This article presents a landscape assessment of the findings from the 2021 Clinical and Translational Science Award (CTSA) Evaluators Survey. This survey was the most recent iteration of a well established, national, peer-led systematic snapshot of the CTSA evaluators, their skillsets, listed evaluation resources, preferred methods, and identified best practices. Three questions guided our study: who are the CTSA evaluators, what competencies do they share and how is their work used within hubs. We describe our survey process (logistics of development, deployment, and differences in historical context with prior instruments); and present its main findings. We provide specific recommendations for evaluation practice in two main categories (National vs Group-level) including, among others, the need for a national, strategic plan for evaluation as well as enhanced mentoring and training of the next generation of evaluators. Although based on the challenges and opportunities currently within the CTSA Consortium, takeaways from this study constitute important lessons with potential for application in other large evaluation consortia. To our knowledge, this is the first time 2021 survey findings are disseminated widely, to increase transparency of the CTSA evaluators' work and to motivate conversations within hub and beyond, as to how best to leverage existent evaluative capacity.

The success rate for translation of newly engineered medical technologies into clinical practice is low. Traversing the “translational valleys of death” requires a high level of knowledge of the complex landscape of technical, ethical, regulatory, and commercialization challenges along a multi-agency path of approvals. The Indiana Clinical and Translational Sciences Institute developed a program targeted at increasing that success rate through comprehensive training, education, and resourcing. The Medical Technology Advance Program (MTAP) provides technical, educational, and consultative assistance to investigators that leverages partnerships with experts in the health products industry to speed progress toward clinical implementation. The training, resourcing, and guidance are integrated through the entire journey of medical technology translation. Investigators are supported through a set of courses that cover bioethics, ethical engineering, preclinical and clinical study design, regulatory submissions, entrepreneurship, and commercialization. In addition to the integrated technical and educational resources, program experts provide direct consultation for planning each phase along the life cycle of translation. Since 2008, nearly 200 investigators have gained assistance from MTAP resulting in over 100 publications and patents. This support via medicine–engineering–industry partnership provides a unique and novel opportunity to expedite new medical technologies into clinical and product implementation.

Community engagement is important for reaching populations at risk for health inequities in the coronavirus disease 2019 (COVID-19) pandemic. A community-engaged risk communication intervention implemented by a community-engaged research partnership in Southeast Minnesota to address COVID-19 prevention, testing, and socioeconomic impacts has demonstrated high acceptability, feasibility, perceived efficacy, and sustainability. In this study, we describe the adaptation of the intervention by a community-academic partnership with rural African American populations in three Mississippi counties with high COVID-19 disparities. Intervention reach was assessed by the number of messages delivered by Communication Leaders to members of their social networks. Perceived scalability of the intervention was assessed by the Intervention Scalability Assessment Tool. Bidirectional communication between Communication Leaders and community members within their social networks was used by the partnership to refine messages, meet resource needs, and advise statewide decision-makers. In the first 3 months, more than 8482 individuals were reached in the three counties. The intervention was deemed to be highly scalable by partnership members. Adaptation of a community-engaged pandemic CERC intervention is feasible and scalable, and it has the potential to reduce COVID-19 inequities across heterogeneous populations. This approach may be incorporated into current and future pandemic preparedness policies for community engagement.

OBJECTIVES/GOALS: The goal of this project is to characterize the adaptive and social behaviors of ametropic children with neurodevelopmental disorders (NDD) including Autism Spectrum Disorder (ASD) undergoing refractive surgery due to spectacle intolerance. Eye-related quality of life and visual behaviors will also be measured. METHODS/STUDY POPULATION: This is an ongoing prospective cohort study of children with NDD who are spectacle-intolerant and undergoing refractive surgery at St. Louis Childrens Hospital starting July 2020. The method of refractive surgery (photorefractive keratectomy (PRK), phakic intraocular lens implantation (phIOL), and refractive lens exchange (RLx)) is chosen based on degree and type of refractive error, astigmatism, and characteristics of the cornea and anterior chamber. Behaviors are characterized using the Adaptive Behavioral Assessment System, 3rd edition (ABAS-3) and Social Responsiveness Scale, 2nd edition (SRS-2), completed by parents/caregivers. Eye-related quality of life is measured using the pediatric Eye Questionnaire (PedEyeQ). Visual behaviors are assessed with optokinetic nystagmus tracking. RESULTS/ANTICIPATED RESULTS: In a preliminary sample of 9 patients, 4 have undergone PRK, 3 phIOL, and 2 are awaiting surgery. Pre-surgical SRS-2 scores had a median t-score of 70 (range 57 to 90), indicating a clinically significant deficiency in reciprocal social behaviors as this score is consistent with moderately severe ASD. Pre-surgical ABAS-3 scores had a median General Adaptive Composite (GAC) of 51 (range 48 to 74.5). This corresponds to a percentile of 0.100 (range <0.1 to 19th percentile for age). As rated by the Parental PedEyeQ, the domains most affected were “Parent Worry About Childs Eye Condition” (median 42.0, range 15.0 to 80.0) and “Parent Worry About Functional Vision” (median 18.8, range 3.2 to 68.7), where 0 represents the worst quality of life or functional vision and 100 the best. DISCUSSION/SIGNIFICANCE: Prior research has shown that refractive surgery can improve observed visual awareness, attentiveness, or social interactions in children with NDD. This is the first study to characterize the baseline adaptive/social behaviors and quality of life using validated surveys, with the goal of subsequently identifying patients most likely to benefit.

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: 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.

OBJECTIVES/SPECIFIC AIMS: Deaf communities in many low- and middle-income countries (LMIC) struggle to organize, advocate, and reach social and health equity in their nations. In the Dominican Republic (DR), the health and social status of Deaf citizens is unclear, which obfuscates action and advocacy based on data. A set of successful pre-existing US-DR partnerships that function well but were not previously connected, organized around submission of a community-based NIH research grant and pilot work to support it. METHODS/STUDY POPULATION: Adapting the Partnership Synergy Framework for this purpose, we evaluate the partnership, its evolution, and its experience in implementing formative research. RESULTS/ANTICIPATED RESULTS: Our experience showed the local Deaf community organization easily recruited and interfaced with the Deaf community; presence of a trusted external organization facilitated entry of the PUCMM-UR research team; and stakeholders are enthusiastic about the partnership, its outputs, and the ability to recruit Dominican Deaf citizens into research. The partnership organized around production of an R21 to the Fogarty International Center (NIH), including Human Subjects certification, budget and scope of work negotiation, and inclusion of preliminary data. DISCUSSION/SIGNIFICANCE OF IMPACT: The engagement of Deaf communities globally is virtually non-existent in clinical and translational research. This partnership in the Dominican Republic shows that partners can organize around common goals and identify logistics required to produce pilot data and an NIH grant.

OBJECTIVES/SPECIFIC AIMS: This study describes the design, operation, and evaluation of a community-based research (CBR) consult service within the setting of a Clinical and Translational Science Award (CTSA) institution. To our knowledge, there are no published evaluations of a CBR consult service at a CTSA hub. METHODS/STUDY POPULATION: A CBR consult service was created to support faculty, healthcare providers/research coordinators, trainees, community-based organizations, and community members. A framework was developed to assess the stages of client engagement and to foster clear articulation of client needs and challenges. A developmental evaluation system was integrated with the framework to track progress, store documents, continuously improve the consult service, and assess research outcomes. RESULTS/ANTICIPATED RESULTS: This framework provides information on client numbers, types, services used, and successful outreach methods. Tracking progress reveals reasons that prevent clients from completing projects and facilitates learning outcomes relevant to clients and funding agencies. Clients benefit from the expert knowledge, community connections, and project guidance provided by the consult service team, increasing the likelihood of study completion and achieving research outcomes. DISCUSSION/SIGNIFICANCE OF IMPACT: Our evaluation suggests that clients benefit by (1) gaining the collective knowledge of the experts comprising the team, (2) learning the process of doing CBR, including the required steps to reach completion, and (3) gaining a project management mentality promoting translational research outcomes. This study offers a framework by which CTSA institutions can expand their capacity to conduct and evaluate CBR while addressing challenges that inhibit community engagement.

OBJECTIVES/GOALS: Total hip replacement (THR) improves function for those with arthritis, but not all patients have equal access to this elective procedure. To better geographically target healthcare resources, we explored whether geographic socioeconomic disadvantage is associated with incidence of elective THR. METHODS/STUDY POPULATION: We performed a cross-sectional analysis of data in the state of Maryland from 2013-2019. We categorized 5-digit zipcodes into national quartiles of socioeconomic disadvantage using the Area Deprivation Index (ADI). For each zipcode, we calculated the THR incidence rate using Maryland Health Services Cost Review Commission (HSCRC) inpatient and outpatient data in those age 65 years and older. We included only elective THRs. We analyzed the association between a zipcode’s disadvantage quartile and THR incidence rate using multivariate linear regression, correcting for differences across zipcodes in gender, race, and ethnicity distributions, and distance to the nearest hospital performing THRs. RESULTS/ANTICIPATED RESULTS: We analyzed 414 zipcodes with overall average THR rate of 370.8 per 100,000 persons >65yo per year. Relative to zipcodes in the least socioeconomically disadvantaged quartile, those in the second-least disadvantaged had 82.2 fewer THRs per 100,000 persons >65yo per year, those in the second-most disadvantaged had 144.2 fewer, and those in the most disadvantaged had 207.4 fewer (all p65yo per year, those in the second-most disadvantaged had 136.2 fewer, and those in the most disadvantaged had 182.9 fewer (all p <.05). DISCUSSION/SIGNIFICANCE OF IMPACT: More socioeconomically disadvantaged areas have significantly lower rates of elective THR, independent of differences in demographics and hospital proximity. These findings show how disparities can affect access and outcomes, and should inform targeting of community-level education and intervention.

OBJECTIVES/GOALS: The effect of immunosuppressive metabolites on anti-tumor immunity in human papillomavirus (HPV)-associated vs carcinogen-driven head and neck cancer is unknown. The objective of this study is to define the extent to which metabolites impair this response and identify novel metabolic targets for enhancing anti-tumor immunity. METHODS/STUDY POPULATION: HPV-associated and carcinogen-driven head and neck squamous cell carcinoma specimens were frozen following surgical excision, and tumor sections were cut onto glass slides. Slides were coated in alpha-cyano-4-hydroxy-cinnamic acid (CHCA) matrix and subjected to mass spectrometry imaging using matrix-assisted laser desorption ionization (MALDI) on a Bruker SolariX XR 12T Hybrid QqFT-ICR mass spectrometer run in positive mode. Slides were then stained for immunohistochemistry (IHC) using markers of CD8 T cells, macrophages (CD163), B cells (CD20), and tumor cells (panCK). Mass spectrometry imaging and IHC spatially resolved data will be co-registered and metabolite intensity in regions of interest (cell types) quantified. RESULTS/ANTICIPATED RESULTS: A total of seven HPV-associated (three metastatic lymph nodes and four primary tumors) and six carcinogen-driven (primary tumors) HNSC specimens were subjected to MALDI and IHC. Metabolites significantly enriched in HPV-associated HNSC relative to carcinogen-driven HNSC include 2,3-diphosphoglyceric acid, xanthine, 2,3,5-Trichloromaleylacetate, and indole-3-carboxyaldehyde. Metabolites significantly enriched in carcinogen-driven HNSC relative to HPV-associated HNSC include hesperetin 3'-O-sulfate, hypoxanthine, phosphorylcholine, and L-homocysteine sulfonic acid. In ongoing analyses, we anticipate identifying a relationship between CD8+ T cell enriched vs depleted regions and immunosuppressive metabolites (e.g., kynurenine, adenosine monophosphate). DISCUSSION/SIGNIFICANCE: Defining the extent to which CD8+ T cells interact with the metabolic milieu of the microenvironment will provide a foundation for metabolic Precision Medicine. Strategically targeting metabolic pathways to enhance the anti-tumor immune response will be leveraged for the design and implementation of immune modulatory metabolic therapy.

OBJECTIVES/GOALS: We aim to identify neurodevelopment delays among children who were born prematurely. We will also calculate the sensitivity and specificity of the assessment tools used to measure the neurodevelopmental profile in early childhood of children exposed to the Neonatal Intensive Care Unit (NICU). METHODS/STUDY POPULATION: This cross-sectional study will include 100 premature children who were born between 32 to 37 weeks of gestational age and admitted to NICU at the University Pediatric Hospital in Puerto Rico. Their neurodevelopment will be measured with the Bayley III. Statistical analysis will be performed using IBM SPSS Statistics 25.0. Descriptive statistics will be used, normality distributions among all continuous variables, frequency distribution for categorical variables and logistic regressions to test association of GA and neurodevelopment delay. We will use the raw item scores for each domain of the Bayley III assessments to measure internal consistency using Cronbach’s alpha and factor analysis. RESULTS/ANTICIPATED RESULTS: We anticipate identifying the ND among children born prematurely between 32 to 37 weeks of gestational age and who were admitted to NICU at the University Pediatric Hospital in Puerto Rico. We also expect to find if gestational age impacts adversely ND in children who were born between 32 to 37 weeks of gestation. We will be able to assess if lower gestational age will impact global ND in contrast to higher gestational age neurodevelopment delays in one specific area of development. We will also be able to assess the sensitivity and specificity of the Bayley- III. DISCUSSION/SIGNIFICANCE: Premature is a major global health problem with a 12.0% prevalence. We want to promote early identification of ND in a diverse Hispanic Puerto Rican population so we can guide public health decisions and lead research initiatives to improve outcomes in the future or facing prematurity.

OBJECTIVES/SPECIFIC AIMS: Our overarching theoretical framework is the health belief model (HBM). Guided by HBM, we aim to identify rural adults’ perceived barriers and motivations to participating in research. Specifically, our research questions are listed below. RQ1: What socio-cultural factors influence rural tobacco users’ intentions to a) participate in research studies and b) undertake tobacco cessation? RQ2: What bio-psychological and behavioral factors influence rural tobacco users’ intentions to a) participate in research studies and b) undertake tobacco cessation? RQ3: How do rural tobacco users perceive citizen scientists as disseminators of a) tobacco cessation and b) recruitment messages? METHODS/STUDY POPULATION: In Phase I of this multi-stage project, we are conducting in-depth interviews with approximately 30 tobacco users in rural Florida. The interview consists of semi-structured questions and multiple validated questionnaires. Specifically, we ask a series of questions about participants’ barriers to participating in research. Additionally, we include questionnaires on participants’ tobacco use history, nicotine dependence, motivation to quit, and willingness to participate in research studies. RESULTS/ANTICIPATED RESULTS: This study consists of two main phases. Data collection for Phase 1 of the study is ongoing, and we will discuss these recent findings. We anticipate data collection and data analysis to be finalized by May, 2019. Beginning in August 2019 through August 2020, we will focus on Phase II, which entails designing and implementing an intervention to increase rural tobacco users’ willingness to participate in research. Given existing literature on other underrepresented groups in research, we anticipate that rural tobacco users will express that logistical barriers, such as transportation and time, prevent them from participating in research. Additionally, we anticipate these individuals may have socio-cultural barriers to participating in research, including distrust in the medical system and apprehension over discipline-specific terminology. DISCUSSION/SIGNIFICANCE OF IMPACT: The results of this formative research will be critical to our development of a targeted intervention to increase rural tobacco users’ participation in research. Additionally, our interdisciplinary and community-based approach in this study acknowledges the importance of involving the target population in the research process, which is in line with NIH’s updated model of translational research. We will discuss the process of collaborating with extension agents in rural counties in Florida to reach underrepresented communities.

OBJECTIVES/GOALS: Patient online portal (POP) allows patients to access electronic health records (EHRs) and have efficient communication with their clinicians. We assessed disparities in access to POP by families with different SES and its impact on asthma research which is little known in the literature. METHODS/STUDY POPULATION: A randomized controlled trial testing the efficacy of an EHRs-based clinical decision support (CDS) system was conducted at a pediatric primary care setting of Mayo Clinic. Asthma Control Test (ACT) questionnaire was administered to parents every 3 months through phone or email for this study after consenting, and reminders were sent to unanswered subjects through the POP. SES was measured by HOUSES (in quartiles), a validated individual-level SES index based on housing features (the higher HOUSES, the higher SES).The association of HOUSES with availability of POP access and missing ACT score rate was assessed. RESULTS/ANTICIPATED RESULTS: The mean age of 184 participants was 9.0 years (57% male) and parents of 152 (83%) children had POP. Only 68% of children from lowest HOUSES (Q1) had access to POP (vs. 74% (Q2), 88% (Q3), and 92% (Q4; highest SES); p = .02). ACT score was completed by 144 (78%), 150 (82%), 171 (94%), and 164 (95%) at each intervention conducted every 3 months with a total of 61 (33%) missing at least once. Overall, children whose parents had access to POP had a lower missing rate in ACT score at all interventions during the study; 16% (those with access to POP) vs. 47% (those without), 13% vs. 44%, 3% vs. 16%, and 1% vs. 23% for 1st, 2nd, 3rd, and 4th intervention, respectively (p < .007 for all). DISCUSSION/SIGNIFICANCE OF IMPACT: There are significant disparities in access to POP by SES defined by HOUSES which impact availability of ACT score resulting in a systematic bias in asthma research and potentially widening disparities in asthma care. CONFLICT OF INTEREST DESCRIPTION: NA.

OBJECTIVES/SPECIFIC AIMS: We evaluated the accuracy of diagnosis and procedure codes to identify acute urinary retention (AUR) due to lack of existing validation studies. METHODS/STUDY POPULATION: We performed a cross-sectional validation study at a single medical institution in the emergency department (ED) and outpatient Urology Clinic in men ≥45 years. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes 788.20, 788.21, 788.29 for urinary retention and Current Procedural Terminology, Fourth Edition (CPT-4) codes 51701, 51702, 51703 for urinary catheterization were used to identify men with potential AUR. Four algorithms using ICD-9-CM and CPT-4 codes were compared against medical record review. Sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve were calculated for both the ED and Urology Clinic. RESULTS/ANTICIPATED RESULTS: A total of 333 treated and released men in the ED were identified using facility billing data, and 245 men using physician billing data in the Urology Clinic were identified using the codes for urinary retention or urinary catheterization. Of the 4 algorithms, any ICD-9-CM diagnosis code for urinary retention was the preferred algorithm with a sensitivity and specificity of 0.95 and 0.91 using ED facility billing data and a sensitivity and specificity of 0.95 and 0.58 using Urology physician billing data. DISCUSSION/SIGNIFICANCE OF IMPACT: Use of the ICD-9-CM diagnosis codes for urinary retention performed well at identifying AUR in the ED. This study provides justification to use urinary retention diagnosis codes (specifically 788.20 and 788.29) in future studies to identify AUR using administrative data, especially in the ED.

OBJECTIVES/GOALS: Transportation is a barrier to research participation, especially for participants from disadvantaged backgrounds. Our goal was to review existing policies and create recommendations for institutional guidance on research-related transportation to support a long-term birth cohort study. METHODS/STUDY POPULATION: To summarize existing institutional policies on research-related transportation (i.e., transportation of participants or research staff travel to/from research activities), we requested and, in addition, searched for such policies across 28 sites involved in the NIH HEAL Initiative’s HEALthy Brain and Child Development (HBCD) study. The HBCD study plans to enroll 7,500 pregnant/postpartum persons, follow their children and families long-term, and assess factors influencing brain and child development. The obtained policies were then summarized, followed by identification of gaps in their recommendations and guidance. RESULTS/ANTICIPATED RESULTS: Outreach to the HBCD study sites and search of their institutional websites resulted in identification of 6 institutional policies or other guidance related to research-related transportation across five HBCD study sites. Three policies/guidance related to ride-share programs in research, two related to reimbursement for participant travel, and the fifth was about car seats. Through the online search, we also found policies or written guidance about employee-related transportation within 15 HBCD study sites in total; they largely pertained to employee business travel and did not specifically address research-related transportation. DISCUSSION/SIGNIFICANCE: To optimally support research teams, participants, and to promote the enrollment and retention of participants from diverse backgrounds, it is critical for research institutions to develop and implement guidance on research-related transportation and remove barriers to participation in research.

OBJECTIVES/SPECIFIC AIMS: To characterize parent communication frequency and content between systems of care (medical, school, and sports/recreation) of concussed youth who are in prolonged recovery. METHODS/STUDY POPULATION: In this ongoing study, 16 concussed youth (average age=14.9 years, SD=1.5; 31.2% female and 68.8% male) and their parent study partner (average age=44.3 years, SD=4.3; 87.3% female and 12.5% male) have been enrolled to date from sports medicine clinics. Demographic information was obtained during the initial clinic intake session. Weekly phone calls were also conducted with the parent and child until the child was considered asymptomatic (ie, reporting no symptoms on the SCAT3), to collect data on communication with the school, sport/recreation, and medical systems throughout the recovery process. For the purpose of this study, we evaluated communication patterns of those parents who had a child in prolonged recovery (ie, symptomatic 14 d or more post-concussion injury). Communication variables included frequency (ie, number of times a parent contacted or attempted to contact a system of care) and content or topic discussed during the contact event. RESULTS/ANTICIPATED RESULTS: Of the 16 enrolled participants to date, 68.8% (n=11) experienced concussion related symptoms 14 days postinjury (M=22.2, SD=4.6) at the time of their 2 week follow-up call and were thus considered to be in prolonged recovery. Of those 11, 81.8% (n=9) of parents reported communicating with the school system at some point between the initial clinic intake session and the 2 week follow-up phone call. The frequency of communication for this period ranged between 0 and 10 instances of contact (M=2.5, SD=2.9). Of the 11 prolonged cases, 8 participants were members of sports teams. Sixty-three percent (n=5) of those parents with a child on a sports team communicated with a coach while none of the parents contacted a team athletic trainer. The frequency of communication with the coach ranged from 0 to 8 (M=1.5, SD=2.5) over the course of 2 weeks from enrollment. With regards to the medical system, the majority of parents (72.7%, n=8) communicated at least once with a medical professional during the same time period. The frequency of communication with the medical system ranged from 0 to 8 (M=2.2, SD=2.6) points of contact. Themes that arose for communicating with the school system included informing school personnel of academic accommodations prescribed by the physician, explaining absences, and concerns about missed academic work and grades. The content of communication with the sports system (ie, coach) pertained to return-to-play issues as well as progress updates on recovery. Themes for communication with the medical system were centered on scheduling appointments, attending follow-up medical appointments, and starting return-to-play protocols. DISCUSSION/SIGNIFICANCE OF IMPACT: Parents of concussed youth who were still in prolonged recovery, for the most part, appear engaged in communicating with multiple systems of care. However, a subset of parents did not participate in contact with these systems. Further discussion of these findings will highlight areas for improvement in concussion management as well as strategies parents can utilize to advocate for their child in terms of return-to-learn and recovery.

OBJECTIVES/GOALS: AI is diagnosed when peak cortisol level after a cosyntropin stimulation test is <18 mg/dL using polyclonal antibody (pAb) immunoassay. However, the polyclonal assay is being replaced by a specific monoclonal antibody (mAb) immunoassay which yields lower cortisol levels, leading to the over diagnosis of AI and use of unnecessary steroid use. METHODS/STUDY POPULATION: We obtained 36 samples from patients undergoing 1 mcg cosyntropin stimulation tests for diagnosis of AI. Samples were analyzed using pAb immunoassay (Abbott Architect Cortisol), mAb immunoassay (Roche Elecsys Cortisol II), and mass spectrometry (MS). AI was diagnosed if serum cortisol level was <18 using the pAb immunoassay. Measurements by MS and mAb immunoassay were individually used in simple logistic regression models to predict AI. For each model, we calculated a cortisol level corresponding to a 50% probability (median) of AI and used the delta method to determine the standard error and 95% confidence interval of the median. We used receiver operator characteristic (ROC) curve, area under the curve, sensitivity, and specificity to evaluate the potential of the median values as thresholds for each predictor. RESULTS/ANTICIPATED RESULTS: Data showed a mean cortisol level of 17 mcg/dL using the pAb immunoassay, 12 mcg/dL using the mAb immunoassay, and 12.96 mcg/dL using MS. The mean difference in cortisol level between the mAb immunoassay and the pAb immunoassay was 5.12 mcg/dL (p-value <0.01). The ROC curve model indicated an area under the curve of 0.997 with a median value of 11.2 mcg/dL for the mAb immunoassay. This provides a sensitivity of 95%, specificity of 95%, positive predictive value of 95%, and negative predictive value of 94%. This new threshold has a Kappa coefficient of 0.89 when compared to the pAb immunoassay. DISCUSSION/SIGNIFICANCE: New and highly specific mAb immunoassays are being used more widely but yield lower cortisol results. This reflects the need for further studies to determine new cut off points for highly specific cortisol immunoassays. A cut off level of 11.2 mcg/dL would provide a sensitivity of 95% and specificity of 95%.

OBJECTIVES/GOALS: The primary objective of this study was to define the transcriptomes and transcriptional regulatory network required for the development and function of adaptive Natural Killer (NK) cells in donors with latent human cytomegalovirus (HCMV) infection. METHODS/STUDY POPULATION: Eight healthy adult human spleens were obtained from four HCMV seropositive and four HCMV seronegative donors. Spleens were provided by the Versiti Organ Donor Center of Wisconsin and were processed to a single cell suspension. CD7+ CD3E- CD14- CD19- CD20- NK cells were isolated, using the BD FACSAria sorter. Following cell sorting, single-cell RNA sequencing (scRNA-seq) was performed, and cDNA libraries were constructed and sequenced via NextSeq 550. Cell Ranger was then used to algin the cDNA reads and the Seurat R package was used to analyze the transcriptional data. Cells were filtered and clustered based on the number of uniquely expressed genes. The monocle software was used for single cell trajectory analysis and the SCENIC software was used to decipher gene regulatory networks. RESULTS/ANTICIPATED RESULTS: Eight healthy spleens from four HCMV seropositive and four HCMV seronegative donors were obtained and their NK cells were sorted and captured for scRNA-seq. Donor median age was 59 [IQR 48.5-56.5], 50% (n=4) were female and all donors were not experiencing any acute or chronic symptoms. Using scRNA-seq, we observed elevated numbers of NKG2C+ adaptive NK cells in HCMV seropositive individuals when compared to HCMV seronegative individuals. In addition, we identify a set of transcription markers and regulators that are responsible for the development and function of adaptive NKG2C+ NK cells. Finally, our trajectory analysis of adaptive NKG2C+ NK cells revealed a unique developmental pathway. DISCUSSION/SIGNIFICANCE: Here, we demonstrate that HCMV infection can induce the formation of adaptive NKG2C+ NK cells that display a unique transcriptional and developmental profile. These findings have the potential to influence the future application of adaptive NK cells in cellular immunotherapies.

OBJECTIVES/GOALS: A primary care clinic is opening in the Eva Rothwell Center (ERC) located in the Keith Neighbourhood of Hamilton, Ontario. This new clinic aims to address rampant health disparities in the community. Effective delivery of health services requires a robust model of care that meets and sustains the specific needs of the community and clinic providers. METHODS/STUDY POPULATION: The primary objective of this study is to describe the current health needs of Keith Neighbourhood residents. The secondary objective is to describe the needs of health providers working within the ERC health clinic. Data collection will involve the collection of primary data (through methods such as surveys and interviews) and secondary data (including historical and current census data). Primary data analysis for primary will use conventional quantitative and qualitative methods. Finally, researchers will use the analyzed data to develop a context-appropriate initial model of care for the ERC health clinic and a subsequent evaluation plan to assess the model’s effectiveness and sustainability. RESULTS/ANTICIPATED RESULTS: All primary and secondary data will be synthesized into a report that will inform the development and implementation of two main deliverables. The first deliverable will be a framework for the clinic’s initial model of care that is context-appropriate to the current needs of the Keith Neighbourhood. The model of care will be culturally sensitive and trauma-informed. The second deliverable will be an evaluation plan for the clinic that can be used to continuously iterate on the initial model, ensuring its sustainability. Furthermore, the project’s process may be extrapolated into a framework that could be used to establish primary care clinics within other priority communities. DISCUSSION/SIGNIFICANCE: The proposed model of care will enable practitioners to deliver relevant and timely health services while being adaptable to the community’s evolving needs. It will help improve the Keith Neighbourhood residents' long-term health and social outcomes. This project will contribute to and inform the development of the field of translational science.

OBJECTIVES/GOALS: 1. Understand the association between patient perceptions of care measured by the Interpersonal Processes of Care (IPC) Survey and glycemic control, appointment no-shows/cancellations and medication adherence in patients with type II diabetes. 2. Determine how these relationships differ by race for non-Hispanic White and Black patients. METHODS/STUDY POPULATION: This is a cross-sectional study of a random sample of 100 White and 100 Black Type II diabetic patients followed in Duke primary care clinics and prescribed antihyperglycemic medication. We will recruit through email and phone calls. Enrolled patients will complete the Interpersonal Processes of Care Short Form and Extent of Medication Adherence survey to measure patient perceptions of care (predictor) and medication adherence (secondary outcome). No show appointments and cancellations (secondary outcomes) and most recent hemoglobin A1c (primary outcome) will be collected from the Electronic Medical Record. We will also collect basic demographic information, insurance status, financial security, significant co-morbidities, and number and type (subcutaneous vs oral) of antihyperglycemic medications. RESULTS/ANTICIPATED RESULTS: -The study is powered to detect a 0.6% difference in HbA1c, our primary outcome, between high and low scorers on the Interpersonal Processes of Care subdomains. -We expect that higher patient scores in the positive domains of the IPC survey and lower DISCUSSION/SIGNIFICANCE OF IMPACT: This study will provide information to develop and implement targeted interventions to reduce racial and ethnic disparities in patients with Type II diabetes. We hope to gain information on potentially modifiable factors in patient-provider interactions that can be intervened upon to improve prevention and long-term outcomes in these populations.