OBJECTIVES/GOALS: Diabetes mellitus and COVID-19 have converged to form a syndemic. Our team sought to identify and respond to the evolving needs of patients and communities affected by diabetes amid the COVID-19 pandemic and to engage community partners and student leaders in the advancement of health equity research and practice in the state of Iowa. METHODS/STUDY POPULATION: A team of faculty, staff, students, and community partners was assembled to facilitate, design, and implement mixed methods research related to diabetes care in collaboration with more than five sites in Eastern and Western Iowa during the pandemic, with a focus on potentially preventable complications such as diabetes-related foot ulcers and amputations in adult patients. Attention was directed towards the experiences of rural residents, persons working in frontline occupations during the pandemic, persons from minoritized racial or ethnic groups, and persons who speak Spanish. RESULTS/ANTICIPATED RESULTS: A semi-structured interview study about diabetes care revealed themes in the experiences of persons with diabetes during the pandemic. A pilot study of an educational tool called the Foot Book among patients and providers demonstrated the potential for use of this tool in health care and community settings to reduce gaps in diabetes foot care. All study materials and activities were offered in English and Spanish. Study results were combined with input from community partners to develop ongoing interventions to improve care in Iowa communities. DISCUSSION/SIGNIFICANCE: Amid the syndemic of COVID-19 and diabetes, urgent action is needed to mitigate health inequities and prevent further acceleration of these inequities. Our team developed a community-engaged, patient-centered, and student-led research program that can respond to the needs of patients and communities in the pandemic era.

OBJECTIVES/GOALS: We modeled risk of reintubation within 48 hours of cardiac surgery using variables available in the electronic health record (EHR). This model will guide recruitment for a prospective, pragmatic clinical trial entirely embedded within the EHR among those at high risk of reintubation. METHODS/STUDY POPULATION: All adult patients admitted to the cardiac intensive care unit following cardiac surgery involving thoracotomy or sternotomy were eligible for inclusion. Data were obtained from operational and analytical databases integrated into the Epic EHR, as well as institutional and departmental-derived data warehouses, using structured query language. Variables were screened for inclusion in the model based on clinical relevance, availability in the EHR as structured data, and likelihood of timely documentation during routine clinical care, in the hopes of obtaining a maximally-pragmatic model. RESULTS/ANTICIPATED RESULTS: A total of 2325 patients met inclusion criteria between November 2, 2017 and November 2, 2019. Of these patients, 68.4% were male. Median age was 63.0. The primary outcome of reintubation occurred in 112/2325 (4.8%) of patients within 48 hours and 177/2325 (7.6%) at any point in the subsequent hospital encounter. Univariate screening and iterative model development revealed numerous strong candidate predictors (ANOVA plot, figure 1), resulting in a model with acceptable calibration (calibration plot, figure 2), c = 0.666. DISCUSSION/SIGNIFICANCE OF IMPACT: Reintubation is common after cardiac surgery. Risk factors are available in the EHR. We are integrating this model into the EHR to support real-time risk estimation and to recruit and randomize high-risk patients into a clinical trial comparing post-extubation high flow nasal cannula with usual care. CONFLICT OF INTEREST DESCRIPTION: REF has received grant funding and consulting fees from Medtronic for research on inpatient monitoring.

ABSTRACT IMPACT: This project will aid in the optimization of treatment for those with heart failure with a reduced ejection fraction in order to both maximize health benefits and minimize financial burdens. OBJECTIVES/GOALS: To evaluate the accuracy and clinical applicability of a novel web-based application programming interface in the optimization of care for patients being treated for heart failure with reduced ejection fraction (HFrEF). The purpose of this validation is to ensure the translatability of this algorithm to a clinical setting using real-world data. METHODS/STUDY POPULATION: This study is a retrospective analysis of a previously created algorithm designed to optimize therapy for patients currently diagnosed with HFrEF. Patients that are seen for HFrEF treatment at Michigan Medicine are enrolled in a heart failure registry and were included in this study. Exceptions include those with heart transplants, LVAD, and those undergoing treatment with chronic inotropes (milrinone/dobutamine). Clinically relevant information (demographics, vital statistics, labs, and medications including dose and frequency) was taken from their respective electronic health record (EHR) and this data was used as the input for the algorithm. The therapy recommendations were collected and manually compared to the 2017 ACC/AHA/HFSA guidelines to verify the accuracy of the algorithm outputs. RESULTS/ANTICIPATED RESULTS: Data is currently being collected and analyzed. At first glance, our algorithm has been successful at detecting patients that are good candidates for therapy optimization. Based on inputs given, the treatment recommendations have been appropriate when compared to the most up-to-date HF treatment guidelines. The algorithm has also correctly identified levels of urgency for therapeutic recommendations. Finally, we have also shown the algorithm to have effectiveness for identifying areas of inappropriately adjusted therapy. Preliminary results have led to changes to the functionality of the algorithm, including how medications are retrieved from the EHR’s and how medication doses are identified. Previous iterations created discrepancies in dosing and the algorithm has since been adjusted. DISCUSSION/SIGNIFICANCE OF FINDINGS: By verifying its validity, our algorithm can accurately flag patients with HFrEF that are eligible for therapy optimization and give providers the opportunity to make appropriate changes. Given the high health and financial burdens of HFrEF, our algorithm has the ability to provide significant morbidity, mortality, and financial benefits.

OBJECTIVES/GOALS: To describe principles, best practices, and techniques recommended to instill deep understanding of the application and interpretation of statistical techniques and statistical inference among translational scientists and trainees, that best support the concepts of scientific Rigor, Reproducibility and Reporting. METHODS/STUDY POPULATION: Each of the six New York City Area Biostatistics, Epidemiology and Research Design (BERD) resources have strong educational programs, novel curricular components, and creative strategies, implemented by award winning educators. To capitalize on shared knowledge, innovation, and resources, the six teams formed the New York City Area BERD Collaborative (NYC-ABC) comprised of BERD resources from Mt. Sinai, Cornell, Einstein, Columbia, Rockefeller, and NYU. The collaborative suggests principles, concepts, tools and approaches to support the concepts of scientific Rigor, Reproducibility and Reporting in translational science. RESULTS/ANTICIPATED RESULTS: Principles:

• Value of team science approach and including biostatisticians early and often.

• Carefully designing experiments to reduce bias and increase precision.

• Trainees’ focus is often on “statistical significance” and the p-value. Consequences of data dredging/p-hacking, and the impact of sample size and other factors on statistical significance.

• Emphasizing the effect size and answering the scientific hypothesis when reporting results.

• Statistical code used to produce results should be well annotated and raw data posted online to enhance reproducibility.

• Incorporate effective multiple modalities (i.e. didactic, demonstrative, hands on workshops, applications, and tools).

• Approach from “the drivers’ seat” perspective, rather than strictly mathematical.

• Endorse flipped classroom approach

DISCUSSION/SIGNIFICANCE OF IMPACT: Like any complex discipline, biostatistical education can be approached from several dimensions, but it remains essential to focus on fundamental goals of science. We remind our trainees that the goal of science is to create knowledge, not to “find significance”. Deep understanding of inferential methods and proper interpretation of results are key. CONFLICT OF INTEREST DESCRIPTION: None.

ABSTRACT IMPACT: Mobile app may help improve the depression symptoms among underserved patients OBJECTIVES/GOALS: Depression is one of most common mental health conditions and the leading cause of disability worldwide, affecting about one in 10 adults in the US. The aim of this study was to explore the factors that affect feasibility of incorporating mobile app self-management tools for depression in integrated primary care settings. METHODS/STUDY POPULATION: This was a cross-sectional questionnaire study of depressed patients at two primary care clinics in a Midwest academic medical center. Adult patients (≥19 years) who had an active or previous diagnosis of depression were included in the study. A self-administered survey collected information pertaining to demographics, smartphone ownership, data plan type, smartphone application usage, mobile app self-management interest, health literacy, and patient activation. Chi-square analysis was conducted to compare the patient demographic characteristics, the smartphone ownership, phone plan, smartphone use for health information between two clinics. Multinominal logistic regression analysis was conducted to examine the association between the patient activation and patient characteristics. RESULTS/ANTICIPATED RESULTS: Over 80% of patients owned a smartphone, 80.5% were willing to use data for depression management, and 68.9% believe an app can help in depression management. A higher literacy level was significantly associated with higher level of patient activation (Chi-square=8.5453; p=0.0360). These results suggest that planning interventions that use mobile apps within this patient population is likely feasible and the intended underserved patients at these clinics have an interest in using depression related apps which is similar to findings found by other studies exploring app interest. DISCUSSION/SIGNIFICANCE OF FINDINGS: Understanding patient activation levels within a given population can help to shape corresponding needs. The use of depression related self-management mobile apps will likely require the development of educational materials to facilitate patient use and engagement which means understanding the literacy needs of this population as well.

OBJECTIVES/GOALS: Specialty care for asthmatic children should prevent adverse asthma outcomes. This study of children receiving care in the Arkansas Medicaid program used a comparative effectiveness research design to test whether allergy specialty care was associated with reduced adverse asthma outcomes. METHODS/STUDY POPULATION: Using the Arkansas All Payer Claims Database we studied Medicaid-enrolled children with asthma using a propensity score greedy nearest neighbor one-to-one matching algorithm. We matched children with (treatment) and without (comparison) an allergy specialist visit in 2018. The propensity score model included 26 covariates (demographic, clinical, and social determinants of health). Multivariable adjusted logistic regression was used to estimate adverse asthma events (AAE: emergency department visit or inpatient hospitalization with a primary or secondary diagnosis of asthma in 2019). RESULTS/ANTICIPATED RESULTS: We identified 3,031 children with an allergy specialist visit in 2018, and successfully propensity-score matched 2,910 of the treatment group with a non-allergy specialist visit comparison group. The rate of AAEs in 2019 was 9.5% for individuals with an allergy specialist visit versus 10.1% among those without a specialist visit (p=0.450). The adjusted regression analysis showed 20.3% lower rates of AAEs (aOR: 0.797; 95% Confidence Interval: 0.650, 0.977; p=0.029) in 2019 for children with an allergy specialist visit in 2018 compared to those that did not. DISCUSSION/SIGNIFICANCE: Utilizing allergy specialist care was associated with better asthma outcomes in our statewide study of Arkansas Medicaid-enrolled children with asthma. Asthma quality metrics based on guideline-based recommendations for allergy specialist care should be considered in population health management programs.

OBJECTIVES/GOALS: To test whether implementing DASH-aligned meals in a congregate meal program, combined with Self-Measured Blood Pressure (SMBP) monitoring, lowers systolic blood pressure in community-living seniors at two senior centers. Secondary Aims included cognitive and behavioral change, and attention to client preferences. METHODS/STUDY POPULATION: The Carter Burden Network (CBN) provides services and congregate meals to older adults in NYC, many with low income, and unmet health needs. Eligible participants at two CBN sites, aged 60 or older and consuming >4 congregate meals/week, were recruited. After baseline assessments, participants received DASH-aligned meals onsite, education on nutrition and BP management, and personal devices and support for self-measured blood pressure (SMBP) monitoring. Primary outcome data (BP measured by health professional) was collected at Month 1, with secondary assessments at Months 3 and 6. Staff downloaded SMBP data regularly. Study surveys tracked cognitive and behavioral changes. Qualitative feedback from a project Advisory Committee, participants and study partners was collected throughout implementation. RESULTS/ANTICIPATED RESULTS: 97 Participants enrolled (49% White, 32% Black, 19% Other races; mean age 73). At Baseline, 67% were overweight/obese; 80% were hypertensive (32% Stage I; 48% Stage 2). Primary outcome: Mean change in systolic BP at Month 1 compared to Baseline, was -4.41 mmHg (n= 61; p=0.07). By multiple regression analysis, change in BP at Month 1 was associated with BMI, age, and baseline blood pressure (p= .02, .04, .00, respectively). SMBP: Mean change in systolic SMBP by End-of-Study was -6.9 mmHg (p=.003). 56% participants completed SMBP through Month 1 and 30% to End-of-Study. Mean frequency of > 1 SMBP measure/day was 3 days/week. Women (n= 22, 88%) and Black participants (n= 15, 60%) were more likely to continue taking their home blood pressure measurements to End-of-Study (p=.002, p=.037, respectively). DISCUSSION/SIGNIFICANCE: This study provides the first data to support the potential of DASH as part of an effective community-implemented program for seniors and demonstrates the feasibility of implementing a multi-component intervention using existing congregate meal programs at senior centers that can reach minority and low-income communities.

OBJECTIVES/SPECIFIC AIMS: Patients with gynecologic cancer are known to have an increased risk of venous thromboembolism (VTE) in the postoperative period secondary to hypercoagulability from both malignancy and pelvic surgery. Recent literature suggests that chemotherapy itself may be thrombogenic and prophylaxis may be beneficial in ambulatory patients receiving chemotherapy. Although extended VTE prophylaxis is commonly given after surgical staging, administration of prophylactic anticoagulation during chemotherapy or radiation treatment is not routinely performed. This study seeks to characterize risk factors and timing of VTE in a cohort of women diagnosed with uterine serous carcinoma (USC). METHODS/STUDY POPULATION: After institutional review board approval, a cross-sectional study was performed of all women diagnosed with USC between January 1999 and January 2016 at Albert Einstein College of Medicine. Data analysis was performed using Stata version 14.2 (Stata Statistical Software: Release 14, 2015. College Station, TX: StataCorp LP). Baseline clinical data was analyzed to calculate descriptive statistics. Normality of continuous variables was visually assessed and if no substantial violations were noted, data was reported as means±standard deviations. Otherwise, they were reported as medians with interquartile ranges. Categorical data was presented as number of patients with percentages. Bivariate analysis was performed to assess the association between clinical variables and diagnosis of VTE. Continuous variables (age, body mass index, number of risk factors for VTE) were visually assessed for normality. Levene’s test was used to assess for equal variance among groups. If no substantial violations were noted, means and standard deviations were calculated using 2 sample t-test for equal variance. Variables violating normality assumptions were analyzed using the Mann-Whitney U-test, calculating medians and interquartile ranges. Categorical and dichotomous variables (VTE risk factors, race, stage) were examined using the χ2 test or Fisher’s exact test (if expected values for more than 20% of cells were less than 5). Odds ratios were reported with 95% confidence intervals. Using a backwards stepwise elimination approach, a multivariable logistic regression model was fit to accurately examine association of risk factors with VTE, adjusting for other covariates. The resulting model was assessed for calibration and discrimination using Hosmer-Lemeshow test for goodness of fit, classification table, and ROC curve. Regression diagnostics were run in order to identify potentially influential covariate patterns in the model. First-order interactions were assessed for using product interaction terms (interaction defined as p-value for the likelihood ratio test <0.05). The resulting model was assessed for calibration and discrimination using Hosmer-Lemeshow test for goodness of fit, classification table, and ROC curve. A Cox proportional hazards model was also fit in order to examine the association between individual covariates and time to clot development. Log-rank testing was performed to compare survivorship experience by groups and survivorship curves were generated using the Kaplan-Meier method. Assumptions of the proportional hazards model was confirmed visually using log-log plots and goodness of fit assessment. RESULTS/ANTICIPATED RESULTS: A total of 413 patients were identified for inclusion in the study. The majority of patients (83%) were of non-White race. Bivariate analysis revealed no significant associations between age, BMI, or race with diagnosis of VTE (p=0.75, 0.49, and 0.28, respectively). Patients who had more than 2 risk factors for VTE had a significantly increased likelihood of VTE diagnosis (p=0.02). There was a highly significant association between stage of USC and diagnosis of VTE (p=0.005). Patients with stage III and stage IV cancer were 2.4 and 3.5 times more likely to develop VTE than patients with stage I cancer (95% CI: 1.09–5.30, 1.74–6.83, respectively). Of the 70 patients who were diagnosed with VTE, most were not postoperative (64.3%) and a large proportion developed clots while receiving chemotherapy (35.7%). Patients who developed VTE while on chemotherapy had a median Khorana score of 1 (IQR: 1, 2). In logistic regression modeling examining association of VTE with potential risk factors, covariates selected as significant for inclusion at the p<0.25 level included cancer stage, composite number of risk factors, diabetes, hypertension, cardiovascular disease (CVD), and COPD. Composite risk score was identified to be a potential confounder of the relationship between individual risk factors and development of clot and was therefore left in the model for adjustment. After adjusting for other covariates, only stage 4 disease (OR: 2.66, 95% CI: 1.53, −4.64) and hypertension (OR: 2.90, 95% CI: 1.14–7.36) were associated with development of VTE and were included in the final model. No concerning violation of assumptions of logistic regression or interaction was identified. The Hosmer-Lemeshow goodness of fit test identified that the model was well-fit using 10 groupings (p=0.35) and receiver operator characteristic testing showed that the model had acceptable discrimination with a ROC value of 0.7. The final model was found to classify 83.1% of participants correctly. Regression diagnostics identified 4 potentially influential covariate patterns. These patterns were eliminated from the model and no meaningful differences were noted. Patients contributed a total of 16,414 person months of analysis time in study follow-up. A negative, linear association was noted between stage of cancer and time to clot development. Long-rank testing revealed a significant difference in failure by stage of disease (p<0.001) and presence of hypertension (p=0.03). Cox proportional hazard modeling revealed that after adjustment for other covariates, only cancer stage and the presence of cardiovascular disease were significantly associated with time to failure. Patients with cardiovascular disease had a 2.02-fold increased risk of CVD compared to those without CVD (95% CI: 1.16–3.47). Those with stage 3 and 4 cancer were 3.19 (95% CI: 1.53-6.64) and 8.05 (95% CI: 4.11–15.78) fold more likely to develop VTE compared to those with stage 1 disease, respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: Our study demonstrated that patients with USC are at high risk of developing VTE at all time points after their disease diagnosis, not just those who have undergone recent surgery. This risk is highest for women with hypertension, CVD, and stages III and IV disease. The fact that patients who developed clots on chemotherapy had an average Khorana score of 1, suggesting that they would not have been successfully risk stratified using previously published tools. To the best of our knowledge, this is the first study to report a high hazard for VTE in patients with serious endometrial cancer even several months after surgical staging. Although this is a retrospective study and cannot make inferences about VTE incidence, it generates the hypothesis that extended VTE prophylaxis may be beneficial in this cohort of patients regardless of their latency from surgical staging. Large randomized studies are needed to test this hypothesis.

OBJECTIVES/GOALS: Identify ways surveys capture the needs of researchers and community partners (CPs) to build a supportive community-engaged research (CEnR) infrastructure Identify strategies to match existing CEnR researchers and CPs who are interested in future CEnR projects Address educational needs of CPs and researchers for sustainable partnerships METHODS/STUDY POPULATION: The Penn State Community Health Equity & Engagement Research (CHEER) Initiative team developed and implemented surveys to capture the unique interests of Penn State researchers and community partners (CPs) in an effort to build a supportive community-engaged research (CEnR) infrastructure. CPs and researchers were identified from the Penn State Clinical and Translational Science CEnR Core, prior engagement in research studies, and through tracking systems of individuals interested in research. The researcher and CP surveys ascertained detailed information of existing CEnR projects and interests in future community-academic partnerships. These results guided six workshops including an Introduction to Community-Engaged Research, Community-Facing Grant Writing, and Research Ethics Training for CPs. RESULTS/ANTICIPATED RESULTS: A total of 99 PSU researchers and 119 community partners (CPs) throughout PA communities completed the baseline surveys. From the data collected, the CHEER Initiative cataloged over 100 CEnR projects, researcher interests, resources/support needed to jumpstart future CEnR projects, types of CPs, PA regions represented by CPs and researchers, and training resources needed to prepare CPs to engage in research efforts. Heat maps illuminating researcher/CP engagement were generated from survey results. While CEnR research projects spanned all 67 PA counties, several studies were in concentrated areas, and thus allow for opportunities to target CEnR outreach in less engaged areas. Data analysis from follow-up surveys will continue to serve as a foundation to best support existing and future CEnR projects. DISCUSSION/SIGNIFICANCE: The CHEER Initiative’s purpose is to reduce health disparities and increase wellness throughout underrepresented PA communities by promoting community-engaged research (CEnR). Surveys used to capture both CEnR interests of Penn State researchers and community partners built a successful and sustainable infrastructure for meeting this goal.

The Common Metrics Initiative aims to develop and field metrics to improve research processes within the national Clinical and Translational Science Award (CTSA) Consortium. A Median Accrual Ratio (MAR) common metric was developed to assess the results of efforts to increase subject accrual into a set of clinical trials within the expected time period. A pilot test of the MAR was undertaken at Tufts Clinical and Translational Science Institute (CTSI) with eight CTSA Consortium hubs. Post-pilot interviews were conducted with 9 CTSA Principal Investigators (PIs) and 23 pilot team members. Over three-quarters (78%) of respondents reported that the MAR could be useful for performance improvement, but also described limitations or concerns. The most commonly cited barrier to MAR use for performance improvement was difficulty in interpreting the single value that is produced. Most respondents were interested in using the MAR to assess recruitment at an individual trial level. Majority of respondents (63%) had mixed opinions about aggregating metric results across the CTSA Consortium for comparison or benchmarking. Collecting data about additional contextual factors, and comparing accrual between subgroups, were cited as potentially helping address concerns about aggregation. Significant challenges remain in ensuring that the MAR can be sufficiently useful for collaborative process improvement. We offer recommendations to potentially improve metric usefulness.

Research experience is often important for academic and career development. This paper describes the implementation and impact of a training program for temporary research assistants (RAs) at an academic medical center. The program includes a 9-month didactic lecture series covering research and professional development skills, a Quality Improvement project focused on improving research processes, and manuscript writing. Overall, the program goals of increasing confidence, self-efficacy, job satisfaction, and well-being, as well as providing an opportunity for career exploration, were met. Thus, this program has the potential to support temporary RAs and enhance their early research experiences.

Clinical research is complex, and research-related terms can be challenging to understand. Clear, supportive communication with patients, potential study participants, and their caregivers must be prioritized by healthcare providers as well as investigators and their research teams. In clinical research, health literacy best practices support the ethical tenets of respect, justice, and beneficence. Plain language advances the understanding of informed consent documents, as well as comprehension of educational information, recruitment materials, study instructions, and study results summaries, among others. Further, a more collaborative research partnership is fostered when study participants are given understandable materials, while a lack of understanding can delay accrual and decrease adherence. We launched a pilot initiative to develop a consensus-driven, plain language clinical research glossary to promote clarity, consistency, and transparency across clinical research stakeholder groups. The resulting resource, described herein, is intended to be used widely to support a greater understanding of clinical research and empower study participants. Considerations for expansion are also discussed.

OBJECTIVES/GOALS: The Colorado Immersion Training in Community Engagement (CIT) provides experiential training in community-based participatory research (CBPR). We summarized evaluations from the first ten years on program outcomes and lessons learned to inform future programming and the field of community research. METHODS/STUDY POPULATION: CIT is a six-month program that includes didactic sessions, group readings and reflections and a one week immersion experience in a Colorado community experiencing health disparities. The Evaluation Center - University of Colorado Denver provides external evaluation services to the Colorado Clinical and Translational Science Institute (CCTSI). Evaluators used three primary methods to collect data to evaluate the program; Document review, interviews, and surveys. Evaluation data were analyzed using the framework of CBPR Principles and the CBPR conceptual logic model to understand potential shifts in researchers’ thinking and actions, as well as to identify the potential for longer-term impact. RESULTS/ANTICIPATED RESULTS: As of 2020, CIT trained 122 researchers. 25 CIT alumni went on to receive 33 CCTSI Pilot Grants. Out of these 33 grants, an additional $8,723,000 of external grant funding was awarded to continue projects. Community Research Liaisons are a crucial component of the program through their efforts to bridge academic researchers and communities. Survey results indicated that community partners reported high levels of satisfactions with the program and shared stories about the impact they have seen in their community. Common challenges for researchers remain 1) protected time and institutional value and, 2) funding opportunities. DISCUSSION/SIGNIFICANCE: CIT has grown CBPR researchers. Similar programs should consider contributing factors: establishing institutional value and funding for CBPR initiatives with protected time for developing and maintaining community relationships. CIT offers a crucial connection between academia and community.

OBJECTIVES/SPECIFIC AIMS: The aim of this study is to compare intestinal phosphorus absorption in healthy adults and moderate stage chronic kidney disease patients in the context of a controlled feeding study METHODS/STUDY POPULATION: Participants are 30-75 years old and include 10 healthy subjects and 10 moderate-staged CKD patients. Each subject pool will be enrolled in a 9-day study period including 7 days of controlled feeding of a 1500 mg phosphorus diet. Following the controlled feeding, two days of absorption tests will take place (oral and IV tests) utilizing radioisotopic phosphorus to calculate fractional absorption efficiency. RESULTS/ANTICIPATED RESULTS: Current enrollment has produced 7 total matched subject (current n = 14/20). Four of the 7 pairs of completed subjects are female and 3 of 7 are black. Preliminary kinetic modeling data from the first enrolled subject show a moderate CKD patient with fractional absorption of 0.375. With forthcoming analyses, we expect that this fractional absorption result will not be statistically different from this subject’s matched pair, nor will each groups average absorption be different from the other. Additionally, we expect absorption to be maintained even with changes in secondary outcomes measures in serum (FGF23, 1,25-dihydroxyvitamin D, parathyroid hormone, and total phosphorus) in CKD patients. DISCUSSION/SIGNIFICANCE OF IMPACT: Lack of statistical difference in fractional phosphorus absorption between gropus would support that intestinal phosphorus absorption is inappropriately normal in CKD patients compared to healthy adults, despite evidence of abnormal phosphorus homeostatic mechanisms. Future studies will consider the effect of dietary P restriction, the most common nutrition intervention in moderate stage CKD, on fractional absorption efficiency in CKD.

OBJECTIVES/SPECIFIC AIMS: The 2 primary objectives were to (i) insure that Scholars can effectively communicate the translational impact of their research to a lay audience and (ii) assess the benefits and efficacy of having community, as well as faculty members, judge the translational impact of KL2 Scholar’s poster presentations. An explicit secondary goal was to further the engagement of community members in CTSI-sponsored translational research. METHODS/STUDY POPULATION: CTSI’s Education, Community Engagement, Discovery and Translation, and Translational Workforce Development Cores created the translational impact questions and evaluation sheets. The Community Engagement and Office of Discovery and Translation recruited community judges from their respective networks and they were assigned to relevant studies. Scholars were provided with the judges scoring template in advance. After the Research Poster Session, the KL2 Scholars evaluated the quality of their presentations and the impact of having feedback from Community Judges. The Community Judges evaluated their perceived “added value” to the research presentations and their interactions with the Scholars. Both Scholars and judges completed evaluations of the poster presentation and judging process, performed on a 5-point Likert scale. RESULTS/ANTICIPATED RESULTS: KL2 Scholars felt that the community impact judges provided valuable feedback on their research (3.8/5) and were satisfied overall with the poster session (3.4/5). In evaluating their own presentations, Scholars tended to rate themselves higher (4.2–4.6/5) on the clarity of their translational impact presentations than the community judges rated the Scholars (4.1–4.2/5). Scholars also rated themselves somewhat higher in the quality of their dealing with any ethical issues and their dissemination plan (4.0/5) than the community judges (3.8/5). Judges were very positive and felt they brought value to the experience (4.2–4.4/5). DISCUSSION/SIGNIFICANCE OF IMPACT: Community judges added qualitative value to the Scholar presentations based on the Scholar and community judge evaluations and based on comparison based on prior year poster sessions. Documenting the degree of impact of the combination of this proscribed poster format and community-judging process awaits future assessment of Scholar presentations before and after the next annual poster presentation.

OBJECTIVES/GOALS: To build a multi-function health profile for older adult (>50 years) women with a history of incarceration; explore group differences by age [45-54, 55-64, 65+], race, and length of incarceration; compare with age-matched control with no history of incarceration; and identify relative contribution of life course risk and asset factors. METHODS/STUDY POPULATION: We will analyze data from the Health and Retirement Survey (HRS) (UMichigan Institute of Social Research). The sample: women >50 years who took the leave-behind psychosocial questionnaire. The sample includes women with history of incarceration (n = 118; 2.93%) and (n = 115; 2.55%), respectively, and in the control n = 4,021 women (2012) and n = 4,114 women (2014). We will use descriptive statistics to profile physical, functional, cognitive, and social health; bivariable tests to compare groups on age-related morbidity, multimorbidity, frailty, and 4-year mortality risk; measure within group differences by age strata and race; estimate GLMs for effects of life course risk on dependent variables in and between groups; and if data permit, test direct mediation by life course risks and indirect by life course assets. RESULTS/ANTICIPATED RESULTS: Our results will characterize health in 4 health domains of women over 50 who have a history of incarceration. In bivariable analysis, we expect significant differences between groups on the dependent variables. Based on previous study using this data set, life course and accumulated stress theory, and our own previous research, we hypothesize that women with incarceration history will have more and earlier cardiovascular disease, stroke, and multimorbidity, higher 4-year mortality risk, and more and earlier cognitive impairment. We anticipate significant contributors to aging-related health outcomes to include childhood challenge and trauma history and, for Black women, perceived racial discrimination. We anticipate education and social support will partially mediate relationships. DISCUSSION/SIGNIFICANCE: The CHARMS findings, based on large-sample, representative, longitudinal HRS survey data, will contribute a profile of multi-function health status, risk, and assets in older women with CLS involvement. The much-needed characterization of aging in the group will set the stage for future interventional study to guide shifts in clinical practice.

OBJECTIVES/GOALS: Over 30% of patients with rheumatoid arthritis (RA) exhibit fibromyalgianess, a symptom cluster associated with increased pain sensitivity. Up to half of RA patients use oral glucocorticoids (GCs) long-term despite their known, dose-dependent toxicity. We examined the association between fibromyalgianess and oral GC persistence in RA patients. METHODS/STUDY POPULATION: We used data from the Central Pain in Rheumatoid Arthritis (CPIRA) cohort to follow participants with active RA on oral prednisone who initiated a new disease-modifying anti-rheumatic drug. We measured fibromyalgianess using the Fibromyalgia Survey Questionnaire (FSQ), previously shown to correlate with key fibromyalgia features often superimposed upon RA. We stratified fibromyalgianess severity as follows: FSQ<8 low, 8-10 moderate, >10 high/very high. We defined GC persistence as GC use at 3 month followup visit. We assessed the association between baseline fibromyalgianess (exposure) and GC persistence at followup (outcome) using multiple logistic regression, adjusted for demographics, RA duration, serostatus, and inflammatory activity measured by swollen joint count and C reactive protein. RESULTS/ANTICIPATED RESULTS: Of 97 participants on prednisone at baseline, 65% were taking prednisone at follow-up. Fifty-seven percent of participants with low baseline fibromyalgianess had persistent GC use, compared to 84% with high or very high fibromyalgianess. After adjustment as outlined above, participants with high/very high baseline fibromyalgianess remained more likely to be on prednisone at follow-up, relative to those with low fibromyalgianess (OR 4.99 [95% CI 1.20 – 20.73]). DISCUSSION/SIGNIFICANCE: In this cohort of patients with active RA, high fibromyalgianess is associated with persistent GC use, independent of inflammatory activity. This finding suggests non-inflammatory pain related to fibromyalgianess may be misclassified as inflammatory pain related to RA disease activity.

OBJECTIVES/SPECIFIC AIMS: This study aims to evaluate potentially traumatic events (PTEs) and its relationship with posttraumatic stress symptoms (PTSS), posttraumatic growth (PTG), and resilience in a sample of help-seeking individuals in Puerto Rico. METHODS/STUDY POPULATION: This is an analytic, cross sectional design. Adults receiving health services will participate in the study. Recruited participants will provide informed consent during a visit to a community mental health clinic or community hospital. They will complete a demographic document and four retrospective questionnaires about the variables of study. RESULTS/ANTICIPATED RESULTS: We expect that a high rate of potentially traumatic events (PTEs) is associated with an increased rate of posttraumatic stress symptoms (PTSS). We also expect that a high rate of PTSS is associated with an increased rate of posttraumatic growth (PTG). We expect that a high rate of resilience is associated with low rates of PTSS and PTG. DISCUSSION/SIGNIFICANCE OF IMPACT: This is a first step in the development of effective, clearly targeted interventions, specifically designed to treat negative effects, and also to facilitate positive change and resilience after PTE exposure.