ABSTRACT IMPACT: By outlining telehealth access disparities in the vision-impaired population, this scoping review has identified a set of effective and clinically appropriate implementation strategies and interventions for improving the technical, provider-level, and system-level accessibility of telehealth for vision-impaired patients. OBJECTIVES/GOALS: Evidence-based recommendations that ensure telehealth access for vision-impaired patients are critical to reducing health disparities. This review identifies, evaluates, and proposes strategies for public and private sector stakeholders to increase telehealth access for vision-impaired patients during the pandemic and beyond. METHODS/STUDY POPULATION: This scoping review included five steps: 1) the implementation of an iterative search strategy using relevant keywords to query 4 electronic databases (PubMed, Cochrane, Google Scholar, and Europe PMC) for relevant articles, 2) the application of a set of inclusion criteria to filter database results for article evaluation, 3) a quality assessment of the articles retained, 4) the extraction and summary of data from each assessed article, and 5) a narrative synthesis of the qualitative literature reviewed. RESULTS/ANTICIPATED RESULTS: To date, 21 articles that fit the inclusion criteria, published between 2006 and 2020, have been identified. To ensure the most robust collection of existing literature is aggregated, the iterative search strategy and inclusion criteria sorting process will be underway until December 20. The assessment of articles, and extraction and summary of data contained within said articles, will be finalized on January 20. The narrative synthesis will be complete on February 1. The poster and abstract will be complete by February 20. DISCUSSION/SIGNIFICANCE OF FINDINGS: Future research should examine outcomes associated with the implementation of accessible telehealth programs to identify remaining barriers. To improve outcomes for vision-impaired patients, policymakers, providers, payers, and industry must collaborate to promote accessibility in telehealth design and implementation.

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.

ABSTRACT IMPACT: The perspectives and guidance from adolescents and young adults (AYA) reported in this study could inform the evidence-based development and delivery of mobile health (mHealth) interventions to improve the health of AYA with chronic diseases. OBJECTIVES/GOALS: To elicit advice from AYA with chronic healthcare needs regarding if and how mHealth interventions could effectively promote illness self-management skills. We selected this goal because including the user perspective from the beginning of the design process could lead to greater future adoption. METHODS/STUDY POPULATION: We purposively recruited AYA patients from a pediatric hospital with heterogeneous chronic illnesses to identify universal chronic disease views rather than condition-specific perspectives. We conducted qualitative face-to-face semi-structured interviews with (N = 19) AYA between 16 and 20 years old (63.2% Latinx; 21.1% Black; 10.5% White; 5.3% Multiracial). Using ATLAS.ti, three coders completed thematic analysis to inform a conceptual framework on how AYA believe mHealth interventions could promote the development and maintenance of self-management skills. Member checking was conducted over the phone to obtain participant feedback on themes to enhance the validity of qualitative results. RESULTS/ANTICIPATED RESULTS: Results suggest that AYA develop self-management skills through several strategies, including 1) getting organized, 2) ‘making it work for me’ and 3) keeping the ‘right’ mentality. AYA described developing these strategies through: 1) receiving social support, 2) accessing helpful tools and technologies, and 3) going through a maturation process. They provided recommendations for how mHealth interventions could improve this process, including: 1) ‘what’ recommendations, describing the content or active ingredients that should be included in mHealth interventions, and 2) ‘how’ recommendations, describing the technological aspects or style in which the interventions should be delivered. DISCUSSION/SIGNIFICANCE OF FINDINGS: The results suggest that an appealing mHealth intervention could increase the support for AYA patients to proactively acquire self-management skills, avoiding trial-and-error or uneven access to guidance. Improving self-management could prevent poor health outcomes and increase quality of life.

ABSTRACT IMPACT: Findings from this study have the potential to improve interventions geared toward YBW, by highlighting the potential for technology-based HIV interventions. OBJECTIVES/GOALS: A stark disparity in HIV exists for Black American women, with 61% of all new HIV infections among American women occurring in Black women. Using technology to address community-level HIV risk may be beneficial, however few studies have examined the association of tech-based communication and HIV prevention behaviors among Black women. METHODS/STUDY POPULATION: Egocentric social network data from 201 young Black women (YBW) were collected from June 2018 to December 2018 to identify how social media use (e.g., amount of time, type of social media used, health information seeking) and sexual health communication (e.g., talk about condom use via face-to-face, text or phone and talk about HIV testing via face-to-face, text or phone) were associated with condom use, HIV testing and interest in pre-exposure prophylactic (PrEP). Statistical analysis proceeded in two stages, descriptive statistics and multivariate logistic regression modeling. RESULTS/ANTICIPATED RESULTS: Instagram (82%) and Snapchat (79%) were the most used social media platforms for communication with SNMs. About 20% of YBW reported spent 4 or more hours on social media per day, and a majority of YBW spoke to at least one SNM via text (85%), face-to-face (98%), or on the phone (97%). Multivariate logistic regression results indicated that YBW who spoke to their SNMs via Instagram had 3.23 times the odds of using condom during last sex, however if they spoke to SNMs on twitter or spent more then 4 hours on social media they had a decrease in odds of using condoms. YBW had 96% decreased odds of ever being tested for HIV if they spoke to a SNM face-to-face about condom use; and notably, YBW had 3 times the increased odds in interest of using PrEP if they had sex with someone they met online or if they sought sexual health information online. DISCUSSION/SIGNIFICANCE OF FINDINGS: By assessing the modes of communication YBW are using to speak with their SNMs and their associations with HIV prevention behaviors, we can better determine the most optimal, efficient, and effective ways of utilizing technology for HIV intervention.

ABSTRACT IMPACT: Optimizing the use of endotracheal aspirate cultures (EACs) has the potential to improve the care of complex mechanically ventilated children by improving testing practices and avoiding unnecessary antibiotic treatment for false-positive results. OBJECTIVES/GOALS: An electronic survey has previously been employed to characterize the practices and attitudes around blood cultures among critically ill children. The objective of this work was to develop and pilot a new survey as a tool to understand practices and attitudes that could inform quality improvement initiatives to optimize EAC practices. METHODS/STUDY POPULATION: Informed by prior experience of diagnostic stewardship of EAC in other settings and using a similar structure to the blood culture practice survey, we developed an electronic self-administered survey sent to respiratory therapists, advanced practice providers, and physicians at the Johns Hopkins All Children’s pediatric intensive care unit. RESULTS/ANTICIPATED RESULTS: A total of 27 of 87 clinicians (37%) responded to the survey (22 respiratory therapists, 9 attending physicians and 1 advanced practice provider). Responses indicated samples are typically collected by respiratory therapists via in-line (endotracheal) or open suctioning (tracheostomy). Most respondents did not feel EACs could lead to unintended negative consequences (71%), agreed practices vary between people (89%), and felt an algorithm would help align the clinical team (79%). Most respondents agreed some clinicians may be reluctant to change practice (82%) and may not change practice due to concern for missing diagnosis of ventilator-associated pneumonia or tracheitis (78%). Surveillance cultures were not used in this unit and there were no prior EAC diagnostic stewardship efforts. DISCUSSION/SIGNIFICANCE OF FINDINGS: This survey captured practices, perceptions and barriers to changes that will inform the implementation of quality improvement initiatives to optimize EAC use in this unit. Future studies can consider utilizing an electronic survey to describe practice variation, clinician believes and attitudes about EAC testing in ventilated patients.

ABSTRACT IMPACT: We review our strategy to use live community events on Facebook to share health and clinical research information and share further steps to increase engagement. OBJECTIVES/GOALS: To describe the use of live community events to enhance communication about clinical and health research through a Facebook platform (MN Research Link) with diverse social media users. The project identified variables associated with video engagement and strategic implications. METHODS/STUDY POPULATION: From June 2019 to November 2020 we streamed 31 events on the MN Research Link Facebook public page. Events highlighted different investigators’ clinical and health research in the areas of mental health, health and wellness, chronic diseases and immunology/infectious diseases. Facebook analytics were used to determine the number of views, total minutes viewed, average video watch time, and audience retention. Engagement score was calculated as the total number of interactions (likes, shares, and comments) divided by total number of followers (N=1437), expressed as a percentage RESULTS/ANTICIPATED RESULTS: Events averaged 24secs/16 min (SD=0.4). A mean of 1.61 (SD=1.28) followers viewed the events live but an average of 417.52 (SD=793.50) followers viewed after the event posted. The average engagement score was 1.1%. Mean total minutes viewed for all 31 videos was 253.5 (SD= 437.6). Viewers spent an average of 17 seconds (SD=0.01) watching each piece of video content. On average 28 followers viewed the events for at least 1-minute event (SD= 48.7). Audience retention at the halfway point for each video was 15.74% (SD=0.19). DISCUSSION/SIGNIFICANCE OF FINDINGS: Results suggest that novel approaches are necessary for active engagement. Promotion of live events is recommended to increase participation and length of engagement. Prior length of engagement (average 17 seconds), suggests refining video introduction will increase engagement.

Implementation of clinically useful research discoveries in the academic environment is challenged by limited funding for early phase proof-of-concept studies and inadequate expertise in product development and commercialization. To address these limitations, the National Institutes of Health (NIH) established the National Centers for Accelerated Innovations (NCAI) program in 2013. Three centers competed successfully for awards through this mechanism. Here, we present the experience of one such center, the Boston Biomedical Innovation Center (B-BIC), and demonstrate its remarkable success at the translation of innovations to clinical application and commercialization, as well as skills development and education.

ABSTRACT IMPACT: Points to strategies to de-implement ineffective, harmful, or unproven practices, lowering burden and cost of healthcare, using evidence-based recommendations on low value care. OBJECTIVES/GOALS: Ineffective, harmful, or unproven practices add burden and cost of healthcare. In national efforts to de-implement low value care (LVC), Choosing Wisely ®campaign generated 25 recommendations through the American Academy of Nursing (CW AAN). Our study described nurse-awareness of CW AAN recommendations as requisite toward de-implementing LVC. METHODS/STUDY POPULATION: A multi-stakeholder state action coalition led the project to achieve the Institute of Medicine Future of Nursing goals by describing nurse awareness of CW AAN recommendations. The survey was the first among nursing professionals. Use of human subjects was approved at the lead university. Registered Nurse contact information was obtained from the state Board of Nursing of a large mid-South state. Qualtrics ®surveys patterned after the CW survey of physicians’ awareness were administered online by the state Center for Nursing Workforce Studies. Content experts developed 2 surveys’‘ one for Registered Nurses (RNs) and one for Advance Practice Registered Nurses (APRNs)’‘ to account for differences in scope of practice. Surveys assessed current knowledge and perception of the Choosing Wisely ®AAN campaign. RESULTS/ANTICIPATED RESULTS: Over six weeks, 374 nurses participated (295 RNs and 79 APRNs). About half of each group indicated that unnecessary nursing care was a ‘somewhat serious problem.’ Only 21% of RNs and 26% of APRNs were aware of Choosing Wisely ®AAN recommendations. Participants identified reasons for the prevalence of low value care in practice as being concerns about malpractice issues, lack of time with patients for meaningful discussion, ‘just to be safe,’ and patients insisting on getting the test or procedure. For the RN group, cost of LVC was rarely discussed; in the APRN group, cost was frequently discussed. Of the APRNs who were aware of CW, 90% believe the recommendations were helpful. When asked for LVC de-implementation suggestions, 78% said EBP recommendations would be effective; at the same time, 20% had low knowledge of EBP. DISCUSSION/SIGNIFICANCE OF FINDINGS: RNs and APRNs reported low awareness of CW AAN advice. While representative, sample size limits generalization. De-implementation in learning health systems will include socioecological strategies focused on provider awareness and confidence, patient preference, cost, strength of evidence, and safe work culture to diffuse fear of litigation.

ABSTRACT IMPACT: This work underscores the importance of judicious utilization of inpatient therapy services as a means to keep patients MORE independent and prevent readmissions OBJECTIVES/GOALS: We aimed to assess the potential over-utilization of physical therapy consults on a hospital medicine service using validated Activity Measure Post Acute Care (AM-PAC) score cutoffs. METHODS/STUDY POPULATION: We conducted a chart review of all patients admitted to the uncovered hospital medicine services at a large academic hospital for one year. For patients who had a PT consult at any time during their admission we obtained age, admission AMPAC score, and discharge destination. PT consults were considered ‘potential overutilization’ for AMPAC scores >/=19 based on previous studies validating this cutoff for predicting discharge to home. Descriptive statistics were used to summarize % of patients < 65 years old vs. >/=65 years and % of patients discharged to home vs. post-acute care. Multivariable logistic regression was used to examine independent associations between age group, AMPAC group, and an interaction term (age group x AMPAC group) with odds of being discharged home. RESULTS/ANTICIPATED RESULTS: Of 6,634 patients admitted during the year, 58% (n=3582) had a PT consult. Mean age was 66.3 +/-15.4 and mean AMPAC was 18.3 +/- 5.3. Seventy percent were discharged home (N=2497). Using AMPAC of >/= 19, 55% of consults were ‘potential overutilization’. Patients <65 with AMPAC>19 represented 31% of PT consults. AMPAC>19 had increased odds of discharge home (OR 3.58 [95% CI=2.17 -5.91]; P<0.001) as did age <45 years (OR 1.81 [95% CI=1.09-3.00]; P=0.02). A significant interaction existed between all ages and AMPAC>/=19 (For age<45 OR 2.85 for discharge home [95% CI=1.37 -4.30] P=0.002; For age 46-64 OR 2.43 for discharge home [95% CI=1.37-4.34] P=0.002). Combining age with AMPAC>/=19 had additional predictive value for discharge home (Pr=89% [95% CI 81%-97%] using age<45 vs. (Pr=83% [95% CI 77%-90%]) using age<45 alone. DISCUSSION/SIGNIFICANCE OF FINDINGS: Many PT consults may represent potential over-utilization. Avoiding these could save hundreds of PT hours per year by conservative estimate. Combining age with AMPAC scores can help predict who may not require a PT consult. Reallocating PT resources to the patients who do require it can help prevent functional decline and readmissions.

ABSTRACT IMPACT: We hosted the Indiana Clinical and Translational Sciences Annual meeting virtually this year which resulted in positive feedback survey scores over 90% and an estimated 87% cost savings OBJECTIVES/GOALS: COVID-19 has forced many in-person meetings to become virtual, not unlike our 2020 Indiana Clinical and Translational Sciences Institute Annual Meeting. However, where anecdotal feedback has shown dissatisfaction with some on-line meetings, we were able to exceed our goals of engaging our audience, securing positive feedback and even saving money. METHODS/STUDY POPULATION: More than 500 people attended the virtual 2020 Indiana Clinical and Translational Sciences Institute (CTSI) Annual Meeting on September 11. The event had two plenary speakers and was completely online, utilizing both Zoom and Microsoft Teams to connect participants with the presenters. Brian Druker, MD, director of the Knight Cancer Institute at Oregon Health & Science University, was the winner of this year’s August M. Watanabe Prize in Translational Research. He gave the first plenary presentation titled, ‘Imatinib as a Paradigm of Targeted Cancer Therapies.’ Consuelo Wilkins, MD, Vice President for Health Equity at Vanderbilt University Medical Center, gave the second plenary titled, ‘Confronting Racial Inequities through Research.' Concurrent online breakout rooms hosted the live poster session. RESULTS/ANTICIPATED RESULTS: Despite being conducted online, the virtual Indiana CTSI annual meeting registered more participants than in years past and secured high feedback scores of 90%, all while experiencing 87% cost savings over last year’s in-person meeting. By utilizing Microsoft Teams as a technology for attendees to the meeting to 'chat’ and 'network’ with one another during the poster presentations and virtual lunch break we were able to demonstrate the implementation of translational science through online plenary and general session presentations as well as the poster presentations. Mailing certificates to the poster winners in advance, allowed them to share their accolades with the audience by holding up their certificates once their winning posters were announced. An e-annual report also supported the success of the meeting. DISCUSSION/SIGNIFICANCE OF FINDINGS: The cost savings and traditionally high feedback scores received through this year’s Indiana CTSI annual meeting, mean virtual meetings are a viable way to disseminate and implement translational science. In addition the 2020 Indiana CTSI annual report received a Gold MarComm award, providing third party recognition of its impact.

Large translational research initiatives can strengthen efficiencies and support science with enhanced impact when practical conceptual models guide their design, implementation, and evaluation. The National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) program brings together data from 72 ongoing maternal–child cohort studies – involving more than 50,000 children and over 1200 investigators – to conduct transdisciplinary solution-oriented research that addresses how early environmental exposures influence child health. ECHO uses a multi-team system approach to consortium-wide data collection and analysis to generate original research that informs programs, policies, and practices to enhance children’s health. Here, we share two conceptual models informed by ECHO’s experiences and the Science of Team Science. The first conceptual model illuminates a system of teams and associated tasks that support collaboration toward shared scientific goals. The second conceptual model provides a framework for designing evaluations for continuous quality improvement of manuscript writing teams. Together, the two conceptual models offer guidance for the design, implementation, and evaluation of translational and transdisciplinary multi-team research initiatives.

Neonatal sepsis is a major cause of death and disability in newborns. Commonly used biomarkers for diagnosis and evaluation of treatment response lack sufficient sensitivity or specificity. Additionally, new targets to treat the dysregulated immune response are needed, as are methods to effectively screen drugs for these targets. Available research methods have hitherto not yielded the breakthroughs required to significantly improve disease outcomes, we therefore describe the potential of zebrafish (Danio rerio) larvae as preclinical model for neonatal sepsis. In biomedical research, zebrafish larvae combine the complexity of a whole organism with the convenience and high-throughput potential of in vitro methods. This paper illustrates that zebrafish exhibit an immune system that is remarkably similar to humans, both in terms of types of immune cells and signaling pathways. Moreover, the developmental state of the larval immune system is highly similar to human neonates. We provide examples of zebrafish larvae being used to study infections with pathogens commonly causing neonatal sepsis and discuss known limitations. We believe this species could expedite research into immune regulation during neonatal sepsis and may hold keys for the discovery of new biomarkers and novel treatment targets as well as for screening of targeted drug therapies.

ABSTRACT IMPACT: As technologies emerge at an increasing pace, the product developed through this work will guide rural health experts through a repeatable method of technology evaluation and selection at a faster and more reliable pace than otherwise possible. OBJECTIVES/GOALS: New technologies are emerging at an increasing pace, which leads to the question: ‘how is one to select a specific technology for their research?’ In response, this project endeavored to develop a technology evaluation and selection framework for rural health researchers. METHODS/STUDY POPULATION: The approach selected for this project included three phases. Phase one was to gain an understanding of rural health challenges, health-related emerging technologies, and rural health resources. Phase two involved using the information from phase one to select and adapt a set of technology foresight and forecasting analysis tools to be compiled within a framework. The third phase of the project was to prototype the framework, obtain researcher feedback, and iteratively implement improvements. Recommendations for the future of the framework were also developed during the third phase. RESULTS/ANTICIPATED RESULTS: The resulting product is the ‘Rural Health: Evaluation and Selection of Technology (RHEST) Framework.’ The RHEST Framework is a guide made available to use to aid in technology selection during the development of a new rural health project. The framework guides researchers through various stages, including ideation, analysis, and decision. Technology analysis tools are introduced in each stage, with links to additional information. The guide also contains a resource catalog for quick information look-up to find data sources, funding opportunities, and expert connections. Quantitative and qualitative data captured indicate that the product would add value for rural health researchers. DISCUSSION/SIGNIFICANCE OF FINDINGS: The initial version of the RHEST framework is limited in value because it is a static document and the primary audience are researchers. The value potential could improve considerably, however, if the framework were expanded to be a dynamic resource available to rural health care providers.