OBJECTIVES/SPECIFIC AIMS: This study sought to develop a mHealth application which was capable of predicting the spread of infectious diseases during the height of the Ebola outbreak in Lagos, Nigeria. Following the success of this primary task, the research then sought to understand behavioral health issues which are indicative of chronic diseases, such as sedentary behaviors and where they occur at a geospatial level in real-time. The results of this study are now being used to develop a larger scale 500 person study in Rochester, NY, USA. METHODS/STUDY POPULATION: During a 3-month period individuals were asked to install a mobile health application known as Node onto the their android device. Consent was done remotely, individuals were recruited through the Lagos University Teaching Hospital, Nigeria Institute of Medical Research, and the University of Lagos. Participants were paid 50 USD/month for each month of study completion, while continuous location data was collected in addition to survey information about participants. RESULTS/ANTICIPATED RESULTS: During the study period 70 individuals enrolled, using this data we were able to create network based models which indicated that diseases were more likely to spread at the beginning of the week, and also indicated who would be most susceptible to being patient zero. In phase 2 we have started to look at behavioral patterns to determine the risk of chronic disease among our study population, by examining their human mobility patterns, since we can determine average sleep patterns, activity patterns using machine learning classifiers, and time spent in traffic—all of which we can visualize in a real-time geospatial manner with higher objectivity than traditional mechanisms for data collection. DISCUSSION/SIGNIFICANCE OF IMPACT: In developing countries, using Nigeria as our example most chronic disease and household studies only enroll a few thousand participants for a country numbering 150 million plus. Using our rapidly available application we were able within 1 week to enroll 70 participants on 1 year of funding, this creates a framework for larger scale public health studies which can be done in developing countries and also demonstrates the value in mHealth which can both answer questions of infectious disease and chronic diseases at the same time. Our results indicate that at an infectious disease level in city environments diseases may be prevented by targeting events early in the week. While at a chronic disease level the lack of reliable power results in less sedentary behavior as individuals seek locations to charge phones, while those with more stable western-like lifestyles have started to exhibit the conditions which cause such outcomes as obesity, which has begun to rise in developing countries. Ultimately, these results serve as a staging point to launch a more wide scale study both in the United States and Nigeria within the year, now that feasibility has been established.

OBJECTIVES/SPECIFIC AIMS: Chronic obstructive pulmonary disease (COPD) is a leading cause of both hospitalizations and readmissions in the United States, and about 1 in 5 hospitalized patients with COPD will be readmitted within 30 days. COPD-focused self-management programs are frequently used to help patients better manage their symptoms and prevent hospitalization. However, while the majority of patients with COPD have at least one comorbidity, most trials of COPD self-management programs either excluded patients with significant comorbidities or did not analyze the impact of comorbidities on patient outcomes. Using data from the BREATHE trial of a COPD self-management program, this study aims to determine if patient post-intervention outcomes differ based on the intensity and type of patient comorbidities. METHODS/STUDY POPULATION: In total, 240 patients hospitalized for COPD were randomly assigned to either a comprehensive self-management intervention or usual transitional care. Primary outcomes for this trial were the number of COPD-related hospitalizations and emergency department visits at 6 months and changes in COPD-specific quality of life. To determine whether patient comorbidities modify the effect of the self-management intervention on readmission and quality of life outcomes, we will compare patient outcomes across groups stratified by comorbidity burden (Charlson Comorbidity Index) and type (baseline diagnosis of congestive heart failure, diabetes, and depression). In addition, we will use regression analysis with interaction terms to test for interaction between comorbidity burden/type and intervention assignment. RESULTS/ANTICIPATED RESULTS: We hypothesize that the effect of the self-management intervention will differ in patients with greater comorbidity burden due to competing medical demands for patients with multimorbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: The results of this study will help clinicians better target disease-specific self-management programs to the groups of patients with COPD who are likely to receive the greatest benefit from this type of intervention.

OBJECTIVES/GOALS: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes. Though largely preventable, DKA is one of the most common acute complications of diabetes. In the US, rates of DKA hospitalization and associated costs have been increasing over the past two decades. METHODS/STUDY POPULATION: In this study, we used the Kentucky Statewide Inpatient Database (2010-2019) and the Nationwide Readmission Database (2010-2018) to explore variation in rates of DKA hospitalization across key sociodemographic subgroups (age, sex, race/ethnicity, rural/urban, insurance coverage, and county-level poverty index) and identify clinical predictors of DKA hospitalization. The primary outcome was hospitalization with a first diagnosis of DKA identified using ICD-9 and -10 codes. Crude rates were calculated using state- and county-level population estimates obtained from the US Census Bureau and are presented as the total number of events per 10,000 people. Regression models will be used to examine the associations between DKA hospitalization and clinical predictors. RESULTS/ANTICIPATED RESULTS: In Kentucky, from 2010-2019, rates of DKA hospitalization increased by 45% (from 65.5 to 94.8 per 100,000). The largest variation was observed by age, race/ethnicity, and insurance. In those aged 15-44, rates of DKA hospitalization were three times higher than rates in the youngest (<15) and oldest (>75) groups (>130 vs <45 per 100,000). Non-Hispanic Blacks experienced rates of DKA hospitalization that were 2x higher than rates observed in non-Hispanic Whites (183.9 vs 92.6 per 100,000). Those covered by Medicaid had the highest rates of DKA hospitalization (171.3 vs 32.4 per 100,000 in commercially insured). Small, but consistent, disparities were observed in rural vs urban counties and higher poverty rates. Predictors of DKA hospitalization are being examined in the Nationwide Readmission Database. DISCUSSION/SIGNIFICANCE: Our findings underscore significant variation in DKA risk across key sociodemographic subgroups and will examine and confirm previously identified clinical predictors of DKA. Because DKA is largely preventable, identifying individuals at higher risk and targeting interventions and services to these individuals may help reduce DKA rates.

OBJECTIVES/GOALS:

1. 1. analyze urinary protein exosome content pattern before and during DASH diet.

2. 2. characterize urine electrolyte changes associated with changes in protein profiles, and hormonal changes before/after DASH diet.

3. 3. analyze the association of these changes to the DASH-related BP response.

METHODS/STUDY POPULATION: In this proof of concept study, hypertension stage 1 volunteers will receive a DASH based menu during 14 consecutive days of elective admission to the RU research hospital. Participants will complete a food frequency questionnaire (VioScreen) with a bionutritionist. Throughout the intervention period, participants will be assessed for blood pressure, plasma renin and aldosterone, and 24 hour urines for electrolytes, creatinine, protein, albumin and first morning urine collected for exosomes. Exosome analysis will be performed by a commercial lab. Proteome analysis will be conducted in the RU Mass-spectrometry service. RESULTS/ANTICIPATED RESULTS: The causal pathway we will elucidate hypothesizes that: 1) changes in diet affect blood electrolytes, and through these, aldosterone. 2) Aldosterone alters the expression of specific transporter proteins in the renal tubule; protein expression will be reflected in the urine exosome. 3) These transporters affect the excretion of electrolytes, as reflected by urinary ratio of sodium (Na) to Potassium (K). During consumption of the Western diet, the Na/K ratio is approximately 2-2.5, whereas we expect the urinary sodium/potassium ratio to be <1, when the participant is eating a DASH based diet. DISCUSSION/SIGNIFICANCE OF IMPACT: This assay provides a clinical tool to assess dietary adherence, and the project will provide insights into the mechanism whereby DASH reduces blood pressure.

OBJECTIVES/GOALS: This study examined patient perceptions on the benefits, barriers, and facilitators of conventional and complementary/behavioral pain strategies that can be offered in the ED setting including physical therapy, mindfulness, acupuncture, and yoga. METHODS/STUDY POPULATION: We conducted and recorded semi-structured interviews with 30 patients who presented to the ED with musculoskeletal pain. Interviews focused on patients’ perceptions of NP pain treatments, barriers/facilitators to utilization, and recommendations that would promote engagement. A hierarchical coding system was developed and refined using the interview guide, the Theory of Planned Behavior, and preliminary review of the transcripts. The iterative process of developing the coding system allowed us to identify preliminary themes. RESULTS/ANTICIPATED RESULTS: Patients believe education on pain and the mind-body connection would give a sense of pain control. Likely barriers to engaging at the ED include lights, noise, interruptions, and uncertainty of their medical status. Post-discharge NP treatment barriers are financial and logistical. Engagement can be facilitated by a desire to avoid opioids, familiarity with meditation practices, and consistent positive communication with the health care team. Patients desire evidence on effectiveness, including testimonials, and suggested NP techniques should be introduced early, with written materials used for post-discharge referral. Patients prefer in-person treatment but would appreciate a virtual option. The initial session should occur in-person to build trust and facilitate virtual session engagement. DISCUSSION/SIGNIFICANCE: Patients are willing to engage in nonpharmacological pain treatment, however the unpredictable ED environment, uncertainty of their medical status, and financial and time constraints are significant barriers.

OBJECTIVES/SPECIFIC AIMS: To assess the usability and adoption of RxUniverse, a novel platform that enables health care providers to directly disseminate proven, evidence-based mobile health apps to patients. METHODS/STUDY POPULATION: Among 5 pilot clinical sites, 40 physicians and front-line providers consisting of medical assistants and receptionists were trained on the RxUniverse platform. They were instructed on the platform’s purpose, were shown a demonstration of the functionality, and were observed in a trial process of prescribing an app. Specific implementation plans were designed with the help of the clinic staff in order to best fit in with their present workflows. The well-validated System Usability Score (SUS) was used to assess the usability of the platform. Prescriptions of 100 relevant app prescriptions within a 8-week pilot period was set as the adoption goal. RESULTS/ANTICIPATED RESULTS: Within the pilot period, greater than 2000 apps were prescribed across all users. Of the 40 providers trained on the RxUniverse platform, 26 prescribed >5 apps during the trial period. Of these 26 individuals, 18 prescribed >20 apps, 14 prescribed >50 apps, and 5 prescribed >80 apps; 58% of users reported frequent use (weekly or daily) of the platform. In total, 19 responses were received for the SUS survey. The RxUniverse platform received a usability score of 82%. DISCUSSION/SIGNIFICANCE OF IMPACT: As the pace of innovation continues to accelerate, health care providers will need to quickly integrate new digital-based tools into their workflows, and patients will need to be able to easily and readily access these tools. RxUniverse provides the necessary mechanisms, user-friendly interface, and EHR integration functionality to accomplish this. The total number of apps prescribed surpassed 2000, which far exceeded the initial target of 100 apps. The platform also scored an 82% on the SUS, which is considered an “A” by industry standards. By comparison, other health apps considered to have to be in the highest-rating groups have reported scores of 77.5% and an overall average of 68% among all systems. These outcomes demonstrate the high adoption and usability of the RxUniverse platform, an important platform that can be used to prescribe the latest technologies directly to patients.

OBJECTIVES/GOALS: The Title V Project at the Medical Sciences Campus aims to expand the knowledge in Clinical and Translational Research (CTR) and diversify the CTR workforce throughout Puerto Rico. A Pilot Project Program (PiP) offers research training for Undergraduate students (UgS), Graduate Students (GS), and Undergraduate program Faculty (UgF). METHODS/STUDY POPULATION: Since 2021, the Title V Project has established a rolling application process to which researchers from any scientific background related to CTR in all post-secondary institutions in Puerto Rico may submit research proposals. These are peer-reviewed considering the following criteria: the research team composition must include UgS, GS, and UgF; the primary researcher’s expertise; the significance of the proposed topic related to Puerto Rico’s health problems; and the research plan’s quality. In addition, proposals must include a career plan for student and faculty members to participate in further training in CTR-related topics, such as scientific communication and statistical analyses, also offered through the Title V program. RESULTS/ANTICIPATED RESULTS: Twelve (12) PiP research teams showcase diversity in research areas with representation from Nursing, Occupational Therapy, Cancer, Cell Biology, Microbiology, Anatomy and Medical Images, Electro-Chemistry, Anatomy, and Physiology. In addition, Pip’s team members represent eleven (11) different institutions across seven different geographical areas, whose complete profiles we delineate in the presentation. Teams have the participation of twelve (12) primary researchers, five (5) mentors, twelve (12) UgF, seventeen (17) UGs, four (4) medical students in different stages, and nine (9) GS. We will present the composition, research topics, development, and participants' feedback. DISCUSSION/SIGNIFICANCE: The PiP program has been instrumental in organizing interdisciplinary and interinstitutional research teams. It has proven to be an effective strategy for fostering inclusion, diversity, and equity in CTR and promotes the practice of team science. Teams' research responds to health issues in this Hispanic population.

OBJECTIVES/SPECIFIC AIMS: Familial partial lipodystrophy (FPLD) is an inherited, rare syndrome characterized by selective absence of adipose tissue from extremities which is associated with severe insulin resistance, and metabolic dyslipidemia (with hypertriglyceridemia, and low HDL) Typically, 30%–50% of patients with FPLD demonstrate a pathogenic variant in Lamin A (LMNA) gene that is associated with inherited cardiomyopathy and arrhythmia syndromes. We inquired the prevalence of having abnormal ECGs and echocardiograms in FPLD and whether there is a difference in evaluated parameters with respect to genotype. METHODS/STUDY POPULATION: We conducted a retrospective review of an established a cohort of 58 patients (age range: 12–71, M/F 8/50) with FPLD. Demographic characteristics, genotype, fasting triglyceride, hemoglobin A1c, LDL, and HDL levels were collected; ECGs and echocardiograms were also interrogated. RESULTS/ANTICIPATED RESULTS: Out of 58 patients, 22 (38 %) displayed a pathogenic variant in the LMNA gene. In total, 71% of patients (41/58) had an abnormal ECG and echocardiogram; 40% (23/58) of the patients displayed an arrhythmia on the ECGs (13 in the patients with LMNA variants and 10 in the non-LMNA group). The likelihood of having an arrhythmia was significantly higher in the patients with LMNA variants versus those without (odds ratio of 3.4, CI: 1.1–10.6). DISCUSSION/SIGNIFICANCE OF IMPACT: The overall prevalence of abnormal ECHO and/or ECG is high at 45/58 (78 %) in FPLD. Patients with LMNA variants have a 3.4 times increased risk of developing cardiac arrhythmias compared to those without. We recommend vigilant, monitoring for cardiac disease in FPLD and for arrhythmias in patients with FPLD and LMNA variants.

OBJECTIVES/GOALS: Precisely, the goal of the device is to initiate a friction force between the delivery system and the arterial vessel wall to both assure immediate stent deployment and prevent axial advancement of the stent-anchoring wire. METHODS/STUDY POPULATION: A prototype was constructed and its effectiveness of applying a friction force to a vessel wall was tested ex vivo using an LRX Plus Materials Testing Machine. Afterwards, the experimental performance of the device was compared to that of a finite element simulated model. RESULTS/ANTICIPATED RESULTS: The device demonstrated the ability to apply a friction force to the vessel wall to meet its objective. However, experimental values were consistently greater than those gathered from the simulation. Since the force prescribed by the device is minimal, future work includes increasing the force capabilities of the device and defining force requirements. DISCUSSION/SIGNIFICANCE OF IMPACT: Upon further development and testing, this device can be implemented into endovascular neurosurgery to improve occlusion rates of intracranial aneurysms and reduce patient risk during these operations. CONFLICT OF INTEREST DESCRIPTION: I am pursuing intellectual property on this invention. I was careful not to describe the invention in too much detail in my abstract submission for this reason. This research is my thesis work, and I placed on one year embargo on it before it is published to give us time to sort out IP. I would like to be considered for inclusion in Translational Science 2020 if I am able to get IP on this work before publishing, which I expect will be the case. I have every intention of obtaining IP before the conference in April 2020.

The Clinical and Translational Science Award (CTSA) Program recognizes that advancing diversity, equity, inclusion, and accessibility (DEIA) requires moving beyond statements of commitment to transformative actions. In 2021, the CTSA Program created a Task Force (TF) to initiate work in support of structural and transformational initiatives that advance DEIA for the consortium and its individual hubs. We describe the process of forming the expertise-driven (DEIA) TF and our activities to date. We 1) developed and adopted the DEIA Learning Systems Framework to guide our approach; 2) defined a set of recommendations across four focus areas (Institutional; Programmatic; Community-Centered; and Social, Cultural, Environmental); and 3) designed and disseminated a survey to capture the CTSA Program’s baseline demographic, community, infrastructural, and leadership diversity. The CTSA Consortium also elevated the TF to a standing Committee to extend our understanding, development, and implementation of DEIA approaches to translational and clinical science. These initial steps provide a foundation for collectively fostering environment that support DEIA across the research continuum.

Access to local, population specific, and timely data is vital in understanding factors that impact population health. The impact of place (neighborhood, census tract, and city) is particularly important in understanding the Social Determinants of Health. The University of Rochester Medical Center’s Clinical and Translational Science Institute created the web-based tool RocHealthData.org to provide access to thousands of geographically displayed publicly available health-related datasets. The site has also hosted a variety of locally curated datasets (eg., COVID-19 vaccination rates and community-derived health indicators), helping set community priorities and impacting outcomes. Usage statistics (available through Google Analytics) show returning visitors with a lower bounce rate (leaving a site after a single page access) and spent longer at the site than new visitors. Of the currently registered 1033 users, 51.7% were from within our host university, 20.1% were from another educational institution, and 28.2% identified as community members. Our assessments indicate that these data are useful and valued across a variety of domains. Continuing site improvement depends on new sources of locally relevant data, as well as increased usage of data beyond our local region.

OBJECTIVES/SPECIFIC AIMS: Traditional clinical trials typically enroll a homogenous population to test the efficacy of an intervention. Pragmatic trials deliberately enroll a more diverse population to enhance generalizability, but doing so may increase heterogeneity of treatment effect among subpopulations. For example, the effect of a treatment on an outcome may vary based on patients’ sex, comorbidities, or baseline risk of experiencing the outcome. We hypothesized that heterogeneity of treatment effect by baseline risk for the outcome could be demonstrated in a large pragmatic clinical trial. METHODS/STUDY POPULATION: We performed a prespecified secondary analysis of a recent pragmatic trial comparing balanced crystalloids Versus 0.9% saline among critically ill adults. The primary endpoint of the trial was major adverse kidney events within 30 days of ICU admission, censored at hospital discharge (MAKE30). MAKE30 is a composite outcome of all-cause mortality, new renal replacement therapy, or persistent renal dysfunction. Using a previously published model with high predictive accuracy for MAKE30 (area under the curve=0.903), we calculated the baseline risk of MAKE30 for all trial participants. We then developed a logistic regression model for MAKE30 with independent covariates of fluid group assignment, baseline risk of MAKE30 as a nonlinear continuous variable, and the interaction between group assignment and MAKE30 baseline risk. RESULTS/ANTICIPATED RESULTS: Among 15,802 patients from 5 intensive care units enrolled in the original trial, 126 had missing variables for predicted risk of MAKE30. Mean predicted risk of MAKE30 among all patients was 15.4%; median was 4.4% (interquartile range 2.2%–17.1%). Predicted risk of MAKE30 did not significantly differ between groups (p=0.61 by Mann-Whitney U-test). The incidence of MAKE30 in the trial was 14.9%, and the prediction model was well-calibrated overall (AUC=0.891). In a logistic regression model examining the interaction between group assignment and predicted risk of MAKE30, group assignment significantly affected MAKE30 (odds ratio saline:balanced 1.13, 95% CI: 1.02–1.27, p=0.02), but we observed no interaction between the effect of group assignment on MAKE30 and patients’ predicted risk of MAKE30 at baseline (p=0.66 for interaction term). DISCUSSION/SIGNIFICANCE OF IMPACT: In a large pragmatic trial demonstrating a significant difference in the primary outcome of MAKE30 between balanced crystalloids and saline, a previously published model accurately predicted MAKE30 using baseline factors. However, contrary to our hypothesis, the baseline risk of MAKE30 did not modify the effect of fluid group on the observed incidence of MAKE30. Our analysis could not account for unmeasured confounders and may be underpowered to detect a significant interaction. Our findings suggest that the impact of balanced crystalloids versus normal saline on renal outcomes in critically patients is consistent across all levels of risk.

OBJECTIVES/GOALS: Physical therapy (PT) is key for treating functional decline that inpatients experience but is a constrained resource in hospital settings. The Activity Measure Post-Acute Care (AM-PAC) score is a mobility measurement tool that has been used to define misallocation of PT. We aim to optimize PT referrals using AM-PAC-based clinical decision support . METHODS/STUDY POPULATION: We conducted a prospective study of patients admitted to University of Chicago Medical Center. AM-PAC scores were assessed by nursing staff every 12 hours. Clinical decision support was designed using validated AM-PAC cutoffs (> 18, a predictor of discharge to home). The tool was embedded in hospital medicine note templates, requiring providers to indicate PT referral status based on current AM-PAC scores. The primary outcome, unskilled consult , was defined as PT referral for patients with AM-PAC > 18. Data were collected for one year prior to implementation and one year after implementation for intervention (hospital medicine) and control (general internal medicine) services. Difference in differences analysis was used to assess the association between the intervention and unskilled consults. RESULTS/ANTICIPATED RESULTS: Between October 2018 and March 2021, 18,241 admissions were eligible for the study. Compared to preintervention, there was a lower rate of referral to PT for patients with high AM-PAC mobility scores in the post-intervention period [18.5% vs 16.6%; X2(1) = 7.02; p < 0.01]. In the postintervention time period, the control group experienced a 2.6% increase in unskilled consults while the intervention group experienced a 2.3% decrease, a difference in differences of 4.9% (95% CI -0.07–-0.03 for difference in differences) controlling for age sex, race, LOS, and change in mobility. Compared to preintervention, there was no statistically significant difference in mean change in mobility score post-intervention for either group. DISCUSSION/SIGNIFICANCE: Our results suggest that clinical decision support can decrease unskilled PT consults. Many functionally independent patients can mobilize with nursing or other mobilization staff. Hospitals should consider mobility score-based decision support to prioritize PT for impaired and at-risk patients.

OBJECTIVES/GOALS: Rapid and accurate identification of primary malaria vector species from collected specimens is the most critical aspect of effective vector surveillance and control. This interdisciplinary team of engineers aims to automate identification using a deep learning computer vision algorithm. METHODS/STUDY POPULATION: The team spent August of 2019 observing and participating in control and surveillance activities in Zambia and Uganda. They conducted >65 interviews with key stakeholders across 9 malaria control and surveillance sites, ranging from field and community health workers, to malaria researchers and Ministry of Health employees. Stakeholder feedback validated the need for a more accurate and efficient method of vector identification in order to more effectively deploy targeted malaria interventions. The team set forth in designing and prototyping a portable, automated field tool that could speciate mosquito vectors to the complex level using artificial intelligence. RESULTS/ANTICIPATED RESULTS: The team’s research demonstrated that accuracy, cost effectiveness, and ease of use would be critical to the successful adoption of the tool. Results of initial prototyping, usability studies, and stakeholder surveys were used to determine the tool’s minimal user specifications: 1) the ability to distinguish between Anopheles Gambiae and Anopheles Funestus, the two principal malaria vectors in the countries visited, 2) achieving an identification accuracy of ≥90% to the complex level, and 3) accessibility to the speciation data 3-7 days following vector collection. Next steps include optimizing the tool to deploy a minimal viable product for testing in Kenya by the summer of 2020. DISCUSSION/SIGNIFICANCE OF IMPACT: The accurate, high-quality surveillance enabled by this device would allow malaria control programs to scale surveillance to remote regions where an entomologist may not be available, allowing malaria programs to deploy effective interventions, monitor results, and prevent disease.

OBJECTIVES/SPECIFIC AIMS: This study sought to determine the accessibility, utilization, and preference for mobile phone use among a marginalized population of teens enrolled in an adolescent substance abuse treatment program and their parents. Specific study aims were to: (1) characterize mobile phone use, (2) assess the accessibility and reliability of mobile phone usage, (3) determine specific barriers to mobile phone use, and (4) examine parent and teen perceptions of the utility of integrating communication technology in substance use treatment. METHODS/STUDY POPULATION: In total, 103 (78.6% female; 75.7% Hispanic) parents of teens participating in an outpatient substance abuse treatment program with an average age of 42.60 (SD=9.28) participated in our study. Upon enrollment in a substance abuse treatment program between October 2014 and July 2016, parents completed a technology use survey as part of program development and a chart review of clinic outbound calls to parent mobile phones was completed to evaluate reliability of parent mobile phone access throughout treatment. Survey collection among teens is ongoing. Study population information for teens will be presented at the conference. RESULTS/ANTICIPATED RESULTS: The vast majority of parents owned a cell phone and used it as their primary phone (97.1%); 83% of parents owned smart phones in particular, with the majority being Android phones (68.7%). Parents were more likely to have pay-as-you-go (41.4%) and yearly (32.3%) contracts, and only 15% of the sample endorsed changing their phone number more than once in the past year (64%=never; 21%=once). Parents reported using several of the phone features: text (97%), email (76%), pictures (93%), and accessing the internet (92%); 92% reported they did not have a texting limit; and the most popular use of the mobile phone was to send and receive text messages (58.6%), followed by accessing the internet (19.2%). During the course of a 10-week treatment program, the clinic made 2776 confirmation phone calls to parents who completed surveys. Report of accessibility matched the clinic’s ability to reach parents. Of the 2776 calls, 97.2% were made to the original number provided, which was in service. Only 2.7% were determined to be disconnected, with the median number of days for disconnected service being 2 days with no voice and no texting capabilities (range=14) and 2 days with no voice, but with texting capabilities (range=28). In terms of parent perceptions of the utility of integrating communication technology in substance use treatment, 91% of parents reported they would be receptive to receiving text messages with parenting tips as aftercare support. Preferred content areas included: strategies for monitoring teen substance use (56%), strategies for using consequences (62%), suggestions for encouraging positive activities (62%), and ways to improve parent-child communication (63%). Accessibility, utilization, and preference for mobile phone use in a treatment program among teen respondents will be presented at the conference. DISCUSSION/SIGNIFICANCE OF IMPACT: This study characterized both subjective and objective mobile phone accessibility and usability among teens participating in an adolescent substance abuse treatment program and their parents. This study also provides information on teen and parent perceptions of using mobile phones during the aftercare period and ratings of acceptable messages following treatment. This data will help researchers design mobile-based interventions both during and after treatment, which is the future direction of our research group.

OBJECTIVES/GOALS: In preclinical Alzheimer disease (AD), biomarkers such as amyloid protein, decreased hippocampal volume, and weaker network connections are apparent in the brain, but memory symptoms assessed by paper and pencil tests have not yet appeared. Performance tests of complex daily tasks may be more sensitive and detect early functional impairment. METHODS/STUDY POPULATION: This is a cross-sectional analysis of an ongoing cohort study. Cognitively normal (CN) older adults completed 3 standardized complex daily tasks from the Performance Assessment of Self-Care Skills (PASS) in their home. Biomarkers of AD were assessed within 2-3 years of an individuals completion of the PASS and include: amyloid accumulation, hippocampal volume, and resting-state functional connectivity (rs-fc) signature. Associations between performance on PASS tasks and the biomarkers of AD were quantified by Pearson point-biserial correlations, as biomarker data was normally distributed and PASS scores fell between two categories (acceptable or optimal quality of performance). Correlations with a 95% confidence interval (CI) that did not include 0 were considered significant. RESULTS/ANTICIPATED RESULTS: 161 CN participants (mean age 74.3 years, 55% female) were included. Mean score on the 3 PASS tasks ranged from 2.67 [standard deviation (SD): .47] to 2.90 (SD: .16) out of 3. Mean amyloid PET on Centiloid scale was 23.8 (SD: 34.8); mean partial volume corrected hippocampal volume was 7448.5 (SD: 909.8); mean rs-fc signature was .805 (SD: .164). After controlling for age and gender, worse performance of complex daily activities was associated with smaller hippocampal volumes (Pearsons r: 0.302, p=.02, 95% CI: .179 to .416) and weaker rs-fc network connections (Pearsons r: 0.276, p=.03, 95% CI: .078 to .453), but not amyloid accumulation. DISCUSSION/SIGNIFICANCE: This study suggests that worse performance of complex daily tasks may be associated with markers of neurodegeneration. These findings could lead to a better understanding of functional changes that may occur during the preclinical stage of AD.

OBJECTIVES/GOALS: Errors in patient matching could result in serious adverse safety events. Unlike publicized mix-ups by healthcare providers these errors are insidious and with increased data sharing, this is a growing concern in healthcare. The following project will examine patient matching errors and quantify their association with safety. METHODS/STUDY POPULATION: EHR systems perform matching out-of-the-box with unknown quality. Using matching processes outside the EMR, the rate at which matching errors are present was quantified and the erroneous records were flagged providing both comparative measures and data necessary to evaluate patient safety. To understand the relationship between matching and safety we will establish a percent of voluntarily reported safety events in our institution where a matching error existed during an encounter. Any safety events occurring for a flagged patient will be reviewed to determine if matching errors contributed to the safety problem. Not all safety events are reported so we will perform full chart review of a filtered list of medical records that have a higher likelihood of safety events. RESULTS/ANTICIPATED RESULTS: We were able to quantify matching errors, and the preliminary matching error rate is approximately 1%, representing over 700 patients. The work is in progress and we are beginning to determine the association between safety events and incorrect matching. Together these results will provide an incentive to identify errors, make corrections, and develop methods to achieve these objectives. The number of matching errors impacts patient care as well as business operations and is likely to have a negative financial impact on institutions with high error rates regardless of its relationship to safety. DISCUSSION/SIGNIFICANCE OF IMPACT: Patient matching is bundled with EHR software and institutions have little control over error rates, yet bear the liability for resulting clinical error. Institutions need to be able to identify undetected matching errors and any associated safety events and this project will provide that solution.

OBJECTIVES/GOALS: Patients utilizing dialysis receive fewer primary care services, especially during the time of initiation of dialysis. This project aims to identify clinical or demographic factors that are associated with either initiation or continuity of PCP use after initiating home dialysis. METHODS/STUDY POPULATION: Using Medicare claims data from the United States Renal Data System (USRDS), we analyzed PCP use for patients aged 67 years or older. We included patients who initiated either peritoneal or home-hemodialysis between 2008-2014. Patients were followed for 2 years: 1 year before and after home dialysis initiation. We used a multivariable logistic model to control for various demographic and clinical factors believed to be confounders and to ascertain factors (i.e. age, race/ethnicity, area of residence, comorbidities, frailty scores) associated with initiation of PCP use or continuity of PCP use. RESULTS/ANTICIPATED RESULTS: Among the 9,854 patients analyzed, 68% of patients used PCP after dialysis initiation. 85% of patients who used PCP before dialysis continued PCP use after home dialysis initiation. Only 29% of patients who had not used PCP before dialysis initiated PCP use after. Employment (vs. unemployment) and use of home-hemodialysis (vs peritoneal) were associated with lower odds of PCP continuity of care. Diabetes and pre-dialysis nephrology care were associated with greater odds of PCP continuity of care. Black race (vs White) and high frailty scores were associated with lower odds of PCP initiation. Those with cardiovascular disease, residence in the South (vs the Northeast), and residence in more urban areas (vs low urban) were associated with greater odds of PCP initiation. DISCUSSION/SIGNIFICANCE: This study highlights the prevalence of PCP use, as well as the factors and subgroups that are associated with lower PCP use among patients receiving home dialysis. These findings will guide future research, interventions and policies in order to improve our understanding of the barriers to PCP use in that population.