The NIH’s Clinical and Translational Science Award (CTSA) program has placed greater emphasis on Continuous Quality Improvement (CQI) in recent years. Our institution’s CTSA-supported Institute for Clinical and Translational Research (ICTR) implemented a novel CQI process in response. This manuscript shares lessons learned from our implementation, reflecting a paradigm shift from managing an “evaluation program” to creating a process whose central goal is CQI. Our objective is to share these reflections to support other CTSA hubs’ efforts to successfully implement CQI programs. Key elements of our implementation included (1) establishing a shared understanding about CQI’s purpose; (2) leveraging a centralized management approach while addressing barriers to implementation; and (3) creating structures that foster collaboration. The CQI framework we chose, FACE (Focus, Analyze, Change, Evaluate), enabled us not only to improve the activities of ICTR modules but also, over time, to refine the CQI process itself. Through regular convenings of module leaders, the ICTR has sought to cultivate a culture of CQI as a dynamic, participatory process that supports mutual learning and collective problem-solving.

Objectives/Goals: This project (1) assesses provider behavior at the Galveston Secure Against the Fentanyl Epidemic (G-SAFE) Clinic in providing evidence-based care for underserved patients in our community and (2) implements evidence-based anti-stigma intervention in local health care. Methods/Study Population: The efficacy and impact of G-SAFE on healthcare utilization, health outcomes, and patient satisfaction will be determined. Evaluations assessing provider behavior will be made across at least 25 clinic patient visits, taking note of medical students, clinicians, and health providers’ interactions with patients related to decision-making, care plan creation, and communication. Health provider discussion groups will provide essential data in understanding the successful management of SUDs, management of safety and risk, and how best to pilot and assess interventions that promote greater trust-building and a harm-reduction approach to clinical care for patient empowerment and positive outcomes. Results/Anticipated Results: Observations in the clinic will be turned into interventions to improve diagnostics and therapeutics for SUD medical care and behavioral change. We will recruit 40 medical students (with/without exposure to UTMB’s free clinics) as well as 20 clinicians in the G-SAFE Clinic, Emergency Medicine, and Primary Care. Baseline stigma will be measured with the Medical Condition Regard Scale and the Drug and Drug Problems Questionnaire alongside measures of care approaches. The data collected and the educational intervention for medical students and clinicians will make a positive impact on the lives of those affected by SUDs and serve as a model for future interventions on a larger scale. Discussion/Significance of Impact: Health provider’s SUDs stigma undermines both care quality, patient empowerment, and recovery success. Addressing provider stigma is crucial for necessitating a shift toward collaborative, responsive, and creative clinical decision-making to tackle the ethical challenges posed by the opioid crisis.

Objectives/Goals: This study aimed to explore Puerto Rican adolescents’ mental health experiences, focusing on risk and protective factors, and cultural perspectives on mental health. Methods/Study Population: Three focus groups were conducted: two with 20 adolescents aged 12 to 18 years of both genders and one with five adults who work with adolescents. Data were analyzed using interpretative phenomenological analysis. Results/Anticipated Results: The majority of participants in both groups of adolescents identified five key themes: social pressures, barriers to discussing mental health, the impact of social media, coping strategies, and institutional interventions. The adult focus group highlighted adolescent mental health problems, support systems, family and social factors, the church’s role, and recommended interventions. Discussion/Significance of Impact: The findings emphasize that social and familial pressures, mental health stigma, and social media significantly impact adolescent mental health. Coping strategies, such as sports, art, and nature, were also identified. These themes underscore the need for safe, supportive spaces, and targeted approaches to address youth mental health.

Prospective consent in neonatal research poses significant challenges, particularly during urgent, time-sensitive clinical windows of study enrollment. This is especially true at referral centers for large geographic regions. A partial waiver of consent offers a potential translational science approach to enhance access to research participation in critically ill neonates. We compared enrollment rates in a study evaluating pulse oximetry accuracy across neonates with varying skin pigmentation before and after implementing a partial waiver of consent. Overall enrollment increased significantly without creating a racial disparity in enrollment, thereby improving generalizability and efficiency in neonatal clinical research.

We describe a training series using a scaffolded approach informed by Vygotsky’s Learning Theory to advance Hawai‘i -based faculty grant-writing skills. Sponsored by the Professional Development Core of the Center for Pacific Innovations, Knowledge, and Opportunities (PIKO) at the University of Hawai‘i at Mānoa, the initiative includes a 2-week series of 1-hour introductory sessions on aspects of grant writing, a 3-session workshop to develop a specific aims page, and a 5-month training program in grant writing. Over three years, 202 Hawai‘i investigators attended at least one 1-hour introductory session, 62 completed the workshop on preparing specific aims, and 30 completed the 5-month training on grant writing. Participants rated all 3 programs as very useful. Of the 62 unique investigators who completed the Specific Aims Workshop, 21 (33%) submitted PIKO pilot grant applications, 4 (6%) submitted grants elsewhere, and 16 (30%) applied to the 5-month training on grant writing. The 30 GUMSHOE participants reported significant gains in their confidence in accomplishing 21 proposal-writing tasks and, as of May 2025, 26 (87%) submitted grants to the National Institutes of Health or another external funder. This scaffolded training approach is labor- and time-intensive for trainees and faculty mentors, but our outcomes demonstrate its success.

Objectives/Goals: • Investigate culturally-specific beliefs, caregiving approaches, care preferences, and unmet needs among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) care partners supporting persons living with dementia • Apply identified findings toward culturally-adapting caregiving resources for AANHPI dementia care partners Methods/Study Population: Qualitative data from the Better Together Dementia Care Study and Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Dementia Caregiving Study were analyzed to investigate culturally-specific beliefs, caregiving approaches, preferences, and unmet needs of AANHPI dementia care partners. Both studies remotely conducted and recorded semi-structured interviews (1.5–2.5 hours), with care partners and providers though interview protocols were distinct. Transcripts were AI-generated, through Zoom or Trint, and analyzed using thematic content analysis by two coders. Apriori codes drawn from literature and inductively-identified codes were identified and coded. Preliminary findings informed sociocultural strategies used to adapt existing care partner resources for use in these groups. Results/Anticipated Results: Preliminary analysis of care partner (CP) interviews (N = 8; 4 romantic partners, 4 adult children), revealed differences in caregiving experiences and networks. CPs supporting care receivers (CR) who had emigrated away from extended family networks reported a lack of instrumental support. Most CR (7/8) had adult children, many of whom (6/8) provided some care, though half of CR-child relationships were distant or had past difficulties. Romantic partners were primary CPs while co-caregiving with children; Adult children served as primary CPs for unpartnered CRs (n = 4). Adapted CP resources integrated these findings, acknowledging the complexities of fulfilling traditional filial expectations in light of difficult past relationships. Formal services were framed as an extension of family-coordinated care. Discussion/Significance of Impact: Care partners of immigrants may have limited local family support and may benefit from formal services. Adult children may provide care, though this may be complicated by poor past relationship quality. AANHPI care partners may benefit from culturally-adapted resources which address these issues, though resource acceptability-testing is needed.

Objectives/Goals: This study’s objective was to explore how a personal cancer diagnosis impacts the social connectedness (i.e., quality, structure, and functions of social relationships) of adolescent/young adult cancer survivors (AYACS, patients diagnosed with cancer between 15 and 39 years old), to inform intervention development fostering social health. Methods/Study Population: In this qualitative study (part of larger study assessing AYACS’ psychosocial challenges), participants were 15–25 years old at the time of cancer diagnosis and within 6 years of cancer diagnosis. Participants (and consenting parents of participants 18 years old and older) had to have fluency in written and spoken English and access to a computer or smartphone. Qualitative interviewers utilized an interview guide to conduct individual participant interviews. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyze data using a phenomenological approach to explore how a personal cancer diagnosis impacted social connectedness. Qualitative data related to social connectedness (corresponding to code “Relationships and Support”) are presented. Results/Anticipated Results: Three themes emerged through thematic analysis: (1) AYACS experience substantial heterogeneity related to social support needs; (2) AYACS leverage multiple relationships and resources when seeking support after a personal cancer diagnosis; (3) AYACS’ individual experiences were unique in that some noted positive changes, whereas others noted negative changes in relationships within social networks, specifically with peers. Discussion/Significance of Impact: AYACS experience various social support needs, and leverage multiple relationships when seeking social support. These translational findings create a foundation to develop AYACS social programming, foster peer relationships, and incorporate social science methods to aid intervention development to strengthen AYACS’ social connectedness.

Objectives/Goals: Summarize literature on parenting stress and treatment outcomes among postpartum women with opioid use disorder (OUD). Describe the causes of parenting stress identified by postpartum women who received medication for OUD (MOUD) and service providers. Discuss recommendations for parenting support services for postpartum women receiving MOUD in outpatient treatment settings. Methods/Study Population: We will conduct focus groups with postpartum women who received MOUD up to one-year after childbirth (2 groups; n  =  10) and service providers (e.g., obstetrics, psychiatry, pediatrics, primary care; 2 groups; n  =  10) to identify causes of and contributors to parenting stress to inform the adaptation of a parenting intervention for postpartum women receiving MOUD in an outpatient clinic setting. Participants will be recruited via flyers, email, and social media reach-outs, clinic staff and patient group meetings, and community-based outreach methods. Participants will be compensated for their participation. Focus groups will be audio-recorded and transcribed. Data will be analyzed via rapid analytic procedures using a summary template matrix. Results/Anticipated Results: We will use parenting-related stressors identified by mothers with substance use disorders in previous research to guide our interview questions. We expect to hear participants speak about their knowledge and experiences with stigma, guilt and shame, mental health symptoms, neonatal opioid withdrawal or neonatal opioid withdrawal syndrome (NOWS), fear of being reported to child protective services, and difficulties with mother–infant bonding and attachment. We will also ask participants about structural barriers that are known to increase parenting stress, such as housing instability, financial strain, and availability and cost of childcare. We will also report on new themes that emerge from the data that are shown to increase stress, challenge sobriety, and hinder continued engagement in the treatment. Discussion/Significance of Impact: Discontinuation of MOUD in the postpartum period is high and can lead to opioid recurrence and overdose. Outpatient treatment programs who offer psychiatric and behavioral health care, and parenting programs that target contributors of early postpartum parenting stress could improve health and MOUD treatment outcomes for mothers with OUD.

Tension between professional obligations and extraprofessional caregiving responsibilities is one reason physician scientists leave academic medicine. The COVID-19 pandemic exacerbated this challenge by increasing caregiving demands and decreasing time spent on research as much as 40%. CARES at UAB (Caregiving Affected Research Early-Career Scientists Retention Program at the University of Alabama at Birmingham) provided “extra hands” awards to early-career physician and non-physician research faculty to hire personnel to expedite research projects already awarded but deleteriously affected by caregiving during the pandemic. Evaluation included tracking awardee publications and grants, surveying awardees, and conducting semi-structured individual in-depth interviews. CARES at UAB distributed 28 grants totaling $1,005,266. Twenty-six awardees (93% retention) remain in academia 2.25–3.25 years after award initiation. Awardees attribute over 200 manuscripts to the funding and have secured 15 new NIH K-, R-, and U-series grants. Surveys indicate improved awardee well-being and decreased caregiving burden since receipt of funding. Scientific productivity, feeling valued, sense of community, and lifeline emerged as themes from interviews. Group “listening sessions” yielded university-level recommendations around tenure and promotion, caregiving culture, and mentoring. Resource to hire “extra hands” holds promise to retain early-career physician and non-physician research faculty with extraprofessional caregiving responsibilities.

Objectives/Goals: Using k-means clustering, we aimed to identify whether clusters characterized by greater exposure to minority stressors (e.g., experienced/anticipated discrimination) were associated with lower moderate-vigorous physical activity (MVPA) and higher sedentary behavior among sexual and gender minority (SGM; e.g., lesbian/gay, bisexual, transgender) adults. Methods/Study Population: SGM adults face higher risks of inadequate PA due to exposure to minority stressors, which may influence their willingness and ability to engage in PA. An online sample of SGM adults completed daily surveys about experienced and anticipated discrimination and wore wrist accelerometers for 28 days to objectively measure PA. We used k-means clustering to identify clusters based on reports of experienced and anticipated discrimination. We determined the optimal number of clusters using established partition criteria and ran linear regression models (adjusted for demographic factors) to examine the associations of minority stress clusters with MVPA and sedentary time. Results/Anticipated Results: Among 42 SGM adults (mean age 27.0±7.7 years) with 1133 person-days of accelerometry data, we identified four minority stress clusters: low anticipated/low experienced (LALE; reference group), low anticipated/high experienced (LAHE); high anticipated/low experienced (HALE), and high anticipated/high experienced discrimination (HAHE). Participants in the HALE cluster (n = 12) engaged in 202 fewer minutes of MVPA than those in the LALE cluster (n = 7). Participants in the LAHE cluster (n = 10) had 123 fewer minutes of vigorous PA than those in the LALE cluster. No differences were identified for sedentary time. Discussion/Significance of Impact: This is the first study to examine the association of minority stressors with objective PA among SGM adults. Participants in the HALE/LAHE clusters had lower PA than those with low levels of experienced and anticipated discrimination. Interventions to improve PA among SGM adults must target reduction of minority stressors.

Objectives/Goals: To describe the evaluation processes of screening services implemented in community pharmacies. Methods/Study Population: A systematic literature review will be conducted from the last 20 years in Ovid Medline, APA PsycINFO, Clinialtrials.gov, and International Pharmaceutical Abstracts. Inclusion criteria are written in English, describes a clinical or health-related screening service in a community pharmacy, and evaluation of said health screening service is included. Approximately 950 articles have been initially identified. Two authors will screen each title, abstract, and full text for inclusion. Subsequent data extraction will occur including elements of 1) evaluation framework, 2) evaluation outcomes assessed, and 3) evaluation results. All elements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be followed. Quality of articles will be assessed using the MMAT. Results/Anticipated Results: Results are expected to show limited evaluation of screening services in pharmacies. Clinical conditions included in the screening services are expected to vary greatly. High-quality evaluations will be noted as templates for future evaluation of screening services in community pharmacies. Discussion/Significance of Impact: This systematic review will describe the current literature on evaluation of health screening services in community pharmacies. This will give readers an overview of how evaluations are currently being carried out in this setting, as well as provide them with templates of high-quality evaluations for future evaluation of screening services.

Objectives/Goals: Community engagement in pediatric emergency medicine research is completed mostly when an exemption from informed consent (EFIC) is involved. A campaign was designed to engage the community surrounding an academic pediatric emergency department in an informal discussion on any pediatric acute care and research topics they felt were important. Methods/Study Population: A flyer inviting members of the community to a virtual session was circulated through social media and word of mouth. Five members of the community attended the first session, including one with healthcare expertise and another with clinical research experience. The participants were not asked any personal characteristic questions and were allowed to self-identify during the discussion, to maintain the informal nature of the session. Results/Anticipated Results: All the participants identified as women, and mothers to children ranging in age from 11 weeks to 14 years. The participants highlighted community engagement as pivotal for advancing children’s health. They stressed the inclusion of groups traditionally underrepresented in healthcare systems, including patients and families who rarely utilize acute services and whose children have no chronic medical conditions. Critical issues in emergency and urgent care for children were extensively discussed, with a focus on when acute medical treatment is necessary and determining appropriate healthcare settings – emergency departments, urgent care centers, or primary care offices. The participants unanimously supported research leading to practical solutions for improving children’s health outcomes. Discussion/Significance of Impact: A group of community caregivers can lead to an established collaborative effort to enhance children’s healthcare outcomes through community engagement, informed decision-making, and practical application of research findings to families and caregivers. A standing community meeting is planned based on the feedback from the first session.

Objectives/Goals: The Research Education and Community Health (REACH) coalition proposes to develop the infrastructure for continuous and comprehensive collection of community health data to drive programs, education, and funding priorities across municipal agencies, institutions, and nonprofit organizations in Galveston County. Methods/Study Population: The workgroup through REACH will organize and adopt a comprehensive community health needs assessment that 1) accumulates existing, readily available data for shared use (e.g., Center for Health Care Data at the UT School of Public Health, the Texas Department of State Health Services Center for Health Statistics, and Epic Cosmos, a data aggregation tool, used by UTMB and other health systems to improve patient care); 2) utilizes data collected throughout the community (i.e. non-profits, municipal agencies, and law enforcement); and 3) applies qualitative data from focus groups and/or key informant interviews, so we can hear directly from community members about what their needs are. By doing so, we hope all can benefit from having access to current and relevant data to drive our programs, education, and funding. Results/Anticipated Results: This Community Health Needs Assessment is being coordinated by a diverse workgroup including community organizations, researchers, and policy makers who will benefit from access to current and relevant data. The Galveston Youth Risk Student Survey, completed every three years and most recently in 2024, revealed lingering health and mental health effects of the COVID-19 pandemic on County youth. This highlighted the need for community access to current, accurate, and ongoing data to drive programming, interventions, and education. The REACH Coalition, made up of 23 UTMB Centers and Institutes and 39 community organizations, is spearheading this effort as a part of its mission to facilitate collaborative research, service, and educational efforts. Discussion/Significance of Impact: Collected data will be used to establish and support ongoing, coordinated interventions in response to identified needs. Shared ownership of data and project implementation optimizes resources and reduces gaps and/or redundancy in community programming.

Objectives/Goals: Chronic stress may accelerate biological aging yet is often overlooked in clinical settings. Many tools to assess stress exist, but a comprehensive measure of cumulative stress across the lifespan is unavailable. This study validates a novel measure of lifetime stress for use as a screening tool in clinical practice. Methods/Study Population: Patients (n > 220) enrolled in brain health research registry at the Washington University St. Louis Knight Alzheimer Disease Research Center completed in-person surveys at baseline and after six months. Baseline measures included the everyday discrimination scale (EDS), total adverse experience (TAE), and demographics. Age and evaluating life course stress experience (ELSE) scores were measured six months later. Ongoing analysis includes age-adjusted correlations of ELSE scores with TAE and EDS scores. We will investigate the correlation with race and ethnicity and sex assigned at birth. We will explore the relationship between ELSE score and multidimensional intersectionality. Results/Anticipated Results: The sample was 87% Black or African American, 8% White, 4% Hispanic, 82% female, and 18% male, with a mean age of 66 ± 10 years. Age-adjusted relationships between patient characteristics and ELSE scores will be analyzed. Additionally, ELSE responses will be compared against age, EDS, and TAE measurements. Intersectionality between race-ethnicity, sex, and gender will be examined. We hypothesize ELSE scores will vary by demographic. Preliminary results indicate the ELSE scale correlates with established life stress measures, accounting for cumulative stress exposure across a lifespan independent of specific stressor topics. Discussion/Significance of Impact: The ELSE scale is a viable tool for clinical screening of chronic stress exposure over a lifespan. Its implementation will allow clinicians to identify patients at high risk for accelerated aging, facilitating targeted interventions and advancing equity in healthcare delivery.