Maternal mortality rates in the USA remain high, with persistent racial and socioeconomic disparities. We identified 207,016 hospital admissions for pregnant women in Maryland, from 2017 to 2019. Logistic regression was used to identity factors associated with maternal death. The health outcome for black women was more prone to give rise to maternal mortality than for white women. Our study revealed numerous racial and age discrepancies in gestational health outcomes, which opioid use disorder exacerbated. Our findings elaborate on the importance of identifying the drivers of adverse pregnancy outcomes, to help inform policy, and resource allocations.

OBJECTIVES/GOALS: Degenerative cervical myelopathy (DCM) can lead to pain, disability, and permanent spinal cord impairment. Timely diagnosis and surgical intervention is essential to optimize functional outcomes for patients with CSM. Here, we compared patients who were admitted through clinic versus the emergency department (ED) for surgical management of DCM. METHODS/STUDY POPULATION: Patients aged ≥18 years admitted for surgery for DCM through clinic (elective cohort) were compared to a surgical cohort who were evaluated through the ED (call cohort). Basic demographics included age, gender, race, ethnicity, and insurance payor. Sociodemographic characteristics were estimated using the Social Deprivation Index (SDI) and the Area Deprivation Index (ADI) for the state of California, which were obtained through aggregated Zip Code Tabulation Area (ZCTA). Cervical MRI was reviewed to assess severity of spinal cord compression. Other outcomes included number of motion segments operated on, functional outcome using the Nurick classification, length of stay (LOS), disposition, and 30-day reoperation and readmission rates. RESULTS/ANTICIPATED RESULTS: From 2015 to 2021, 327 DCM patients received surgery (227 Elective Cohort, 100 Call Cohort). Elective cohort was mainly female (48.0 vs 30.0%, p=0.002) and white (72.7 vs 51.0%, p=0.0001). Call cohort was mainly uninsured/covered by Medicare/Medicaid (78.0 vs 67.0%, p=0.04), had higher SDI (68.0 vs 56.2, p=0.0003), ADI (7.9 vs 7.2, p=0.009), and cervical cord compression on MRI (78.0 vs 42.3% Grade III, p DISCUSSION/SIGNIFICANCE: Compared to DCM patients undergoing elective surgery, those admitted through the ED were more likely to be male, non-White, and socioeconomically disadvantaged, as measured by SDI and ADI. Postoperative outcomes were less favorable for these patients, including longer hospital stay, discharge disposition, and less Nurick grading improvement.

OBJECTIVES/GOALS: People experiencing homelessness vs. housed peers have higher rates of substance use disorders as well as increased emergency medical services (EMS) use. However, it is unknown if EMS administers naloxone at different rates to people experiencing homelessness. We address if patient housing status impacts naloxone administration by EMS providers. METHODS/STUDY POPULATION: We conducted a retrospective, cross-sectional analysis of electronic patient care reports (ePCRs) for all 911-incidents attended by the Los Angeles Fire Department (LAFD) during the study period, January to December 2018. Individuals who were medically assessed by the LAFD and who were administered naloxone by LAFD EMS were included. Exclusion criteria was incomplete ePCRs. The primary outcome was prevalence of EMS naloxone administration by housing status in the city of Los Angeles. We used descriptive statistics and a logistic regression model to examine differences in care. RESULTS/ANTICIPATED RESULTS: Naloxone was administered in 2,438 of the 345,190 incidents that occurred during the study period. 608 (25%) incidents involved people experiencing homelessness. Top indications for naloxone administration were similar in both groups: overdose, altered consciousness and cardiac arrest. Of those who received naloxone, people experiencing homelessness were more likely to be male (82% v 67%) and younger (41 v 46 years). People experiencing homelessness were more likely to receive naloxone (OR 2.6, 95% CI 2.4-2.9). People experiencing homelessness received naloxone at a rate of 44 times that of housed peers. A logistic regression model adjusting for gender, age, respiratory depression and transport status showed people experiencing homelessness remained more likely to receive naloxone (OR 2.3, 95% CI 2.0-2.5). DISCUSSION/SIGNIFICANCE: Emergency medical services are more likely to administer naloxone to people experiencing homelessness than housed peers. There is a need to identify bias and factors that impact prehospital care and patient outcomes of people experiencing homelessness. New care pathways for people confronting homelessness and opioid use disorders are needed.

OBJECTIVES/GOALS: The objective of the study is to test the feasibility and acceptability of a remote glucose monitoring program for pregnant Marshallese women with pre-gestational (PGDM) or gestational diabetes (GDM) without excluding women with limited English proficiency. The study will explore changes in patient-physician communication and self-efficacy. METHODS/STUDY POPULATION: Twenty Marshallese pregnant women with PGDM or GDM will be identified for recruitment. The patient will meet with a bilingual staff member to explain the study and provide consent. At enrollment, patients will complete an enrollment survey and be provided with the iGlucose monitor and receive training its use. Their provider(s) will receive access to their patient’s online portal for monitoring. At 14 days postpartum patients will receive a post-intervention survey and invitation to participate in interview, and their provider(s) will receive a satisfaction survey for the remote monitoring program. RESULTS/ANTICIPATED RESULTS: We hypothesize that the use of a remote glucose monitoring intervention is feasible and acceptable for Marshallese women with PGDM or GDM. Further, we hypothesize that the remote glucose monitoring program will increase satisfaction with physician-patient communication and will increase self-efficacy with glucose management. We anticipate that providers will find the program feasible and acceptable for use with the Marshallese population. DISCUSSION/SIGNIFICANCE: RPM technology can transform the way PGDM and GDM are managed. RPM may have greater benefits when there is a lack of language concordance by providing more time for patient-provider communication, thereby improving patient satisfaction and decreasing the risk of negative outcomes for Marshallese women.

OBJECTIVES/GOALS: Older adults in rural communities are at an elevated risk of falling. Perturbation-Based Balance Training (PBT) is a highly effective fall prevention paradigm but its feasibility in the community is unknown. The purpose of this study was to determine the feasibility and acceptability of PBT to older adults and local clinicians in rural communities. METHODS/STUDY POPULATION: 19 older adults (60+ years) were recruited from communities in rural Montana to take part in a PBT program. The PBT program was implemented using a bespoke portable PBT treadmill developed by our research team and validated against commercial PBT treadmills. To increase ecological validity, the program was implemented by local clinicians. The PBT program lasted 6 weeks, with 1 session per week, participants received up to 35 trip perturbations per session. The feasibility and acceptability of PBT to participants and clinicians was assessed within the Theoretical Framework of Acceptability, prospectively and retrospectively via interviews and surveys, and concurrently via field notes. RESULTS/ANTICIPATED RESULTS: Data analysis is ongoing and will be complete by the time of presentation. Preliminary results suggest the portable PBT program was generally acceptable to older adults and local clinicians. Perceived effectiveness was generally positive and increased balance awareness and low burden are emerging as common themes. Local clinicians indicated the burden of implementing PBT was low, PBT fit within their views on fall prevention, and had a high level of perceived effectiveness. There appear to be a few limitations to feasibility, which are primarily related to the weight and transportation of the treadmill. We are currently working to refine the treadmill and lower its weight and are developing a grant with local clinicians and extension agents that would facilitate transportation to a broader network of communities. DISCUSSION/SIGNIFICANCE: Our preliminary findings suggest PBT is feasible in rural communities and accepted by older adults. Increased balance and fall awareness and low burden are emerging as important factors in the feasibility and acceptability of PBT. This study provides a foundation for future studies to translate other PBT modalities from the lab to the community.

OBJECTIVES/GOALS: To outline the successes of Partners for the Advancement of Community Engaged Research (PACER), a Special Interest Group (SIG) of ACTS, created to bring together academic and community researchers to promote best practices, contribute to science and form collaborative networks to improve public health through community research and dissemination. METHODS/STUDY POPULATION: Developed from the CTSA Key Function Committee, PACER began monthly meetings in early 2015. Zoom replaced teleconference technology for the initial email list of about 100 people from 50 institutions which has grown to 225 members from 88 affiliates. Meeting attendance is 40 to 50. PACER meetings start with operational updates and member announcements (15 minutes), proceed to presentations (20-25 minutes), followed by Q & A and discussion (20 minutes). A subset of members functions as an Operations Workgroup, meeting monthly to discuss emerging issues and guide the group’s activities. Email traffic is intentionally limited to one or two messages a month, including meeting announcements. RESULTS/ANTICIPATED RESULTS: PACER meetings have included 65 presentations. Featured speakers have described local community engaged research, explored methodology, and talked about diversifying the workforce, ethics, programs and partnerships. PACER members have collaborated on three manuscripts published in the Journal of Clinical and Translational Science; one with 50 members and 20 institutions contributing. Additionally, PACER members obtained two federal grants, including a network to recruit underrepresented scientists and diverse participants for the All of Us precision medicine effort. These projects totaled $23.5M in funding and involved 9 CTSA hubs. Measuring the value of ongoing dialogue and promulgation of successful practices through presentations has proven challenging. DISCUSSION/SIGNIFICANCE: ACTS support helps PACER SIG members share research interests, develop papers and proposals, and archive meeting materials on the SIG webpage. Beginning with Translational Science 2018, the in-person PACER meeting is a much-anticipated opportunity to meet colleagues and foster new collaborations, and is a critical addition to the PACER calendar.

OBJECTIVES/GOALS: Social distancing practices during COVID-19 may impact experience of stress, substance use and violence exposure. This study aims to describe the effect of the COVID-19 stay-at-home orders on stress, substance use, and teen dating violence (TDV) among young women living in Baltimore City. METHODS/STUDY POPULATION: Study participants were recruited from an observational study examining TDV before the COVID-19 pandemic, through snowball sampling, pediatric and adolescent primary care clinics, the pediatric emergency department, and a registry for patients interested in participating in COVID-19 research. Participants were between the ages of 16 and 22, identified as female, and lived in Baltimore, Maryland. They were asked to complete a baseline survey. March 16, 2020 (Maryland governor’s stay-at-home order) through June 2022 defined the COVID-19 pandemic period. The survey assessed stress experiences, including isolation, finances, job loss, transportation, school stress, substance use, experiences of violence and adherence to COVID-19 safety measures. We conducted descriptive and bivariate analyses. RESULTS/ANTICIPATED RESULTS: Participants (n=105) had a mean age of 19.4 years (SD 1.73). Preliminary analyses demonstrate that stress associated with isolation, finances, transportation, and school increased during the pandemic compared to pre-pandemic. In addition, the majority of participants who used marijuana, e-cigarettes, and alcohol used about the same amount or more of each substance during the pandemic. For the next steps, we will examine experiences of TDV for young women during the pandemic and examine whether experiences of TDV differ for young women who reported a greater adherence to COVID-19 safety measures compared to participants who adhered less. DISCUSSION/SIGNIFICANCE: Assessing the impact of COVID-19 safety measures on stress, substance use, and TDV is critical to informing and designing future public health interventions. In addition, the information obtained from this study may be used to address the unique challenges faced by disenfranchised populations while curbing the spread of infectious diseases.

Institutional Development Award (IDeA) programs build research infrastructure in regions with historically low access to NIH funds. The Mentored Research Development Award (MRDA), a professional development program embedded in our IDeA-funded center, provides junior investigators with mentorship and effort offset to write a grant. We evaluated outcomes from the first eight years (2013–2021; N = 55) using administrative records, publicly available data, and a self-report survey (n = 46, 84% response rate). Fifteen MRDA recipients (27%) went on to receive NIH funding. Providing just-in-time grant-writing support may launch early career clinician-scientists in an IDeA state context.

OBJECTIVES/GOALS: 1. Describe the development and implementation of a Community Scholars Program to train graduate and professional students on principles of community engagement and its application to their research. 2. Evaluate lessons learned and overall impact implementing a Community Scholars Program. METHODS/STUDY POPULATION: After identifying a need to train scholars on the principles of community engagement, the Community Engagement Research Core’s (CERC) Community Advisory Council (CAC) developed the Community Scholars Program (CSP) in 2014. The CSP was designed to educate scholars on community engaged research and how it can be applied to their research projects. The program is currently in its ninth cohort with 19 graduate and professional students having participated in the program to date. Prospective scholars identify a community partner and faculty mentor and apply to conduct a community engaged research project over the course of an academic year. The purpose of this project is to describe the development and implementation of a CSP and identify lessons learned throughout the process. RESULTS/ANTICIPATED RESULTS: Five lessons learned have been identified: five major lessons learned from implementing the CSP: (1) establish partnership agreements between the scholars and their community partners and faculty mentors, setting expectations to avoid conflict and increase mutual understanding; (2) expand and implement more creative outreach approaches to cultivate a more diverse pool of applicants; (3) increase networking between current and past scholars to share experiences and serve as a resource for each other; (4) provide formal CE training for scholars to develop a better understanding of the principles of CE and CE research; and (5) document progress of the program through formal feedback and evaluations. DISCUSSION/SIGNIFICANCE: The CSP was constructed to fill a gap in CE research training for graduate and professional scholars. Over the course of the program, the identified lessons learned have created program clarity and increased accountability for scholars, mentors, and community partners alike.

OBJECTIVES/GOALS: To present a community engaged pilot study of minority participation in clinical research that translates principles of trauma informed care and culturally responsive education into research practices for Investigators that elevate African American patients’ trauma survivorship, and prioritize their values for meaningful research engagement. METHODS/STUDY POPULATION: Data will generated from Phase 1 pilot project research activities including: a) a scoping review of trauma-informed care and culturally responsive education principles, and published recommendations for translating these principles to clinical research practices, b) semi-structured Key Informant interviews (~10) capturing the perceived impact of trauma on Portland-area African Americans’ health, well-being, and clinical research participation, and c) a 2-day stakeholder council meeting with clinicians, patients, community health workers, Investigators, and IRB staff that will prioritize the clinical research principles and practices that matter most to African American patients, from pre-design to dissemination. Data will be collected Fall 2022/Winter 2023, and analyzed in Winter 2023. RESULTS/ANTICIPATED RESULTS: The results will empirically validate published recommendations on how to apply trauma-informed, culturally responsive (TICR) principles to clinical research practices, specifically for African American patients. They will illuminate the sociocultural and historical contexts under which clinical research is conducted with minoritized patients--drawing on the experiences of personnel who intersect at various levels of the clinical research ecosystem, and African American patients with varying experiences with clinical research. Results will illuminate challenges, needs, assets, cultural funds of knowledge, and values for meaningful research engagement, and provide practical, tangible strategies for Investigators to align with equity- and justice-based clinical research practices. DISCUSSION/SIGNIFICANCE: The TICR research approach disrupts the cycle of trauma, health disparities, and low minority research participation through a paradigm shift that equips Investigators to exercise universal precautions to minimize harm, protect African American research participants from retraumatization, prioritize their cultural values, and promote safety.

OBJECTIVES/GOALS: Low and middle income countries (LMICs) face challenges in early detection of breast cancer resulting in high breast cancer mortality. This study serves to identify gaps and opportunities for innovators seeking to address problems in early detection of breast cancer in Uganda and other LMICs. METHODS/STUDY POPULATION: Two methods were used: 1) Three weeks of ethnographic research in Uganda through primary stakeholder interviews and clinical observations. Interviews were conducted with patients, clinicians, NGOs, and key opinion leaders from the Uganda Cancer Institute, Makerere University, and JHPIEGO. Clinical observations were performed to note the workflow and availability of resources across diverse health centers ranging from village health teams in rural settings to the national referral hospital in the urban center. 2) A targeted literature search focused on breast cancer detection in LMICs. Keywords included breast cancer’, screening’, and diagnosis’. Identified challenges were validated through stakeholder interviews and categorized. Potential solutions to each challenge were explored. RESULTS/ANTICIPATED RESULTS: Three broad categories of challenges and suggested innovation targets were identified. 1) Ineffective clinical processes: deskilling and improving training around the process of clinical breast examinations, imaging operation and interpretation, and pathology preparation and interpretation; 2) Accessibility: increasing screening throughput, improving rural community access to breast cancer care, and increasing opportunistic screening; 3) Sensitization: increasing patient and health worker awareness of clinical presentations of breast cancer, reducing cultural barriers, and improving trust in the medical community. DISCUSSION/SIGNIFICANCE: Innovators seeking to solve problems in early breast cancer detection in LMICs should focus on ineffective clinical processes, accessibility, and sensitization. In conjunction with prompt treatment, there is potential to reduce breast cancer mortality rates in line with the Global Breast Initiative.

OBJECTIVES/GOALS: To examine i) how longstanding (≥6 years) community-based participatory research (CBPR) partnerships nationwide implemented a validated questionnaire to measure success and its contributing factors and ii) how the CBPR partnerships utilized and applied a feedback mechanism, or reports of findings from the questionnaire and a facilitation guide METHODS/STUDY POPULATION: This mixed methods study builds upon a larger NIH-funded project entitled ’Measurement Approaches to Partnership Success (MAPS). MAPS developed and validated the 109-item MAPS questionnaire to measure success in longstanding (≥6 years) CBPR partnerships. In 2020, 55 CBPR partnerships nationwide completed the MAPS Questionnaire and, a year later, received the MAPS Feedback Mechanism, consisting of questionnaire findings and a facilitation guide on how to present the findings. In this follow-up study, we administered multi-method surveys to each partnership contact person in 2022 to examine their experience with and utility of the MAPS Questionnaire and the MAPS Feedback mechanism. We performed descriptive analysis of quantitative responses using SAS and thematic analysis of qualitative responses. RESULTS/ANTICIPATED RESULTS: Survey responses have been presently collected from 14 partnerships. Preliminary findings suggest that the most frequently reported benefits of completing the MAPS Questionnaire included stimulating partnership reflections and ease of completion. Many partnerships shared results of the MAPS Questionnaire by e-mail or during partnership meetings. Nearly half of the partnerships rated components of the MAPS feedback mechanism as useful. Over one-third of the partnerships reported that the COVID pandemic limited their capacity to engage with the MAPS Feedback Mechanism. Key qualitative suggestions included making the MAPS Questionnaire shorter, providing it in a different format, and offering additional facilitation to support the implementation of the MAPS Feedback Mechanism. DISCUSSION/SIGNIFICANCE: This study examines how CBPR partnerships utilize an evaluation instrument and apply results on success. Current findings suggest potential utility of the MAPS Questionnaire and Feedback Mechanism for ongoing evaluation. Reducing the questionnaire length and providing facilitation resources may enhance implementation across diverse settings.