Accelerating innovation translation is a priority for improving healthcare and health. Although dissemination and implementation (D&I) research has made significant advances over the past decade, it has attended primarily to the implementation of long-standing, well-established practices and policies. We present a conceptual architecture for speeding translation of promising innovations as candidates for iterative testing in practice. Our framework to Design for Accelerated Translation (DART) aims to clarify whether, when, and how to act on evolving evidence to improve healthcare. We view translation of evidence to practice as a dynamic process and argue that much evidence can be acted upon even when uncertainty is moderately high, recognizing that this evidence is evolving and subject to frequent reevaluation. The DART framework proposes that additional factors – demand, risk, and cost, in addition to the evolving evidence base – should influence the pace of translation over time. Attention to these underemphasized factors may lead to more dynamic decision-making about whether or not to adopt an emerging innovation or de-implement a suboptimal intervention. Finally, the DART framework outlines key actions that will speed movement from evidence to practice, including forming meaningful stakeholder partnerships, designing innovations for D&I, and engaging in a learning health system.

Introduction. Family health history (FHx) is an important factor in breast and ovarian cancer risk assessment. As such, multiple risk prediction models rely strongly on FHx data when identifying a patient’s risk. These models were developed using verified information and when translated into a clinical setting assume that a patient’s FHx is accurate and complete. However, FHx information collected in a typical clinical setting is known to be imprecise and it is not well understood how this uncertainty may affect predictions in clinical settings. Methods. Using Monte Carlo simulations and existing measurements of uncertainty of self-reported FHx, we show how uncertainty in FHx information can alter risk classification when used in typical clinical settings. Results. We found that various models ranged from 52% to 64% for correct tier-level classification of pedigrees under a set of contrived uncertain conditions, but that significant misclassification are not negligible. Conclusions. Our work implies that (i) uncertainty quantification needs to be considered when transferring tools from a controlled research environment to a more uncertain environment (i.e, a health clinic) and (ii) better FHx collection methods are needed to reduce uncertainty in breast cancer risk prediction in clinical settings.

Clinicians who are interested in becoming principal investigators struggle to find and complete training that adequately prepares them to conduct safe, well-designed clinical and translational research. Degree programs covering these skills require a significant time investment, while online trainings lack engagement and may not be specific to local research contexts. Staff at Tufts Clinical and Translational Science Institute sought to fill the gap in junior investigator training by designing an eight-module, noncredit certificate program to teach aspiring clinician-investigators about good clinical practice, clinical research processes, and federal and local regulatory requirements. The first iteration of this program was evaluated using pre- and posttest questionnaires and by gathering clinician learner feedback in a focus group. Based on the pre- and posttest questionnaires, learners experienced an increase in self-efficacy and confidence related to clinical research competencies. Feedback from learners also highlighted important program strengths, including an engaging program format, a manageable time commitment, and an emphasis on identifying crucial research resources. This article describes one approach to creating a meaningful and efficient clinical trial training program for clinicians.

The Trial Innovation Network has established an infrastructure for single IRB review in response to federal policies. The Network’s single IRB (sIRBs) have successfully supported over 70 multisite studies via more than 800 reliance arrangements. This has generated several lessons learned that can benefit the national clinical research enterprise, as we work to improve the conduct of clinical trials. These lessons include distinguishing the roles of the single IRB from institutional Human Research Protections programs, establishing a consistent sIRB review model, standardizing collection of local context and supplemental, study-specific information, and educating and empowering lead study teams to support their sites.

ABSTRACT IMPACT: This formative evaluation can inform selection and development of implementation strategies for implementing this and other similar interventions in future implementation studies or practice. OBJECTIVES/GOALS: Al-Anon mutual-help groups help concerned others (COs; e.g., families, friends) of persons with an alcohol use disorder better cope with their own problems. Despite widespread availability of Al-Anon meetings, participation is limited. We developed and evaluated an intervention to facilitate CO engagement in Al-Anon. METHODS/STUDY POPULATION: Al-Anon Intensive Referral (AIR) was developed to facilitate COs’ engagement in Al-Anon through four coaching sessions and is being tested in a NIAAA-funded randomized controlled trial (RCT). Consistent with a hybrid type 1 effectiveness-implementation design, we also conducted a formative evaluation to learn about facilitators, barriers and recommendations for AIR implementation in substance use disorder (SUD) treatment programs. We interviewed key informants (director and two staff) at eight sites in the AIR RCT and two ‘naive’ sites unfamiliar with AIR. Sites included community and Veterans Administration (VA) treatment programs in Arkansas, California, and Nebraska. Semi-structured interviews were based on the Consolidated Framework for Implementation Research, and were thematically analyzed. RESULTS/ANTICIPATED RESULTS: Facilitators included AIR’s face validity, adaptability, and alignment with staff values and skills, requiring only minimal training. Several community sites thought AIR would fit with their current practices (e.g. family groups), and some sites reported having sufficient staff available for delivering AIR. Barriers included limited staff time (some sites), and VA sites having limited resources for providing services to COs. Furthermore, many clients have no COs, or COs who are unwilling or unable to engage. Recommendations included fitting AIR within existing workflows and focusing on COs with highest readiness. Participants also thought AIR could be adapted as an online or smartphone app, which may expand its reach to younger and more tech-savvy populations while decreasing staff burden. DISCUSSION/SIGNIFICANCE OF FINDINGS: AIR has strong potential for implementation, but sites vary on implementation capacity and readiness. Most sites could implement it partially (e.g., case-by-case basis), and sites with sufficient capacity (e.g., family groups, staff time) could implement it more fully. An app-based AIR could help mitigate some barriers.

OBJECTIVES/GOALS: Using the NIH’s expanded definition of underrepresented populations in the biomedical, clinical, behavioral and social science research enterprise, we examined the impediments for conducting translational research experienced by those from underrepresented groups. [https://acts.slayte.com/calls/detail/740a13de-316c-11ee-90f4-0e0ce905385c/draft/389221c1-434e-11ee-90f4-0e0ce905385c#_ftn1] #_ftn1 METHODS/STUDY POPULATION: One hundred and ninety-nine people completed a survey distributed to 750 persons who had interacted with our Center’s service cores as users, awardees, mentors, committee members, seminar attendees, and/or participated Center sponsored programming (response rate = 26.5%). The survey addressed barriers to conducting clinical and translational research at the respondent’s institution, awareness of and interest in using specific Advance RI-CTR services, and satisfaction with their institution’s efforts to support clinical and translational research. RESULTS/ANTICIPATED RESULTS: Women reported access to collaboration across institutions as a barrier to clinical and translational research that existed to a great extent (28%) significantly more than men (10%). More than half (53%) of the other underrepresented researchers surveyed identified insufficient grant administration supportas a barrier that occurs to a great extent, compared with 35% of researchers who were not from an underrepresented group. Other barriers reported more frequently among underrepresented researchers included lack of pilot project funding, inadequate space for conducting research, lower access to collaborators across institutions, and difficulty obtaining advice on regulatory issues and commercial development. DISCUSSION/SIGNIFICANCE: Efforts to address the barriers identified by underrepresented groups will include, but not be limited to, improving collaborations across institutions, support for grant administration, and a discussion of plans for the Center to augment and advocate at the partner institutions on behalf of these underrepresented individuals.

OBJECTIVES/SPECIFIC AIMS: To describe how Michigan Institute for Clinical & Health Research (MICHR) has engaged communities in its leadership and governance structure. This presentation will describe these practices, how they are being evaluated, and future plans for institute-wide engagement of communities in translational research. METHODS/STUDY POPULATION: Engaged partners from various communities across Michigan in various ways within MICHR’s Community Engagement Program. RESULTS/ANTICIPATED RESULTS: MICHR has utilized participatory practices in the development of the CAB to strengthen existing relationships and build new ones with potential partners. DISCUSSION/SIGNIFICANCE OF IMPACT: MICHR-wide Community Advisory Board (CAB) will ensure community voices are heard and utilized in leadership and strategic decisions for CTSA activities.

Objectives/Goals: To assess the attitudes toward social justice of residents and faculty following the didactic series and evaluate the impact of the longitudinal curriculum on resident engagement in social justice activities through community engagements. Methods/Study Population: Data were gathered through questionnaires collected from participating residents and faculty. The session topics were chosen based on “Precepting Toward Social Justice” curriculum from the University of Minnesota Department of Family Medicine and Community Health, including sessions on advocacy, diversity, and implicit bias, among others. The self-assessment questionnaires were specific to the topics of the lecture, assessing knowledge, skills, and attitudes before and after the education sessions. Participants were asked to rate these aptitudes of each topic from “none” to “expert.” Results/Anticipated Results: Out of 22 total participants, 16 returned surveys. Overall, there was a substantial improvement in aptitudes after the lecture. There was an increase in reported above average knowledge of topics: Agency (12.5% to 56.25%), Humility (18.75% to 62.5%), Dignity (12.5% to 62.5%), Partner (18.75% to 50%), Awaken (37.5% to 75%), Place (12.5% to 43.75%), Asset (0% to 37.5%), Sanctuary (6.25% to 50%), Belonging (0% to 37.5%), Whole (0% to 43.75%), Liberation (12.5% to 68.75%), and Heal (37.5% to 75%). 31% reported that the lectures alone had an above average influence on pursuing more social justice activities through community engagement. 44% reported that the lectures had an above average impact on their subsequent patient encounters. 69% stated that this series helped develop their overall social justice skills. Discussion/Significance of Impact: All patients deserve equitable care. Family physicians have a unique role in addressing social justice concerns to eliminate inequalities and drive for better health outcomes. By enforcing social justice in education and implementing it into practice, satisfaction, trust, and well-being of patient and provider will be improved.

Objectives/Goals: Hypermobile Ehlers-Danlos syndrome (hEDS) and endometriosis are under-diagnosed conditions that are not well understood by many clinicians. This study aims to increase provider readiness to diagnose and treat women with these conditions by identifying clinicians’ perceived gaps in knowledge and preferred educational resources and modalities. Methods/Study Population: A national survey of clinicians (N = 121) was created in the Qualtrics survey-building platform, with recruitment taking place via the Prolific online research platform from 09/04/25 to 10/02/25. Clinicians responded to a series of established, closed-ended measures assessing their educational experiences regarding hEDS and endometriosis, comfort with diagnosing and managing the care of women with these two conditions, perceived barriers to diagnosis and care management, and preferred educational/training modalities for enhancing their understanding of these conditions. To be eligible for participation, respondents had to self-report that they were a) clinicians, b) at least 18 years of age, and c) working in the US healthcare sector. Descriptive statistics were performed on all variables of interest. Results/Anticipated Results: Clinicians first heard about hEDS from medical texts (60%) and patients (15%), and endometriosis from medical texts (50%) and personal relationships (including own diagnosis; 33%). A substantial proportion of clinicians reported being not at all comfortable understanding diagnostic criteria (hEDS 36%, endo 17%), diagnosing patients (hEDS 46%, endo 30%), or making plans of care (hEDS 42%, endo 17%). Top barriers included lack of knowledge, confidence, and mentoring. Respondents identified Online activities and Internet Point-of-Care as the most desirable CME resources, and Evidence-Based Medicine and Case-Based Learning as the most desirable learning modalities. Online learning offered flexible timing and self-paced modules, whereas in-person learning offered interaction with experts and peers. Discussion/Significance of Impact: This project recognizes the dearth of resources on hEDS and endometriosis available to clinicians and fills that gap by soliciting feedback directly from clinicians on their educational needs. Results will be translated into two prototypes of specialized educational interventions tailored to clinicians’ desired resources and methods of learning.

Objectives/Goals: To enhance collaboration, communication, and research professional development in a newly aligned academic learning health system by implementing two innovative training programs – Leadership in Focus and Research Mentor Academy – that build leadership and mentoring capacity across the research workforce. Methods/Study Population: To elevate and support research leadership and mentoring development across a large, multi-state academic health system, we launched two complementary programs. Leadership in Focus is a monthly virtual series featuring interviews with enterprise leaders, offering insights into leadership, strategy, and team science. Mentor Academy is a 10-week virtual course that provides formal training through skill-building, discussions, and guest speakers. Aligned with national best practices, it emphasizes communication and mentee-focused career development across the translational spectrum. Results/Anticipated Results: Both programs have shown early success in increasing engagement, awareness, and leadership competency. Leadership in Focus has drawn growing attendance from researchers, staff, and clinicians, fueling internal networking opportunities. The Research Mentor Academy participants bring strong representation from across departments and campuses. Participant feedback indicates improved confidence in mentoring, greater clarity in career advancement strategies, and expanded professional networks. These initiatives are creating new entry points for leadership development across the research enterprise, contributing to a stronger, more connected learning health system. Discussion/Significance of Impact: Through strong leadership and mentoring training, these programs strengthen collaboration and skill development of the translational research workforce. The success of these programs fosters a culture of learning and emphasizes the value of professional growth in an academic learning health system.

Objectives/Goals: Undergraduate Medical Education (UME) may apply Just-in-Time training (JITT) to provide medical students with learning experiences closely aligned with real-time clinical needs. The purpose of this scoping review is to offer an overview of the implementation of JITT training in UME. Methods/Study Population: Following the five-stage framework by Arksey and O’Malley to methodically collect and analyze studies on JITT in UME, five electronic databases were searched, and a supplemental search for grey literature was conducted. Studies exploring the integration of JITT principles into UME clinical training and their time to follow-up after training were included. Bloom’s Taxonomy was used to assess educational goals of JITT interventions. Results/Anticipated Results: The review yielded 21 studies across 4 countries. The majority were cohort studies (13) and randomized control trials (5). Assessment definitions and use of JITT varied widely. Most studies focused on short-term outcomes, defined by being measured immediately after JITT session (15) or at the end of JITT-based rotation or clerkship (3). Three studies evaluated outcomes at a period longer than 2 weeks after completion of session or clerkship. Attitudes (9), followed by skills (8) were the most common educational goals of intervention. The efficacy and utility of JITT in improving educational goal acquisition was demonstrated in 90% (17/19) of the studies with reported outcomes. Discussion/Significance of Impact: The introduction of JITT in UME has been shown to meet the immediate needs of healthcare environments; however, evidence is limited in the evaluation of longer-term outcomes. Further research to determine the impact of JITT on long-term learning retention and education goal acquisition in UME is merited.

OBJECTIVES/SPECIFIC AIMS: The specific objective of this proposal is to identify and validate targetable tumor-associated antigens (TAAs) in ovarian and pancreatic cancer. It is our central hypothesis that the accurate identification and selection of appropriate TAAs will provide a foundation on which to develop of novel and effective cancer immunotherapies. We have formulated this hypothesis on the basis of preliminary results in which we have used high-throughput tandem mass spectrometry (MS) to successfully identify TAAs from melanoma patient tumors. We have subsequently generated TAA-specific T-cells that showed specific recognition and killing of tumor cells, and will form the basis of an upcoming clinical trial for our melanoma patients. We now have extended this antigen identification pipeline into ovarian cancer to accomplish our objective of developing effective T-cell-based immunotherapies for ovarian cancer and pancreatic patients. METHODS/STUDY POPULATION: We have collected patient tumor specimens, and we performed HLA immunoprecipitation, peptide elution, and completed high-throughput tandem MS on these eluted samples to identify TAAs. In addition, we have validated the safety of potential targets through the use of the publicly available RNA sequence data sources GTEX and TCGA. RESULTS/ANTICIPATED RESULTS: To date, we have successfully completed over 60 peptide elutions from ovarian and pancreatic patients samples. In total, we have found several potential novel tumor-associated targets. VGLL1, is one of these identified antigens, and in conjunction with our collaborators, we have successfully generated T-cells against it. Additionally, we have found that VGLL1 is a potential novel TAA for 3 other cancer types, including bladder, gastric, and triple negative breast cancers. We are now focusing our efforts on testing these T-cells against additional ovarian cancer cell lines and these cancer types to determine their specificity. We plan to continue the generation and testing other identified potential TAAs as well. We plan to use these T-cells directly in clinical trials in the future. DISCUSSION/SIGNIFICANCE OF IMPACT: The rationale for this proposal is that through the identification and validation of TAAs, we can open the door to a new world of therapies that can potentially increase the survival rate in a disease with a historically grim prognosis.

OBJECTIVES/SPECIFIC AIMS: To use a systematic and iterative process to develop and refine toolkits to support dissemination and implementation (D&I) research. METHODS/STUDY POPULATION: Participants included research staff from the Dissemination and Implementation Research Core (DIRC), a research methods core from the Institute of Clinical and Translational Science at Washington University in St. Louis, other D&I experts from the University, and national experts from the D&I field. This project used education design research methodology and a systematic and iterative process involving several phases. The first phase (preliminary research and initial development) consisted of analysis of the educational problem and its context, and led to the development of toolkit prototypes and plans for their implementation. In the second phase (development and formative evaluation), toolkits were iteratively evaluated with emphasis on content validity and consistency and effectiveness as perceived by the users. Finally, in the summative evaluation, the toolkits were evaluated based on their use as intended. RESULTS/ANTICIPATED RESULTS: Our team identified the target audience as DIRC customers and investigators from disciplines across the University, and found that resources for beginners to D&I were lacking. The team developed 8 toolkits: (1) Introduction to D&I; (2) How to develop D&I Aims; (3) D&I Designs; (4) Implementation Outcomes; (5) Implementation Organizational Measures; (6) Assessing Barriers and Facilitators; (7) D&I Designs; and (8) Guideline research. These prototypes were iteratively revised for content validity and consistency. Finally, each toolkit was evaluated by two national experts in D&I science, and further refined. DISCUSSION/SIGNIFICANCE OF IMPACT: This systematic and cyclical process led to the development of 8 toolkits to support researchers in D&I science, which are now available on the DIRC Web site. This set the stage for development of new toolkits as additional needs are identified.

OBJECTIVES/GOALS: Rising rates of youth obesity, diabetes, depression, and anxiety necessitate programs that address physical and mental health concurrently. We describe a feasibility study for DiscoverU, an afterschool mentoring program that integrates multiple aspects of health including social emotional learning, physical activity, and mindful eating. METHODS/STUDY POPULATION: Trained college students mentored middle and high school students in a Midwestern school district. DiscoverU was delivered 2 hours, 2 days/week for 8 weeks. Based on self-determination theory, DiscoverU was designed to meet National Afterschool Association healthy eating and physical activity and social emotional learning standards. We assessed feasibility with participant attendance (middle, high school, and college students) and acceptability through qualitative data from participants and relevant stakeholders regarding facilitators/barriers to program implementation. We observed indicators of mentoring, lesson fidelity, and assessed physical activity using accelerometry. Pre-post surveys measured self-realization, self-regulation, mindful eating, and physical activity self-efficacy. RESULTS/ANTICIPATED RESULTS: We expect DiscoverU to be feasible and well accepted. We anticipate attendance will be similar or higher than that of other afterschool programs in the district. From focus groups we expect to hear a variety of factors that facilitate/prevent program engagement and learn about the acceptability of specific lessons. We expect to gain insight on processes and procedures from school stakeholders that will inform the sustainability of DiscoverU. We expect program fidelity to be high and mentoring skills to improve over the course of the program. We anticipate the majority of participants will meet National Afterschool Alliance physical activity guidelines. Preliminary outcomes of self-determination, self-regulation, mindful eating, and physical activity self-efficacy are expected to improve over the program. DISCUSSION/SIGNIFICANCE: Findings will help determine the readiness of DiscoverU to be scaled to other schools. A subsequent randomized effectiveness study will evaluate DiscoverU’s impact on intervention mechanisms (e.g., self-determination, self-efficacy) as well as on physical activity, diet, weight, and depression/anxiety symptomology.