OBJECTIVES/GOALS: To quantify clinical exam in total knee arthroplasty by answering the following questions: (1) What are the magnitudes of forces applied by surgeons during the varus-valgus exam? (2) Is the choice of tibial insert thickness related to the magnitude of the applied forces? (3) How accurately does a surgeon estimate the gaps in the varus-valgus exam? METHODS/STUDY POPULATION: Three cadaveric knees were implanted with standard TKA trial implants. Four pliable force sensors were wrapped around the foot and ankle of each cadaver to measure the push-pull forces applied during the varus-valgus exam. Six surgeons with varying experience independently conducted a varus-valgus exam in extension and flexion and reported the gaps that they observed. Motion capture was used to measure the gaps between femur and tibia by placing cluster of reflective markers on femur and tibia. Subsequently, each surgeon chose the tibial insert that they thought best fit each knee. The measured peak applied forces were related to the insert thickness and the measured gaps were compared to the observed gaps by surgeons. Since insert thickness was in 1 mm increments, 1 mm gap error was considered a meaningful difference. RESULTS/ANTICIPATED RESULTS: The peak forces varied among surgeons for each cadaver. In cadaver one, the peak forces in varus and valgus in extension were 48±20 and 20±12 N, and in flexion were 27±14 and 8±11 N. Peak forces in cadavers two and three were similar; in varus and valgus in extension, 24±14 and 35±10 N, and in flexion, 23±12 and 20±10 N, respectively. It was observed that the larger the valgus force in extension, the thinner was the inserts choice (β = −0.08 mm/N, p = 0.012). In extension, the difference between estimated gaps and measured gaps was > 1 mm for 36% of all assessments and 91% of gaps were underestimated. Only one measure, however, was underestimated by > 2 mm. In flexion, gap estimates were > 1 mm for 35% of all measurements and 59% of all measurements were overestimated. Four measures were overestimated, and one was underestimated by > 2 mm. DISCUSSION/SIGNIFICANCE OF IMPACT: We found that the applied forces varied among surgeons and a negative association between insert thickness and forces in extension valgus exam. We also found that error in gap estimates among surgeons was > 1 mm a third of the time and that underestimation is more common in full extension, which may lead to using smaller inserts that affect knee stability. CONFLICT OF INTEREST DESCRIPTION: The corresponding author has no COI but my coauthors had the following COI:

1. 1. Royalties from a company or supplier: Zimmer; Stryker; Exactech, Inc; Lima; Mathys Ltd.

2. 2. Speakers bureau/paid presentations for a company or supplier Acelity; Flexion Therapeutics; Smith & Nephew; Exactech, Inc; Mallinckrodt Pharmaceuticals; Stryker.

3. 3B. Paid consultant for a company or supplier Acelity; DePuy Synthes; Exactech, Inc; Flexion Therapeutics; Intellijoint; Smith & Nephew; Zimmer; Stryker

4. 4. Stock or stock options in a company or supplier Imagen; Insight Medical; Intellijoint; Parvizi Surgical Innovation; OrthAlign; Orthobond.

5. 5. Research support from a company or supplier as a Principal Investigator Acelity; Exactech, Inc; Intellijoint; Smith & Nephew; Mallinckrodt Pharmaceuticals; Stryker; Lima.

6. 6. Royalties, financial or material support from publishers (The following conflicts were disclosed) Exactech, Inc.

7. 7. Medical/Orthopaedic publications editorial/governing board Bone and Joint Journal 360; Journal of Orthopaedics and Traumatology; Techniques in Orthopaedics.

8. 8. Board member/committee appointments for a society Knee Society; Eastern Orthopedic Association.

OBJECTIVES/GOALS: Supported by the State of Alabama, the Alabama Genomic Health Initiative (AGHI) is aimed at preventing and treating common conditions with a genetic basis. This joint UAB Medicine-HudsonAlpha Institute for Biotechnology effort provides genomic testing, interpretation, and counseling free of charge to residents in each of Alabama’s 67 counties. METHODS/STUDY POPULATION: Launched in 2017, as a state-wide population cohort, AGHI (1.0) enrolled 6,331 Alabamians and returned individual risk of disease(s) related to the ACMG SF v2.0 medically actionable genes. In 2021, the cohort was expanded to include a primary care cohort. AGHI (2.0) has enrolled 750 primary care patients, returning individual risk of disease(s) related to the ACMG SF v3.1 gene list and pre-emptive pharmacogenetics (PGx) to guide medication therapy. Genotyping is done on the Illumina Global Diversity Array with Sanger sequencing to confirm likely pathogenic / pathogenic variants in medically actionable genes and CYP2D6 copy number variants using Taqman assays, resulting in a CLIA-grade report. Disease risk results are returned by genetic counselors and Pharmacogenetics results are returned by Pharmacists. RESULTS/ANTICIPATED RESULTS: We have engaged a statewide community (>7000 participants), returning 94 disease risk genetic reports and 500 PGx reports. Disease risk reports include increased predisposition to cancers (n=38), cardiac diseases (n=33), metabolic (n=12), other (n=11). 100% of participants harbor an actionable PGx variant, 70% are on medication with PGx guidance, 48% harbor PGx variants and are taking medications affected. In 10% of participants, pharmacists sent an active alert to the provider to consider/ recommend alternative medication. Most commonly impacted medications included antidepressants, NSAIDS, proton-pump inhibitors and tramadol. To enable the EMR integration of genomic information, we have developed an automated transfer of reports into the EMR with Genetics Reports and PGx reports viewable in Cerner. DISCUSSION/SIGNIFICANCE: We share our experience on pre-emptive implementation of genetic risk and pharmacogenetic actionability at a population and clinic level. Both patients and providers are actively engaged, providing feedback to refine the return of results. Real time alerts with guidance at the time of prescription are needed to ensure future actionability and value.

Objectives/Goals: To evaluate the impact of social determinants of health (SDOH), specifically socioeconomic status and medical insurance coverage, on access to mental health services for adults aged 60 and older served by Federally Qualified Health Centers (FQHCs) in Puerto Rico. Methods/Study Population: A secondary retrospective analysis of electronic health records from FQHCs in Puerto Rico will be conducted to examine the relationship between SDOH needs and mental health service utilization among adults aged 60 years and older receiving primary care. SDOH data will be collected using the PRAPARE® tool, assessing factors such as socioeconomic status, insurance coverage, and emotional support, with a focus on identifying unmet needs. Multivariable and logistic regression models, using Stata v.17, will be employed to evaluate correlations between these SDOH factors and mental health service utilization, adjusting for age, gender, and mental health conditions. This analysis aims to quantify the impact of SDOH on access to mental health services and elucidate key barriers to care for older adults in Puerto Rico. Results/Anticipated Results: We anticipate that lower socioeconomic status, lack of supplemental insurance, and inadequate family support will be strongly associated with the underutilization of mental health services among older adults in Puerto Rico. These disparities are expected to be more pronounced in individuals with limited income, weaker family networks, leading to significant gaps in access to necessary mental health care. Barriers such as healthcare insecurity, financial hardship, and fragmented support systems will likely emerge as major obstacles. By including patients from both rural and urban regions, the study will capture the distinct challenges each population faces, enhancing the contextual relevance of the findings to broader populations, ultimately informing policy and developing intervention strategies. Discussion/Significance of Impact: The findings will provide crucial insights for developing targeted interventions to enhance mental health care access for older adults in Puerto Rico. These results will inform policy development and public health strategies, addressing disparities and promoting equitable care in underserved populations.

OBJECTIVES/GOALS: Research Education Towards Opportunities (RETO) Mentoring Offering Training Opportunities for Research (MOTOR) 1 – 2 and the elective courses (INTD 5998/ MDCL 101) in CTR of Title V Coop were designed to provide the participants from higher education institution (HEI) in Puerto Rico (PR), interdisciplinary – interprofesional knowledge in CTR. METHODS/STUDY POPULATION: Since April 2017, Research Education Towards Opportunities (RETO) and Mentoring Offering Training Opportunities for Research (MOTOR) 1 - 2 trainings were offered as part of the Title V Coop. In addition, since January 2020, as part of the institutionalization of the trainings in CTR, two elective courses (INTD 5998 and MDCL 101) were created-offered. The trainings/courses present the main concepts underlying CTR performance through lectures, workshops and presentations, in hybrid modalities, as well as the services-resources of the Center Research Education and Science Commnunication Opportunities (CRESCO). These programs have given students (undergraduate and graduate) and faculty the opportunity to get started in CTR and to integrate in Clinical and Translational Mentoring Teams (CTMT). RESULTS/ANTICIPATED RESULTS: Eight (8) cycles of RETO-MOTOR 1 and seven (7) cycles of RETO-MOTOR 2; two sessions of INTD 5998 and one session of MDCL 101 were offered. The RETO-MOTOR 1 training was completed by 219 participants and RETO-MOTOR 2 by 130 participants. The INTD 5998 course was completed by 22 students and the MDCL 101 course by 18 students. A total of 389 participants have been initiated in the CTR. Of the trainings, 90% indicated that the knowledge acquired in CTR was invaluable, 85% understand that the most significant achievement, as students, was present at a scientific conference, and 100% indicated interest in continuing to do CTR. Of the courses, 100% indicated that they were a good learning experience, helped them increase their knowledge in CTR, met their expectations and would recommend other students to take the course. DISCUSSION/SIGNIFICANCE: The RETO-MOTOR 1, RETO-MOTOR 2 trainings and CTR courses provide a based of research knowledge and valuable interprofessional experience for those who whish to start in the clinical and translational research. The Title V Cooperative Project provides this opportunity to undergraduate and graduate students such as faculty of HEI in PR.

OBJECTIVES/GOALS: Preeclampsia, a hypertensive disorder in pregnancy, disrupts immune cell profiles at birth in both mice and humans. In mice, it affects offspring’s memory and behavior. This study aimed to investigate whether preeclampsia induces lasting immune cell changes after birth and its impact on astrocyte and microglia cell counts in offspring. METHODS/STUDY POPULATION: Preeclampsia was induced in C57BL/6 females by infusion of vasopressin (24 ng/hr) or saline throughout gestation via osmotic minipump. Parturition was allowed to occur naturally. Offspring were euthanized at various timepoints post-delivery for experimental measures. Total urine protein was determined via bicinchoninic acid assay. Single cell suspensions were prepared from thymus spleen, and brain tissue and separated via density gradient. Cell suspensions were stained with fluorochrome-conjugated monoclonal antibodies for flow cytometry. Statistical significance was determined using a two-tailed Student t test or one way ANOVA multiple comparisons test. The minimal level of confidence deemed statistically significant was p<0.05. RESULTS/ANTICIPATED RESULTS: Preeclampsia resulted in lower body and heart masses in offspring. Although T cell populations in the thymus were not altered in preeclampsia offspring, total T cells, Thelper, and cytotoxic T cells were elevated. Total B and isotype-switched B cells were increased in offspring of preeclampsia. Total dendritic cell percentages were not changed in offspring of preeclampsia, however, total anti-inflammatory markers on dendritic cells were reduced. Lastly, offspring of preeclampsia had a reduction in microglia and astrocytes within the brain. DISCUSSION/SIGNIFICANCE: Our study could establish including in utero data in predicting future disease risk, addressing gaps in understanding rising rates of cardiovascular and behavioral diseases. It also uncovers the impact of preeclampsia on early immune programming and reduced glial cell populations, potentially affecting cognitive and behavioral development.

OBJECTIVES/SPECIFIC AIMS: Virtual communities are an untested method to enhance community engagement in biomedical research. Our CTSA Hubs collaborated to assess receptivity to engage in a statewide Facebook (FB) group. METHODS/STUDY POPULATION: Cross-sectional online survey administered via iPads at the MN State Fair in 2018 to adults aged 18+ years residing in MN assessed demographics, social media use, interest in participating in a FB group for biomedical research; and open-ended questions on health topics of interest, and what would keep people engaged in this group. RESULTS/ANTICIPATED RESULTS: Respondents (N=487) were 21% racial minorities and 65% female sex. Most (87%, n=422) had created a personal FB profile. Of these, the proportion who agreed/strongly agreed was: 57% that the FB group sounded interesting, 45% were interested in being part of it, 41% were willing to share it with others, 62% that it would allow the community’s thoughts/ideas to be heard and 59% wanted to learn about opportunities to participate in research on health topics they care about. Using content analysis, the top 3 health topics people wanted to learn about were chronic disease and prevention, wellness, and mental health. Top ways to keep people engaged were providing personable, relevant health information; and interactive bi-directional discussions. DISCUSSION/SIGNIFICANCE OF IMPACT: Findings will inform development of a FB group to engage diverse populations in biomedical research.

OBJECTIVES/GOALS: The goal of this study is to highlight the unique characteristics of Miami CTSIs Master of Science in Clinical and Translational Investigation (MSCTI) as part of CTSIs overall translational workforce development program and to describe program outcomes. METHODS/STUDY POPULATION: The MSCTI at the University of Miami offers a structured, individualized, and mentored educational program that trains students in the principles and practice of translational science and clinical research. Based on student feedback and needs assessment, three courses were specifically created for the program to include additional scientific cognates and promote essential skills for the translational research workforce – team science and entrepreneurship, research ethics, and writing for clinical and translational science. A fourth course on applied statistics is currently under development that provides training in practical statistical knowledge required for clinician-researchers. Career trajectory of graduates and academic output were tracked through surveys and secondary data collection. RESULTS/ANTICIPATED RESULTS: The MSCTI Program has enrolled 76 students over its lifetime, including KL2 scholars, NIH K scholars and T32 trainees; with 25% of students holding foreign degrees. In addition to traditional outcomes such as funding and publications, qualitative case studies will highlight scientific impact and career progress of students. The program has performed exceptionally well in recruiting underrepresented persons in research, with 41% of the students identifying as Hispanic, and 52% of the students as female. Of the graduates, 84% have gone on to achieve leadership positions in NIH and pursue research careers in academic institutions, while 16% have moved to industry, government, or non-profit careers. Overall, 92% of graduates were engaged in research after two years of graduating from the program. DISCUSSION/SIGNIFICANCE: Miami CTSIs MSCTI Program has trained students with a wide range of incoming experience to establish successful careers in clinical and translational research and is a critical component of CTSIs translational workforce development program.

OBJECTIVES/GOALS: The aim of this study was to quantify balance impairments in stance in individuals with degenerative cervical myelopathy (IwDCM) in response to external perturbations. IwDCM have damage to their spinal cord due to degeneration of the cervical vertebral column, but little is known about balance. METHODS/STUDY POPULATION: Recovery time following a perturbation may be an important measure of balance. Changes in recovery time were measured in 7 IwDCM (2m, 58.59±15.00y) and 6 controls without DCM (2m, 56.91±11.04y) as they stood on an instrumented treadmill and received cued (predictable) and uncued (unpredictable) lateral pulls to the waist at 12% (high) and 6% (low) pull magnitudes. Individuals stood with feet together, shoulder width, and wide. Recovery time was defined as the time following pull onset when the absolute value of the center of pressure velocity returned to <1x baseline standard deviation. Repeated measures ANOVA was performed on recovery time. RESULTS/ANTICIPATED RESULTS: We anticipate that feet together standing, unpredictable, higher magnitude perturbations will be most challenging evidenced by longer recovery times. For waist pull recovery time, there was a trend for a Group x Predictability x Magnitude x Stance Width interaction (p = 0.1) which we anticipate being greater with additional participants. There were significant Group x Predictability x Stance Width (p = 0.01) and Group x Magnitude x Predictability (p = 0.01) interactions. IwDCM had exaggerated recovery times in narrow and wide stances with unpredictable pulls. IwDCM recovered more slowly in response to unpredictable higher magnitude pulls. DISCUSSION/SIGNIFICANCE OF IMPACT: Balance responses in IwDCM are most impaired in narrow stances and when perturbations are unpredictable. Rehabilitation should focus on shortening latency of response timing and increasing power utilization during balance response to promote quicker recovery.

ABSTRACT IMPACT: This work sheds diagnostic insight on patients with idiopathic rare disease and has the potential to further their care and treatment as a result. OBJECTIVES/GOALS: Correct diagnosis is imperative to treating patients with idiopathic, suspected genetic conditions, yet sequencing approaches leave up to 70% of these patients undiagnosed. We sought to improve diagnosis rates for a cohort patients referred for sequencing by characterizing deleterious variants within the 5’UTR. METHODS/STUDY POPULATION: We retrospectively analyzed whole exome sequencing (WES) data from 472 unsolved rare disease patients within the Mayo Clinic Center for Individualized Medicine to identify variants within the 5’UTR that affect the presence of upstream open reading frames (uORFs). uORFs are short regions (typically 30bp - 600bp) that typically influence downstream gene translation by sequestering ribosomes. We specifically searched for variants with the potential to disrupt existing uORFs or introduce new uORFs within the 5’UTR, and developed a pipeline to annotate these variants with information including GnomAD allele frequency and gene loss of function intolerance (pLI) score. To aid in variant interpretation, we applied two deep learning tools to predict variant impacts on transcript ribosome load (TITER and FramePool). RESULTS/ANTICIPATED RESULTS: Our pipeline identified a median of 21 variants per patient that were predicted to have a deleterious impact on the translational efficiency of protein coding transcripts, primarily by introducing new start codons within the 5’UTR or by altering the Kozak consensus of existing start codons. A median of 10 of these variants occur upstream of haploinsufficient genes with an existing disease association. We also identified a subset of variants that are predicted to introduce translationally active N-terminal extensions to protein coding transcripts, with the potential to disrupt protein localization and processing. DISCUSSION/SIGNIFICANCE OF FINDINGS: This work demonstrates that analysis of 5’UTR variants can be incorporated into existing WES pipelines, and identifies a group of variants with potential significance to patient disease. Further experimental evidence is necessary to ascertain the pathogenicity of these variants.

OBJECTIVES/GOALS: A growing number of older adults in the United States have multiple social determinants of health (SDoH) that are barriers to effective medical care. We used generalizable machine learning methods to identify and visualize subtypes based on participant-reported SDoH profiles, and their association with delayed medical care (self-reported yes/no). METHODS/STUDY POPULATION: Data. All participants aged >=65 in All of Us with complete data on 18 SDoH self-reported variables, selected through consensus by 2 experienced health services researchers, and guided by Andersen’s behavioral model. Covariates included demographics, and the outcome was delayed medical care . Cases (n=4090) consisted of participants with at least one of the 18 SDoH variables, and controls (n=7414) consisted of participants with none of them. Method. (1) Used bipartite network analysis and modularity maximization to identify participant-SDoH biclusters, and visualize them through ExplodeLayout. (2) Used multivariable logistic regression (adjusted for demographics and corrected through Bonferroni) to measure the odds ratio (OR) of each participant bicluster to the outcome, compared with the controls. RESULTS/ANTICIPATED RESULTS: The analysis identified 7 SDoH subtypes (https://postimg.cc/Vd7Pg4xZ) with statistically significant modularity compared with 100 random permutations of the data (All of Us=.51, Random Mean=.38, z=20, P DISCUSSION/SIGNIFICANCE: The results identified 7 distinct subtypes based on SDoH profiles and their risk for delayed medical care, highlighting the importance of addressing specific combinations of barriers, with affordability having the highest risk. Furthermore, the analytical methods used are generalizable and have been made publicly available on CRAN and All of Us.

Objectives/Goals: To identify clinician and researcher barriers, facilitators and learning preferences for patient partner engagement in research. In addition, to describe the strategies, our Patient Partners Program has planned for building clinician and researcher capacity to engage patient partners in clinical research. Methods/Study Population: Our program to promote authentic patient–researcher partnerships to advance clinical and translational research is grounded in participatory approaches to maximize meaningful engagement. We utilized small group listening sessions with health care providers involved in clinical research at the University of Michigan, Michigan Medicine healthcare system. Insights from these sessions are informing the development of learning models and curriculum content. We used purposive sampling to recruit individuals (n = 12) with a wide array of patient engagement experiences across diverse clinical departments. The study materials and interview guide were co-created with a patient research partner who also participated in co-facilitating the listening sessions. Results/Anticipated Results: The interview guide included questions about the benefits, challenges, and supports to engagement and capacity building training programs for researchers. The listening sessions were recorded, transcribed, and analyzed for common themes. Preliminary findings have identified the following themes related to barriers: (1) identifying and onboarding patient partners, (2) communication challenges, and (3) institutional and structural challenges (e.g., time constraints and difficulty offering compensation) and facilitators: (1) institutional and administrative support, (2) flexibility, and (3) respect, trust, and partnership. Improved knowledge about how and when to engage patient partners was identified as a key component to build researcher capacity in patient partnered research. Discussion/Significance of Impact: Integrating patient partners into study teams accelerates innovation and translational science, increases the relevance of research findings, improves health outcomes and patient empowerment, and elevates the value of the patient perspective allowing researchers to gain a new point of view from an individual with lived experience.

ABSTRACT IMPACT: Preliminary results will inform the formal evaluation of the reliability of point-of-care ultrasound (POCUS) done by the gastroenterologist compared to standard of care methods such as MR-Enterography. OBJECTIVES/GOALS: Evaluation of mucosal healing is standard for pediatric patients with inflammatory bowel disease (IBD). Point-of-care ultrasound is a non-invasive, cost-efficient tool for assessing intestinal inflammation. We aim to evaluate the agreement between POCUS and typical cross-sectional imaging, such as MR-Enterography (MRE). METHODS/STUDY POPULATION: In this cross-sectional study, we recruited consecutive patients newly diagnosed with IBD, presenting to the specialty outpatient clinic or hospitalized in a pediatric tertiary care center between August to November 2020. They underwent POCUS performed by a single gastroenterologist, in addition to MRE. The sonographer was blinded to MRE results. Bowel wall thickness (BWT) was measured across different bowel segments and recorded twice in longitudinal view and twice in axial view. An average segmental BWT of the four measurements of more than 3 mm was considered inflamed. Agreement between sections of the bowel measured as inflamed were compared to inflamed bowel segments seen by MRE, using Cohen’s kappa. RESULTS/ANTICIPATED RESULTS: Eight of 12 patients completed both MRE and POCUS.A total of 40 bowel segments were assessed, namely the terminal ileum, ascending, transverse, descending and sigmoid colon. There were 4 girls with a median age of 15 years (IQR 14.25-16 years), and 6 patients were diagnosed with Crohn’s disease. Median PCDAI was 32.5 (IQR 30.6-40), and median PUCAI was 75 (72.5-77.5). Agreement between MRE and point-of-care ultrasound was substantial to perfect for the terminal ileum *(κ= 0.75, 95%CI 0.31-1), transverse colon (κ= 1, 95%CI 1-1) and sigmoid colon (κ= 1, 95%CI 1-1). The agreement was poor for the ascending (κ= 0, 95%CI 0-0) and moderate for the descending colon. (κ= 0.6, 95%CI -0.07-1) DISCUSSION/SIGNIFICANCE OF FINDINGS: In pediatric patients with IBD, we found a high agreement between POCUS and MRE for imaging of the terminal ileum, transverse and sigmoid colon, areas commonly involved in IBD. This reinforces adult data, outlining the potential of POCUS as an evaluation tool of disease activity in clinical practice.

Objectives/Goals: Resource navigator programs (RNPs) improve care coordination and access to social resources, but designs vary widely. We aim to evaluate patient and family experiences across three distinct pediatric RNPs, focusing on how program structure and context influence satisfaction and perceived impact. Methods/Study Population: Using purposive, criterion-based sampling, we will recruit families who completed one of three established Bay Area RNPs. Surveys will assess satisfaction and perceived support addressing social needs, while qualitative semi-structured interviews informed by the Consolidated Framework for Implementation Research and literature review will examine participants’ lived experiences with the RNPs, probing family attitudes on identifying social needs, their experiences in being connected with community-based organizations, and their perceived impact on their child’s health and well-being. Dedoose will be used for qualitative data management and coding organization. Survey and interview findings will be triangulated to identify converging themes. Results/Anticipated Results: Our interview guide has been developed and we are in the process of recruiting participants. Two of the sites are tertiary children’s hospitals and one is a safety-net hospital. The programs vary in structure and intensity, from a student volunteer model and a community health worker model with 6-month follow-up to an interventionist-led model with 1-year follow-up. We hypothesize that clinics serving medically complex patient populations will benefit most from longitudinal RNPs with dedicated interventional staff, given their extended contact with the healthcare system, whereas volunteer-based programs with shorter follow-up may be more effective in primary care settings, reaching larger populations with less intensive needs. Discussion/Significance of Impact: Insights from patient and family experiences can guide adaptation to local contexts and inform evidence-based decisions for hospitals implementing or refining RNPs. Findings will better inform the design and implementation of a new RNP for socially vulnerable pediatric surgical patients in the Bay Area.

Objectives/Goals: Physical activity (PA) is critical to improving the health and well-being of patients with congenital heart disease (CHD); however, rates of PA, specifically in children and adolescents with CHD, remain significantly lower than the general population. Our goal was to understand what factors influence rates of PA in children and adolescents with CHD. Methods/Study Population: A rapid review was performed in February 2024 across 5 databases: PubMed, Scopus, CINAHL, PsycINFO, and PEDRO (PROSPERO 2024 CRD42024516250). A search strategy combined all possible terms and MESH terms related to the population of interest: children or adolescents with CHD and the outcome of interest: PA levels. Descriptive analysis and concept maps were used to further describe the various barriers and facilitators to PA. Results/Anticipated Results: We identified 49 articles. Most articles were quantitative (76%) and assessed demographic influences, such as age and gender. Self-efficacy was the most common facilitator to PA, in addition to wanting to fit in and have fun. Self-imposed limitations and self-perceived barriers such as fears and anxiety, feelings of inadequacy, and lack of enjoyment were barriers to PA. Parents, teachers, and peers facilitated PA by providing support, possessing knowledge about the importance of PA, and by engaging in the activity with the child; however, these groups limited PA by showing anxiety and stress. Barriers related to social determinants of health (SDOH) include costs, lack of education, and accommodations during PA. Environmental barriers included less PA during winter, weekends, and between the hours of 15:00 and 17:00. Discussion/Significance of Impact: Identifying barriers and facilitators to PA in patients with CHD is necessary to design tailored programs that will increase PA behaviors. Future work should integrate perspectives of clinicians, patients, and families with the factors described in this review, to create programs that effectively address low PA levels in the young CHD population.