Jessica Andrews, Alycia Horn, Christian Sanchez-Jordan, Amos Shemesh, Jeremy Silver, Tara Song, Katherine Wang, Al Robinson, and Marianne Burke
Background/Introduction: Vermont was ranked the nation’s healthiest state, according to 2007 America’s Health Rankings. However obesity, currently the second most common cause of death among VT adults, is becoming so common it may replace cigarette smoking as the number one risk factor for death. In fact obesity affects 21% of adults in VT, most commonly low income adults. Obesity is a risk factor for high cholesterol, high blood pressure, heart diseases, and diabetes. Diet quality and physical activity are important factors in preventing obesity. 42% of Vermont adults are below the recommended level of physical activity. Greater knowledge about nutrition correlates with improved diet quality and greater physical activity. A successful educational strategy on physical activity and nutrition promotes group activities and adapts for cultural relevance.
Claire Ankuda, Ben Kelmendi, Phillip Lam, Amy Odefey, Mimi Ogawa, Chase Petersen, Emily Schonberg, Jon Bourgo, and Rodger Kessler
Introduction: Vermont has programs to assist low income individuals in obtaining basic needs such as health insurance, food security, fuel assistance, housing and transportation. However, these services are often underutilized by eligible individuals. Major barriers to enrollment include lack of knowledge about available programs and their income cutoffs, cumbersome application processes, literacy barriers, and lack of transportation to application sites. In other states, efforts to reduce these barriers have included shortened application forms, removal of asset tests, mail-in applications, media outreach, and eligibility workers placed in outreach agencies. Many studies suggest that the presence of an eligibility worker at a community health center can help overcome some social service enrollment barriers.
Promoting Physical Activity in Local Communities: Understanding Health, Nutrition, and Physical Activity Needs in Winooski, VT
Nicholas Aunchman, Anna Bovill, Garret Fidalgo, Oli Francis, Tara Goecks, Sarah Guth, Vandi Ly, Pam Farnham, and Kevin Hatin
Introduction: Since the Winooski YMCA opened in March 2008, enrollment has been much lower than expected, with only 200 members enrolled by September 2008. One goal of the YMCA is to promote the health of the community by increasing involvement in physical activity in Winooski. Regular exercise is associated with enhanced health and decreased risk of diabetes, cardiovascular disease, as well as many cancers. In order to promote physical activity in the Winooski community, the YMCA set a goal to increase their enrollment to 500 members by December 2008.
Elizabeth Baker, Matthew Meyer, Asya Mu’Min, Lindsey Oliver, Daniel Oppenheimer, Steven Perrins, Whitney Young, Razelle Hoffman-Contois, William Bress, and Jan Carney
Introduction: •The average annual temperature in Vermont has gradual increased roughly 1° Centigrade with an increase of 1.16 inches of annual precipitation over the past 112 years. •According to expert analysis, humans are responsible for 60% of the warming overthe past 140 years. •Projected greater than 1° Centigrade increase in global temperature by 2100 and a correlated rise in precipitation. •Climate changes result in the introduction and reproduction of non-endemic flora and fauna. •Vector-borne diseases accompany warming trends and can become endemic and cause new illnesses in areas which were previously uninhabitable.
Dino Barhoum, Joanna Conant, David Diller, Annya Fischer, Marisa Hori, Hunter Moore, Kathryn Richard, Colin Robinson, Burton Wilcke, and Jan Carney
Background: The societal impact of Paid Sick Days (PSDs) has not been fully addressed in Vermont. Evidence suggests that PSDs benefit the well being of the employee in addition to saving expenses for the employer and the state. PSDs prevent the spread of diseases such as influenza and allow the ailing individual to receive proper medical attention. Inadequate PSDs not only affect the individual who needs time away from work due to illness, but extend to their entire family. Studies have documented the adverse effects from lack of PSDs on the ability for parents to care for their child. The following facts are known: • 7 states require private sector employees to provide “flexible” PSDs for family members (Vermont does not). • 66% of employers in Vermont do not provide PSDs for their employees. • Parents with PSDs or vacation are 5.2 times more likely to take time off from work to care for their sick child. We hypothesize that elementary aged children of working parents, who have an insufficient amount of PSDs, are more likely to attend school with an acute illness and are more likely to receive inadequate health care (i.e., miss well child check ups).
Jessica Barry, Jennifer Kneppar, Timothy Salib, Jonathan Severy, Bennett Shapiro, Kathryn Skelly, Kara Tweadey, Rebecca Ryan, and Gerald Davis
Introduction: Important public health policy decisions must be based on reliable epidemiologic studies and evidence-based medicine. In the effort to ban smoking in the workplace, there must be clear evidence from the constituency that such laws are desired. Current Vermont law states: "Employers may designate up to 30 percent of an employee cafeteria or lounge as a smoking area and may permit smoking in designated unenclosed areas only if … smoking will not be a physical irritant to any non-smoking employee, and 75 percent of the employees in the designated areas agree to allow smoking." State legislators must address this issue for several reasons: * Long term effects including lung cancer, emphysema, heart and neurologic disease. * Secondhand smoke contains at least 250 chemicals known to be toxic, including more than 50 that can cause cancer. * The total cost of secondhand smoke exposure in the U.S. at $10 billion annually, $5 billion in direct medical costs, and $5 billion in indirect costs such as lost productivity. * Methods to reduce the effect of secondhand smoke, such as ventilators are ineffective. * One study found a 17% increased risk of developing lung cancer with smoking exposure in the workplace. Regardless, Vermonters continue to smoke; as of 2007, 18% of Vermont’s adults were smokers. Such information is important in making legislative decisions that affect the entire Vermont population
Angus Beal, Hannah Caulfield, Elizabeth Cipolla, Theodore Elsaesser, Andrew Gagnon, Megan Gossling, Yangseon Park, Jill Jemison, Annika Hawkins, and Mary Anne Kohn
Introduction: Low income individuals are faced with numerous barriers to health care that can lead to worse health outcomes. Limited access to transportation, in particular, has been linked to lower rates of doctor’s visits and consequently, a greater burden of disease. Community agencies such as Safe Harbor (SH), the Community Health Center (CHC), and the Committee on Temporary Shelter (COTS) in Burlington, Vermont reported the move of many ambulatory care practices from Fletcher Allen Hospital, located on a citywide bus route, to Tilley Drive, which was not located on a bus route, as a significant barrier for their patients.
Erin Beardsworth, Kelsey Davidson, Andrew Fanous, Rebecca Gordon, Brian Kilonzo, Isaac Leader, Jason Shen, Tania Bertsch, and Debbie Dameron
Background: The utilization of mammography has been shown to be lower in socioeconomically disadvantaged groups, which includes the African refugee community in Vermont. Mailed letters, telephone reminders, and massive media campaigns have proved ineffective at increasing rates of mammography screening in socioeconomically disadvantaged populations. However, a promising method to increase mammography screening is the use of peer educators to conduct home visits or group educational sessions. The Association of Africans Living in Vermont (AALV) has trained peer educators from the African community, known as Lay Health Educators (LHEs), to help increase mammography screening in this population.
Rachel Bell, Francois Coutu, Robert Johnston, Brendan Kelley, Shailen Mhapsekar, Jane Roberts, Heather Viani, Jennifer Hunter, Tom Delaney, and Patricia Berry
Background: Aging is associated with numerous risk factors for declining physical and mental health. As a result, many elder individuals are forced to relocate to nursing homes, assisted living centers or just closer to adequate medical facilities. Studies have shown: • Relocation of elders is associated with depression, anxiety, memory loss, and decreased social adjustment and life satisfaction • Persistently lonely people exhibit a 2-fold greater risk for developing Alzheimer’s disease (AD) than those who are not chronically lonely • Increased social interaction improves cognitive function in individuals with AD By helping seniors to age in place, many of the deleterious risks of relocation, such as social isolation, depression, and cognitive decline could be avoided. In addition to relocation, other risk factors that affect cognition have been identified: • Physical activity is associated with higher cognitive functioning in elders • Polypharmacy is a risk factor for impaired cognition Thus, simple modifications that allow seniors to age in place may reduce morbidity and enhance quality of life. Cathedral Square Corporation (CSC) is a non-profit organization whose mission is to develop, manage, and own housing that provides community services to promote the health and well-being of elders, low income persons, and persons with disabilities. Students from the University of Vermont College of Medicine (UVM) partnered with CSC in a project to promote aging in place via evaluation of seniors’ current needs and the development of a service model to meet these needs at home.
Aaron Bos, Lawrence Dagrossa, Rachel McEntee, David Morrow, Erin Perko, Anthony Vu, Jennifer Wlodarski, Caroline Homan, and Robert Luby
Background: Organic food is the fastest growing sector of the U.S. food market. It is a common belief that organic food is healthier and more environmentally friendly when compared to food grown and processed conventionally. Despite presumed benefits, our objective was to answer the following questions: • Why do consumers choose organic, especially when faced with a higher average price? • Is there scientific evidence that organic foods are healthier than their conventional counterparts? This project built on a previously conducted demographic and shopping habits survey by our partner agency, City Market, of Burlington, VT.
Benjamin Briggs, Alan Frascoia, Vadim Petrov-Kondratov, Shayna Rivard, Phan Thai, Lauren Wendell, Matthew Williams, Carol Dembeck, Peter Nattress, R Wilson, Mark K. Fung, and Jan Carney
Introduction: Declining blood collection endangers the blood supply at a time when the health care system is requiring an increasingly greater amount of blood products. Blood donation centers are challenged to recruit and develop first-time donors into reliable repeat donors, thereby ensuring a sufficient blood supply. Communication strategies such as e-mail reminders have been shown to be an effective communications tool to promote blood collection. Alternatively, Text Messaging has been shown effective in primary care and preventative medicine. Text messaging improved patient compliance with a schedule of vaccine dosing, as well as improving patient attendance at outpatient clinics. Additionally, text messaging reminders have been shown to be as effective as phone reminders in increasing patient attendance at outpatient appointments. Finally, text messaging has been shown to be useful for managing self-care such as smoking cessation, monitoring asthmatic symptoms, and diabetes control. We investigated whether offering the use a text message reminder to donors would increase attendance at donation events, demonstrating that text messaging can be an effective tool in maintaining a pool of blood donors.
Theresa Duong, Andrew Eyre, Ari Garber, Abby Gross, Melissa Hayden, Joshua Kohtz, Julie Lange, William Wargo, Virginia Hood, and Jan Carney
Background: Physicians today need a working knowledge of pertinent medical law. With an increased focus on patients’ rights in health care, states are encouraged to set specific laws protecting patients. The additional medical legislation places a challenge on physicians to continually update their medical-legal acumen such as disease reporting, malpractice issues, and medical information access.Little research has been conducted on physicians’ knowledge of the law and medicine. In an effort to expand upon these topics and to find an efficient way to make information about the law and medicine accessible to Vermont physicians, the University of Vermont College of Medicine partnered with the Vermont Board of Medical Practice to answer the following questions: • How well do Vermont physicians understand laws that relate to the practice of medicine? • How do Vermont physicians access nformation on law and medicine? • What topics are most relevant and important to Vermont physicians? • What educational methods willbe effective and how can the Vermont Board of Medial Practice best serve such education needs?
Referral Patterns Between Allopathic Physicians and Complementary and Alternative Medicine Practitioners
Dan Gale, Shohei Ikoma, Quinn Meisinger, Caroline Moats, Jessica Sayre, Marvin Scott, Susan Varga, Mimi Reardon, Helene Langevin, Margaret Eppstein, and Robert Davis
Introduction and Objectives: The provision of basic healthcare in the United States may be viewed considering two different, and sometimes combined, therapeutic approaches: •Allopathic/osteopathic medicine •Complementary and alternative medicine (CAM) Our study is interested in the intersection of allopathic medicine and CAM. Evidence suggests that Americans are seeking CAM at a similar or even a higher rate than allopathic medicine, yet there seems to be a division between practitioners of each discipline. Isthis division created by a lack of coordination, such as an inadequately established referral system, or by a general lack of knowledge, or by the attitudes of the practitioners? In our study our objectives were: ? To assess the referral patterns between allopathic and CAM practitioners in Chittenden County. ? To examine the various factors that may influence these referral patterns using confidential surveys.
Patrick Hackett, Elizabeth Lagana, Metasebia Munie, Sinan Ozgur, Heather Provencher, AmiLyn Taplin, James Ware, Sarah Russell, and Amanda Kennedy
Background: • 23.6 million people or 7.8% of the US population have diabetes • Type 2 diabetes can cause many serious problems that affect the heart, nerves, eyes, and kidneys • Lifestyle choices, including dietmanagement, can be used to control or help supplement medical care used in minimizing the risk factors associated with diabetes
Aaron Kraut, Barron Reyes, Catherine Mygatt, Tim LeClair, Sarah Gillett, Molly Wasserman, Hal Colston, Karin Brenin, and Karen Richardson-Nassif
Introduction: associated health complications have increased steadily across the United States. As a result, physical activity considerations have become a more significant focus of healthcare providers and government agencies. Recent studies suggest that social support network approaches, such as the "buddy-system," improve participant adherence to physical activity regimens. To improve physical activity frequency and adherence, we implemented a buddy system approach with participants involved in a community outreach organization.
Joseph Platz, Elizabeth Crowley, Adham Zayed, Matthew Lynch, Mary Guillot, Hugo Valencia, Jessica Alsofrom, Alan Rubin, and Judith Christensen
Abstract: Intro Teens at the Woodside Juvenile Rehabilitation Center struggled with personal health and self-empowerment in the health care setting. Methods We spoke with both detention and treatment residents about their health. We constructed self-health surveys which were completed by 16 residents. Analysis of the results led to creation a self-health advocacy and activity booklet to be completed by current and future residents. Results Residents had health coverage but only sought dental care, feeling little control over doctor visits. Stress stemmed from family and friends and was coped with via exercise. Interest in learning about relaxation and long term health was expressed. Discussion Health information needed to be incorporated into patient-interactive teaching methods and self-analysis, focused on self-reflection and changing attitudes rather than raw health knowledge.