We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
This journal utilises an Online Peer Review Service (OPRS) for submissions. By clicking "Continue" you will be taken to our partner site
https://mc.manuscriptcentral.com/jcts.
Please be aware that your Cambridge account is not valid for this OPRS and registration is required. We strongly advise you to read all "Author instructions" in the "Journal information" area prior to submitting.
To save this undefined to your undefined account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your undefined account.
Find out more about saving content to .
To save this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
OBJECTIVES/GOALS: Non-operative management is preferred for pediatric solid organ injury (SOI). Despite this children treated at adult trauma centers (ATC) are more likely to be treated surgically and have worse outcomes than those treated at pediatric trauma centers (PTC). We hypothesize there are disparities by sex and race in management of pediatric SOI at ATC vs PTC. METHODS/STUDY POPULATION: Retrospective review of the National Trauma Data Bank (NTDB) from 2010-2018 was conducted. Inclusion criteria were age£18 and injury to spleen, liver or kidney. Outcomes at American College of Surgeons accredited ATC, PTC, and combined ATC/PTC trauma centers were evaluated. The primary outcome was operative management. Secondary outcomes include length of stay, and in-hospital complications. Multivariate logistical regression adjusting for race, sex, and insurance type will be performed. RESULTS/ANTICIPATED RESULTS: 40,111 children were treated for SOI from 2010-2018. 39.3% were treated at an ATC and 26.4% at a PTC. Of children treated at an ATC, 62% were White, 17% were Black, and 1% were Asian. Children treated at the PTC were 60% White, 20% Black, and 0.9% Asian. Primary insurance type was Medicaid for 33% of patients at an ATC and 39% at PTC. Median length of stay at ATC and PTC was 4 days (2-7) and 3 days (2-6) respectively. 3.85% of patients at ATC underwent splenectomy compared to 0.8% at PTC. It is anticipated that further analysis will demonstrate that ICU admission, transfusion, embolectomy, and other operative interventions will be more prevalent at ATC than MTC. Moreover, we anticipate that multivariate logistical regression will show the odds of receiving operative management at each center differ by race, sex and insurance type. DISCUSSION/SIGNIFICANCE: Initial analysis of the NTDB from 2010-2018 shows that children treated for SOI at ATC receive operative interventions more often than those treated at PTC. Elucidating disparities in SOI care is an important step towards minimizing the impact of these disparities and better allocating resources such that they may be eliminated.
OBJECTIVES/GOALS: This study aims to assess associations over time between several area-based indices of concentration at the extremes and COVID-19 hospitalization and death in Los Angeles County, from January 2020 to June 2023. These measures reflect concentrations of racial/ethnic and economic segregation at the census tract level. METHODS/STUDY POPULATION: Indices of concentration at the extremes (ICEs) for economic segregation, racial/ethnic segregation, and a combination of the two were constructed for each Los Angeles County (LAC) census tract, using 2015-2019 ACS data. The index ranges from -1 to 1 and is the number of advantaged households (HH) minus the number of disadvantaged HH over the total number of HH measured. Economic segregation is HH income over $100,000 vs. below $25,000 per year and racial/ethnic segregation defined as White and Non-Hispanic vs. non-White or Hispanic HH. The distribution of index scores was divided into quintiles (Q1-Q5) for all LAC census tracts. Age-adjusted hospitalization and death rates were derived at the census tract level by quarter (QTR) based on Los Angeles County Department of Public Health surveillance data. RESULTS/ANTICIPATED RESULTS: Age-adjusted hospitalization and death rates were consistently higher across all quarters in Q1 (most deprived) vs. Q5 (most privileged) for all ICE measures. For ICE of economic segregation, the age-adjusted hospitalization and death rate ratios between Q1 and Q5 were 2.12 (range: 1.32 - 4.15; peak 2020 QTR2) and 2.02 (range: 1.46 - 3.21; peak 2021 QTR1), respectively. For ICE of racial segregation, the age-adjusted hospitalization and death rate ratio between Q1 and Q5 was 2.03 (range: 1.08 - 3.95; peak 2020 QTR3) and 1.77 (range: 1.03 - 2.80; peak 2021 QTR1). The ICE of economic/racial segregation combined was the highest, with averages of the age-adjusted hospitalization and death rate ratios between Q1 and Q5 being 2.26 (1.16 - 4.43; peak 2020 QTR2) and 1.99 (range: 1.22 - 3.32; peak 2021 QTR1). DISCUSSION/SIGNIFICANCE: This study assesses the impact of geographic segregation based on indices that quantify the concentration of both deprivation, privilege, and racial/ethnic group, demonstrating that segregation and economic deprivation are consistently associated with higher rates of age-adjusted hospitalization and death from COVID-19 in LAC.
OBJECTIVES/GOALS: Investigators are looking to integrate DE&I into trials, increasing study population diversity. In response, the Community and Recruitment programs of the Oregon Clinical and Translational Research Institute (OCTRI), built a collaborative, community-focused system for investigators interested in community engagement and recruitment. METHODS/STUDY POPULATION: Historically, the OCTRI Community and Recruitment programs operated independently. To build a community-focused support system for investigators, we began with the programs learning about each other’s goals, values, and operations over a six-month period. Over the next two years, we then began integrating into each other’s team meetings and processes. Each team has their own process for providing services to investigators, consisting of intake and consultations. To these, we added tags for the other’s program topics. This allowed efficient identification of opportunities for referrals and joint consultations. Program leads meet regularly to discuss referrals and partnerships allowing for more effective and consistent collaboration. RESULTS/ANTICIPATED RESULTS: Over the last two years, OCTRI Community and Recruitment built a collaborative process that allows investigators to work with both programs, receiving comprehensive, supportive assistance and education on how to design their study, engage with community, and recruit participants in a community-based setting. During this time, the programs have: provided consultations that discussed the other’s program (N=21); made direct referrals to the other program (N=4); and, provided joint consultations (N=2). Studies that are investigator-initiated, in planning phase, and population focused were found to benefit most from the collaborative efforts. Additionally, we have improved the collaborative process during this time, resulting in more streamlined, efficient support services for investigators. DISCUSSION/SIGNIFICANCE: Diverse study populations and DE&I are essential to research. This collaborative, community-engaged recruitment approach by our programs allows investigators to leverage both programs’ resources and expertise. We continue to identify best practices and study types that benefit from this collaborative approach to improve our services.
OBJECTIVES/GOALS: The NC Translational and Clinical Sciences (NC TraCS) Institute’s Latine Community Review Board (CRB) provides expertise to researchers seeking to culturally adapt interventions and improve language access in clinical and translational science. Early efforts aimed to expand CRB membership, build member capacity, and assess CRB impact. METHODS/STUDY POPULATION: Founded in 2021, the NC TraCS Latine CRB is an advisory group of natively Spanish-speaking, Latine North Carolinians who contract with research teams (RTs) to review Latine community-facing study materials (e.g., decision aids, scales, recruitment scripts) and provide feedback for improving or validating materials’ linguistic accuracy and cultural relevance. Bilingual staff facilitate members’ review of materials, use focus group methods to solicit feedback, and report key findings and suggested revisions to RTs. In 2023, we recruited new age-, gender-, and racially diverse members; and implemented process and impact evaluation, via (1) post surveys of RTs and (2) assessment of members’ experiences and visions for growth utilizing the Focused Conversation Method (Top-network, 2021). RESULTS/ANTICIPATED RESULTS: Since 2021, NC TraCS has conducted 11 Latine CRB review sessions to support 7 research studies. Current CRB members (n=8) report that (1) their work effectively supports Latine inclusion in research; (2) increased group size and diversity help ensure study materials are comprehensible to heterogenous Latine populations; and (3) an hourly member compensation rate equal to the hourly rate of TraCS’ staff accurately represents member contributions. Members also cited that they value open communication, continuous improvement, communication via email and group chat, periodic programming meetings, and RT updates on study outcomes. Post-session RT surveys to date (n=3) show that RTs would recommend this program to other researchers (pending survey responses from RTs this year will provide additional impact data). DISCUSSION/SIGNIFICANCE: Early data highlight the value of fairly compensated, bilingually coordinated input from diverse Latine community members for improving studies’ inclusion of heterogeneous, multilingual communities. Our approach can inform the development, growth, and continuous improvement of multilingual review boards at other research institutions.
OBJECTIVES/GOALS: The CHW TAB is exploring pre-diabetes knowledge and perceived needs in south Texas to facilitate the role of CHWs to increase the capacity of community members to better manage their prediabetes diabetes risk. The long-term goal of this project is to show how the diagnosis of pre-diabetes can be managed to prevent type 2 diabetes. METHODS/STUDY POPULATION: We selected a two-pronged approach to gather quantitative and qualitative data. CHW TAB members collected data participated in different aspects of the project (e.g., study design, survey development, etc.). Data collection procedures include Quantitative - a 9-item survey in English and Spanish administered by each participating CHW in 2022 at community events. One hundred surveys were collected. In Phase 2: Qualitative, participants attended focus groups to gather in-depth data about pre-diabetes management, including challenges and opportunities, which will inform CHW-led intervention development. Eight English and one Spanish focus groups, with 65 participants in 6 counties were completed. RESULTS/ANTICIPATED RESULTS: This project is still in progress. Preliminary results show that most survey participants identify as Hispanic, and half have been diagnosed with pre-diabetes. Additionally, 87.8% report that prediabetes is a problem in their community. Preliminary focus group findings indicate that knowledge and support for managing prediabetes is missingin South Texas. Many participants report feeling “doomed” to develop type 2 diabetes but are eager to share their experiences. Additionally, participants report that family and culture play a huge part in their ability to eat healthier foods. DISCUSSION/SIGNIFICANCE: These findings can help identify knowledge gaps, strengths, and areas for promoting and empowering better health behaviors among those who have pre-diabetes. Participant feedback and focus group responses will inform a CHW-led educational intervention through our TAB.
OBJECTIVES/GOALS: Despite food pantries’ efforts to improve nutritional quality and encourage healthy cooking, limited evidence exists regarding pantry shoppers’ culinary preferences and kitchen equipment access. This project utilized pantry food demonstrations and samples to collect recipe and kitchen tool feedback. METHODS/STUDY POPULATION: For 4 months, a Culinary Medicine team delivered food demonstrations at Crossroads Community Services food market in Dallas, Texas, which serves primarily Hispanic and Black residents. Each demo provided a food sample, corresponding printed recipe in English or Spanish, and a survey. Part 1 of the survey measured shoppers’ hedonic liking of the sampled food and their likelihood of recreating it. Part 2 used the same scale for non-sampled recipes adapted from Health meets Food Community Culinary Medicine programming. Averages of appeal and likelihood to cook between sampled and unsampled groups were compared with a student’s T test. Part 3 contained a visual graphic of 24 kitchen appliances, and shoppers circled each item they owned. Investigators collected surveys from 207 shoppers across 12 demos. RESULTS/ANTICIPATED RESULTS: Preliminary analyses showed a positive response to the food demonstrations with a mean rating on a 5-point Likert scale of 4.58 for recipe appeal and 4.46 for likelihood of cooking the recipe at home. The Health meets Food recipes not demonstrated were also positively reviewed (4.40 for appeal and 4.32 for likelihood to cook). There was a statistically significant difference in appeal between sampled and non-sampled recipes (p = 0.03) while no significant difference was found for likelihood to cook (p = 0.08). On average, clients owned 75% of kitchen appliances with most clients owning a sauté pan (94%) but few having access to a food processor (27%). DISCUSSION/SIGNIFICANCE: An effective nutrition program for food pantry clients must be accessible, culturally relevant, nourishing, and enjoyable. Providing samples alongside recipes may increase appeal and engagement. Consideration of kitchen equipment access is essential to promote recipe recreation at home.
OBJECTIVES/GOALS: Communities of color often report that their concerns are ignored and desire a means to facilitate effective community-academic engagement, especially during a crisis. The objective is to share lessons learned and challenges faced in the development of an online portal designed to meet this need. METHODS/STUDY POPULATION: The Michigan Institute for Clinical & Health Research (MICHR) worked with community and academics to develop an online tool, the Michigan Research Engaging the Academy and Community in Health (M-REACH) platform. The community-engaged research (CEnR) project involved conducting qualitative interviews exploring connectivity to community and academic organizations and pilot testing of the novel platform. Following development, efforts were made to implement the statewide use of M-REACH. We will report on the challenges encountered and lessons learned from development and optimization of the platform. RESULTS/ANTICIPATED RESULTS: Authors will review the timeline of the launch of M-REACH. Steps to promote engagement of the locally developed platform to statewide utilization will be shared. Challenges encountered with scaling, matching the needs of differing communities both rural and urban, and navigating connections between remote geographies will be presented. Lessons learned and potential solutions will be discussed. DISCUSSION/SIGNIFICANCE: M-REACH can connect partners by increasing understanding of the CEnR process, enhancing alignment, and building a foundation for well-functioning research partnerships. Further work is required to address the challenges encountered in development and implementation.
OBJECTIVES/GOALS: This study explored personal recovery support, including social determinants of health and psychosocial needs to understand factors for sustaining recovery among parenting and pregnant women with opioid use disorder. METHODS/STUDY POPULATION: This study used a mixed method quantitative/qualitative design and recruited women from residential/transitional facilities in an urban area. We used the Accountable Health Communities Health-Related Social Needs tool to assess social determinants of health factors, level of physical activity, family/community support, and mental health (stress). Through focus groups, we interviewed women to describe challenges to recovery and to resources including access to providers, housing, childcare, and food assistance from lived experiences. RESULTS/ANTICIPATED RESULTS: Survey analysis showed social determinants of health factors such as food and transportation were partially mitigated by residential living; however, parenting and pregnant women with opioid use disorder remained concerned about housing and finances; and encountered low levels of physical activity and significant stress. Preliminary results from the focus groups revealed a theme of positive recovery and retention experiences from residential living. DISCUSSION/SIGNIFICANCE: Evidence from studies suggests focused interventions for recovering women to reduce relapse risk factors and adverse maternal outcomes. Opportunities for improving personal recovery capital are accessible in residential facilities, however, further exploration of unmet social determinants of health factors are needed for recovery retention.
OBJECTIVES/GOALS: There is a scarcity of research examining the views of Black and Latine HIV care consumers on healthcare experiences that influence medical mistrust. The present qualitative study aims to bridge the existing gaps in the literature pertaining to the experiences of Black and Latine HIV care consumers. METHODS/STUDY POPULATION: We conducted 21 semi-structured interviews with Black and Latine HIV care consumers from November to December 2021 to explore perceptions of provider behaviors that increase or decrease HIV care consumers’ trust and mistrust, experiences of stigma, and behaviors and responses when experiencing medical mistrust. Conventional content analysis was conducted to derive meaning from the narratives shared by participants. RESULTS/ANTICIPATED RESULTS: Provider behaviors that increase HIV care consumers’ mistrust include lack of person-centered care, lack of partnership in health decision making, perceived provider incompetence, lack of adequate follow-up to care, and lack of trustworthiness of providers and organizations. Perceived experiences of intersectional stigma in healthcare included feeling judged and discriminated against by healthcare providers regarding HIV status and observing differential care outcomes and delayed care delivery by race and ethnicity. DISCUSSION/SIGNIFICANCE: Findings can inform the development of provider-level interventions to address medical mistrust.
OBJECTIVES/GOALS: Mechanisms underlying racial and ethnic disparities in rectal cancer care remain poorly understood. We aimed to identify barriers and facilitators to care among rectal cancer patients who identify as Hispanic/Latino (H/L) and to understand how these factors may differ based on rurality, social/physical context, and community support. METHODS/STUDY POPULATION: We utilized qualitative methods and a community-based participatory research framework, including partnership with a community-based organization and oversight from a community advisory board. We developed an initial semi-structured interview guide based on an ecological model of health behavior and then iteratively refined it with the assistance of our partners to incorporate unique aspects of the H/L community in a culturally appropriate manner. Eligible patients and their caregivers are invited to participate in hour-long interviews in both English and Spanish, depending on participants’ preferences. All interviews are recorded, translated, transcribed, and coded. Findings will be compiled and fed back to participantsand community stakeholders as a part of a community forum. RESULTS/ANTICIPATED RESULTS: We identified 6 areas for discussion based on our model: health beliefs (perceived severity, benefit, and barriers; self-efficacy), health literacy, others’ experiences with cancer, patient-provider relationship (patient-provider communication; provider-provider communication; language; cultural competency; discrimination), sources of support, and access to care. Participants are currently being recruited by clinical providers, through flyers in the cancer center, or via outreach from our community partner. We have interviewed 8 participants to date, with discussions ranging from the shock of the initial diagnosis, difficulties with navigating specialty care, and the complexities of shared decision making. We are expecting a total of 30-40 interviews to reach thematic saturation. DISCUSSION/SIGNIFICANCE: We hope to improve our understanding of mechanisms underlying racial and ethnic disparities in rectal cancer care and to identify potential targets for improvement. We plan to use our results to develop community-based policy interventions to improve care delivery, patient experience, and health equity.
OBJECTIVES/GOALS: There are notable disparities in cervical cancer screening. Theobjective of this study was to examine knowledge, screening practices, attitudes towards cervical cancer screening, and willingness to adopt screening innovations such as self-sampling and HPV rapid testing for cervical cancer among Hispanic women in Lake County, Indiana. METHODS/STUDY POPULATION: This mixed-methods study encompassed an online cross-sectional survey (n=231) and in-depth interviews (n=9) of individuals with a cervix aged 21-65 residing in Lake County, Indiana. Outcome variables focused on cervical cancer knowledge, willingness to adopt self-sampling, and willingness to adopt HPV rapid testing. Descriptive statistics included frequencies and percentages. A cervical cancer knowledge score was computed from 7 questions. Scores below the mean 3.62 were labeled ‘low’ while higher scores were ‘high’. We also examined associations between demographic and outcome variables. Quantitative analysis was conducted using SPSS software. Qualitative analysis was conducted using NVIVO software to thematically analyze interviews using deductive and inductive coding techniques. RESULTS/ANTICIPATED RESULTS: Majority of participants identified as Hispanic (58%), aged 31 or older (58%). While 80.5% reported being screened for cervical cancer, only 44.6% demonstrated ‘high' cervical cancer knowledge. 89.6% felt screening is important as emphasized in qualitative findings for its preventive value. Over half were willing to take their vaginal swab in clinic (55.8%) and at home (51.9%). However, among the Hispanic/Latinx groups reluctance to adopt self-sampling was notable (56.7% in clinic and 62.7% at home). Qualitative analysis revealed concerns about test accuracy. Willingness to use a hypothetical HPV rapid had higher acceptance (69.7%), with 52.2% in the Hispanic/Latinx group. Qualitative findings highlight benefits like increased screening access, comfort, and convenience offered by an HPV rapid test. DISCUSSION/SIGNIFICANCE: Hispanic/Latinx women in the sample were less willing to adopt cervical cancer screening methods such as self-sampling and rapid testing compared to non-Hispanic whites. Despite being considered beneficial for testing among vulnerable populations, our study found limited acceptance from these populations for various reasons.
OBJECTIVES/GOALS: To establish the root causes of vaccine hesitancy in populations who have less equitable access to health and healthcare services, and experience healthcare inequities, related to the environmental and social determinants of health, through community engagement and conversations, collaboration, circulation, and communication. METHODS/STUDY POPULATION: Existing data from a cross-sectional survey, vaccine hesitancy (VH) parent study, entitled 'Western New York (WNY) COVID-19 Collaborative to Promote Vaccine Acceptance,' conducted July to November 2022, after IRB approval, will be qualitatively analyzed. In the parent study, surveys were administered in WNY community congregations and community centers to individuals that historically have less equitable access to healthcare resources and may encounter health and healthcare disparities. Minorities, in urban and rural areas, age eighteen and older were identified through the NYS Department of Health’s Immunization Information System for daily vaccination rates. A qualitative analysis, promoting fact base HL, and building an inferential statical machine learning tool are the next steps. RESULTS/ANTICIPATED RESULTS: We anticipate the results to show an interplay of multiple factors, including personal, cultural, historical, social, and political, and varies depending on circumstances of time, place, and the type of vaccine being offered. Additionally, a lack of awareness or understanding of vulnerabilities and seriousness of vaccine-preventable diseases, lack of trust in health care providers, social norms, distrust of the healthcare system, biomedical research, and government policy, limited knowledge and understanding of vaccine safety and efficacy, and fear/uncomfortable with needles, as well as the less addressed environmental and social determinants of health associated with racial/ethnic minorities in communities with limited resources may also contribute to VH and less favorable health outcomes. DISCUSSION/SIGNIFICANCE: Identifying people who historically have less equitable access to healthcare resources and may be more likely to resist healthcare services, due to distrust in the system is important. Creating and evaluating an innovative tool to predict refusal of public health interventions is essential to avoid spreading preventable diseases.
OBJECTIVES/GOALS: Clinical and epidemiological studies focusing on Hispanics/Latinos are often designed by academic researchers with little input from mental health professionals in underserved communities. Our objective is to establish an academic-community partnership in South Texas to help improve mental health outcomes of Hispanics. METHODS/STUDY POPULATION: Hispanics in the Rio Grande Valley (RGV, South Texas) are burdened with high rates of diabetes and obesity, and interventions have been identified for these conditions, but there is less information about strategies that may help improve their mental health status and address needs. We have explored mental health and psychological factors in Hispanics/Latinos in Latin America (Gil etal., 2021) and consider community participation in the research process to be an understudied topic. Thus, in the present study, we recruited mental health professionals in the RGV to establish an academic-community partnership as a strategy to facilitate translational research that focuses on RGV Hispanics. Partners worked as a team to generate information, identify problems and solutions, and design future projects. RESULTS/ANTICIPATED RESULTS: Our academic team (at the University of Texas Rio Grande Valley) successfully established a partnership with the Cameron County Mental Task Force (CCMHTF), a non-profit organization in South Texas that seeks to “meet the mental and behavioral health needs of the people” in South Texas. The CCMHTF comprises 12 board members that are representative of RGV mental health providers: counselors, social workers, academic clinicians, hospital and county employees, and mental and behavioral health facility providers/clinicians. Our partnership generated qualitative descriptions of the mental health needs of RGV Hispanics/Latinos and barriers to access and utilization of mental health services in South Texas. In the future (phase 2 of the study), we plan to report results of focus groups and mental health assessments. DISCUSSION/SIGNIFICANCE: Hispanics/Latinos are underrepresented in clinical/translational research, and this lack of representation is particularly true for Hispanics/Latinos living along the U.S.-Mexico border of the RGV, South Texas. Our academic-community partnership may serve as a model to facilitate translational research in underserved Hispanic communities.
OBJECTIVES/GOALS: Historically, Latino farmworkers have lacked access to healthcare. 1 Telehealth promises to bridge this gap in hardly-reached populations. 2 We evaluated the impacts of ACTIVATE, a community-engaged project co-developed withcommunityp artnersAmplaHealth, and a local grower. METHODS/STUDY POPULATION: Mixed-methods outcome evaluation included attitudes survey, knowledge tests, attendance records, exit interviews, and participant observations. Attitudes survey, based on the Unified Theory of Acceptance and Use of Technology (UTAUT) model 3, measured Latino farmworkers’ telehealth acceptability. Pre/Post knowledge tests measured participant knowledge gained on telehealth and mental health services. Semi-structured exit interviewsidentifiedthe impacts of incentives, Promotora training, and health education curricula on participants and community partners. Structured participant observation as certained the level of participant engagement and Promotora facilitation skills. RESULTS/ANTICIPATED RESULTS: Results [https://drive.google.com/file/d/1jQpQdDM3dIR_PzMc1xXPh45Jvz8uBka6/view] On what aspects of the project worked well: “This project really helped us… to make it a priority, to do [health education] workshops. When I was hired, we went out to a few farms and shared information about our services, but it wasn’t anything hugely structured like what you proposed. We hadn’t done a whole lot of Promotora health education prior to this project.” -Ampla Health Administrator The most significant change observed: “Their attitudes… I feel that the very first session, I saw how they were more laid back, not really answering questions, just listening to us. And then the second one… they were more talkative and the very last one they were more comfortable sharing.” -Promotora DISCUSSION/SIGNIFICANCE: Attendence and participant engagement increased over time. Results from the evaluation point to greater telehealth acceptability among participants, increased health education capacity among Ampla Health, and farm worker cohesiveness at the workplace.
OBJECTIVES/GOALS: Promoting Academics and Community Engagement (PACE) Dissemination grants are funding opportunities via the Michigan Institute for Clinical and Health Research Community Engagement program designed to support the science of clinical and translational research demonstrating community impact. METHODS/STUDY POPULATION: Two statewide funding announcements over a 3-month period were issued to over 2,000 academic and community partners. Proposals were required to meet the following criteria: 1) data collection from an academic and community partnered research project completed; 2) research findings analyzed; and 3) a community-focused dissemination plan developed. Projects were funded up to $5000. RESULTS/ANTICIPATED RESULTS: Six PACE dissemination grants with community-focused plans were funded spanning Southeast, Western, and the Upper Peninsula regions of Michigan, as well as statewide. Examples of funded projects topics areas include the following: firearm safety; housing discrimination; opioid misuse; suicide prevention; and youth mental health. Community dissemination activities include: a) presenting at a community town hall; b) writing a pamphlet for community use; c) creating artwork installation showcase for community display; d) storytelling through community channels; and e) designing and implementing a local social media campaign. DISCUSSION/SIGNIFICANCE: Traditional funding mechanisms often do not provide resources to disseminate research findings with community benefit or impact back to communities. Funding dissemination awards through the PACE mechanism directly supports and accelerates translational science by sharing results directly back to the community in meaningful ways.
OBJECTIVES/GOALS: Racial discrimination and its associated stress are well-documented contributors to health disparities among African Americans (AA).This feasibility study aimed to acquire methodological insights and build the infrastructure for a subsequent mindfulness interventional study to reduce the effects of racism-based stress. METHODS/STUDY POPULATION: 20 AA participants ( female 12, male 8 )ages 18-50 were enrolled, and clinical data (blood pressure, waist/hip, BMI, lipids, HbA1c, creatinine) for Allostatic Index were collected. Racism-based stress was measured using RBTSSS and the Everyday Discrimination Scale (EDS). Psychometric measures (Coping, resilience, mindfulness, social connection) and sleep (PSQI) were included. Bivariate analysis explored associations between psychological measures and stress biomarkers, supported by Spearman’s correlation analysis. RESULTS/ANTICIPATED RESULTS: Low discrimination (EDS) was associated with a lower Total cholesterol/HDL ratio (2.99 vs. 4.20, p=0.009) and higher HDL (62 vs. 52, p=0.001). Low EDS participants also had better sleep (mean=3, SD=1.33, vs. mean=5.8, SD=3.99, p=0.05*) but reported less coping through drugs and alcohol (p=0.022*) and higher resilience (p=0.047*). Mindfulness negatively correlated to sleep disturbance (r=-0.477 to r=-0.62), coping and resilience. . EDS correlated with overall life stress and drug and alcohol use. Sleep disturbance was negatively associated with social connection (r=-0.569**) and mindfulness. Sleep disturbance and discrimination correlated positively with drug and alcohol use and overall life stress (r=0.52 and r=0.0.59, respectively), while resilience was negatively correlated with sleep (r=-0.45). DISCUSSION/SIGNIFICANCE: Discrimination was associated with increased stress and unfavorable coping, while mindfulness may offer potential benefits for sleep, coping, and resilience. These preliminary findings provide a foundation for further exploring the potential of mindfulness interventions to address the biopsychological impacts of racism-induced stress.
OBJECTIVES/GOALS: The objective for this study was to evaluate the associations between weight stigma and symptoms of depression, anxiety, and binge eating following bariatric surgery. METHODS/STUDY POPULATION: Bariatric surgery is the leading evidence-based treatment for severe obesity; however, mental health challenges can compromise long-term improvements in quality of life. Weight stigma is a major contributor to mental health challenges for individuals with obesity generally; however, the role of weight stigma post-operatively after significant weight loss is poorly understood.148 patients underwent pre-bariatric surgery psychological evaluation and completed a follow-up study approximately 2 years after. Measures included the Stigmatizing Situations Inventory-Brief, Patient Health Questionnaire, Generalized Anxiety Questionnaire, and Binge Eating Scale. RESULTS/ANTICIPATED RESULTS: In regression models controlling for demographic covariates (sex, age, education, race), body mass index, and baseline measure of each outcome (e.g., depressive symptoms pre-surgery in models predicting depression post-surgery), weight stigma was independently associated with depression (p=.023), anxiety (p <.001), and binge eating (p=.008) symptoms post-surgery.Above and beyond weight, demographics, and pre-surgery measurements of mental health, weight stigma continues to influence mental health outcomes in the years following bariatric surgery. Despite weight loss after bariatric surgery, this data suggests the cumulative experiences of stigma and discrimination continue to negatively impact mental health. DISCUSSION/SIGNIFICANCE: Interventions for bariatric surgery patients must consider the effects of weight stigma, at both the societal and individual levels. Interventions countering stigma could optimize long-term quality of life and associated outcomes.
OBJECTIVES/GOALS: Limited access to medication and poor medication adherence exacerbate chronic diseases following disasters. Experts recommend individuals in disaster-prone areas be prepared to manage their chronic diseases in the event of resource disruption. This study’s goal is to identify factors underlying personal medical preparedness. METHODS/STUDY POPULATION: A cross-sectional survey of 120 insured adults age ≥50 in Southeast Louisiana with hypertension and ≥1 daily medication during the 2023 Atlantic Hurricane Season is underway. The survey includes the Household Emergency Preparedness Index Access and Functional Needs Section (HEPI AFN), a validated measure of medical preparedness that accounts for special circumstances including refrigerated medication and electricity-dependent medical equipment. The mean score of the 9-item tool ranges from 0 to 1, with higher scores indicating more preparedness. The survey also includes 3 open-ended questions where participants can explain difficulties with medication adherence during hurricanes in their own voice. Data collection is ongoing. This interim analysis provides descriptive statistics. RESULTS/ANTICIPATED RESULTS: An interim analysis of the first 50 respondents included 46% women, 52% Black, mean age 61.2 (SD=7.3) years, and mean 52.5 (SD=16.2) years living in a hurricane-impacted area. Participants had a median of 1 comorbid condition; 72% reported taking >5 daily medications. Most respondents (94%) stated their household was at least “somewhat prepared” to handle a disaster and reported medical preparedness on an average of 82% of HEPI-AFN items (mean score = 0.82, SD=0.18); 90% reported that they had never had a healthcare worker talk to them about personal medical preparedness. On open response questions, participants cited insurance restrictions as the primary barrier to having extra medication on hand. In the final sample, regression models will be used to examine factors associated with increased preparedness. DISCUSSION/SIGNIFICANCE: While most participants in this insured, disaster-experienced preliminary sample are medically prepared, few have discussed preparedness with a healthcare provider. Identifying socio-demographic factors associated with preparedness will help to strengthen mitigation strategies addressing widening of health disparities during disasters.
OBJECTIVES/GOALS: Rural recovery community organizations (RCOs) are key to fostering people’s resilience in the face of the nation’s substance use crisis. However, their development is often a black box. METHODS/STUDY POPULATION: A community-engaged multiple-methods approach was conducted to elucidate stakeholders' perspectives about the creation of two RCOs through a consortium intended to build peer recovery support services in a rural Southern Indiana designated health professional shortage area. Document review (e.g., meeting minutes, event photography, and administrative reports) were extracted to map activities, products, and milestones of the development of the RCOs. Consortium members, RCO leadership and staff, and community members identified by consortium or RCO leadership/staff participated in one-on-one interviews or community roundtable sessions were held to reflect on the evolving development of the RCOs. Procedures were approved by the Institutional Review Board of Indiana University. RESULTS/ANTICIPATED RESULTS: This designated health professional shortage area is unique as it is the nonmetropolitan county with two accredited RCOs. Each RCOs has its own distinct brand. One RCO primarily provide support services to prepare justice-involved individuals who are re-entering the community from jail or probation. The second RCO operates a recovery café – a drug free space that offers accountability groups (recovery circles), volunteer opportunities, and multiple pathway (e.g., 12-steps, referral to medication assisted treatment) meetings. Services are facilitated through peer recovery coaches. Services are provided by certified peer recovery coaches (individuals who has lived experience with addiction and recovery) who offers informational, socio-emotional, and instrumental/basic needs support. DISCUSSION/SIGNIFICANCE: This collaborative rural-based model features recovery community organizations as emerging lead agencies in providing informational, socio-emotional, and basic needs for individuals living in long-term recovery as well as individuals using substances and is not yet in recovery services or acknowledging an addiction is present.
OBJECTIVES/GOALS: Investigate the perspectives of people experiencing homelessness (PEH) on clinical trials to uncover knowledge gaps and attitudes. This study aims to offer insights for clinical researchers to enhance engagement with this marginalized group, ushering in a more inclusive clinical trial process. METHODS/STUDY POPULATION: A 14-question survey was developed in collaboration with the Street Medicine Team at the University of Southern California and other stakeholders of PEH research. Initial questions assess knowledge of clinical trials, followed by questions gauging sentiments on clinical trial participation, and final questions on the significance, benefits, and risks of clinical trials. Upon approval by the local Institutional Review Board, the survey will be administered in an interview format. Study participants will be from locations within the area of operations of the USC Street Medicine team–in and around Hollywood, South Los Angeles, and/or the Los Angeles Council District 1. RESULTS/ANTICIPATED RESULTS: We anticipate that the results of this study will offer valuable insights into the perspectives of PEH regarding clinical trials. Results will also provide varying levels of knowledge and understanding among PEH about clinical trials, along with their past experiences in clinical trial participation, and willingness for future involvement in such trials. Further, the results will reveal whether respondents feel they are being properly represented in clinical research projects that could impact themselves and their community. This project can also enhance our understanding of the expectations and concerns of PEH regarding their potential participation in clinical trials. DISCUSSION/SIGNIFICANCE: The outcomes of this research project have the potential to lay the groundwork for enhancing the involvement of PEH in translational science research, encompassing aspects from study design to participation. This improvement could benefit not only participants but also various stakeholders involved.