (i.e. member of an ethnic or racial minority group) (Thurman, & Harrison, 2020). ORN classifies 26 types of UHRP these types are not mutually exclusive. A frequency analysis of the UHRP types was conducted. Bivariate correlations between UHRP types that had a minimum of 30 cases were performed. RESULTS/ANTICIPATED RESULTS: Among 746 TA requests selected, 226 had missing information about UHRP types and 29 had missing information TA levels. These requests were excluded from the frequency analysis. The three most common UHRP types were people living in rural or remote areas (n=262, 50%), people who are uninsured or underinsured (n=162, 31%), and people who inject drugs (n=158, 30%). Most TA requests were targeted (69%), 23% were intensive, and 9% were basic. Bivariate correlations were performed between 21 UHRP types. Moderate (Pearson’s r=0.4-0.6) or strong correlations (r>0.6) were found for 11 occurrences for the UHRP type of ‘LGBT’, 8 for ‘Mental Illness’, and 7 for ‘Veterans’. Strong correlations were found between ‘Justice Involved’ and ‘Incarcerated’ (r=0.645), and between ‘Disabilities’ and ‘Chronic Pain’ (r=0.603). DISCUSSION/SIGNIFICANCE OF FINDINGS: There were more TA requests at targeted and intensive levels than basic levels suggesting the need for services to enhance readiness and build capacity. The moderate/strong correlations indicate that UHRP types were likely to coexist with other types. Future research can explore combining UHRP types that have moderate/strong correlations.

ABSTRACT IMPACT: This public health work contributes to the development and implementation of best practices for working with sex trafficked youth who experience placement instability and justice involvement. OBJECTIVES/GOALS: Youth removed from their home into foster care or a group home (i.e., placement instability) are vulnerable to sex trafficking. This study examines whether placement instability predicts mental health, behavioral and justice-related outcomes among sex-trafficked girls. METHODS/STUDY POPULATION: Placement instability occurs when children are temporarily or permanently removed from their home and placed in foster care or a group home. Domestic minor sex trafficking is exploitation and abuse of children for commercial sexual purposes in exchange for money or other goods/services. We hypothesize that sex trafficked girls who experience placement instability will report more mental health challenges, substance use, abuse history and justice involvement than those without placement instability. Data came from participant files in a specialty court program from 2012-2014 (N=184). Multiple sources contribute to the information contained court files; all data extracted by the research team come solely from the court files. Descriptive, bivariate, and logistic regression analyses were performed. RESULTS/ANTICIPATED RESULTS: All participants were (cis)female, 74% were African American, 96% US citizens, with average age of 16 years. Three-quarters of participants had a documented mental health challenge, such as depression and 88% reported substance use. Eighty-one percent of participants had been in a placement, with a group average of 4.5 placements. Girls with placement instability reported more mental health challenges (p<.001), substance use (p<.001), abuse (p<.001), running away (p<.001) and bench warrants (p<.001) than girls without placement instability. Logistic regression estimated housing instability was positively associated with mental health challenge, substance use, running away, number of bench warrants, and number of citations. DISCUSSION/SIGNIFICANCE OF FINDINGS: Among girls who have been trafficked, placement instability places them at greater risk for personal and behavioral challenges, including increased justice involvement. Comprehensive trauma-informed services should be provided to the family to help mitigate issues in the home.

ABSTRACT IMPACT: Identifying factors associated with opioid overdoses will enable better resource allocation in communities most impacted by the overdose epidemic. OBJECTIVES/GOALS: Opioid overdoses often occur in hotspots identified by geographic and temporal trends. This study uses principles of community engaged research to identify neighborhood and community-level factors associated with opioid overdose within overdose hotspots which can be targets for novel intervention design. METHODS/STUDY POPULATION: We conducted an environmental scan in three overdose hotspots’‘ two in an urban center and one in a small city’‘ identified by the Rhode Island Department of Health as having the highest opioid overdose burden in Rhode Island. We engaged hotspot community stakeholders to identify neighborhood factors to map within each hotspot. Locations of addiction treatment, public transportation, harm reduction programs, public facilities (i.e., libraries, parks), first responders, and social services agencies were converted to latitude and longitude and mapped in ArcGIS. Using Esri Service Areas, we will evaluate the service areas of stationary services. We will overlay overdose events and use logistic regression identify neighborhood factors associated with overdose by comparing hotspot and non-hotspot neighborhoods. RESULTS/ANTICIPATED RESULTS: We anticipate that there will be differing neighborhood characteristics associated with overdose events in the densely populated urban area and those in the smaller city. The urban area hotspots will have overlapping social services, addiction treatment, and transportation service areas, while the small city will have fewer community resources without overlapping service areas and reduced public transportation access. We anticipate that overdoses will occur during times of the day when services are not available. Overall, overdose hotspots will be associated with increased census block level unemployment, homelessness, vacant housing, and low food security. DISCUSSION/SIGNIFICANCE OF FINDINGS: Identifying factors associated with opioid overdoses will enable better resource allocation in communities most impacted by the overdose epidemic. Study results will be used for novel intervention design to prevent opioid overdose deaths in communities with high burden of opioid overdose.

ABSTRACT IMPACT: This qualitative study describes health system barriers to high-quality care for Latino older adults with Alzheimer’s Disease and Related Dementias OBJECTIVES/GOALS: Compared to non-Latino Whites, Latino older adults are more likely to receive low-quality dementia care such as high-risk medications or services. Caregivers play a critical role in managing medical care for persons with dementia (PWD). Yet little is known about the perceptions and knowledge of dementia quality of care among Latino caregivers of PWD. METHODS/STUDY POPULATION: We used a qualitative research design and conducted interviews with Latino caregivers of PWD and caregiver advocates. We recruited both from community organizations, senior centers, and clinics. Our interview guide focused on experiences of caregiving, interactions with medical system, and knowledge and experiences managing behavioral and eating problems. We used Grounded Theory methodology for coding and analysis, focusing on contrasting and comparing experiences within and between caregivers and caregiver advocates. RESULTS/ANTICIPATED RESULTS: Preliminary results from interviews with two caregivers and two caregiver advocates illustrate that caregivers of persons with dementia have a difficult time receiving high quality care from primary care clinicians. All participants noted that many primary care doctors didn’t know how to diagnose ADRD and dismissed critical symptoms as part of old age. Caregivers also reported that they wished they had more information on what to expect with ADRD disease progression, noting they received little information from the formal medical care system. With respect to behavioral problems, caregiver advocates noted that primary care doctors often did not provide non-pharmacological alternatives to behavioral problems. DISCUSSION/SIGNIFICANCE OF FINDINGS: Findings from our pilot study demonstrate that there is a clear need to train primary care physicians who serve Latino older adults on ADRD care. Improved diagnosis and management could improve outcomes among Latino older adults with dementia.

ABSTRACT IMPACT: In alignment with principles of community engaged research, feedback from participants in this research study may influence infertility clinics to offer psychological support for individuals or couples experiencing high levels of psychosocial burden when pursuing fertility procedures, especially during periods of interrupted care or uncertainty. OBJECTIVES/GOALS: 1) To assess the psychosocial impact on patients whose fertility treatments were interrupted during the COVID-19 shutdown. 2) To assess the correlation of patient perceived risk at the time of treatment cessation compared to the resumption of treatment, both during an ongoing pandemic. METHODS/STUDY POPULATION: Female patients with scheduled fertility treatments at Mayo Clinic within 6 months of 3/15/2020, were contacted through the patient portal and invited to participate in this study. Interested patients were contacted by a study staff member to obtain their consent and HIPAA authorization and to schedule a phone or Zoom interview. Semi-structured interviews were conducted individually, or in partner dyads depending upon participant preference, and were recorded with their permission. Audio recordings were professionally transcribed and de-identified. Transcripts were qualitatively analyzed using NVivo 12 based on the principles of grounded theory. RESULTS/ANTICIPATED RESULTS: 26 participants were interviewed; 20 interviews were conducted individually and 3 were conducted in dyads with their partners. Initial themes from the interviews show that COVID-19 compounded existing psychosocial burden on individuals and couples undergoing fertility treatments. Women who were older in age, had prolonged history of infertility, or multiple unsuccessful treatment cycles reported feeling an increased urgency to proceed with fertility treatments due to the time sensitive care, which outweighed the perceived risks of COVID-19 to either themselves or the potential pregnancy. Patients also reported a desire for improved communication regarding their procedures and overall well-being, as well as options for counseling services for individuals or couples undergoing fertility treatments. DISCUSSION/SIGNIFICANCE OF FINDINGS: Participants indicated the need for increased psychological support for patients pursuing fertility treatments, especially during periods of interrupted care or uncertainty, as highlighted during the COVID 19 pandemic. Offering counseling as a routine part of the treatment process may mitigate this burden.

ABSTRACT IMPACT: This research suggests that African American and Latinx smokers who bear a disproportionate burden of tobacco-related harms are able to switch to e-cigarettes that present reduced harm to the user due to their similar reinforcement profile to cigarettes. OBJECTIVES/GOALS: Complete switching from combustible to electronic cigarettes (ECs) reduces harm to the user. For ECs to be a viable substitute, they need to be rewarding enough for regular use, indicated by factors such as craving and dependence (reinforcement value). Little is known about short-term changes in reinforcement value across trajectories of EC use. METHODS/STUDY POPULATION: Participants were randomized 2:1 to switch to a nicotine salt pod system EC or continue smoking (assessment-only control) in a 6-week trial. 114 African American (n=60) and Latinx (n=54) smokers were randomized to receive ECs and are included in the current investigation. At week 6, participants were classified by use trajectory: exclusive smokers (n=16), exclusive EC users (n=32), or dual users (n=66). Participants reported on their EC, cigarette, and total nicotine dependence (cigarette + EC dependence), cigarette and EC use, and nicotine craving and withdrawal at baseline and week 6. Cotinine and exhaled carbon monoxide were assessed at baseline and week 6. RESULTS/ANTICIPATED RESULTS: Participants who completely switched from smoking to ECs (exclusive EC users) and those that partially switched (dual users), maintained cotinine levels (ps>.05) and showed reductions in cigarette dependence and withdrawal (ps<.01). However, exclusive EC users showed no significant changes in total nicotine dependence from baseline to week 6 (p=.123), while dual users showed increased total nicotine dependence (p<.001). Dual users displayed similar levels of EC dependence as exclusive EC users but a lesser reduction in cigarette dependence. Exclusive EC users and dual users showed reductions in craving and withdrawal from baseline to week 6. DISCUSSION/SIGNIFICANCE OF FINDINGS: This study is among the first to prospectively examine changes in dependence, craving, and withdrawal among an understudied sample of smokers making a switch attempt. Smokers who completely switch to ECs maintain nicotine levels and dependence, suggesting that they have a similar reinforcement profile to cigarettes and facilitate switching.