OBJECTIVES/GOALS: This study aimed to determine the prevalence of cardiovascular risk factors in a group of victims of CSA in Puerto Rico and determine the impact of both the offender and the number of victimizations on the presentation of cardiovascular risk factors. METHODS/STUDY POPULATION: A study design of a retrospective chart review at a clinical forensic service in Puerto Rico. The demographic variables were age, sex, and health plan; the CV risk factors were family health history, level of physical activity, blood pressure, BMI, and lipid profile. Sexual violence experience variables were sexual assault, sexual molestation, the relationship with the offender, and the number of victimizations. Medical records were used to identify cardiovascular risk factors and variables associated with child sexual abuse victimization. Central tendency and frequencies were used to describe the risk factors and victimization. The Mann–Whitney and Fisher exact tests were used to determine the differences between the type of victimization and the risk factors for cardiovascular health. RESULTS/ANTICIPATED RESULTS: Most of the victims were female (81%), with an average age of 10 (SD 3.8). According to the 31 reviewed charts, 55% were victims of sexual assault, the offender was a family member (84%), and the assault had occurred more than once (81%). The study also found that systolic blood pressure, diastolic blood pressure, total cholesterol, and body mass index (BMI) were at unhealthy levels (based on age and sex); when the victim reported sexual assault, the offender was a family member, and more than one assault occurred. Systolic blood pressure, diastolic blood pressure, and fasting blood sugar were statistically significant among victims who reported being either sexually assaulted or sexually molested when the offender was a family member, and the victimization occurred more than once. DISCUSSION/SIGNIFICANCE: This study indicated a higher prevalence of CVD risk factors in children victims of sexual assault. The blood pressure, lipid profiles, and BMIs were much higher than the standards. Early childhood screening is crucial in alerting health professionals to a child’s exposure to trauma.

The identification of sexual and domestic violence, frequent among women, depends on the disposition of health professionals (1) to intervene with women referred by agencies that provide services to victims and (2) to screen for violent experiences during routine clinical services. PASOS de las Mujeres, within the Puerto Rico Women and Health Center, a DHHS-designated National Center of Excellence in Women's Health, provides forensic medical services by request of individuals, POLICE, family services, and others. The service promotes routine screening for violent experiences. The purpose of the study is to develop a profile of the clinic's patients as it relates to violence and its possible impact on health. From April 2002 to February 2005, 208 survivors were evaluated, which constitutes 39% of the total new patients seen. There is limited information about women survivors who access ambulatory health services. This information is important for service planning, professional education, prevention strategy development, funds allocation, and public health policy designs. Methods Used: A medical chart review of PASOS was done for service improvement and intervention strategy development. Different variables (age, region of origin, weight, menarche, history of asthma, constipation and sleeping difficulties, relationship with offender, place of assault, signs of trauma, and HPV-related findings) were analyzed for possible associations. Summary of Results: Of the 684 new clinic patients, from April 2002 to February 2005, 27% were survivors of violence. Educational levels were diverse. The assailant was a family member in 53% of the cases and 57% of the assaults occurred in the home. In our clinic, 24% of the minors are overweight while 3% are underweight. Most of the literature is consistent in that most cases of sexual abuse have no physical findings consistent with injury. In our clinic only 29% of the cases have some finding consistent with trauma. All survivors were examined for subclinical HPV. Other related health issues observed among the survivors were constipation, asthma, and sleeping difficulties. Conclusions: In order to provide the health services needed by survivors of sexual and domestic violence, it is important to identify the participant's profile. This review shows that in Puerto Rico data are consistent with national findings. Also in the case of HPV, it demonstrates the value of colposcopy in the examination. Results emphasize that it is time to do prospective research on survivors of violence for short-and long-term health consequences if we are really going to provide services that respond to the concept of violence as a public health issue.

Victims of childhood sexual abuse are at an increased risk for a multitude of mental health conditions. While many children exhibit concerning behavioral changes following abuse, there is often a delay in identification and implementation of psychiatric services, resulting in worsening mental and physical health outcomes for victims. This case series aims to demonstrate the importance of multidisciplinary victim-centered and trauma-focused treatment including proactive psychiatric care. The review presents three cases of child victims of sexual abuse who received psychiatric care after their initial presentation to the Puerto Rico Health Justice Center (PRHJC). As evidenced by the following cases and extant literature, child victims of sexual abuse have an increased risk of severe mental health disorders. This indicates the importance of recognizing and understanding behavioral warning signs of childhood sexual abuse and the importance of psychiatric care as early as possible following disclosure. Categories: Psychiatry Keywords: child sexual abuse, multidisciplinary decision-making, mental health services, child abuse and neglect, access to healthcare, • access to healthcare and health outcomes of vulnerable populations, child and adolescent psychiatry, clinical forensic medicine, psychiatry and mental health

IMPACT: The impact of this study is to encourage health professionals to screen for violent experiences as potential risk factors for CVD and adapt interventions from the non-abused in children as in adults. OBJECTIVES/GOALS: This study aims to assess the relationship between child sexual abuse and cardiovascular risk factors (CVDRF) that present in children. The objectives will provide the prevalence of CVDRF, their association with types of sexual victimization, and a score to assess the impact. METHODS/STUDY POPULATION: This study is a chart review, cross-sectional study. The Puerto Rico Health Justice Center (PRHJC) is a forensic, transdisciplinary, victim-centered, trauma-informed, and evidence-based service. The demographic variables collected are age, sex; the cardiovascular risk factors variables include a level of physical activity, tobacco exposure/alcohol, vital signs (blood pressure, BMI), lipid profile, and C-reactive protein. Sexual violence variables are the type of victimization (sexual assault, sexual molestation), the number of victimizations, and the relationship with the offender. RESULTS/ANTICIPATED RESULTS: A previous study, which examined types of evidence related to the prosecution of sexual violence cases, found that among female victims, 54% was a victim of sexual assault, and 59% had at least one health concern. The study’s hypothesis includes that older and female victims have a higher prevalence of cardiovascular disease risk factors. Also, children victims of sexual assault will have more cardiovascular risk factors than victims of sexual molestation. The age group, sex, number of victimizations, and relationship with the offender will also impact the relationship between the type of victimization and cardiovascular risk factors. DISCUSSION/SIGNIFICANCE OF FINDINGS: Early identification of child sexual abuse is needed to prevent long-term health impacts. The study’s results will be significant in developing clinical guidelines for health care providers to identify child sexual abuse as a predictor of cardiovascular risk factors and encourage victim advocates to identify cardiovascular risk factors.

Purpose of the StudyThe identification of sexual and domestic violence, frequent among women, depends on the disposition of health professionals (1) to intervene with women referred by agencies that provide services to victims and (2) to screen for violent experiences during routine clinical services. PASOS de las Mujeres, within the Puerto Rico Women and Health Center, a DHHS-designated National Center of Excellence in Women's Health, provides forensic medical services by request of individuals, POLICE, family services, and others. The service promotes routine screening for violent experiences. The purpose of the study is to develop a profile of the clinic's patients as it relates to violence and its possible impact on health. From April 2002 to February 2005, 208 survivors were evaluated, which constitutes 39% of the total new patients seen. There is limited information about women survivors who access ambulatory health services. This information is important for service planning, professional education, prevention strategy development, funds allocation, and public health policy designs.Methods UsedA medical chart review of PASOS was done for service improvement and intervention strategy development. Different variables (age, region of origin, weight, menarche, history of asthma, constipation and sleeping difficulties, relationship with offender, place of assault, signs of trauma, and HPV-related findings) were analyzed for possible associations.Summary of ResultsOf the 684 new clinic patients, from April 2002 to February 2005, 27% were survivors of violence. Educational levels were diverse. The assailant was a family member in 53% of the cases and 57% of the assaults occurred in the home. In our clinic, 24% of the minors are overweight while 3% are underweight. Most of the literature is consistent in that most cases of sexual abuse have no physical findings consistent with injury. In our clinic only 29% of the cases have some finding consistent with trauma. All survivors were examined for subclinical HPV. Other related health issues observed among the survivors were constipation, asthma, and sleeping difficulties.ConclusionsIn order to provide the health services needed by survivors of sexual and domestic violence, it is important to identify the participant's profile. This review shows that in Puerto Rico data are consistent with national findings. Also in the case of HPV, it demonstrates the value of colposcopy in the examination. Results emphasize that it is time to do prospective research on survivors of violence for short- and long-term health consequences if we are really going to provide services that respond to the concept of violence as a public health issue.