Public Health Projects, 2008-present

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

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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
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.
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.
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.
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.
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.
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).
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
Competition as a Potential Motivator for Blood Donation

Brandon Childs, Gary Gilmond, Hannah Lowe, Benjamin Jorgensen, Angelina Palombo, Chris Frenette, and Mark Fung

Introduction. Investigating motivational factors for blood donation is invaluable to understanding how to increase blood availability. Our study evaluates the perceived effect of competition as an intrinsic motivator for blood donation.
Creating an Online CME Module: Early Detection and Diagnosis of Dementia and Alzheimer’s Disease

Alex Coffman, Grant Goodrich, Matthew Jordan, Erica Marden, Xiaofan Pan, Cornelia Willis, Emily Xue, Martha Richardson, and William Pendlebury

Introduction. The number of individuals living with dementia and Alzheimer’s disease (AD) in the United States is growing annually; only 40% are properly diagnosed. Primary care providers should identify individuals with cognitive impairment and provide options for care; early diagnosis of dementia and AD helps patients and families plan for the future, increases quality of life, and allows for treatment options.
The Effectiveness of Health Care Coordinators within a Novel Home Care Model for Elders

Betsy Davis, Jan Carney, Sean Bullis, Sarah Fieber, Chang-Wei Huang, Elizabeth May, Caitlin McFarland, Jacob Reynolds, and Katelyn Shea

Introduction. Our project studied the effectiveness of health care coordinators in a program known as Support and Services at Home (SASH). SASH has been designed to fill the needs of independent, home-bound elders who still need regular access to healthcare.
Circle Time Health Curriculum Designed for Pre-Schoolers

Angela Doswell, Laura Griesinger, David Hermel, Bharath Krishnamurthy, Josephine Stout, Daniel Stratz, Phildrich Teh, Elizabeth Valitchka, Jennifer Fink, and Cate Nicholas

Introduction. Over 20% of low-income, Head Start eligible children are not up to date on regular healthcare exams. While many barriers exist in ensuring universal access and compliance with standard healthcare visits for young children, we sought to educate children about physician’s practices in order to engage and integrate their involvement and understanding of their well-being.
Barriers to Identifying Trafficked Youth in the Vermont Healthcare Setting

Benjamin Earle, Sarah Johnson, Nishan Bingham, Sarah Rosner, Maya Son, Edith Klimoski, Courtney Schaad, and Andrea Green

Introduction. Human trafficking affects victims’ physical and psychological health. This study aimed to identify the barriers to access, disclosure, and identification in a healthcare setting for potential trafficked youth in Vermont.
Congestive Heart Failure Patient Education Intervention to Address 30 Day CHF Readmission

Jeanne Gosselin, Jennifer Hanson, Sonam Kapadia, Matthew Lin, Brenton Nash, Luke Neill, Christine Tran, Ted James, William Hopkins, and Lori Notowitz

Introduction. The ACA Hospital Readmissions Reduction Program recently cut reimbursement for 30 day readmissions. Risk-adjusted congestive heart failure (CHF) 30-day readmission rate at Fletcher Allen Health Care (FAHC) in 2012 approached 22.2% among Medicare patients.
Assessing the Feasibility of a Mobile HIV Screening Unit in Vermont: A Community Survey

Kelsey Preston, Daniel Haddad, William Thompson, Sarah Ebert, Kevin Saiki, Leslie Wenning, Stephen Balise, Janel Martir, Peter Jacobsen, and Jerry Larrabee

Introduction. Estimates show that 20% of HIV-positive individuals are unaware of their serostatus, in part due to limited access to testing services. Challenges of HIV testing within communities may be overcome by providing non-traditional avenues for testing and counseling, such as mobile HIV testing units. Such services have demonstrated success in increasing awareness of personal HIV status, and facilitating diagnosis and treatment.