Public Health Projects, 2008-present

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  Vermont Restaurant Owner & Manager Perspectives on Creating Heart-Healthy Kids Meals

  Elisabeth Lucas, Mary K. LoPiccolo, Lauren Haggerty, Apoorva Trivedi, Alex Jacobson, Daniel Trigg, Taylor Sommer, Carolyn Payne, Tina Zuk, and Paula Tracy

  Introduction: The prevalence of sugar sweetened beverages and fried foods combined with a lack of healthy children’s menu options has contributed to the obesity epidemic among young Americans. Recent legislation in New York City and San Francisco instituted strict nutritional requirements on children’s menu items.

  We performed a cross-sectional study that focused on independently owned restaurants with printed children’s menus in Vermont. We investigated the nutritional content of children’s menu items, restaurant owner and manager perspectives on customer ordering habits, and barriers that restaurants would face if they made children’s menu items healthier.

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  Healthcare Barriers of Residents at a Subsidized Housing Community

  Curtis T. Adams, Amy M. Hopkins, Daniel J. Ianno, H. Omer Ikizler, Kristi Kilpatrick, Jani M. Kim, Sargis Ohanyan, Sarah K. Russell, and Virginia Hood

  Introduction: Despite expanded healthcare programs, the low income and elderly lack coverage of vision, hearing, and dental services. Community services are often asked to fill these gaps. To evaluate the situation in Burlington, VT, we surveyed staff and residents in Burlington Housing Authority (BHA) subsidized housing to (1) identify gaps in healthcare coverage and (2) assess barriers to accessing those services in this population.

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  Vermonters’ Opinions on Low-Dose CT Lung Cancer Screening

  Benjamin Albertson, Eric Bennett, Homer Chiang, Erin Keller, Katherine Lantz, Melanie Ma, Sharon Mallory, Rebecca Ryan, and David Kaminsky

  Introduction: Lung cancer is the number one cause of cancer death among men and women in Vermont and the United States. Smoking increases the risk of lung cancer—nearly 90% of lung cancer is due to smoking. Frequently, lung cancers do not present clinically until they are advanced stage and therefore prognosis is poor. However, if detected early lung cancers are more operable and patients have better outcomes. In December 2013 the US Preventive Services Task Force released new guidelines for lung cancer screening among current and former smokers ages 55 to 80. It is recommended that current and former (within 15 years of quitting) smokers of 30 pack years receive an annual low-dose CT scan. The objective of this project was to assess the level of knowledge and attitudes towards lung cancer screening with low-dose CT scanning among Vermonters in the Burlington area.

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  University of Vermont Community Tobacco Use and Attitudes Survey

  Hillary Anderson, Kyle Concannon, Catherine LaPenta, Robin Leopold, Christina Litsakos, Imelda Muller, Asaad Traina, Tom Delaney, Burton Wilcke, and Jan K. Carney

  Introduction: Smoking remains an important public health issue in U.S. Colleges. 17.3% of U.S. smokers are 18-24 years old. 28% of U.S. college students began smoking at age 19 or older. Currently 1,104 U.S. Colleges have adopted Tobacco-Free policies.

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  A Life Skills Toolkit: Curriculum Development for Sustainable Public Health Community Engagement

  Muhrtaza Bharmal, Bryce Bludevich, Tracey DaFonte, Jonathan Hernandez, Jill Jemison, Sarah Kelso, Tristan McKnight, Ryan Nichols, Christopher Williams, Margaret Schwalbaum, and Luke Zitterkopf

  Introduction: Committee On Temporary Shelter (COTS) is a community organization that provides gateway housing opportunities to fourteen previously homeless veterans through its Canal Street program in Winooski, VT. Many of the residents struggle with physical fitness, poor nutrition, and mental illness, including PTSD. Research has shown that there is an increasing prevalence of overweight or obese veterans returning from service, and these individuals present a particular challenge to primary care physicians as their mental health issues are closely related to their level of fitness. It has been demonstrated that veterans often suffer from ingrained food insecurity, which negatively influences post-service eating behavior, and readjustment solutions are needed to ease reentry into civilian life. While literature recommendations exist outlining the important role of initiating easy-to-use exercise programs and the beneficial impact of exercise in a natural environment on veterans, there has been little research into more holistic approaches to improve the diminished quality of life impacting many individuals with PTSD. Recent literature shows decreased PTSD symptoms after a life skills intervention and that short-term nutritional education interventions have the capacity to favorably change eating behaviors in a low income population. Therefore, we decided that a comprehensive, yet personalized intervention was needed.

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  Public Perception of Pesticide Exposure in Vermont

  Nicholas Bonenfant, Ayse Celebioglu, Bridget Colgan, Pierre Galea, Lucas Grover, Joshua Weaver, Tom Delaney, Razelle Hoffman-Contoi, Linda Boccuzzo, Heidi Hales, Jan Carney, and Razelle Hoffman-Contois

  Introduction: A pesticide is any substance intended for preventing, destroying, repelling, or mitigating any pest.1 The public generally believes that insects, diseases, and other pests need to be controlled but is also becoming concerned about the impact of pesticides on their health and the local ecosystem. Pesticide exposure occurs with public and private use. Studies indicate consumers have diverse levels of awareness, knowledge, and attitudes regarding pesticide use and health risks.2 The goal of this project is to identify levels of awareness, knowledge, and attitudes toward pesticide usage in Vermont to help State agencies focus public awareness and education.

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  Evaluating Communication Tools and Increasing Fruit and Vegetable Consumption in Vermont Head Start Classrooms

  Meghan Breen, Leah Cipri, Troy Larson, Laura Leonard, Andy Liu, Will Manning, Kai Ping Wang, Isobel Santos, Jennifer Fink, Missy Kuncz, and Andrea Green

  Introduction:

  We designed a program for four Head Start classrooms that aimed to: 1) Provide classrooms a tool that would facilitate communication with families about nutrition, 2) Educate families about the MyMeal tool, and 3) Increase fruit and vegetable consumption by providing families with fresh fruits and vegetables Fruit and vegetables are important components of a healthy diet, and sufficient consumption helps reduce the risk of developing cardiovascular disease, cancer, diabetes and obesity. Eating behaviors during childhood are highly parentally influenced and function as the foundation for future eating patterns. Studies have shown that the extent to which fruits and vegetables are present and accessible in the home correlates with the amount of fruit and vegetables eaten by children.

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  Living with Hepatitis C: A Vermont Needs Assessment

  Alexandra Brown, Justin Genziano, Julia Powers, Samy Ramadan, Amy Schumer, Matthew Shear, Katherine Wang, Peter Jacobsen, and Jerry Larrabee

  Background:

  Hepatitis C (HCV)

  Viral infection of the liver spread primarily via blood-to-blood contact (e.g., intravenous drug use (IVDU))

  United States: 3.2 million chronic HCV infections (2010)

  Vermont: 1.63 cases per 1000 people (2012-2013)

  Barriers to Care

  Exclusion of current IV drug users from HCV treatment programs despite their high rates of infection

  Lack of support, causing decreased treatment adherence

  Poor access to treatment: cost, transportation, competing priorities of housing, addiction management, and food

  HIV and HCV

  Research has shown that the multidisciplinary and integrated HIV model is appropriate for HCV

  Vermont CARES

  Non-profit organization that provides comprehensive services to clients with HIV in Vermont

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  Improving WIC Retention in Vermont: Beneficiary attitudes toward co-location in medical homes

  Lillian Chang, Eunice Fu, Erin Pichiotino, Sasha Taylor, Brian Till, Amy Triano, John Whittier, Donna Bister, Jenna Whitson, and Allison K. Howe

  Introduction:

  The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a national program aimed at improving the nutrition and health of pregnant women and children.

  Those eligible for Vermont WIC include anyone pregnant or with children under 5 that has an income below 185% of federal poverty level or is enrolled in Vermont Medicaid.

  WIC has been shown to improve birth outcomes1, breast feeding rates2, infant growth and development, and consumption of important nutrients.

  Those enrolled in WIC report high levels of satisfaction

  Despite the benefits of WIC, retention rates of eligible families remain low.

  Studies have shown that mandatory bi-annual recertification appointments pose logistical problems. Rescheduling missed appointments and long waiting times at the WIC offices were also barriers.

  Other states have found that integration of WIC recertification appointments with the family’s primary care medical visits may improve retention.

  A limited scale co-localization of WIC and the medical home in Vermont showed some promise.

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  The Role of Art in the Patient Experience: An Evaluation of Art from the Heart at UVM Medical Center

  Doug Chieffe, Steven Coffin, Sarah King, Syed Shehab, Catherine Suppan, Gwen Warren, Rebecca Wieland, Rebecca Schwarz, and Mark Pasanen

  Introduction: The World Health Organization defines health as a state of total physical, mental and social well-being, not just the absence of disease or fragility. Making art in medical settings reduces pain, tiredness, emotional distress and other feelings that negatively affect well-being, while enhancing positive emotions and communication. According to the 2009 “State of the Field Report” by the Society for the Arts in Healthcare, 43-45% of healthcare institutions reported having some form of an art program. Art from the Heart (AFTH) is a program of Burlington City Arts in collaboration with the University of Vermont Medical Center. With the aid of volunteers, AFTH offers pediatric patients and their families the opportunity for a more normalized experience by providing them with time and materials to experience the joys of creativity and imagination. Waiting areas, in-patient hospital rooms, exam rooms and chemotherapy infusion bays become temporary art studios. The purpose of our public health project was to evaluate the presence and impact of AFTH in three pediatric points of care at UVM Medical Center.

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  Evaluating Services for Bhutanese Elders at the Champlain Senior Center

  Elizabeth Cochrane, Nazey Gulec, Dylan Hershkowitz, Mary Ledoux, Dale Lee, Mohammad Mertaban, Carl Nunziato, Elena Siani, Bonnie Campono, and Jeanne Hutchins

  Introduction:

  •Bhutanese refugees have been living in Vermont since 2008. They constitute a vulnerable population due to lack of language skills, increased health care requirements and lack of access to transportation.

  The Champlain Senior Center (CSC) provides services and a community space for Bhutanese refugee elders (older than 55 years).

  We aimed to determine the necessity for the CSC in the elders’ wellbeing and to demonstrate that services are crucial to ensure this New American elderly population’s needs are being met.

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  Role of Physicians in Addressing Food Insecurity in Vermont Seniors

  Joshua Cohen, Reid Feller, Olivia Harris, Lohrasb Sayadi, Margaret Seybolt, Alejandro Velez, Amy Yu, Daty Davis, Naomi Fukagawa, and Jane Kolodinsky

  Introduction:

  This study investigated Vermont physicians’ awareness of - and engagement in – addressing food insecurity experienced by their elderly patients. This information is needed to better understand the role physicians play in solving this problem and to know how education and access to services could ensure that the needs of elders are met in a culturally sensitive manner.

  Many elders must choose between paying bills, buying medication or buying food. Some elders are unaware that they qualify for food assistance, or would feel stigmatized using it.

  Nationally, 56% of physicians reported that they were not knowledgeable about food insecurity.

  Food insecurity can be screened for by using Hunger Free Vermont’s Two Question Screen.

  Screening, followed by a multidisciplinary team approach with contributions from dietitians, geriatricians, social workers and psychologists may be the most effective way of assessing at-risk patients.

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  The Charitable Habits of Blood Donors

  Kathryn Colelli, Alyssa Correll, Shannon Li, Jameson Loyal, Ryan Sofka, Jordan Taylor, Andrew Tranmer, Chris Frenette, and Mark Fung

  Introduction: There is a need for a constant supply of blood and blood products (e.g. plasma and platelets) in the American health care system. Common recipients of blood include: patients at risk for major hemorrhage, patients with sickle cell anemia, patients undergoing surgery, and thrombocytopenia in neonatal patients. This demand is met through nationwide blood banks, such as the American Red Cross, and their blood donation programs. The American Red Cross relies solely on volunteer donors; thus, one of the most pressing issues facing this institution is getting donors in the door. Through our survey questions we hope to uncover more factors that guide individuals in their philanthropic ways. The overall goal of this research is focused on unveiling new information that will supply the American Red Cross with valuable insight into their donor population and possible opportunities for joint publicity. We investigated the similarities and difference between how and why individuals undertake certain charitable activities.

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  Attitudes Towards Vaccination Among Medical Students: A Two-Site Study

  Dylan Devlin, Michael Grant, Trishul Kapoor, Marie Lemay, Sarah Manning, Meredith Sooy, Chris Finley, and Jan Carney

  Introduction:

  Mandatory immunization for school age children in the 20th Century led to a substantial decline in infectious disease.

  All US states allow medical exemptions from immunizations with 49 permitting additional religious exemptions and 19 permitting additional philosophical exemptions.

  Vaccine exemptions have lead to an increase in the incidence of disease outbreaks.

  Healthcare providers play a critical role in educating parents about the benefits and risks of immunizations.

  This project compares student attitudes and knowledge regarding vaccination at medical schools in two distinct states: one with no additional exemptions (West Virginia) and one with both additional exemptions (Vermont).

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  Who's accessing emergency food services?

  Jia Xin Huang, Michael Hudson, Johanna A. Kelley, Billy Kien, Christopher R. Mayhew, Kiyon Naser-Tavakolian, Jamie Elyse Richter, Alexander W. Thomas, Kelly McLemore, and Judith Christensen

  Introduction:

  Last year, Chittenden Emergency Food Shelf provided 1,260,517 pounds of food to over 11,000 people each month via groceries, hot meals and home delivery, supplying an average of almost 40% of food for families.

  CEFS seeks to improve their services and offerings by better understanding the demographics, food preference, and needs of the clients they serve.

  Our goal was to collect demographic and utilization data to identify areas where CEFS could enhance services and improve client access to healthful food.

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  Barriers to Exercise and Nutrition for Special Olympics Athletes

  Alyssa Kwok, Danielle Leahy, John McLaren, Christopher Meserve, Joseph Miller, Sierra Trejos, Jacqueline Wade, Mike Frisbie, Chris Langevin, and Stephen Contompasis

  Problem

  People with intellectual disability (ID) have higher rates of obesity.

  Special Olympics Vermont (SOVT) athletes compete in sports events throughout the year.

  Athletes may lose fitness between seasons.

  Their nutrition habits remain unknown. •Barriers to exercise and nutrition remain unknown.

  Goal

  We were tasked with designing a successful exercise and nutrition program for SOVT athletes.

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  Public Awareness and Perception of Ionizing Radiation

  Jenna Bateman, Bryce Edwards, Katherine Evans, James Levins, Amanda O’Meara, Merima Ruhotina, Richard Smith, Razelle Hoffman-Contois, Heidi Hales, Linda Boccuzzo, and Jan Carney

  Introduction. Exposure to ionizing radiation has potential for acute and chronic health effects. Within the general public, there is discrepancy between perceived and actual health risks. It is vital to assess existing knowledge and perceptions about ionizing radiation among Vermonters.

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  Family, Social, and Sexual Health Education in Elementary Aged Children

  Sabrina Bedell, Madeline Eells, Tara Higgins, Suleiman Ismael, John Nesbitt, Colette Oesterle, Nicholas Sinclair, Liz Shayne, and Eileen CichoskiKelly

  Introduction. Multiple public health agencies stress the importance of school health education, including family, social and sexual health. The Schoolhouse Learning Center, a private elementary school with grades K-5, wishes to implement a social health curriculum guided by the Sexuality Information and Education Council of the United States (SIECUS).

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  Barriers to and Resources for Asthma Management in Vermont Elementary Schools

  Samantha Boyd, Benjamin Farahnik, Anja Jokela, Emily Keller, Russell Landry, Mikaela Lee, Alice Stoddart, Christopher Ting, Rebecca Ryan, and David Kaminsky

  Introduction. Asthma is a chronic obstructive lung disease that causes wheezing, coughing, and shortness of breath, and is a cause of school absenteeism. School nurses play an integral role in asthma care for elementary-aged children.

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  Nutrition as the Foundation for Good Health: Evaluating the Impact of Food Programs on Health

  Adam Burgess, Nicholas Field, Douglas Handley, Laura Lazzarini, Dilasha Mahat, Daryl Selen, Raj Thakrar, Sarah Adams-Kollitz, and Janice Gallant

  Introduction. Previous studies have demonstrated a link between food insecurity and childhood behavioral problems, particularly internal problems such as anxiety and depression. Burlington Children’s Space (BCS), a local preschool and daycare in Burlington, VT, has created a healthy and nutritious meal program for their children, many of whom cannot afford enough to eat well at home.

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  An Evaluation of Food Insecurity & Health Behavior among Rural Community Supported Agriculture (CSA) Participants

  Michael Capata, Ian Crane, Taylor Goller, Angie Li, Erin McElroy, Noah Quinlan, Deborah Shamsian, Thomas Delaney, Jill Jemison, Paul Feenan, and Breck Knauft

  Introduction. Access to healthy foods is a major barrier for individuals achieving a healthy diet. The literature reveals several investigations into causes of food insecurity, but few focus on Community Supported Agriculture (CSA) programs that attempt to address food insecurity and related health behaviors of participants.

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  Access to Transportation For Chittenden County Senior Citizens

  Alejandro Castro, Leah Fox, Emily Hadley Strout, Pishoy Haroun, Blake Leavitt, Cordelia Ross, Mutlay Sayan, Alyson Platzer, and Jeanne Hutchins

  Introduction. Elderly age often means a progressive loss of independence and mobility. Research has shown that this lack of mobility has a detrimental effect on health and well-being. It is estimated that 25% of Vermonters will be ?65 years by 2030. Thus, the rapid rise in the elderly population will translate into a greater need for reliable transportation. We sought to explore if and how lack of transportation compromised areas of seniors’ daily lives.

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  Ensuring Access to Dental Care for Pregnant Women in Vermont

  Katia Chavez, Heather Gardiner, Shane Greene, Nicolas Monte, Dwight Parker, Shravan Rao, Reiko Sakai, Kristin Fontaine, and Wendy Davis

  Introduction. In Vermont, $2.7 million is spent annually caring for children ages 0-5 with early childhood caries (ECC) who require hospitalization for treatment. Nationwide, obstetricians are often not familiar with published prenatal oral health guidelines. It is unclear how providers in Vermont address prenatal oral health. Recently, the $495 Medicaid cap on reimbursement for perinatal dental care was lifted and now extends coverage 60 days after delivery, making the prenatal period an ideal time to intervene.

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  Factors Leading to Adolescent Drug Abuse in Winooski

  Yun-Yun Kathy Chen, Gia Fraher, Megan Wetzel, Ilsley Colton, Herman Kalsi, Weiss Surkhabi, Flang Nguyen, Kate Nugent, and Burton Wilcke

  Introduction. This study collaborated with the Winooski Coalition for a Safe and Peaceful Community (WCSPC) in order to identify underlying risk factors for initiating drug use in adolescents, ages 13-18 in Winooski, Vermont by implementing focus groups with community stakeholders and agencies.

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  Happy Feet: Podiatric Needs of the Burlington Homeless Population

  Priyanka Chilakamarri, Gurpinder Gill, Karl Kristiansen, Benjamin Rayikanti, Michael Sun, Whitney Thomas, Mark Pasanen, Julia Paradiso, and Aurora Lenz-Watson

  Introduction. Many homeless individuals spend a large portion of their days standing or walking, placing particular importance on lower extremity health in this population. However, few studies have been performed to investigate the podiatric needs of this group.