Public Health Projects, 2008-present

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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

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  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.

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  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

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  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.

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  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.

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  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.

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  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.

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  Opportunities and Barriers to Implementing Tobacco 21 in Vermont

  Audrea Bose, Cameron Burke, Jack Chen, Jenna Dafgek, Kathryn Kurchena, Alexander Miller, Catherine Pratt, Rebecca Ryan, and David Kaminsky

  Introduction

  • Tobacco is the leading cause of preventable disease and death in the U.S. Demographics

  • Approximately 90% of current smokers starting smoking before age 182

  • Earlier age of tobacco use initiation associated with lower rates of smoking cessation

  • The proposed Tobacco 21 bill (T21) would raise the minimum legal age of sales to 21, creating the opportunity to reduce tobacco use initiation

  • Within five years of implementing the nation’s first T21 bill in 2005, the 30-day smoking rate in Needham, MA dropped from 13% to 7%

  • Recently in Vermont, the age of gun sales was raised to 21, the age of marijuana possession was set to 21, and the Burlington City Council resolved to recommend the age of tobacco products sales be raised to 21

  Objectives

  • Understand why T21 has been unable to pass in Vermont to date

  • Understand the current view of T21 held by Vermont legislators

  • Identify opportunities and barriers to implementing T21 in Vermont

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  Understanding and Evaluating Quality of Life for Individuals with Intellectual Disabilities: A Northwestern Vermont Population Study

  Karla Brandao-Viruet, Katherine Callahan, Michael Chmielewski, Samuel Epstein, Elizabeth Lynch, Emily Puleo, Derek Tan, Mike Reilly, and Stephen Everse

  Introduction

  There are 7-8 million individuals with intellectual or developmental disabilities living in the US.

  • 91,795 of this population lives in Vermont

  • Historically marginalized and isolated community

  • Socioeconomic, health-related, and emotional burden

  • Public health-related disparity

  Champlain Community Services (CCS): non-profit service provider and coordinator for 86 persons with intellectual disabilities in Northwestern Vermont

  Objectives:

  • Develop and apply measures to better understand and evaluate quality of life in the population CCS serves.

  • Recommend improvement to CCS data collection and evaluation methods.

  • Provide a basis for future recommendations to CCS services that are aligned to the needs of consumers.

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  Needs Assessment of Winooski Food Shelf Clients

  Susan Campbell, Lexi Churchill, Michael Lawrence, Shae Rowlandson, Kathryn Thomas, Matt Tsai, Timothy Woodin, Linda Howe, and Jan Carney

  Food shelves offer a unique, centralized location to engage with populations with multiple needs. Food shelf clients demonstrate poorer overall health and less access to healthcare and other social services. Winooski has a large refugee and immigrant population, whose needs may differ greatly from clients served by nearby food shelves in Chittenden County. Winooski Food Shelf visits provide opportunities to link clients to other needed health and social services. Previous studies have demonstrated efficacy in resource intervention guided by information gathered from food shelf clients.

  PROJECT GOAL: Assess the greatest health and social needs for clientele of the Winooski Food Shelf and make recommendations based on data gathered.

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  Oral Health and Barriers to Care in Burlington Housing Authority Residents

  Cari Carpenter, Andrew Darling, Reed Hausser, Mary Ann Kelly, Adam Lacayo, Elizabeth Lanata, Scott Olehnik, Molly Moore, and Taylor Puckhaber

  Background

  Oral health affects everyone and serves as a model for the long term benefits of establishing preventative health practices early in life. However, children with significant socioeconomic stress or cultural and language barriers to access may have difficulty obtaining oral hygiene information, or developing and maintaining oral health regimens. The Burlington Housing Authority (BHA) provides housing subsidization to low-income families and services many resettled refugee families in Burlington, VT. We recognize some intervention initiatives are already and place, and will evaluate program efficacy and utilization. Ultimately, we seek to understand barriers to the existing programs and recommend strategies to increase utilization, compliance, and education in our target population.

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  Effects of Nostalgia Directed Music Therapy on Residents with Dementia in Nursing Home

  Garrett Chan, Jack Fitzsimons, Sidika Kajtezovic, Kristen Keene, Marc Kostrubiak, Jessica Sikka, John Vandenberge, Shaden Eldakar-Hein, and Cameron Segal

  Background

  • Studies support a beneficial relationship between music therapy and the management of dementia.

  • Music therapy intended to activate memory may improve apathy and decrease cognitive decline in patients with mild to moderate dementia.

  • Individuals are typically most influenced by music encountered during early adulthood.

  Objective

  To analyze the effect of nostalgia directed music therapy on the quality of life of nursing home residents with moderate to severe dementia.

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  Training: Key in Recognizing Potential Trafficking Victims in a Healthcare Setting

  Alexis Dela Cruz, Jennifer Holland, Ibrahim Hussein, Dylan Koundakjian, David Viscido, Candice Wolf, Hannah Woodruff, Edith Kilmoski, and Mariah McNamara

  Background

  • Human Trafficking (HT) is a crime that involves exploiting a person for labor, services, or commercial sex.

  • HT can happen in any industry, to persons of any gender, age, economic status, religion, and nationality.

  • In FY 2018, service agencies in the State of Vermont submitted over 180 reports of HT.

  • HT has a profound negative impact on survivors’ physical and mental health.

  • 25-88% of HT victims interact with a healthcare professional while they are being exploited.

  • Providers have cited a lack of confidence and knowledge on HT as a major barrier to proper care of potential victims, stemming from a lack of adequate training.

  • There is a need to assess healthcare workers’ knowledge in recognizing and providing appropriate care and options to potential victims of HT.

  Objectives

  • Assess awareness of University of Vermont Medical Center (UVMMC) and affiliated primary care staff and providers regarding the recent implementation of a UVMMC policy on providing support to victims of HT.

  • Understand current behaviors of staff and providers when providing care to a patient suspected of being a victim of HT.

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  Vermont Legislators' Opinions Regarding the Opioid Epidemic

  Liam du Preez, Emily Eichner, Jonathan Gau, Ryan Harned, Matthew Lebow, Bridget Moore, Casandra Nowicki, Elizabeth Cote, Charles MacLean, and Jan Carney

  Introduction

  • The VT General Assembly includes 180 legislators: 150 representatives and 30 senators

  • State legislators have substantial power to create opioid-related policies

  • During the 2017-18 VT legislative session 22 opioid related bills were introduced and 9 were passed

  • No data currently exist on how VT legislators gather information and formulate public health decisions regarding opioid policies

  Purpose

  • Examine VT legislators’ understanding of the opioid epidemic

  • Identify what drives legislators to draft legislation, including beliefs, priorities, and voting decisions

  • Inform health and human services professionals to best respond to legislators’ knowledge gaps and continuing education needs

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  Community Awareness and Utilization of School Based Health Centers in Burlington, Vermont

  Sarah French, Cinduja Nathan, Kenneth Palanza, Sienna Searles, Sarah Sherman, Joshua Taylor, Michael Weber, Rebecca McCray, Matthew Saia, and Barbara Frankowski

  Most K-12 students will miss at least one day of school each year due to illness or injury; in 2010, six percent missed 11 days or more. School Based Health Clinics, SBHC, are provider-based health clinics located in schools, supplementing routine nursing care and complementing the role of a pediatrician while the child is in school.

  SBHCs aim to:

  • Reduce the amount of school that students miss

  • Provide quick and convenient care for a variety of routine and acute medical concerns

  Our objective was to:

  • Investigate community awareness and utilization of the SBHCs in the Burlington School District

  • Providing insight regarding how to increase engagement of students and parents with the SBHC’s and thereby reduce avoidable class absenteeism.