Public Health Projects, 2008-present

All posters from the UVM College of Medicine Public Health Projects, 2008 to present.

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E-cigarette and tobacco use on a tobacco-free UVM campus

Sameer Alidina, Lauren Gernon, Kalin Gregory-Davis, Alexa Pius, Olivia Quatela, Samuel Raszka, and Zeynep Tek

The prevalence of e-cigarette use has significantly increased in recent years. In the US, e-cigarettes are now the most common nicotine products used by adolescents. The CDC reported 1,299 cases of lung injury correlating to the use of e-cigarette and vaping products; the current recommendation is to refrain from using e-cigarette products that contain THC and/or nicotine.
Food Security in the COVID-19 Era

Dana I. Allison, Alex Cohen, Elena Dansky, Willie Dong, Helen Gandler, Luke Hallgarth, Sarah Kendrick, A Carmola, M Bridges, TV Delaney PhD, and JK Carney MD

Food insecurity is a national issue, one that affected 10.5% of households during some point of the year 2019. Those affected by food insecurity can have their access to food jeopardized due to financial hardship, eating patterns altered to prolong the food available, or various other adjustments including reliance on low-cost food, skipping meals, etc.

The state of Vermont is not immune to food insecurity, with a rate of 11.3% of households in 2018.

The Covid-19 pandemic created an unprecedented shift in daily life, with households having to rapidly adapt to meet newly imposed governmental regulations, including stay at home orders, while maintaining access to food essentials. This changed exacerbated food insecurity in already food-insecure households, while simultaneously creating food insecurity for those previously unaffected. A study focusing on food insecurity in Vermont from March to April 2020 found a 32.3% increase in food insecurity, with 35.5% of food-insecure households being previously food-secure.

This change highlighted not only the growing incidence of food insecurity, but also acknowledged the demographic change seen by newly food insecure households.

While this increase is dramatic and alarming, to our knowledge there is no research looking at the continuation of these trends regarding the impact of the Covid-19 pandemic on food insecurity in Vermont households. This lack of data indicates a need for continued follow up to best inform governmental agencies on both how Vermont households are being affected, and how regulations during summer & fall 2020 impacted the rise in food insecurity. These data will then provide guidance for future action to combat current and future food insecurity.
Social Determinants of Health Among Blood Donors

Amelia Anderson, Lauren Bougioukas, Alexander Braun, Adam Morehead, Collins Oguejiofor, Christina Sanchez-Grew, Rachel Tobin, Jenny Lamping, and Mark Fung

Understanding the influences of social determinants of health (SDOH) on blood donation may help define the relationship between health in a community and rates of blood donation. While much is known about the demographics of blood donors in the United States, their SDOH have not yet been studied. Research examining SDOH outside the United States has found that many factors influence the likelihood of blood donations. These factors include education, income, health insurance, health status, and marital status. The aim of this study is to examine U.S. blood donors’ SDOH such as emotional support, stress levels, physical safety and access to food, housing, and healthcare, as well as identify trends between these factors and donation frequency.
Physician Attitudes Toward Screening for Social Determinants of Health

Michael Barnum, Rosie Friedman, Tierra Lynch, Collin Montgomery, Irene Sue, Jenna Wells, Hakeem Yousef, Elizabeth Cote, and Charles Maclean

Social determinants of health (SDH) have a significant impact on health outcomes. Screening for SDH in the clinical setting can identify at-risk patients, but follow-up and management remain challenging. Currently, there is no single preferred screening tool recommended for SDH and the screening process varies widely. The goal of this study was to determine family medicine physician attitudes and practices regarding screening and follow-up for SDH in Chittenden County, VT.
Trends in Buprenorphine Use and Barriers to Medication-Assisted Recovery

Isi Beach, Richard Brach, Carolyn Geraci, Kyle Leonard, Rose Martin, Nikkole Turgeon, Faith Wilson, Kayla Donohue, and Mariah McNamara

Since the initiation of the "Hub and Spoke Model" in 2014, VT has been able to eliminate the waitlist for receiving Medication-Assisted Recovery (MAR) and has increased the number of MAR providers. However, many people still report using non-prescribed “street” MAR prior to entering treatment to avoid withdrawal from opiates. Our study aims to assess current trends and barriers to access in buprenorphine use.
Development of a Sustainable Volunteer Model to Address Food Insecurity

Abigail Belser, Adrian Berg, Leah Miller, Kaitlyn Peper, Allison Tzeng, Carolyn Gould, Linda Howe, and Jan Carney

Food insecurity is a predictor of poor health outcomes and a critical social determinant of health. Food shelves are critical community resources aimed to counter food insecurity by providing nutrition and other resources to those in need. Food insecurity in Winooski, Vermont is substantial and increasing, with 10% of residents utilizing the Winooski Food Shelf (WFS) in 2018. To aid in the increasing demand of the WFS, we determined the greatest need(s) to implement a sustainable intervention to ensure capacity to meet demands.
Assessing Burnout in Early Childhood Educators

Megan Boyer, Sarah Clark, Emma Hall, Malla Keefe, Elena Martel, Michael Tabet, Mohammad Wali, Sarah Adams-Kollitz, and Molly Moore

The stress of working as an early childhood educator can manifest as increased job turnover and burnout, leading to reduced teaching efficacy. Resilience training can increase wellbeing and decrease stress. This study assessed burnout, resilience, and organizational constraints at Burlington Children’s Space (BCS), a childcare education non-profit.
Assessing the Feasibility of a Peer Developed Risk Reduction Plan in a Rural Middle School

Sara Brennan, Christian Brooks, Patrick Clarke, Isaac de La Bruere, Nicole Delgado, Alexandra Kuzma, Emma Levine, Joanna Jerose, and Leigh Ann Holterman

Sheldon Middle School (SMS) reported above-average suicidal ideation and risky behavior (e.g., sexual activity, alcohol use) on the 2017 Youth Risk Behavior Survey, compared to state levels. Current literature highlights programs designed to reduce risky youth behavior. Little research exists on the feasibility of designing and implementing peer-created, peer-driven intervention programs. There is a gap around parent and faculty opinions surrounding the feasibility of these programs. We investigated the feasibility of partnering with students to design an empirically-based program that addresses some root causes of risky behaviors, then measured parent and faculty attitudes.
Housing Initiatives Implementation in Vermont to Improve Health Outcomes

Jose Calderon, Marlijne Cook, Benjamin Kagan, Sylvia Lane, Maha Saleem, Kayla Sturtevant, Angela Troia, Heidi Klein, and Jan Carney

Vermont Department of Health goals include improving population health outcomes, including social determinants of health. There is compelling evidence between housing and health; research demonstrates housing insecurities increase rates of negative health outcomes. Research further demonstrates improve-ments in housing reduce hospital stays, thus reducing financial burdens on hospitals. This project sought to understand what housing initiatives Accountable Communities for Health (ACH) in Vermont are implementing to alleviate the burdens of housing insecurity.
Primary Care Perceptions: Health Services for Vermonters with Intellectual Disabilities

Magalie Carey, Gia Eapen, Adam Fakhri, Taylor Marquis, Cara Rathmell, Claudia Russell, Nicole Wershoven, Elizabeth Cote, Mike Reilly, and Stephen Everse

Champlain Community Services (CCS) provides developmental services and health care to Vermonters with intellectual disabilities (100 individuals in 2019), offering coordinated one-to-one support at work, home, school, and in the community. The goals of this study were to learn which services local primary care practitioners believe to be most beneficial to patients with intellectual disabilities (ID), to identify barriers to developmental services, and to gauge practitioners’ familiarity with CCS.
Attitudes & Roles Regarding Firearm Access and Suicide Prevention in Vermont Middle & High Schools

Cari Carpenter, Kelly Chan, Jeremy Greenberg, Alyssa Heiser, Ashleigh Peterson, Peter Twining, Emerson Wheeler, Kristin Fontaine, and Wendy Davis

Adolescent suicide is a serious public health concern in Vermont, and the presence of firearms in the home is a known risk factor. Suicide attempts with firearms are more likely to be completed than attempts with other means, with an 85% mortality rate of suicide with firearms compared to 5% with other means. This project aimed to assess attitudes, comfort, and perceived roles among school personnel in addressing gun safety and access to firearms with Vermont students and parents.
A Comprehensive Needs Assessment of Rural Syringe Services

Deena Chanowitz, Julia Clemens, Alim Esemenli, Matthew Hill, Erick MacLean, Adessa Morano, and Adam Ross

The current opioid epidemic has resulted in a significant increase in opioid-related overdoses, and a corresponding rise in HIV and HCV transmission. Syringe Service Programs (SSPs) provide resources for people who inject drugs. There are fewer SSPs in rural U.S. and little research has been conducted to determine unique needs of SSP participants in rural areas.
Addressing Vermont Childhood Obesity Through Public Policy: Scoring Vermont Supervisory Union Wellness Policies Using the WellSAT Assessment Tool

Olivia Cooper, Rachel Harrison, Jugerta Istrefi, Colby McGinn, Micheal Mikheal, John O'Keefe, PJ Tran, Tina Zuk, and Paula Tracy

As of 2016 the state of Vermont has required all public school supervisory unions to have a wellness policy guiding nutritional and physical education, nutritional quality of food served and sold, and the implementation and modification of the policy in the future. We hypothesize that differences between these policies throughout the state of Vermont will lead to changes in health outcomes for the students that they impact.
HPV and Cancer Prevention: It’s Not Just About the Warts

Matthew Dier, Elizabeth Hahn, Rachel Madhur, Francis Mtuke, Carley Mulligan, Lauren Schlussel, Kristina Valentine, Bill Couzens, and Jan Carney

Human papillomavirus (HPV) infections are responsible for 34,000 cancers per year throughout the United States, including cervical, anal, vulvar, vaginal, penile, and oropharyngeal cancers. In 2018, only 51% of adolescents received all recommended doses. Our study goal was to assess knowledge of HPV in a population likely well-informed about cancer risks.
Assessing Prenatal Care Providers’ Promotion of Immunization in Pregnancy

Emily Eakin, Francesca Garofalo, William Holden, Sunny Hutson, Ambrose Orr, Melanie Parziale, Anya Srikureja, Emily Straley, Christine Finley, Jill Jemison, and Raj Chawla

Accurate information regarding prenatal immunization is critical for first-time mothers. Many vaccine-hesitant mothers decide whether to vaccinate their children during pregnancy. The Centers for Disease Control and Prevention (CDC) guidelines urge providers to recommend the Tdap and influenza vaccines to pregnant patients to reduce the risk of complications from pertussis and influenza, respectively, in both expectant mothers and infants. In 2018, about half of pregnant women in the US received an influenza vaccine and Tdap vaccine; however, uptake varies state to state. This study demonstrates the first survey of providers regarding prenatal immunization practices in Vermont.
A Community Based Approach to a Client- Centered Wellness Program

Sheridan Finnie, Diane Kim, Prasanna Kumar, Kelly MacPherson, Allyson Miller, Megan Prue, Jacob Weiss, Cathie Buscaglia, Joseph Lasek, and Alison Howe

Despite health benefits of wellness programs, no such program has been adapted to meet the needs of adult clients receiving services addressing mental health, substance-use, and developmental needs at a community-based mental health organization. We investigated preferred evidence-based diet and exercise wellness programs for potential implementation.
Vermont Legislature’s Views on the Reliability and Accessibility of Available Resources Regarding Public Health Concerns of Youth Marijuana Use

Aram Garewal, Luke Higgins, Jeannie Lin, Kathleen O'Hara, Michelle Oberding, Anna Quinlan, Joseph Teague, Lori Augustyniak, and Karen Lounsbury

Vermont previously legalized possession and limited cultivation of marijuana. Proposed legislation for 2020 would legalize commercial sale of marijuana. Current knowledge surrounding public health impacts of the legal commercial sale of marijuana on youth is inconsistent, insufficient, and poorly understood by the public. This study investigated legislator utilization and perception of sources contributing to growing knowledge surrounding youth marijuana use.
Converting Whole Blood Donors to Apheresis Donors

Collin Anderson, Racquel DeCastro, Alexa Golden, Sidney Hilker, Flora Liu, Vincent Nocera, Seth Wolf, Jenny Lamping, and Mark Fung

Donating blood is a noble act with real potential to save lives. Although millions of Americans donate blood each year, supplies of one blood component—platelets—is in chronically short supply. This is in part due to its significantly shorter shelf life (5-7d) vs. red blood cells (28-42d) or plasma cells (1yr). Platelet apheresis donation offers the opportunity to donate platelets more frequently and in higher quantities but accounts for only a small percentage of all donations. Our study aimed to better characterize perceived barriers in conversion to platelet apheresis donation.
Assessing Food Insecurity Screening Among Healthcare Providers in Vermont

Menna Awadalla, Juan Conde Fabela, Annabelle Davey, Jack Dubuque, Jhaimy Fernandez, Ian McClain, Haewon Park, Connor Scagnelli, John Gorton, and Shaden Eldakar-Hein

What influences primary care providers’ screening for food insecurity and recommending food resources?

This study examined the barriers primary care providers have to screening for food insecurity and recommending resources to their patients. By analyzing the factors that drive or prevent providers from making recommendations, we can help address food insecurity within the healthcare setting

• Food security is defined as having access to enough food in order to maintain an active and healthy life

• An estimated 1 in 8 Americans suffer from food insecurity, which is associated with adverse health outcomes and an increase of $77.5 billion in additional healthcare costs annually

• Resources exist to ease the burden of food insecurity, but these resources may be underutilized and poorly integrated within the healthcare field
Attitudes & Behaviors Surrounding Active Commuting in Chittenden County, VT

Daniel Bak, Elizabeth Congdon, Doré Grier, Naira Goukasian, Max Silverstein, Georges Tahhan, Katrina Thornburgh, Rebecca Jones, Chester Areson, Dan Quinlan, and Meredith Graves

Climate Change, Active Commuting, and Health

• Climate change contributes to 7 million deaths/year globally

• Negative health outcomes from increased carbon emissions include heat-related illness, mental health issues, and respiratory and allergic disease

• Active commuting reduces carbon emissions, promotes physical activity, and reduces chronic diseases such as hypertension, diabetes, and obesity

Active Commuting in Chittenden County

• Only 8.5% of Vermonters commute actively

• Burlington has been intensely promoting active commuting through developments in infrastructure and safety

• Most Burlington residents still commute by car

Project Goal

• Compare how active commuters and non-active commuters in Chittenden County differ on attitudes and beliefs on health, vehicle emissions, economics, convenience, and safety.

• Advise VTCHA on possible targets for the promotion of active commuting.
Impact of Interactions Between First Responders and Opioid Drug Users

Rio Beardsley, Pirapon Chaidarun, Kalle Fjeld, Benjamin Grebber, Brian Muchmore, Ellen Seyller, Lauren Struck, Heng Tan, Peter Jacobsen, and Jerry Larrabee

INTRODUCTION

In 2017, First Responders (EMS, Police, and Fire Department) in Vermont administered 848 doses of naloxone (Narcan®), an opioid antagonist that can block the effects of opioids in overdose. However, the rate of opioid-related fatalities has continued to rise from 74 in 2015 to 101 in 2017. Vermont CARES, a nonprofit organization, helps address this issue by working “for and with Vermonters affected by HIV/AIDS to promote well-being through a continuum of prevention, support, and advocacy services.” Their syringe service programs throughout the state provide access to clean needles, overdose prevention education, and naloxone.

AIMS

1. To better understand the perceived experience of opioid drug users (Vermont CARES clients) when interacting with First Responders following an overdose.

2. To explore how such interactions of a Vermont CARES client – essentially as positive or negative – affects the likelihood to request such help in the future
Legislator Beliefs, Perceptions, and Voting Influences regarding Carbon Pricing: Implications for Climate Change and Health Advocacy

Joy Benner, Istvan Kanyo, Meri Lackie, Evan Lowry, Shivani Seth, Alan Su, Jill Jemison, Raj Chawla, and Sally Kerschner

Carbon pricing was proposed to reduce carbon emissions which has been linked with negative health effects such as:

• Increased incidence of heat stroke

• Food poisoning

• Malnutrition via food shortages

• Vector-borne illnesses

• Asthma

• Allergies

Purpose: To understand factors that affect legislators’ carbon pricing voting, guiding future health educators and advocates.
Safe Driving Attitudes and Behaviors Among Vermont Student Drivers

Samantha Bissonette, Megan Garrido, Nicholas Haslett, Ashton Pike, William Prince, Davina Tolbert, Catherine Westbom, James Lockridge, and Wendy Davis

Distracted driving contributes to approximately 10% of all driver fatalities and 17% of injuries in the US. Vehicle crashes are the leading cause of death for teens in the US. Drivers aged 16-19 are 3 times more likely to be involved in fatal crashes than those > 20 years. Increased teen risk is related to attachment to technology, limited driving experience, and an illusion of invincibility. Previous National Highway Traffic Safety Administration assessment of distracted driving attitudes and behaviors does not include significant data on teenage drivers. The goal of this project is to assess safe driving attitudes and behaviors among Vermont Student Drivers.
Evaluation of Interactive Rhythm Activities on the Engagement Level of Individuals with Memory Impairments

Jared Bomba, Raghav Goyal, Marc Hammond, Van Hoang, Alexander Karabachev, Laura Nelson, Hanaa Shihadeh, Judith Christensen, and Ellen Meagher

Alzheimer's dementia can lead to a decreased quality of life in patients through the manifestation of inappropriate behavioral and psychological signs and symptoms. Music therapy has been shown to decrease agitation and disruptive behaviors in patients with dementia, although improvement in overall cognitive function was minimal. However, there is evidence showing an increase in grey matter in those who actively participate in music activities. Our goal in this study is to focus on how participation in rhythm-based activities affects quality of life.
The Effect of Food Insecurity Training on Knowledge, Awareness, Screening, and Intervention Practices within Two Pediatric Wards at an Academic Medical Center

Jonathan Borden, Hillary Danis, Christina Dawson, Max Knapp, Jessica Lyon, Jordan Munger, Nam Trinh, Katy Davis, and Alison Howe

Background and Introduction

• Food insecurity is a major driver of preventable disease. Providers can screen to identify patients at risk for food insecurity using a two-question survey tool called “The Hunger Vital Sign”. Screening barriers identified in the literature include lack of provider knowledge, comfort, and capacity for effective intervention. Addressing this provider knowledge gap through training is essential for implementing robust and sustainable clinical food insecurity screening practices.

• This study aims to evaluate the effect of food insecurity education on providers’ knowledge and awareness of food insecurity and their likelihood to screen and make referrals for at-risk patients, as well as to encourage healthcare providers to foster a culture of food insecurity screening and intervention in their practices.

Objectives

1. To determine providers’ knowledge of food insecurity and awareness of referral practices and resources to help patients experiencing food insecurity.

2. To determine if providers’ participation in formal food insecurity training influences their likelihood of incorporating food insecurity screening into their patient interviews.

3. To determine if providers’ action following a positive screen is affected by participating in food insecurity training.