OBJECTIVES/SPECIFIC AIMS: Immigrants to North America receive more interventions at end of life.The reasons for this are not entirely clear but may potentially be due to knowledge gaps. The primary objective of this study was to measure and describe levels of perceived knowledge about palliative care among immigrants to the US compared to those born in the US. Our secondary objective was to identify trusted sources for seeking information about palliative care among immigrants and compare these trusted sources with those born in the US. We hypothesized that immigrants would have less knowledge of palliative care than those born in US and would trust different sources for information about palliative care. METHODS/STUDY POPULATION: We analyzed data from the nationally representative 2018 Health Information National Trends Survey (HINTS 5, cycle 2). Questionnaires were administered via mail between January and May 2018 to a population-based sample of adults. The primary outcome of interest was assessed using the item “How would you describe your level of knowledge about palliative care?” The secondary outcome of interest was determined using the item “Imagine you had a strong need to get information about palliative care, which of the following would you most trust as a source of information about palliative care?” All analyses were complete case analyses and conducted with survey commands using SAS 9.3 (SAS Institute Inc, Cary, NC, USA). Descriptive statistics were calculated, and bivariate analyses run between the outcomes of interest and sociodemographic characteristics (age, sex, education, race/ethnicity, nativity, English language proficiency). Multivariable logistic regressions were conducted to assess the role of nativity, controlling for statistically significant and relevant sociodemographic variables. Jackknife weighting was used to generate population-level estimates. RESULTS/ANTICIPATED RESULTS: The response rate was 33% (n=3384) and included 2846 (85.3% weighted) born in the US and 492 (14.7% weighted) not born in the USA. About 70% of those born in the US and 77% of immigrants (weighted) responded that they had “never heard of palliative care.” Trusted sources of palliative care were very similar between the groups (all p > 0.05). Both groups’ preferred trusted source of palliative care knowledge was “health care provider,” with over 80% of respondents in each group selecting this option. Printed materials and social media were the least popular trusted sources among both groups. After adjusting for relevant sociodemographic characteristics, we found no association between poor knowledge of palliative care and nativity (p=0.22). Female respondents had 2.5-fold increased odds of reporting low levels of perceived knowledge of palliative care (OR = 2.58, 95% CI = 1.76-3.78; p<0.001). Education was an important predictor of perceived knowledge of palliative care; as education level increased, so did perceived knowledge of palliative care (p < 0.001). DISCUSSION/SIGNIFICANCE OF IMPACT: Perceived knowledge of palliative care is poor generally, regardless of birthplace. Trusted sources for palliative care are similar between immigrants and those born in the US. Education is important and is a strong predictor of perceived knowledge of palliative care. Women perceive they have lower levels of knowledge of PC than men. Differences in end of life care between immigrants and non-immigrants cannot be explained by knowledge differences. Further research is needed to examine the potential factors including suboptimal communication between providers and immigrant patients to understand why these differences are noted. Future strategies for improving knowledge of palliative care should target health care providers as the key trusted source of information to help address deficits noted in this study.

OBJECTIVES/SPECIFIC AIMS: The aim is to investigate if sustained weight loss due to caloric restriction can be achieved in a community setting, using faith-based organisations (FBOs) as hubs; and if this weight loss can lead to the re-establishment of normal metabolism (using the normalisation of blood sugar levels while off glucose lowering medication as a proxy) in a person with pre-diabetes or T2DM. METHODS/STUDY POPULATION: Members of the FBO with either a diagnosis of T2DM for <6 years or pre-diabetes as defined by the American Diabetes Association (ADA); and a Body Mass index (BMI) of ≥27 kg/m2 are eligible. After counselling, participants will be placed on a 12 week low calorie liquid diet, supplemented by low carbohydrate vegetables, totalling approximately 840 kcal/day. During this time, participants will be monitored weekly at their FBO by trained members of their congregation, with oversight from the study team, for change in weight, fasting blood glucose, waist and hip circumference and blood pressure. This will be followed by a 3 month period during which participants will receive ongoing dietary advice as they transfer to a balanced, reduced calorie, solid diet. Physical measurements will be monitored monthly during this 3 month period. The next 6 months is a period where the participants and the FBO health team move towards ‘independence’. This involves further training of the FBO health team and participants in healthy lifestyle habits; and a commitment by the leadership of the FBO to assume ‘ownership’ for NCD monitoring within their community. Physical measurements will be repeated at the end of one year. RESULTS/ANTICIPATED RESULTS: Based on previous studies, we expect that participants who are compliant to the diet will lose approximately 2.2 kg per week over the 12 week period. This will be associated with rapid (within 1 week) normalisation of fasting blood glucose levels (<7mmol / L). We expect that, due to the accessibility of NCD monitoring and support, that participants to be satisfied with their care and compliant to their regime and that the results of the first 12 weeks will be sustained at the 12 month follow up. We expect that the FBO leadership will assume the responsibility of continuing and NCD programme, not only for the local congregation but for the surrounding community. DISCUSSION/SIGNIFICANCE OF IMPACT: Diabetes remission with a low calorie diet is a viable intervention for T2DM remission however social support is key to an individual’s success. This novel study which proposes institution of a diabetes remission intervention which fits into the participant’s locale and involves peer support, should increase long-term success.

OBJECTIVES/SPECIFIC AIMS: This presentation will highlight a structured, collaborative approach to implementing and utilizing the RPPR process created at the University of Minnesota CTSI in response to the need to enhance the quality, efficiency, consistency, and utilization of annual program reporting. The approach is in line with the NCATS’s strategic objective that encourages all CTS organizations to “disseminate research results and best practices broadly, and promote a culture of openness, sharing and transparency” (NCATS, 2016, p. 19). Program activities that support translational processes and contribute to clinical outcomes are complex, nonlinear, and multidisciplinary (Smith etal., 2017). In this complex context, the meaningful engagement and reflection of program staff and collaborators is essential for all aspects of program planning, implementation, reporting, and dissemination. The University of Minnesota CTSI’s key objectives, goals, and uses of RPPR are as follows: - Develop, align, and leverage the RPPR to fulfill the accountability requirements, needs, and expectations of multiple stakeholders: NIH/NCATS, Internal Advisory Board and External Advisory Board, campus/hub, program staff and collaborators. - Engage the CTSA staff and collaborators as a team in multiple aspects of program reporting. - Inform strategic management, continuous improvement, monitoring and evaluation, organizational learning and dissemination to program stakeholders. - Translate the reported information into practical, evidence-based issues and strategic questions for the leadership discussions and advisory board consultations, actionable work plans, communication to stakeholders, organizational learning, and translational science knowledge base. METHODS/STUDY POPULATION: A case study of the programmatic/evaluative and methodological approach/technique development that resulted in a formal, structured, collaborative, transparent process with detailed guidelines, templates, and timelines. The process and content for reporting has been developed via a variety of methods and sources: specific funder (NIH) requirements, Huddle meetings, document/content/database analysis, reflection meetings with component staff, informal conversations, and observations. Preparation for the report began almost one year in advance, including careful analysis of the report requirements, developing user-friendly, detailed guidelines, templates, and examples. The guide templates and worksheets were created as a result of time spent navigating current instructions provided by NIH and NCATS. Timeline/project plan was developed with start and end dates for all of the moving parts along with identified responsible personnel for each of the tasks. A grid of the grant components and responsible personnel was designed to highlight the matrixed organization of the grant and the need to work across components to create single reports. The RPPR key categories have also been considered for incorporating and tracking in a program activity/customer tracking system for ongoing data management and use. As a complex translational science program, UMN CTSI has multiple initiatives, variables, and metrics to report. The program staff has been deeply engaged in the evaluative reflection to identify, prioritize, and incorporate into the RPPR the metrics that most useful to manage and describe CTSI processes, participation, products, and outcomes. Program components responded differently to the collaborative approach implemented. The M&E technical assistance was implemented in 3 different ways: components either did the M&E RPPR template themselves, with minimal M&E team assistance; responded to comments and information provided by the M&E team as a first step; or requested a significant level of assistance from M&E. Participants/partners in developing and using RPPR include CTSI program leadership and staff, administration, communication staff, M&E team, and our collaborators. RESULTS/ANTICIPATED RESULTS: The proposed comprehensive approach to the annual program performance reporting shows sound promise to enhance program staff engagement, report utilization, learning, strategic management, self-evaluation capacity, and continuous improvement within a clinical and translational science organization. DISCUSSION/SIGNIFICANCE OF IMPACT: This structured approach’s impact is significant in that it fills the current gap in the practice, literature, and methodology and offers a practical example of a “practice that works” for CTR (and other) organizations and programs striving to improve their reporting practices, staff engagement, learning, and program impact. Leveraging and synergizing the RPPR requirements and other complex, data-demanding obligations and needs can help the CTS programs move beyond the once-a-year compilation of project accomplishments and challenges to developing and sharing a thoughtful translational science program success story. References: National Center for Advancing Translational Sciences. (2016). NCATS Strategic Plan. NIH. Available at: https://ncats.nih.gov/strategicplan Smith, C., Baveja, R., Grieb, T., & Mashour, G. (2017). Toward a science of translational science. Journal of Clinical and Translational Science, 1(4), 253-255. doi: 10.1017/cts.2017.14

OBJECTIVES/SPECIFIC AIMS: Of the six Centers for Medicare and Medicaid Services (CMS) monitored diagnoses targeted for readmissions reductions, reasons for readmissions within academic hospitals are poorly understood and reflect complex interactions between the patient, provider and organizational-level responses to initial hospitalization. Learning health systems (the organizational and orchestrated integration of research into evidence-based practice) can address the complexities of readmissions through an innovative approach to knowledge translation and patient-centered outcomes research. The objective of this review is to define and optimize the architecture of learning health systems to produce a dynamic pre-implementation framework of knowledge translation and patient-centered outcomes research, leveraging two engines (research and learning) within the academic and clinical settings for reducing readmissions. METHODS/STUDY POPULATION: Three databases were utilized for this scoping review (PubMed, Academic Search Premier, and Scopus) focusing on 1.) learning health systems and the methods of defining and building these systems within an academic hospital setting and 2.) the use of learning health systems in reducing readmissions within academic hospitals. Empirical articles and reviews pertaining to the architecture, development, conceptualization, definition, and translation of learning health systems were identified and compiled into a scoping review and proposed framework. RESULTS/ANTICIPATED RESULTS: The scoping review yielded 139 articles; from which 28 articles were retained. No articles were found utilizing learning health systems to address readmissions. Thus, a new architectural framework was developed incorporating common architectural themes from the literature with adaptations to fit the interests of patients, providers, and researchers in reducing readmissions within academic hospitals (Figure 1). DISCUSSION/SIGNIFICANCE OF IMPACT: Given the dearth of information applying learning health systems to readmissions, the proposed architecture for an integrative learning health system can be utilized as a dynamic foundation for adoption and pre-implementation planning for reducing readmissions within academic hospital settings. Additionally, the authors expect this model to be tested and continually refined to address historical and emerging issues for clinically-relevant and clinically-effective approaches to patient-centered practice and research.

OBJECTIVES/SPECIFIC AIMS: The objective of this exploratory study is to evaluate the relationship between the individual genetic variants in COMTrs4680 and DRDrs1076560 and relevant alcohol use behaviors (i.e. alcohol consumption and reward processing behaviors) in non-dependent drinkers within experimentally controlled IV-ASA CAIS sessions. The overall goal of this study is to begin gathering data on the influence of individual genetic variants on alcohol consumption and other drinking-related behaviors. This will aid in the creation of a polygenic model of risk for AUD which will provide more insight into how the mesolimbic pathway is affected by alcohol use. METHODS/STUDY POPULATION: Study population: The sample included male and female non-dependent drinkers (N=149). Genotypes for functional polymorphisms in COMT (rs4680) and DRD2 (rs1076560) genes were determined for all subjects from blood samples obtained during screening. Alcohol consumption was assessed using the 90-day Timeline Followback Interviews (TLFB). Study population demographics: Self-reported gender (53.5% identified as male); Self-reported race (61.2% identified as white); Age ranged from 21-46 years old, with 22 years being the mode. Experiment: Free access (open-bar) intravenous alcohol self-administration (IV-ASA) using the computer-assisted alcohol infusion system (CAIS) paradigm; Subjects had the choice of pressing a button ad libitum for IV alcohol infusions during the session, neurobehavioral questionnaires were collected throughout the 2.5-hr alcohol infusion session. Primary outcome measures included: Total Rewards, Peak breath alcohol concentration (BrAC) achieved, and Total Ethanol consumed. Statistical Analyses: Conducted using SPSS IBM Statistics Versions 1.0.0-2482; non-dependent drinkers were organized into two groups based on their genotypes, minor allele carriers and major allele homozygotes. Outcome measures were compared between genotype groups using analysis of variance or non-parametric Mann-Whitney U-test as appropriate. RESULTS/ANTICIPATED RESULTS: -We expect the genetic makeup of the sample to be reflective of larger genome samples that are publically available (e.g. e!Ensembl) - Initial analysis for COMTrs4680 did not reveal significant effects on IV-ASA measures. Specifically, the majo DISCUSSION/SIGNIFICANCE OF IMPACT: Alcohol Use Disorder (AUD) affects millions of men and women globally. The heterogeneity within AUD individuals has made it difficult to identify biological and/or psychological factors that could be targeted for the development of treatments. By using the human laboratory model of free access IV-ASA, this study evaluated the relationship between dopaminergic genetic variants, COMTrs4680 and DRDrs1076560, and alcohol consumption in non-dependent drinkers within a controlled experimental environment. This study will begin to evaluate genetic and behavioral data that can be used to create a polygenic model of risk for AUD, which will provide more insight as to how the mesolimbic reward pathway is affected by alcohol use and contributes to risk for AUD.

OBJECTIVES/SPECIFIC AIMS: As pediatric care becomes more concentrated in large urban hospitals, smaller rural hospitals with reduced pediatric care capacity may opt to transfer pediatric patients to higher levels of care even if the patient has a condition that is manageable in a general ED. Up to 20-40% of pediatric transfers are considered avoidable, placing a burden on the patient, their family and the health care system. The aim of this study is to determine the association between pediatric readiness (as measured by the National Pediatric Readiness Project score) and risk of interfacility transfer. We hypothesized that emergency departments with higher measures of pediatric readiness would be less likely to transfer pediatric patients to another facility. METHODS/STUDY POPULATION: The most recent and complete National Pediatric Readiness Project data were from 300 California hospitals in 2012. These data include the overall pediatric readiness score, presence of inter-facility guidelines (written protocols on patients needing care not available at the hospital), presence of interfacility agreements (written agreements with other hospitals regarding transfer patients), and other variables on the facility’s capacity to care for pediatric patients. We linked these hospital data with patient encounter data from the California Office of Statewide Health Planning and Development Emergency Department (ED) Database (OSHPD) using hospital name and zip code. To be eligible for the study, the patient must have a documented ED encounter and be less than 18 years old during the encounter. A patient was considered a transfer patient if they were transferred to a separate general hospital, children’s hospital, federal health care facility, rehabilitation facility, Critical Access Hospital or psychiatric hospital. Chi-square tests and t-tests were used for descriptive statistics. For non-normal data, we used the non-parametric Kruskall-Wallis test. We also used logistic regression to compare the odds of transfer between comparison groups. Statistical analyses were conducted in the R environment version 3.4.4. RESULTS/ANTICIPATED RESULTS: In 2012, there were 2,604,723 pediatric ED encounters, of which 10,966 resulted in a transfer (0.4%). Transferred patients on average were older (15 vs. 5 years, p < 0.001) and more likely to be female (58.6% vs 46.6%, p < 0.001). The transfer group originated from hospitals with a lower median pediatric readiness score (76.0 vs 78.3, p < 0.001). Patients were less likely to be transferred if they were seen at a hospital with written guidelines with transfer protocols (OR 0.89, 95% CI 0.83—0.95, p < 0.001). Patients were more likely to be transferred if they were seen at a hospital with written interfacility agreements with other hospitals (OR 1.17, 95%CI 1.10—1.25, p < 0.001). We anticipate, that even with more sophisticated multilevel statistical models, pediatric readiness scores will remain associated with odds of transfer. DISCUSSION/SIGNIFICANCE OF IMPACT: These preliminary data suggest that hospitals with higher levels of pediatric readiness and written guidelines with transfer protocols are less likely to transfer pediatric patients. There may be actionable policy and procedural items that a hospital could enact to lower the rate of transfer patients. Future analyses will include more complex statistical modeling to adjust for confounders, will include inpatient data, and will compare the risk of potentially avoidable transfers between hospitals with varying levels of pediatric readiness.

OBJECTIVES/SPECIFIC AIMS: The goal of this study was to investigate the associations of systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP) with knee articular cartilage composition using magnetic resonance imaging (MRI)-based T2 relaxation time measurements in study participants from the Osteoarthritis Initiative (OAI). METHODS/STUDY POPULATION: In this longitudinal study, 1,139 participants from the OAI, a multi-center, observational study of the evolution of knee OA, were selected using the following inclusion criteria: right knee Kellgren Lawrence (KL) score (radiographic classification of OA severity) 0-2 indicating no to mild radiographic OA at baseline, no history of rheumatoid arthritis at baseline, available blood pressure measurements at baseline, available T2 measurements in at least three knee compartments at baseline and 48-month follow-up. Linear regression models were performed using standardized values for SBP, DBP and PP as primary predictors and change in cartilage T2 over 48 months, a measure of cartilage matrix quality and degeneration, as the primary outcome. PP was defined as SBP minus DBP. Change in superficial layer and deep layer cartilage T2, which reflect differences in the laminar organization of knee cartilage T2, were also included as outcomes. Statistical models were adjusted for common risk factors for knee OA (baseline age, sex, BMI, KL score) as well as number of currently used anti-hypertensive medications (AHM) reported at baseline. We included AHMs whose primary indication was the treatment of hypertension including beta blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARB), thiazides, chlorthalidone, dihydropyridine calcium channel blockers (CCB) and aliskiren. All predictors, outcomes and covariates (except sex) were analyzed as continuous variables. We included interaction terms in the models to evaluate whether the covariates (age, sex, BMI, KL score, number of AHMs) modified the association of SBP, DBP and PP with cartilage T2. RESULTS/ANTICIPATED RESULTS: The average age of all study participants was 58.8 years (SD ± 8.6) with a higher proportion of men (59.4%), average body mass index (BMI) was 28.3 (SD ± 4.5), average SBP was 122.4 (SD ± 15.4) mmHg, average DBP was 75.5 (SD ± 9.6) mmHg and 469 (38.1%) study participants were taking at least one AHM. Higher baseline DBP was significantly associated with a faster increase in global T2 (0.22 [0.10,0.35], P < 0.001), global deep layer T2 (0.20 [0.03,0.36], P < 0.022) and global superficial layer T2 (0.39 [0.20,0.58], P < 0.001). These associations were significant in both unadjusted and the models adjusted for age, sex, BMI and KL score. No significant associations were found between SBP or PP and cartilage T2 and no significant interactions were found between SBP, DBP, PP and the covariates. DISCUSSION/SIGNIFICANCE OF IMPACT: Higher baseline DBP was associated with a faster increase in knee cartilage T2, suggesting accelerated cartilage degeneration. This association was stronger for the superficial layer of knee cartilage T2 compared to the deep layer. Although further basic mechanistic studies are needed to elucidate the underlying pathophysiology of this relationship, these results suggest lowering DBP may influence knee OA.

OBJECTIVES/SPECIFIC AIMS: For this reason, our overall objectives are to determine (i) whether natural disaster-related PNMS alters infants’ EC at two years of age, and (ii) if the timing of exposure moderates its effects on toddlers EC. METHODS/STUDY POPULATION: We propose a longitudinal study with 50 mother-toddler dyads. Natural disaster-related PNMS would be measured at 12-18 and 24-30 months of age and will include: objective exposure and maternal distress. EC will be measured with a questionnaire and a Laboratory Temperament Assessment Battery at two years of age. To accomplish our objectives, we will conduct regression and moderation analyses. RESULTS/ANTICIPATED RESULTS: We anticipate that children exposed to Hurricane-related PNMS would present low EC levels compared to those with low prenatal exposure. DISCUSSION/SIGNIFICANCE OF IMPACT: These results are expected to provide evidence for further promoting early intervention and ameliorating adverse effects of PNMS on child outcomes.

OBJECTIVES/SPECIFIC AIMS: Promote knowledge translation and evidence-informed decision-making by assessing barriers and facilitators to balancing cost and quality of care within the US state of Maryland and nation of Denmark. METHODS/STUDY POPULATION: Open-ended and semi-structured key-informant interviews were conducted in 2016 and 2017 among high level decision-makers in Maryland (N=21) and the Danish (N=17) healthcare systems, including hospital, local, regional, and cross-organizational administrators and elected officials. The interviews consisted of questions related to: (1) currently practiced and preferred approaches to resource allocation and development and use of quality performance measures, and (2) preferred sources, formats/styles, modes of information, and decision-making strategies based on a shift from volume to quality-driven care. RESULTS/ANTICIPATED RESULTS: Decision-makers in Maryland expressed the need for collaboration in a changing environment, yet increasingly rely on cost and quality outcomes data to drive decisions and note the struggle to identify credible and useful information. Maryland decision-makers also face challenges in regulating utilization and costs without mandated participation of physician practices within the global budget cap model, which is perceived to be a primary driver of healthcare utilization in the hospital sector. Similarly, decision-makers in Denmark conveyed the importance of quantitative data to aid decisions, however, stress collaboration and dialogue as driving factors and important sources of information. Danish decision-makers also express challenges to wide-spread adoption of a quality-driven approach due to unsustained quality assurance regulatory bodies. DISCUSSION/SIGNIFICANCE OF IMPACT: The findings suggest implementation of value-based healthcare is highly driven and influenced by availability of credible data, which may significantly impact development of policies and innovative cost control strategies, and regulatory oversight to promote adoption of quality measures in decision-making. Furthermore, collaboration within and across healthcare organizations remains a key component to health system improvement as it fosters dialogue and sharing of best practices among stakeholders.

OBJECTIVES/SPECIFIC AIMS: The objective of this study was to prospectively assess caregiver-perceived barriers to accessing post-acute care for their injured child and determine if caregivers report ongoing, unmet health needs for their children after trauma. METHODS/STUDY POPULATION: This was a prospective cohort study that followed 50 participants for 6 months and administered surveys to parents of children who are admitted to a pediatric level 1 trauma center for injury. Surveys were given bi-weekly regarding care children received after hospital discharge. At 3 months, parents were surveyed over the phone on whether they were able to access all needed health services and if there were any perceived barriers to obtaining or providing at-home care. At 6 months, parents were given the Child & Family Follow-up Survey to assess ongoing physical, mental, social, and scholastic needs. Free responses and transcribed interviews were analyzed using thematic content analysis and frequencies are reported for discrete data. RESULTS/ANTICIPATED RESULTS: Out of 50 families recruited, 47 completed follow-up assessments. At 3 months, common themes regarding challenges after hospital discharge included difficulty scheduling specialist care; uncertainty in managing their child’s pain; transitioning home without enough knowledge to meet their child’s medical needs; lack of communication between multiple providers; distress at having providers release children to full activities before caregivers were comfortable. At 6 months, approximately 24% of parents reported children had ongoing cognitive limitations, 29% reported emotional problems, 19% reported physical limitations, 33.3% reported difficulty in school, and 15% reported play/social difficulties. DISCUSSION/SIGNIFICANCE OF IMPACT: Evidence suggests families face significant barriers in accessing follow-up care, despite nearly universal health insurance coverage for children. Further, a large percentage of parents report ongoing health needs, despite the majority of the cohort having only mild or moderate severity injuries. Making follow-up care more patient-centered for families of traumatically injured children may improve compliance with medical regiments and reduce the likelihood of future disability. Examples of this may be coordinating care among multiple specialty providers, so that patients with multiple injuries can schedule multiple follow-up appointments on the same day. Additionally, more caregiver education on administering pain medication, caring for wounds, and safe practices for returning to full activities would be beneficial for families.

OBJECTIVES/SPECIFIC AIMS: The aim of this study is to understand how porosity and collagen filling impact cell proliferation and differentiation in 3D printed scaffolds. METHODS/STUDY POPULATION: 3 groups of scaffolds will be 3D printed using FDM: solid scaffold, porous scaffold and porous scaffold with collagen gel (n=10 for each group) Internal geometries and surface structure will be analyzed using micro CT and Scanning Electron Mi RESULTS/ANTICIPATED RESULTS: We hypothesize that porosity and collagen filler will increase signal from Picogreen assay and ALP assay when normalized to scaffold surface area, indicating enhanced cell proliferation and differentiation. DISCUSSION/SIGNIFICANCE OF IMPACT: 3D printing PCU is a relatively new technique with very little published in the literature. Previous work has focused on the mechanical properties and not the biological response to the polymer. Understanding how to optimize cellular proliferation and differentiation can lead to the development of better implants that will integrate into the host’s structure and facilitate tissue regeneration.

OBJECTIVES/SPECIFIC AIMS: Using national Medicaid claims, this retrospective cohort study aims to compare the outcomes of levetiracetam (LEV) versus phenobarbital (PHB) as initial monotherapy in infants with epilepsy aged one month to one year. We primarily analyzed health services outcomes, as follows: (1) Emergency Department (ED) visits: proportion of those with at least 1 ED visit, time to first ED visit, total number of ED visits, proportion leading to inpatient admission (2) Inpatient Admissions: proportion of those with at least 1 admission, time to first admission, total number of inpatient admissions, total length of stay (3) Treatment discontinuation: proportion of those who discontinued medication, time to discontinuation, proportion of those with prescription of second antiepileptic drug (AED) (4) Cost: total cost at 1 year from first prescription. METHODS/STUDY POPULATION: The project is a retrospective cohort study utilizing Medicaid claims from 2009-2012 from all states and DC. Inclusion criteria were: (1) Epilepsy diagnosis (ICD9 345.x) at age 1 month to 1 year (2) 1 year of continuous Medicaid enrollment Exclusion criteria were: (1) Neither LEV nor PHB monotherapy as initial treatment (2) Neither LEV nor PHB prescription within 45 days of epilepsy diagnosis (3) Less than 1 year of follow-up after first LEV or PHB prescription (4) Infantile Spasms diagnosis (5) Brain Surgery (6) Death within 1 year of follow-up Using R for statistical analysis, we analyzed outcomes including ED visits, inpatient admissions, treatment discontinuation, and total cost. In this abstract, we present our preliminary bivariate analysis. RESULTS/ANTICIPATED RESULTS: Demographics and Etiology: Compared to infants prescribed PHB (n = 1954), infants prescribed LEV (n = 1248) were older (median 6 months [IQR 3-9] vs 3[2-6]; p < 0.001), more likely to be white (44.2% vs 38.9%; p < 0.05) and not Hispanic (63.5% vs 58.9%; p<0.05). There were also important differences in epilepsy etiologies (p < 0.05). For example, infants prescribed LEV were more likely to have a diagnosis of tuberous sclerosis (1% vs 0.15%) or traumatic brain injury (12.8% vs 0.56%). Health Services Outcomes: After 1 year, infants prescribed LEV had more ED visits (2 [0-4] vs 1 [0-3]; p < 0.001) but shorter inpatient length of stay when admitted (3 days [2-5] vs 3 [2-6]; p < 0.001). They were less likely to discontinue the medication (46.6% vs 64.3%; p<0.001) but more likely to have a second AED prescription (53.3% vs 43.4%; p < 0.001). Other outcomes, including total cost, were similar. DISCUSSION/SIGNIFICANCE OF IMPACT: This preliminary analysis suggests that the healthcare trajectory of infants treated with LEV and PHB differ in complex ways. In ongoing work, we are conducting a multivariable comparative effectiveness analysis of LEV versus PHB using propensity score weighting to account for observable selection bias and multiple imputation to account for missing data.

OBJECTIVES/SPECIFIC AIMS: Objectives: To examine the differences in health outcomes of adolescents and young adults treated for malignancy at a pediatric cancer center compared to an adult cancer center. To determine the differences in receipt of supportive care for adolescents and young adults with malignancy who are treated at a pediatric cancer center compared to an adult cancer center. METHODS/STUDY POPULATION: Methods: This will be a retrospective cohort study of patients from the ages of 15 to 39 years who are diagnosed with a malignancy common between adult and pediatric facilities within 2013-2017. Data will be abstracted from an existing database at MCW containing patient information at the adult and pediatric centers. Study population: Patients ages 15-39 years of age who are categorized as young adolescent and adult patients (AYAs). Patients are eligible for the cohort if they have a diagnosis that is common between adult and pediatric oncology centers and that is made within the years 2013-2017. These diagnoses will include ALL, AML, Hodgkin Lymphoma, Non-Hodgkin Lymphoma, Germ cell tumors, Osteosarcoma, Ewing Sarcoma, other sarcomas, and CNS tumors. RESULTS/ANTICIPATED RESULTS: There will be a difference in health care utilization, clinical trial enrollment and toxicity of therapy in AYAs with malignancies treated at an adult facility than AYAs treated for similar malignancy at pediatric facility. DISCUSSION/SIGNIFICANCE OF IMPACT: There will be a difference in receipt of supportive care referrals, including psychology, social work, sperm banking, initiation of palliative care, in AYAs treated at a pediatric facility compared to AYAs treated at adult facility.

OBJECTIVES/SPECIFIC AIMS: To determine the association of participant’s characteristics and socio-cultural factors including acculturation, community identity and discrimination with the adherence to cancer screening guidelines and participants’ quality of life. METHODS/STUDY POPULATION: As part of the Cancer Disparities Research Network pilot cohort, the study recruited 333 participants across four sites: Boston Chinatown, African American communities in Philadelphia, and Hispanic communities in Columbus, and rural white communities in Appalachia, Ohio. Enrolled participants were eligible if they were 40 to 74 years old, did not live in a nursing home or other facility, and had no prior invasive cancer diagnosis. Additionally, each participant met at least one of the following criteria: living in a medically underserved area, having low literacy, low income (defined as 100% of the 2015 Federal Poverty Level FPL according to 2015 FPL Guidelines), or being uninsured or receiving subsidized health insurance coverage. Participants completed a baseline survey of demographic data, health status, including health behaviors and risk factors to cancer, Primary Care Physician (PCP) status and most recent breast, cervical, prostate, skin and colorectal cancer screenings. Information related to discrimination, acculturation or adaptation, and sense of belonging to their community was collected using validated instruments. RESULTS/ANTICIPATED RESULTS: Of the 333 participants enrolled in the study, 65.5% were women, 14.1% were 40-50 years of age, 59.8% were 51-64 years, and 26.1% were 65-74. The cohort was racially and ethnically diverse: 8.4% of participants identified as Hispanic, 30.3% as non-Hispanic White, 31.2% as non-Hispanic Black, 29.4% as non-Hispanic Asian, and 0.6% as Other. 62.2% spoke English, 8.1% Spanish, and 29.7% Chinese as their primary language. Low incomes were common: 33.6% reported incomes $15,000 or less, and 25.8% reported incomes between $15,000 and $24,999. Overall adherence to USPSTF guidelines on cancer screening rates was 77.9% for breast cancer, 71.1% for cervical cancer, and 67.7% for colorectal cancer. Analyses will present the association of acculturation, community identity, and discrimination with cancer screening and quality of life measures. DISCUSSION/SIGNIFICANCE OF IMPACT: This study will promote the increase of cancer disparities research, and reinforce the importance of inclusion and increased recruitment of diverse populations in future studies. By determining the potential factors associated with cancer disparities among minority populations, it may provide new information for clinicians to have more cultural sensitivity addressing potential disparities in the clinical setting. It will also promote the creation of more tailored interventions and programs to deliver adequate healthcare among these populations.

OBJECTIVES/SPECIFIC AIMS: Population health research seeks to identify and address variation in needs, care experiences, and outcomes for a defined geography or subgroup. Solutions often require collective actions of complex interdependent health and social service systems in communities. System sciences focused on implementation and dissemination are vital for developing interventions that work at the intended scale in these “real world” environments; yet these approaches are often underutilized. METHODS/STUDY POPULATION: The UCLA Clinical Translational Science Institute (CTSI) co-developed a Population Health Program with the local health department to advance the practice and use of these system science methods. The vision is integrated training, methodological innovation, and real-world application in the region. One specific aim of the program is preparing investigators to apply suitable translational methods to solve population health problems in both health systems and in public health. Investigators from different parts of the university partnered with health services and public health leadership to develop and team-teach new curriculum in system sciences that integrates their disciplines (epidemiology, education, psychology, health policy and management). RESULTS/ANTICIPATED RESULTS: New curriculum in population and implementation/improvement sciences offers junior investigators effective modules and training opportunities that can support their career awards. The program is also increasing the receptivity and readiness of population health delivery systems to apply system science methods to pressing problems. Program metrics include total participants, research yielded by the collaboration, and skills and system science mindset acquisition among trainees, investigators, and health personnel. DISCUSSION/SIGNIFICANCE OF IMPACT: CTSAs can partner with health and public health agencies to develop shared infrastructure, developing capacity in the university and in the partnered local agencies so that investigators and the agencies that are responsible for population health can work together to apply suitable translational methods to solve population health problems in both health systems and in public health.

OBJECTIVES/SPECIFIC AIMS: The aim of this study is two-fold (1) to include a participatory action research design in the development of a community-based health advocate (HA) training programme which empowers community members to support the Barbados diabetes remission study 2 protocol – a low-calorie intervention for T2DM remission (2) to study the implementation of this programme with in select faith-based organisations (FBOs) which will act as community hubs. METHODS/STUDY POPULATION: Translation was informed using the RE-AIM framework. The target population were members of select FBOs. We assessed the readiness of FBOs to become community hubs in relation to human resources (the HA team must include someone with a clinical degree), infrastructure capacity (a private room for interviews) and the perspective (knowledge and attitude) of the FBO leadership to both the training and diabetes remission programmes. An open recruitment for HAs was made to the FBO membership and all who responded were accepted to the programme; which consisted of 8 weeks of face to face sessions inclusive of lectures and practical demonstrations and exercises specific to NCDs e.g. assessment of basic clinical parameters, ethics and nutrition. This was followed by a simulation exercise and a formal objective structured clinical examination (OSCE). HAs will participate in focus groups aimed at exploring the barriers and facilitators to the use of social media as a support system; this will be followed by participatory design workshops where the HAs will design support systems, inclusive of social media support, to assist participants in the diabetes remission intervention. RESULTS/ANTICIPATED RESULTS: All three FBOs that were approached responded favourably and the programme was described as ‘necessary’ and ‘timely’ by the leadership. The FBOs were assessed and found to be ready. Thirty-eight persons signed up for the programme (more than the 21 we anticipated); 31 (82%) attended at least 1 session and 29 completed the training; this indicates that implementation in the community is feasible. All who completed the programme attained an overall passing grade indicating the effectiveness of, and fidelity to the training. Initial feedback on the programme from HAs and volunteers indicates that it was acceptable. DISCUSSION/SIGNIFICANCE OF IMPACT: This community-based training programme was successful in terms of reach, as both the FBO and the individual HA responded favourably; and effectiveness as measured by the expanded skill set of the HA. Initial feedback suggests that implementation of the programme is feasible in the community and acceptable to the HAs. Although this model focusses on diabetes remission utilising FBOs as hubs, it can be easily adapted to other NCDs e.g. hypertension and mental health; other disciplines e.g. surveillance; and other communities e.g. workplaces, homeless shelters.

OBJECTIVES/SPECIFIC AIMS: This study aims to understand the factors influencing engagement with out-patient services from pregnancy to 1 year postpartum among women in recovery from opioid use disorders (OUD). METHODS/STUDY POPULATION: We conducted semi-structured qualitative interviews and a brief survey with 20 mothers in OUD recovery recruited from health care and community organizations in Western MA. Transcripts were coded by two independent coders and analyzed using a qualitative descriptive approach. RESULTS/ANTICIPATED RESULTS: The average duration of any addiction treatment among the 20 participants was 5.6 years with 80% receiving medication-assisted treatment during a pregnancy. Approximately two-thirds experienced relapse during pregnancy or the first year postpartum. We identified 3 themes elucidating women’s experiences around service engagement: “How I see myself” (personal development), “How services see me” (service delivery quality), and “Are you with me?” Personal development included response to past trauma, coping strategies and self-advocacy, and adjusting to parenthood. Service delivery quality was influenced by service design, efficacy of individual providers, and cultural norms (organizational and societal). In the final theme, intersection of individual and service-level factors influenced the degree and quality of the women’s experience engaging with services. DISCUSSION/SIGNIFICANCE OF IMPACT: Women describe successful engagement when they experience service providers as being emotionally supportive, delivering relevant services, and advocating on their behalf. To best support and engage families affected by OUD, relevant and timely services should be linked with compassionate delivery.

OBJECTIVES/SPECIFIC AIMS: Given the poor prognosis of HCC and its increasing incidence worldwide, identifying biomarkers of HCC has been an active area of research. While biomarkers are being identified at a rapid pace, many are still in early phases of clinical study and very few have proven clinical utility. The objective of this study is to identify novel biomarkers of HCC and evaluate their clinical utility as predictors of disease development and prognosis with specific emphasis on disease recurrence after liver transplantation. Biomarkers will be identified through GWAS, as well as through analysis of qualitative and quantitative liver traits by magnetic resonance imaging (MRI). These novel biomarkers will then by implemented into risk prediction models aimed to assess an individual’s risk for development of HCC and stratify their level of risk according to predicted disease prognosis. METHODS/STUDY POPULATION: This will be a case-control study, analyzing data from previously created biorepositories from four cohorts of recipients across multiple centers which have undergone liver transplant. First, a GWAS will be performed to identify genetic variant(s). Second, pre-transplant MRI’s will be evaluated using CAVASS software to assess liver quantitative and qualitative traits, including visceral adiposity. Lastly, these findings will be implemented into risk stratification models to assess each individual’s level of risk for development of HCC and for recurrence of HCC after transplant. RESULTS/ANTICIPATED RESULTS: We hypothesize that genetic variant(s) are associated with positive HCV status and the development of HCC. Additionally, we hypothesize that increased visceral adiposity measured by MRI will have an association with recurrence of HCC after transplant. Lastly, we hypothesize that possession of these aforementioned features will be associated with an increased risk of HCC development and recurrence after transplant. DISCUSSION/SIGNIFICANCE OF IMPACT: As more is learned about the nature and reliability of these biomarkers, their potential clinical applications will be revealed. Ideally these proposed risk score models will ultimately be used by clinicians to provide personalized disease management while optimizing the allocation of health care resources. For instance, this may lead to changes in the MRI screening frequency of patients considered to be at high risk for HCC. The ability to diagnose patients early and provide personalized therapies may ultimately result in fewer disease related mortalities in the future.

OBJECTIVES/SPECIFIC AIMS: 1) Describe strategies pediatric providers perceive improve chlamydia screening of sexually active female adolescents (SA), and 2) describe barriers to regular screening of SA for chlamydia METHODS/STUDY POPULATION: Using qualitative methods, 14 general pediatric providers across 7 clinical sites in Vermont were interviewed to ascertain best practices and remaining challenges. Semi-structured interviews lasting 30-45 minutes were audiotaped and transcribed. Chlamydia screening rates provided by BCBS-VT were used to categorize participant responses across three performance tiers, data were coded, and themes identified within these tiers. RESULTS/ANTICIPATED RESULTS: Facilitators: When asked to describe facilitators of chlamydia screening, providers in the top tier of chlamydia screening emphasized the importance of adequate insurance to cover the cost of testing. Providers in the middle performance tier cited use of pre-visit questionnaires, and those in the bottom performance tier identified no best practices. Other strategies included improving physician confidence and awareness, establishing practice- and individual-level routines, and providing strong leadership and communication of local screening rates. Barriers: Across the 3 performance tiers, the most common challenges to consistent chlamydia screening were threats to patient confidentiality, cost of the screening test, and requirement for patient disclosure of sexual activity. Less commonly, providers were concerned that adolescent patients were not reliable to obtain screens off-site, or fill treatment prescriptions without the help of a parent. DISCUSSION/SIGNIFICANCE OF IMPACT: The need for systematic, confidential, and inexpensive means for screening SA for chlamydia was highlighted in both the best practices and challenges described by providers of pediatric care in the suburban practice setting. Policy and practice interventions may target these needs to improve the reproductive health of female adolescents.

OBJECTIVES/SPECIFIC AIMS: There is currently a gap in the literature regarding the relationship between acute cellular rejection and frailty in LT patients. We aimed to evaluate the association between frailty and acute cellular rejection in LT patients. METHODS/STUDY POPULATION: Included were LT recipients from 2014-16 at a single center who had a frailty assessment prior to LT using the Liver Frailty index consisting of grip strength, chair stands, and balance. Frailty was defined by a Liver Frailty Index > 4.5. Data on acute cellular rejection at 3 months (primary outcome) and immunosuppression regimens were collected from medical chart review. Univariable and multivariable logistic regression assessed the associations between frailty and acute cellular rejection. RESULTS/ANTICIPATED RESULTS: A total of 241 LT recipients were included. Of these, 37% were female, 55% had Hepatitis C, and the median (IQR) age was 60 (54-65); 46 (19%) were classified as frail. 98% of patients were on a combination of mycophenolate, corticosteroids and tacrolimus on discharge compared to 80% by 3 months. Within the first 3 months post-LT, 7 (15%) of frail patients versus 10 (5%) (p = 0.02) of non-frail patients experienced acute cellular rejection. In univariable logistic regression, frailty was associated with a 3.3 times higher odds of acute cellular rejection at 3 months (95%CI 1.19, 9.26, p = 0.02); age (OR 0.91), Black race (OR 3.2), autoimmune disease (OR 2.3), and diabetes (OR 0.3) were also associated with acute cellular rejection at 3 months with a p-value<0.20. In a multivariate analysis, after adjusting for age, frailty remained significantly associated with rejection (OR 3.06, 95%CI 1.04, 9.01, p = 0.043). There were no significant differences in immunosuppression regimens or rates of mycophenolate dose reduction in the first 3 months between frail and non-frail patients. DISCUSSION/SIGNIFICANCE OF IMPACT: Frailty is associated with an increased rate of acute cellular rejection within 3 months post-LT, despite similar immunosuppression regimens and doses. Future studies should evaluate whether frailty should be considered in the management of immunosuppression in the early post-transplant period.