OBJECTIVES/GOALS: Goals: Engage in collaborative approaches that target health disparities, especially among communities experiencing poverty or ethnic/racial minorities. Develop and sustain effective community-academic partnerships that foster trust through bidirectional communication and shared leadership leading to improved translational research. METHODS/STUDY POPULATION: The Community Health Science model was developed at UTSW over the past 20 years in efforts to integrate practices across 3 component areas – clinical practice, population health, and community organizations – into a single collaborative effort to improve health and reduce disparities. As part of the CTSA Program’s translational science efforts, we have extended this model to promote community engagement in research as an additional strategy needed to achieve health equity. Our Office of Community Health & Research Engagement operates 9 programs that each fit within one or more of 4 overarching conceptual pillars - Education/Resources, Collaboration/Partnership, Outreach/Service, Priorities/Perspectives - serving to bridge the community-academic divide and build strong, trusting relationships. RESULTS/ANTICIPATED RESULTS: The implementation of our model has resulted in measurable outcomes. To date, we have hosted 23 HealthStreet community events resulting in 464 health screenings, 203 health needs assessments completed, and 123 individuals joining our Community Research Registry allowing for future contact to participate in research. Our Community Health Coalition, comprised of 32 organizations, provides a forum for co-learning between researchers and stakeholders. We have awarded 9 grants ($175,800) for community-engaged projects. Our Community Advisory Panel has participated in 8 sessions with research teams. A total of 13 projects utilized the Spanish Language Resource, for a total of 30,617 translated words. Finally, we have hosted 9 Community Engagement Grand Rounds lectures, which included a total of 559 attendees. DISCUSSION/SIGNIFICANCE: Our model strengthens our capacity to build trust with communities and facilitate sustained community-academic partnerships. By prioritizing community engagement in research, we improve health equity by understanding community perspectives and increasing diversity in trials. We hope our model can be disseminated and scaled for greater impact.

OBJECTIVES/SPECIFIC AIMS: Acculturation and discrimination are associated with negative health outcomes including functional disability. The effect of these on functional disability in older African immigrants in the United States is not well understood. The purpose of this study is to describe and examine the experiences of acculturation, racial discrimination and functional disability in older African immigrants. METHODS/STUDY POPULATION: This study will use cross-sectional quantitative and qualitative mixed methods design. We plan to recruit 150 older (>55 years) participants through the African Immigrant Health Study and community-based organizations serving African immigrants. We will use the PROMIS physical function measure to assess functional disability, the Everyday Discrimination scale and the Psychological Acculturation scale will be used to measure discrimination and acculturation respectively. Higher scores indicate greater severity. RESULTS/ANTICIPATED RESULTS: We have recruited 12 participants so far. The mean age is 57 years and mean length of stay in the United States is 23 years. Mean disability score is 6.5 (range 1–38). Mean discrimination is 8.2 (range 4–15). The prevalent acculturation strategy of these participants (7) is marginalization (neither identified with the American nor African cultures). DISCUSSION/SIGNIFICANCE OF IMPACT: Preliminary results indicate pervasive discrimination and marginalization of study participants. Exploring these experiences can inform preventive strategies of coping and health behaviors that can decrease the negative effects of discrimination, acculturation and functional disability in African immigrants.

OBJECTIVES/GOALS: Recent in vitro evidence suggests that diverse parasite protein families called RIFINs and STEVORs are displayed on the surface of infected red blood cells and may have a role in severe malaria, but they remain sparsely studied in natural infections. We measured the RNA expression of these antigens in Malian children with severe or mild malaria illness. METHODS/STUDY POPULATION: We collected blood samples from Malian children aged six months to five years, including 14 with cerebral malaria, 10 with severe malarial anemia, and demographic-matched controls with mild, uncomplicated malaria. We extracted total RNA from each patient and used a custom capture array to selectively enrich Plasmodium falciparum parasite RNA. We then performed Illumina next-generation RNA sequencing and reconstructed parasite transcriptomes using reference-free de novo assembly. We identified RNA encoding RIFINs and STEVORs using an in-house classifier, then measured the diversity and abundance of gene expression for each infection. Expression diversity was defined as the number of unique variants transcribed. Expression abundance was calculated as transcripts per million (TPM). RESULTS/ANTICIPATED RESULTS: Cerebral malaria cases, but not severe malarial anemia cases, had higher diversity and abundance of RIFIN expression compared to mild infections. Type A RIFINs predominated over Type B RIFINs, and the same two RIFINs were predominantly expressed in all disease phenotypes. We anticipate that predominantly expressed RIFINs share high sequence homology with variants previously shown to bind blood antigens or immune inhibitory receptors. STEVOR expression was also higher in cerebral malaria compared to mild malaria, but STEVOR transcripts were sparse overall. DISCUSSION/SIGNIFICANCE: Elevated RIFIN expression in cerebral malaria over mild malaria supports a role for these antigens in pathogenesis. Severe malarial anemia may progress through a different pathogenic mechanism. Predominantly expressed RIFIN variants may be promising targets for vaccines and therapeutics to protect children against cerebral malaria.

OBJECTIVES/GOALS: We aimed to determine if GLP-1 receptor agonists exert beneficial effects on surrogate measures of cardiovascular function independently of weight loss. Our objective was to compare the outcomes between GLP-1 receptor agonist treatment versus a similar drug without cardiovascular benefit versus weight loss through diet alone. METHODS/STUDY POPULATION: We enrolled 88 individuals with obesity (BMI ≥ 30kg/m2) and pre-diabetes and randomized them in a 2:1:1 ratio to 14 weeks of the GLP-1 receptor agonist liraglutide, the dipeptidyl peptidase-4 inhibitor sitagliptin, or hypocaloric diet. Sitagliptin blocks degradation of endogenous GLP-1 but does not cause weight loss or lower adverse cardiovascular outcomes. Treatment was double-blinded and placebo-controlled for drug, and unblinded for diet. Primary endpoints were flow-mediated dilation (FMD) to assess endothelial vasodilatory function, and plasminogen activator inhibitor-1 (PAI-1) to assess endothelial fibrinolytic function. We used a general linear model for each outcome and included gender as a covariate for FMD. Baseline characteristics were similar. Mean age was 50, with 32% men and 13% black. RESULTS/ANTICIPATED RESULTS: At 14 weeks, diet and liraglutide caused weight loss (diet -4.3 ± 3.2 kg, P<0.01; liraglutide -2.7 ± 3.2, P<0.01), while sitagliptin did not (-0.7 ± 2.0, P=0.17). Diet did not improve FMD at 14 weeks compared to baseline (+0.9%, 95% CI [-1.5, 3.3], P=0.46). FMD tended to increase after liraglutide and sitagliptin but was not significant (liraglutide +1.2 [-0.3, 2.8], P=0.12; sitagliptin +1.6 [-0.6, 3.8], P=0.15). Given that liraglutide and sitagliptin work through the same GLP-1 pathway, we combined the liraglutide and sitagliptin groups for overall effect on FMD, which was significantly improved from baseline (+1.4 [0.1, 2.8], P=0.04). Diet and liraglutide improved PAI-1 at 14 weeks (diet -4.4U/mL, [-8.5, -0.2], P=0.04; liraglutide -3.4 [-6.0, -0.7], P=0.01), while sitagliptin did not (-1.4 [-5.1, 2.3], P=0.46). DISCUSSION/SIGNIFICANCE: Activation of the GLP-1 pathway by liraglutide or sitagliptin improves FMD independent of weight loss, while PAI-1 improvement is weight-loss dependent and is only seen after liraglutide or diet. Our study suggests the cardiovascular benefit of liraglutide may be due to combined improvements in endothelial vasodilatory and fibrinolytic function.

The opioid crisis in the USA requires immediate action through clinical and translational research. Already built network infrastructure through funding by the National Institute on Drug Abuse (NIDA) and National Center for Advancing Translational Sciences (NCATS) provides a major advantage to implement opioid-focused research which together could address this crisis. NIDA supports training grants and clinical trial networks; NCATS funds the Clinical and Translational Science Award (CTSA) Program with over 50 NCATS academic research hubs for regional clinical and translational research. Together, there is unique capacity for clinical research, bioinformatics, data science, community engagement, regulatory science, institutional partnerships, training and career development, and other key translational elements. The CTSA hubs provide unprecedented and timely response to local, regional, and national health crises to address research gaps [Clinical and Translational Science Awards Program, Center for Leading Innovation and Collaboration, Synergy paper request for applications]. This paper describes opportunities for collaborative opioid research at CTSA hubs and NIDA–NCATS opportunities that build capacity for best practices as this crisis evolves. Results of a Landscape Survey (among 63 hubs) are provided with descriptions of best practices and ideas for collaborations, with research conducted by hubs also involved in premier NIDA initiatives. Such collaborations could provide a rapid response to the opioid epidemic while advancing science in multiple disciplinary areas.

Northwest Arkansas, particularly Benton and Washington counties, is one of the highest COVID-19 hot spots in the United States (US), with more than half of all reported cases in this area identifying as Latinx or Pacific Islander, even though these communities account for less than 20% of the overall population. The University of Arkansas for Medical Sciences (UAMS) leveraged their existing relationship with 18 key community partners. Partners collaboratively developed a COVID-19 Response Strategy to ensure coordinated effort for Latinx and Pacific Islander communities with four interrelated strategies: health education, testing, contact tracing, and supported quarantine/case management.

OBJECTIVES/GOALS: Tumor PDL1 signals to immune cells for tumor immune evasion but has cell-intrinsic signals that promote tumor virulence. We identify novel tumor PDL1 depleting drugs (PDDs) to interrupt tumor-intrinsic PDL1 signals and sensitize tumors to targeted therapy in vitro and in vivo. METHODS/STUDY POPULATION: We screened the Prestwick and LOPAC libraries for FDA-approved drugs reducing B16 melanoma PDL1 > 2.6-fold. ?-lactam antibiotics were used at 80 ?M and Chk1 inhibitor rabusertib as indicated in T24 human bladder cancer, and murine ID8agg ovarian cancer, 4T1 breast cancer and B16. Genetic PDL1 KO was by CRISPR or shRNA and re-expression by lentivirus. Viability was by MTT and protein by immunoblot. We challenged 5 NSG mice/group with 2x106 T24 (SQ) cells and 5 BALB/c mice/group with 5x105 4T1 cells (mammary fat pad) and treated with cefepime (200 mg/kg), rabusertib (2.5 mg/kg), vehicle, or combo daily from day 3. RESULTS/ANTICIPATED RESULTS: Structurally-related ?-lactam antibiotics cefepime and ceftazidime are tumor PDDs. Cefepime or ceftazidime reduced tumor PD-L1 and thus its cell-intrinsic signals to deplete the DNA damage sensing Chk2 protein and promote rabusertib synthetic lethality in vitro and in vivo in a tumor PDL1-dependent manner independent of immunity. Structurally distinct ?-lactam antibiotics did not sensitize tumor cells to rabusertib, suggesting ?-lactam antimicrobial functions did not promote PDL1 depletion or rabusertib treatment effects in vivo. Although rabusertib effects were immune-independent, both PDDs induced immunogenic tumor STING signaling, suggesting they can improve tumor immunotherapy. DISCUSSION/SIGNIFICANCE: We show a rapidly translatable way to deplete detrimental tumor-intrinsic PDL1 signals, and sensitize tumors to rabusertib. We are testing PDD structure activity relationships to improve PDD effects and testing PDD effects on other treatments, e.g., PARP inhibitors, immunotherapy.

OBJECTIVES/SPECIFIC AIMS: Over 80% of CTSA programs have a community advisory board (CAB), an effective strategy to increase community engagement (CE) in research. Little is known about how the research discussed with CABs aligns with community priorities (i.e., bi-directionality). This program evaluation assessed the health topics presented by researchers to the CABs linked to our CE Program at all three Mayo Clinic sites (MN, AZ, and FL) for relevance to local community needs. METHODS/STUDY POPULATION: Two coders classified Mayo researcher presentations to our CABs from 2014-2018 for relevance to needs identified in the local 2013 and/or 2016 County Health Needs Assessments and specific topic(s); with high levels of agreement (Kappa=0.90). RESULTS/ANTICIPATED RESULTS: Overall, of the 65 presentations 41 (63%) addressed one or more local health needs (47% MN, 60% FL, 80% AZ). Cross-cutting health topics addressed at 2 sites were physical activity/obesity/nutrition and mental health. DISCUSSION/SIGNIFICANCE OF IMPACT: Findings were shared with our CABs to obtain input on future directions. The FL and AZ CABs are systematic in seeking out or initiating research projects that address local health needs, an approach the MN site is interested in adopting. Ultimately, it is important to demonstrate improved health outcomes with CTSA-based CE research strategies. Understanding community health needs and depth of researchers in those areas may help to focus priorities for demonstrating such outcomes.

OBJECTIVES/SPECIFIC AIMS: The goal of this study is to develop an effective and efficient STI preventive intervention among college students following the principles and phases of MOST. METHODS/STUDY POPULATION As part of the preparation phase, an explicit conceptual model, drawing heavily on theory and prior research, was used to translate the existing science into 5 candidate intervention components (ie, descriptive norms, injunctive norms, expectancies, perceived benefits of protective behavioral strategies, and self-efficacy). For the optimization phase, in Fall 2016 all first-year students (n=3547) from 4 universities were recruited to participate. Students were randomized to 1 of 32 different experimental conditions that included a combination of the candidate intervention components. Component effectiveness was evaluated using data from an immediate post-intervention survey on respective component mediators (eg, alcohol and sex-related descriptive norms). After a second factorial experiment (Fall 2017), only those intervention components that meet the pre-specified criteria of day ≥0.15 will be included in the optimized intervention. The evaluation phase will evaluate the effectiveness of the optimized STI preventive intervention via a randomized-control trial (Fall 2018). RESULTS/ANTICIPATED RESULTS: Preliminary results from the first factorial experiment suggest that descriptive norms and injunctive norms intervention components were significantly effective in reducing post-intervention perceived alcohol prevalence (β=−0.28, p<0.001) and approval of alcohol (β=−0.33, p<0.001), and sex-related norms (β=−0.23, p<.001). These results, in combination with process data, are being used to inform revisions of the intervention components to be included in a second factorial screening experiment. DISCUSSION/SIGNIFICANCE OF IMPACT: This study demonstrates how an iterative approach to engineering an STI preventive intervention using MOST can affect the behaviors of college students and serve as a foundation for other translational science.

OBJECTIVES/GOALS: Reduced cerebral blood flow (CBF) along with vascular risk factors (e.g., dyslipidemia) are prevalent in Alzheimers disease (AD) and related dementias. Statins are one of the most effective pharmacologic treatments for vascular risk reduction, which may contribute to CBF in individuals with an increased risk for AD. METHODS/STUDY POPULATION: Cross-sectional analysis of 212 older adults with a family history of dementia. Heart rate via electrocardiogram, mean arterial pressure (MAP) via brachial sphygmomanometers, end-tidal CO2 via capnograph, and CBF velocity at the middle cerebral artery (MCAv) via transcranial Doppler ultrasound were collected following 20-minutes of supine rest. Mean MCAv (cm/s) was measured within each cardiac cycle and averaged over an 8-minute duration. Cerebrovascular conductance was calculated by dividing mean MCAv by MAP. Pulsatility Index was calculated by subtracting systolic MCAv from diastolic MCAv and then dividing by mean MCAv. RESULTS/ANTICIPATED RESULTS: 125 females (68 ± 6 years; 49 statin) and 87 males (70 ± 6 years; 47 statin) were included in analyses. There were no significant differences between heart rate, MAP, or end-tidal CO2 between statin and non-statin users. After controlling for age, sex, and low-density and high-density lipoprotein, statin use did not significantly contribute to MCAv (p = 0.09). However, statin use did significantly contribute to cerebrovascular conductance (MCAv/MAP; p = 0.03) as well as Pulsatility Index (assessment of cerebral health, p < 0.01). DISCUSSION/SIGNIFICANCE: Our findings suggest statin use significantly and positively contributes to resting cerebral blood flow velocity and cerebrovascular health. Further investigation is warranted into statin interventions with other components of cerebrovascular function, as differences may have implications for brain health and disease pathogenesis.

OBJECTIVES/GOALS: The Michigan Institute for Clinical & Health Research (MICHR) Community Engagement (CE) Program fosters translational science and community-engaged research (CenR) through education, connecting, supporting, and funding efforts and opportunities. METHODS/STUDY POPULATION: In Michigan’s Upper Peninsula, CE partnered with the Michigan Health Endowment Fund to develop a 3-hour workshop that consisted of a panel discussion on best practices of community engagement and a presentation on community engaged nonprofit management. The workshop was designed from mapping 60 participants’ pre-workshop survey findings and reviewing themes from a planning meeting transcript with six community partners. Key themes that emerged included participatory budgeting, collaborative governance, communications, and community planning. RESULTS/ANTICIPATED RESULTS: A mix methods post-workshop evaluation feedback survey was completed. The 9-item survey assessed workshop content, satisfaction, and knowledge gained using a Likert scale as well as opened questions about key takeaway and value added. Quantitative results to be analyzed. Qualitatively, some participants described the workshop as helpful and thoughtful about how to strengthen community engagement within their organizations. Others expressed a desire for more time. Regarding impact, CE received an uptake in consultations and inquiries into statewide pilot grants. The workshop facilitated new collaborations with philanthropic and community organizations serving the Upper Peninsula. DISCUSSION/SIGNIFICANCE: Lessons learned highlight trust, understanding community culture, and moving slowly in a newly formed collaboration. The approach utilized in the Upper Peninsula can inform translational methods for additional partnerships underway across the state of Michigan.

ABSTRACT IMPACT: These findings identify a new way in which the COVID-19 pandemic exacerbates racial/ethnic health disparities, and will thus direct future research to explore potentially avoidable hospitalizations, as well as direct health policy to improve the value of this specific aspect of care without further widening the disparity. OBJECTIVES/GOALS: Racial and ethnic disparities in potentially avoidable hospitalizations predate COVID-19. In order to identify and address healthcare disparities exacerbated by the pandemic, we examined whether and to what extent the pandemic affected numbers of potentially avoidable hospitalizations by race and ethnicity. METHODS/STUDY POPULATION: This single-center pre-post study of 904 patients at UCLA included all patients admitted to an internal medicine service for an ambulatory care sensitive condition (ACSC) between March-August of 2020 (post) and March-August of 2019 (pre). We measured the change in number of potentially avoidable hospitalizations (defined per the Agency for Healthcare Research and Quality guidelines) stratified by race and ethnicity. We calculated 95% CIs for the number of potentially avoidable hospitalizations using a cluster bootstrap procedure, clustering at the level of patients. We inverted the bootstrap CIs to calculate p-values for overall changes within racial/ethnic groups as well as differential changes between groups. Patients with missing or unspecified racial/ethnic data were excluded (n=1,003; 7.8%). RESULTS/ANTICIPATED RESULTS: Between March 1 and August 31, 2020, 347 out of 4,838 hospitalizations (7.2%) were potentially avoidable, compared to 557 out of 6,248 (8.9%) during the same 6-months of 2019. Reductions in potentially avoidable hospitalizations among Non-Hispanic White (-50.3%; 95% CI, -60.9 - -41.2; p<0.001) and Latinx (-32.3%; 95% CI, -59.8 - -12.2%, p<0.001) patients were statistically significant, whereas reductions among African American (-8.0%; 95% CI, -39.9 - +16.2) and Asian (-16.1%; 95% CI, -75.7 - +20.4) patients were not statistically different from 0%. The relative differences in magnitudes of reduction were only statistically significant between African American and non-Hispanic White patients (-50.3% v. -8.0%; 95% CI as above; p=0.015). DISCUSSION/SIGNIFICANCE OF FINDINGS: Racial disparities in potentially avoidable hospitalizations increased during the COVID-19 pandemic at this large urban health system. Healthcare leaders, researchers, and policy makers should focus on efforts to prevent a post-pandemic resurgence of low-value hospitalizations in ways that do not further widen disparities.

OBJECTIVES/GOALS: Examining the impact of the Building Capacity for Research and Action (BCRA) Award created by the Community Engagement (CE) Program at the Michigan Institute for Clinical & Health Research (MICHR)--a Clinical & Translational Science Award (CTSA) site at the University of Michigan--in partnership with Community Based Organization Partners (CBOP). METHODS/STUDY POPULATION: The BCRA is a funding mechanism that supports new community-engaged research (CEnR) partnerships and projects that address community-identified health needs in Flint, Michigan. BCRA projects are required to be Flint-based and inclusive of both community and academic partners. A study section consisting of 10 MICHR-affiliated faculty and community partners reviewed proposals and made funding decisions. Funded teams were trained on Institutional Review Board (IRB) and reporting requirements by CE staff. MICHR provides support to BCRA-funded teams through monthly email correspondence with the CE Flint connector, budget review, mediation, regulatory assurance of IRB and the National Center for Advancing Translational Science (NCATS) requirements, coordinating six-month and final reporting, and hosting an annual stakeholder meet and greet. RESULTS/ANTICIPATED RESULTS: In 2017, the BCRA Award submitted its first request for proposals. It received 20 applications in 2018, and selected eight awardees, providing them with a total of $60,000 in funding. Four received $5,000 for partnership development and another four received $10,000 for their research projects. The BCRA Award received 16 applications in 2019, expanding its academic pool to include the University of Chicago, U-M Flint, Michigan State University, and Michigan State University-Flint in addition to the University of Michigan. Five recipients were selected and received a total of $45,000 in funding. One was awarded $5,000 for partnership development and another four were awarded $10,000 for their research projects. MICHR has invested over $100,000 in Flint through this mechanism, which was renewed in 2019. DISCUSSION/SIGNIFICANCE OF IMPACT: Each awardee presented at the annual stakeholder meet and greet. They showcased their projects with a brief overview and spoke about their expectations, lessons learned, partnership strengths and challenges, translational issues, and proposed next steps for subsequent grants, publications.

OBJECTIVES/GOALS: Dystonia is a brain disorder which causes excessive muscle activation, manifesting as abnormal movements. Neuroimaging studies of dystonia have revealed changes in a network involving the cerebellum. We sought out to determine whether subjects with dystonia in the UK Biobank exhibit MRI-based cerebellar pathology. METHODS/STUDY POPULATION: This nested case-control study drew from the UK Biobank, a cohort of >500,000 subjects in the United Kingdom, aged 40-69, enrolled 2006-2010. Eligible subjects must have undergone diffusion-weighted brain MRI. Dystonia cases were ascertained using ICD10 codes. We selected controls without neurologic diagnoses, matched (1:3) on age, sex, imaging site, and medical comorbidities. Mean diffusivity, fractional anisotropy, intracellular and isotropic volume fractions, and orientation dispersion were extracted from four white-matter tracts (inferior, middle, superior cerebellar peduncles; superior thalamic radiations) along with cerebellum, basal ganglia, and whole-brain grey and white-matter volumes. Means were compared using two-tailed t-tests and the Benjamini-Hochberg procedure (FDR = 0.05). RESULTS/ANTICIPATED RESULTS: 23 cases of dystonia and 69 control subjects were selected and ascertained. After correcting for multiple-comparisons (40 volumetric and 35 diffusion-related), intracellular-volume-fraction (ICVF) of the middle- and superior-cerebellar peduncles was significantly lower in subjects with dystonia, suggesting reduced axon density. Volumetric analysis showed significantly reduced volumes of the motor cerebellum (lobules VI and VIII). There were no differences in basal ganglia, cortical, or whole-brain volumes. DISCUSSION/SIGNIFICANCE: These findings support the hypothesis that abnormalities of cerebellar networks contribute to dystonia. In future we will use similar techniques to assess these tracts in subjects with dystonia who are undergoing Deep Brain Stimulation, with the goal of guiding stimulation targeting, and predicting therapeutic outcomes.

OBJECTIVES/SPECIFIC AIMS: Family members are often critical in the delivery of hands-on care and decisions about care for persons approaching end-of-life (EOL). Prompted by concerns about the poor quality and high costs of care at the EOL, recent delivery reform efforts—such as the growth of hospice and palliative care—have been directed at improving EOL care for both patients and family. Trends of the characteristics of EOL family caregivers and care recipients over time have not been well described. The goal of this study is to evaluate changes in EOL family caregiving from 1999 to 2015. METHODS/STUDY POPULATION: This study uses reconciled data from two nationally representative surveys and their linked caregiver surveys: the 1999 wave of the National Long-Term Care Survey (NLTCS) and the Informal Care Survey (ICS), and the 2015 wave of the National Health and Aging Trends Study (NHATS) and the National Survey of Caregiving (NSOC). RESULTS/ANTICIPATED RESULTS: Crude analysis shows that older adults living in the community and receiving help from family caregivers in the last year of life were significantly better educated (72% with greater than 12 years of education vs. 46%), and more diverse (78% White vs. 89%) in 2015 compared with 1999. Family caregivers in the last year of life were less likely to be female in 2015 compared with 1999 (74% vs. 68%, NS) and significantly less likely to be spouses (45% vs. 38%) in 2015. In 2015, a significantly greater proportion of older adults received help with five or more activities of daily living (47% vs. 34%), but family caregivers reported significantly lower levels of caregiving-associated distress: financial strain (80% reporting none in 2015 vs. 53%), emotional (51% vs. 39%), and physical strain (70% vs. 45%). In addition, a significantly greater proportion of EOL family caregivers used respite care in 2015 compared to 1999 (15% vs. 4%). DISCUSSION/SIGNIFICANCE OF IMPACT: Changes in the experience of EOL family caregiving may be impossible to capture in studies of single interventions, but tracking nationally representative trends can be used as an indicator of broader changes that take place cumulatively over time. Although studies of this nature cannot identify causal mechanisms of change, they are important to monitor long-term impact of program implementation and to guide future research, policy, and resource allocation.

OBJECTIVES/SPECIFIC AIMS: Approximately 25%–45% of veterans are dual users of VA and civilian healthcare. In order to maximize patient outcomes, understanding factors related to dual use is important. This study examined mental and physical health factors related to dual use of VA and civilian healthcare among U.S. National Guard and Reserve (NG/R) soldiers. METHODS/STUDY POPULATION: NG/R soldiers and their partners (n=411 couples) participated in an electronic survey assessing health and health behaviors. Logistic regression models were used to examine the relationship between mental health (anxiety, depression, PTSD, anger), general health, and VA disability status at baseline, with usage of both VA and civilian healthcare among male soldiers (n=109) at the second year follow-up, controlling for age and race. RESULTS/ANTICIPATED RESULTS: In the final adjusted models, of the mental health conditions, only anxiety was related to dual use (OR: 1.08, 1.01–1.16, p<0.05). Having a VA disability rating (OR: 4.00, 1.22–13.18; p<0.05) was also related to being a dual user. General health was not related to dual use. DISCUSSION/SIGNIFICANCE OF IMPACT: While research has identified demographic characteristics (e.g., rurality, race, income) related to dual healthcare use, our results indicate that mental health, particularly anxiety, may also be related to dual use. Further study is needed to tease out the prime drivers of dual use to identify future care delivery mechanisms that will maximize treatment outcomes and minimize duplicative care.

OBJECTIVES/SPECIFIC AIMS: The Rockefeller University-Center for Clinical and Translational Science and Clinical Directors Network (RU-CCTS/CDN) community-academic-partnership engaged with Carter Burden Center for the Aging (CBCA), a multisite senior community services organization serving Upper Eastside and East Harlem, NY, to develop community-engaged research. Many seniors served by CBCA are racial/ethnic minorities, live in poverty, suffer from multiple chronic conditions, depression, and food insecurity; there is no simple measure routinely used to characterize the health/health risks of program participants. Multiple biological, musculoskeletal, psychosocial and nutritional factors collectively contribute to frailty a construct that is variously defined, and has been used as a surrogate or predictor for health outcomes. Aim 1: We will engage seniors, CBCA leadership, New York City Department for the Aging, staff and other stakeholders in research priority-setting, joint protocol writing, research conduct, analysis and dissemination to cultivate a population of elder stakeholders interested in designing and participating in this and future research. Aim 2: We will characterize the health status of the resident and nonresident populations by collecting data across 3 sessions to include validated cardio-metabolic, musculoskeletal, chronic condition prevalence, quality of life, psychosocial, and nutritional assessments. METHODS/STUDY POPULATION: Stakeholders will be engaged through the process of Community Engaged Research Navigation and a series of meetings and exercises to refine priorities and research design, co-write the protocol, provide feedback on conduct, analyze and disseminate results of the project. RESULTS/ANTICIPATED RESULTS: Outcomes will include rates of participation and retention in assessments and engagement activities, themes from qualitative research, contributions to study design, placement of aims on the T0-T48 spectrum, social network analysis, classification of engagement on the spectrum of Community-based Participatory Research (CBPR) and partnership assessment. The primary outcome is frailty (6-minute walk test); We will examine associations among these measures with services utilization data captured electronically by CBCA. A key deliverable of this project will be a REDCap data capture platform that integrates and displays these measures that will be sustainable for CBCA. DISCUSSION/SIGNIFICANCE OF IMPACT: This practice-based research partnership will allow us to extract, replicate and extend the lessons learned about engaging stakeholders in generating hypotheses, operationalizing research, collecting and analyzing data, and disseminating results. The collaboration is built around generating and testing rigorous clinical an health services hypotheses that are derived from real-world practice-based needs and also incorporate basic science measures to embed and examine mechanistic hypotheses. Testing a simple to implement validated surrogate frailty measure will accelerate progress on evidence-based practices to test interventions that enhance healthy aging and serve as a model for future similar partnerships to form a network for community-based senior research. This work aligns with the RU-CCTS grant Hub Research goal to engage populations across the life span, including hard-to-reach and underserved populations, such as minority seniors.