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In early 2022 in the U.S., rural adults were the least likely to vaccinate against COVID-19 due to vaccine hesitancy and reduced healthcare access. This study explored the factors influencing rural adults’ COVID-19 vaccine perceptions and their acceptance of pharmacist-administered vaccination. We utilized phone-based semi-structured interviews with 30 adults living in rural regions of one southwestern state and analyzed the data using a team-based thematic analysis approach. Vaccine-willing participants described knowing other people affected by the virus and their desired protection from the virus. They reported trusting scientific institutions and the government to provide safe vaccines. Vaccine-hesitant populations, however, feared that the COVID-19 vaccine development process had been rushed, compromising the safety of these newer vaccines. Although they differed in the news sources they preferred for receiving COVID-19 vaccine information, both vaccine-willing and vaccine-hesitant participants described trusting local authorities, such as healthcare providers and county government officials, to provide accurate COVID-19 vaccine information. Regarding the acceptability of pharmacist-administered COVID-19 vaccinations, all but one participant described their acceptance of this healthcare delivery approach. Future outreach should leverage rural adults’ trust in local sources, including community pharmacists, deemed more convenient access points to healthcare, when addressing vaccine hesitancy.

Background Outpatient antibiotic (OP Abx) prescribing in adults in Arkansas (AR) was among the country’s highest in 2019. AR Medicaid analyzed prescription (Rx) claims data and communicated the relative prescribing intensity as an informational metric to each patient-centered medical home (PCMH) beginning in 2020. We describe the Abx prescribing patterns in calendar years 2019 and 2020, during the COVID-19 pandemic. Methods Data from AR Medicaid paid claims for OP Abx Rxs in adult patients attributed to a PCMH practice for > 6 months were analyzed. Annual Abx Rx claims per 1000 patients were calculated for rural or urban status and by 2019 prescribing rate histories, defined as the low-, middle-, and high-rate prescribers based on 1st, 2nd - 3rd, & 4th quartiles, respectively. The five most common classes in 2019 and fluoroquinolones were explored. A paired t-test, Wilcoxon signed rank test, and one-way ANOVA with post hoc least significant difference test were used to determine statistical significance. Results 183 PCMHs qualified for analysis. There was a significant decrease in overall annual Abx claim rate, from 1034 to 910 (-12.0%, p< 0.0001). Claim rates decreased in rural (-10.9%, p< 0.0001) and urban areas (-13.3%, p< 0.0001) with no difference between groups (p=0.240). Low-rate prescribers did not change practice from 2019 to 2020, with claim rates of 666 to 665 (-0.2%, p=0.957), while middle- and high-rate prescribers decreased, from 1032 to 897 (-13.1%, p< 0.0001), and from 1404 to 1183 (-15.7%, p< 0.0001), respectively. Claim rates significantly decreased for penicillins (-16.0%, p< 0.0001), fluoroquinolones (-15.5%, p< 0.0001), sulfonamides (-13.1%, p< 0.0001), macrolides (-9.9%, p=0.0001), and tetracyclines (-6.3%, p=0.021). First-generation cephalosporins down trended (-7.9%, p=0.111). Conclusion OP Abx Rx claims significantly decreased from 2019 to 2020 in middle and high-rate prescribers. Low-rate prescribers maintained low Abx Rx claim rates throughout 2020. Future analyses are needed to highlight any rebound effect of Abx prescribing when the pandemic subsides, discerning the informational metric effect versus COVID-19, and informing the next steps for antimicrobial stewardship for PCMHs in AR. Disclosures Jill Johnson, Pharm.D., BCPS, Pew Charitable Trust: Pew provided financial support for authors, analysis, and presentation. Cheng Peng, MPA, MS, PhD, Pew Charitable Trust: provided financial support for the authors, analysis, and presentation. Holly Maples, Pharm.D., Wolters Kluwer-LexiComp: Advisor/Consultant Jeremy Thomas, Pharm.D., Pew Pew Charitable Trust: Grant/Research Support.

A1 Introduction to the 8th Annual Conference on the Science of Dissemination and Implementation: Optimizing Personal and Population Health David Chambers1, Lisa Simpson2 1Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, 20850, USA; 2AcademyHealth, Washington, DC, 20036, USA For the second year in a row, we are pleased to be able to share the proceedings of the Annual Conference on the Science of Dissemination and Implementation in Health, a large meeting reflecting the expanding and evolving research field that seeks to optimize the use of evidence, interventions, and tools from health research within the myriad of settings where people receive health care, make health-related decisions, and increase knowledge of influences on the health of the population. We once again benefitted from a strong partnership, co-led by AcademyHealth and the National Institutes of Health (NIH), with co-sponsorship from the Agency for Healthcare Research and Quality (AHRQ), the Patient Centered Outcomes Research Institute (PCORI), the Robert Wood Johnson Foundation (RWJF), the US Department of Veterans Affairs (VA), and the WT Grant Foundation. In addition, we benefitted from the collaboration of staff from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). NIH and AcademyHealth again co-led the program planning committee, which focused on the development of the plenary sessions, and convened a scientific advisory panel to suggest speakers and advise on the overall conference development. The planning committee identified four key areas around which to focus the plenary panels and keynote address. Dr. America Bracho, M.D., M.P.H., Executive Director of Latino Health Access in Orange County, California, spoke about the opportunities for implementation science to inform efforts to improve community health and engage underserved populations. The three plenary panels each focused on a significant future direction for dissemination and implementation (D & I) research: the interface between D&I science and population health, emerging opportunities for global implementation science, and the challenges around implementation of precision medicine. The plenary sessions were complemented by facilitated lunchtime discussions on the same three topics, which offered participants an opportunity to identify key research questions for each and brainstorm next steps. Synopses of the lunchtime discussions are included in this supplement. Given the overwhelming success of the 2014 conference and the large number of abstracts received in 2014 (660), the program planning committee identified eight program tracks for abstract submitters to respond to, and through which the concurrent sessions of the conference would be organized. These tracks—Behavioral Health, Big Data and Technology for Dissemination and Implementation Research, Clinical Care Settings, Global Dissemination and Implementation, Promoting Health Equity and Eliminating Disparities, Health Policy Dissemination and Implementation, Prevention and Public Health, and Models, Measures and Methods— were designed to enable conference participants to follow a consistent theme across the multiple sessions of the conference and form the structure of this supplement. The call for abstracts, including individual paper presentations, individual posters and panel presentations, resulted in 515 submissions, spread across the eight thematic tracks. Over one hundred reviewers devoted their time to ensuring a comprehensive and expert review, and reviews were conducted within each track and coordinated by the track leads. For the final program, 64 oral presentations, 12 panels, and 263 posters were presented over the two-day meeting. Slides for the oral presentations and panels (with the agreement of the authors) were posted on the conference website (http://diconference.academyhealth.org/archives/2015archives) and all abstracts were included on the conference webapp (https://academyhealth.confex.com/academyhealth/2015di/meetingapp.cgi). This supplement has compiled the abstracts for presented papers, panel sessions, and lunchtime discussions from the 8th Annual Meeting on the Science of Dissemination and Implementation in Health: Optimizing Personal and Population Health. We are pleased to have the abstracts from the conference together in one volume once again, and look forward to the 9th Annual meeting, scheduled for December in Washington, D.C.

Distributed data networks representing large diverse populations are an expanding focus of drug safety research. However, interpreting results is difficult when treatment effect estimates vary across datasets (i.e., heterogeneity). In a previous study, risk estimates were generated for selected drugs and potential adverse outcomes. Analyses were replicated across eight distributed data sources using an identical analytic structure. To evaluate heterogeneity of risk estimates across data sources, the estimates were combined with summary-level data characterizing the population of each data source. Meta-analysis, meta-regression, and plots of the influence on overall results versus contribution to heterogeneity were examined and used to illustrate an approach to heterogeneity assessment. Heterogeneity, as measured by the I-squared statistic, was high with variability across outcomes. Plots of the relationship between influence on overall results and contribution to heterogeneity suggest that certain datasets and characteristics were influential but there was variability dependent on the drug and outcome being assessed. Exploratory meta-regression identified many possible influential factors, but may be subject to ecological bias and false positive conclusions. Distributed data network drug safety analyses can produce heterogeneous risk estimates that may not be easily explained. Approaches illustrated here can be useful for research that is subject to similar problems with heterogeneity.