Public Health Projects, 2008-present

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  The Sara Holbrook Community Center: A Needs Assessment

  Elizabeth Abernathey, Meredith Bryden, Kristin Carr, W. Christian Crannell, Colin King, Andrew Nobe, Michelle VanHorne, Stephen Contompassis, and Jenny Kounta

  Introduction. The Sara Holbrook Community Center (SHCC) offers an after school program for 36 elementary students from the diverse North End neighborhood of Burlington. In recent years, disrespectful behavior and bullying have become a growing problem in the program. Through administering a needs assessment to the staff at Sara Holbrook, we examined the strengths and challenges facing the program and devised potential recommendations to address staff-identified issues.

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  What Are the Barriers and Motivators to Exercise in 50-65 Year-Old Adults?

  Raymond A. Addante, Patrick M. Benson, Liqun Chen, Jenna Ford, Jessica Louie, Kenneth S. Mensch, Dijana Poljak, Kathryn Schlosser, Pam Farnham, and Alexandra Jasinowski

  Introduction. The benefit of exercise in adults has been well established. Research has demonstrated improved cardiovascular health, decreased bone fractures, and increased mental capacity. While the benefits of exercise has clearly been demonstrated, personal barriers to exercise are yet to be fully elucidated. Thus, in collaboration with the YMCA, this study aimed to clarify barriers to exercise in 50-65 year-old adults.

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  Addressing Health Needs of Burlington Probation and Parole Clients

  Zoe F. Agoos, Alison W. Frizell, David Y. Harari, Michael Ma, Jigar M. Patel, Jordan E. Perlman, Michael Ursiny, Herb Sinkinson, and Jill K. Jemison

  Introduction. Higher rates of recidivism have been observed in offenders with specific health risks. Criminal justice literature identifies probation/parole as an ideal time to im-plement health interventions to reduce recidivism, but significant barriers exist

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  Screening for Food Insecurity in Primary Care

  Jenna Arruda, Logan Bartram, Bruno Cardoso, Andrew Jones, Amanda Peel, Darlene Peterson, Justin Van Backer, Sarah Weisman, and Marianne Burke

  Introduction. Hunger Free VT (HFVT) is a non-profit organization whose mission is to end the injustice of hunger and malnutrition for all Vermonters. HFVT developed an internet-based Continuing Medical Education (CME) course in order to bring awareness to the issue of food insecurity and enhance medical provider training. The CME course entitled Childhood Hunger in Vermont: The Hidden Impacts on Health, Development, and Wellbeing was started by 59 health care providers in VT but only completed by 4.

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  Assessing Attitudes Towards Tobacco Advertising in Winooski, VT

  Kristopher Azevedo, Benjamin Brown, Eric Chang, Jessie Evangelista, Ian McDaniels, Olga Kusina, Anisha Patel, Kate Nugent, Burton Wilke, and Jan Carney

  Introduction. Smoking rates are 15% in Vermont and higher in low-income populations. Winooski, Vermont is vulnerable to high tobacco use rates given that 23.6% of Winooski residents live below the poverty line. Tobacco advertising, which has been shown to have a direct, dose-dependent association with youth tobacco use, is highly prevalent in stores in Winooski.

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  Analysis of Learning Outcomes in LGBTQ+ Medical School Curriculum

  S. Blaney, S. Gardner, J. Garuz, J. Hobson, J. Kelada, H. Munroe, J. Pan, J. Taylor, C. Nicholas, and M. Murray

  Introduction. Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth are at increased risk for negative health outcomes and experience increased barriers to health care.

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  Establishing A Continuum of Care to Improve Follow-Up Rates for Survivors of Sexual Assault

  M. Bole, J. Ellis, W. Hine, J. Larson, D. Nettlow, J. Price, K. Root, K. Vastine, and J. Gallant

  Introduction. In 2011 there were over 1000 reported sexual assaults in Vermont. Current recommendations suggest that survivors of sexual assault (survivors) receive follow- up care within two weeks after an initial Sexual Assault Nurse Examiner (SANE) exam, but fewer than 15% receive documented follow-up. A published report has demonstrated increased follow-up to over 80% when appointments are scheduled prior to discharge from the emergency department (ED).

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  Promoting Screening of Cognitive Impairment and Dementia in Vermont: A proposal for ongoing continuing medical education (CME)

  Bryan Brown, Jessica Faraci, Shrey Kanjiya, Elizabeth Landell, Marisa Liu, Emily Rosen, Eli Schned, William Pendlebury, Jeanne Hutchins, and Martha Richardson

  In 2010, 11,382 Vermonters were diagnosed with dementia, many of whom had Alzheimer’s disease (AD). In 2025, an estimated 1 in 8 Vermonters aged 65 or older will have some form of dementia. Reported rates of overlooked dementia are between 35% and 90% or greater. Clinical presentations of dementia are often insidious and attributed to aging, making an accurate diagnosis difficult. Because of the challenges of dementia screening and diagnosis, primary care physicians (PCPs) are often unwilling to diagnose, discuss, and treat dementia due to AD.3 Although physicians are reluctant to screen for dementia, research in Vermont (VT) has shown a clear preference by patients and their families for earlier diagnosis. A timely diagnosis allows the patient and their family to plan for the future and start treatment earlier. Our research demonstrated PCPs may be misinformed about the usefulness and implications of dementia screening and diagnosis. In an effort to further educate physicians, we propose instituting a mandatory continuing medical education (CME) hour focused on screening for dementia. Our project surveyed 72 physicians to determine their attitudes towards screening, the assessment tools they use, and their attitudes towards a required CME hour.

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  Evaluating Barriers to Health in Homebound Individuals

  B. Clements, T. Goldberg, D. Gorlen, E. Goveia, K. Hughes, D. Mealiea, N. Meredyth, R. Meehan, A. Anton, and J. Carney

  Introduction. Homebound individuals in Vermont often have multiple comorbidities and can face significant food insecurity. In response to this problem, the Chittenden County Emergency Food Shelf (CEFS) Homebound Delivery Program (HDP) delivers one week of food per month to 130 individuals in Chittenden County, Vermont.

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  Money Follows the Person: Transitioning Nursing Home Residents into the Community

  Whitney Creed, Ryan Hendrix, Matthew MacKinnon, Marissa Mendez, Nancy Tran, Shane Verhoef, Hope Yu, Linda Martinez, Rio Demers, Jeanne Hutchins, and William Pendlebury

  Introduction. Research has shown that admission to nursing homes (NH) is associated with decline in several measures of well-being; transitioning out of a NH into the community is a positive predictor for quality of life. Currently, the State of Vermont offers several housing options for Medicaid eligible NH residents; however, there are very few opportunities to fully integrate into the community

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  Heat vs. Health: Wood Smoke in Vermont

  Michael Cunningham, Avanti Golikeri, Ethan Leveillee, Jennifer Makrides, Hank Ng, Janet Trang, Mark Wilkinson, Heidi Hales, Razelle Hoffman-Contois, and Jan Carney

  Introduction. Given rising energy prices in recent years, wood burning stoves offer an attractive and affordable means of home heating. Unfortunately, wood smoke emissions have been linked to respiratory and cardiovascular disease and, in some cases, premature death. Recent studies have also discovered known carcinogens in wood smoke emissions.

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  Pilot Study of the Effects of Tai Chi on Elderly Fall Risks

  A. Dauten, K. Klingman, K. Min, E. Schloff, V. Shah, C. Sheahan, S. Vossoughi, P. Trabulsy, K. Hall, and D. DeLuca

  Introduction. Falls in the elderly are a significant public health concern. Tai Chi has been shown to reduce falls in this population and increase muscle strength, balance, mood, confidence and sleep.

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  Smoke-Free Policy in Vermont Public Housing Authorities

  C. Hackett, J. Hood, J. Lane, E. Laryea - Walker, T. Lemay, A. Paine, M. Squiers, R. Ryan, and D. Kaminsky

  Introduction. Millions of adults and children living in public housing face exposure to second hand smoke from adjacent apartments. These tenants are less able to escape smoke exposure by moving, and Housing Authorities are beginning to implement smoke-free policies. We assessed the status of smoke-free policy in Vermont public housing, and explored the experience of tenants and managers in Burlington who recently implemented such a policy.

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  Is Blood Donation an Opportunity for Hypertension Awareness?

  J. Hao, C. Kerrigan, L. Kreiger, J. McAvoy, C. Sikavi, D. Swift, L. Wickberg, C. Dembeck, C. Frenette, J. Carney, and M. Fung

  Blood centers serve as a cornerstone of public health by providing potentially lifesaving blood products. Interactions with millions of potential donors provides these centers with a unique means of health education and screening opportunities.

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  Opiate Prescription Practices and VPMS Use: Impacts of the Vermont Prescription Monitoring System

  J. Kilcj, N. Mulheron, K. Pelletier, A. Roberts, J. Simon, C. Wilson, A. Rubin, and M. Sanderson

  Introduction. Our project assessed prescriber use of the Vermont Prescription Monitoring System (VPMS) and collected suggestions for its improvement, and for reducing opiate diversion.

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  A Community Model to Improve Physical Activity in Children

  Hany Abdallah, Laura Caldwell, Conor Carpenter, Katherine Scovner, Timothy Snow, Karan Verma, Janice Gallant, and Sarah Adams-Kollitz

  Introdction: • The prevalence of overweight / obese children aged 2-5 in the United States is 21.2%. The National Center of Health Statistics estimates a 30% increase in the prevalence of obesity between 2001 and 2004. • The Vermont Department of Health estimates that about 30% of low income children between 2 and 5 years of age are overweight or at risk of becoming overweight. • Physical activity programming at child care centers is the most important predictor of physical activity in preschool-aged children, more important than the child’s socioeconomic and demographic characteristics. • Although the National Association for Sports and Physical Education offers some guidelines, there are no clear recommendations for physical activity in childcare settings in Vermont and nationwide.

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  The Effects of Game Based Nutrition Intervention on 5th Graders School Lunch Choices

  Adam Ackerman, Karina Eastman, Albert Emery, Paige Georgiadis, Camilo Martinez, David Reisman, Maramawit Wubeshet, Sarah Heusner, Caroline Homan, and Robert Luby

  Introduction: Evidence shows that consumption of fruits and vegetables has health benefits, yet children across the country consume less than levels recommended by the USDA. Breifel et. al. showed that children aged 5-18 consume up to half of their daily nourishment in the school setting. The National School Lunch Program (NSLP) aims to ensure access to nutritious food for school aged children. The Burlington School Food Project aims to provide nutritious and appealing meals to all students which meet the NSLP guidelines. Observations demonstrate that although the food is available children do not always take advantage of the healthy options provided. Studies have shown that where food is eaten as well as how food is marketed impacts the choices children make on what they consume.[iv],[v] A recent study showed that intervention coupled with food-based education was successful in improving eating habits. Our goal was to improve the food choices made by 5th graders eating lunch at school through a game-based intervention. We hypothesized that by presenting fruits and vegetable in a fun and dynamic manner, in conjunction with education and role-modeling, we could increase the amount and variety of fruits and vegetables consumed by students at lunch.

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  Assessing Wellness Needs of Breast Cancer Survivors in Vermont

  Alison Alpert, Wai Lun Au, David Larsen, Jenna Pariseau, Vanessa Patten, Elizabeth Robison, George Vana, Linda Dyer, and Jan Carney

  Background: • In Vermont, 500 breast cancer diagnoses are made annually. • As of 2005, epidemiological data suggest that as many as 7,000 breast cancer survivors were living in VT. • Dragonheart Vermont’s “Survivorship NOW”4 initiative aims to bridge the gap between treatment and recovery. • A literature review, including the Taking Charge program and a survivor needs assessment done by Dr. Geller, supported conducting a needs assessment in three areas: exercise, nutrition, and emotional support. • UVM COM paired with Dragonheart Vermont’s “Survivorship NOW” initiative to determine how to best address these needs.

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  3 Squares VT Food Assistance Usage by Patrons at the Chittenden Emergency Food Shelf

  Ashley Atiyeh, Elizabeth Blasberg, Katelyn Cushanick, Daniel Edberg, Mairin Jerome, Patrick Ng, Rob Meehan, and Jan Carney

  • The federally funded 3SquaresVT program (formerly Food Stamps) increases access to healthy food and helps to stimulate local economies. • 10.9% of Vermont households are food insecure and 15.8% of children live in food insecure households. • Many families are eligible for 3SquaresVT but choose not to enroll, hurting Vermont’s economy and stressing charitable organizations like the Chittenden Emergency Food Shelf (CEFS).

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  Depression in the Elderly: Attitudes of Seniors and Practices of Healthcare Providers

  Jacob Azurdia, Jocelyn Hu, Elisabeth Kispert, Autumn Polidor, Matthew Saia, Matthew Thomas, Richard Tan, Molly Dugan, Tom Delaney, and Patricia Berry

  Introduction: Support & Services at Home (SASH) is a model for independent housing for seniors that was developed in 2009 by a partnership of community providers and Cathedral Square Corporation. Results of a 2010 PHQ-9 screen on depression administered to seniors living at Heineberg Senior Housing, a Cathedral Square community, found that 30% of residents had mild depression, 6% moderate depression, and 6% moderate to severe depression. This topic has been targeted by SASH coordinators so that they may provide more support for their residents. Furthermore, a high prevalence of depression amongst the elderly population has been well-documented and this disease is often under-diagnosed, under-treated, or missed altogether.

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  Huntington’s Disease: Assessing The Needs of Patients and Caregivers in Vermont

  Agnes Balla, Caitlin Baran, Larry Bodden, Joseph Foley, Kelly Gardner, Laura Rabideau, Christopher Taicher, Benjamin Ware, Jim Boyd, and Linda Martinez

  Introduction: Huntington’s disease (HD) is an inherited neurological disorder that causes a progressive decline in motor, cognitive and psychiatric function. • HD affects 30,000 people in the USA. In Vermont it is estimated that 69 individuals have HD and 420 people are at risk for developing the disease. • Crescent Manor Care Centers is currently the only long term care facility in Vermont that houses Huntington’s patients. Patients receive care specific to HD including PT, OT, Speech Therapy and community activities. Currently, 13 of 40 beds are occupied. • There is one HD support group in the state located in South Burlington which meets once a month. Due to the low population of HD patients in the state, there is no single state government agency responsible for managing the care of HD patients.

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  Assessing Health Needs of the Burlington Probation and Parole Population

  Nicole Benson, Katelynn Ferranti, Laura Frischer, Jonathan Galli, Kevin Kuruvilla, Stanislav Lazarev, N. J. Louras, Herb Sinkinson, and Jill K. Jemison

  The Burlington Probation and Parole population confronts numerous social, economic, and healthcare challenges upon their return to the community. While health and healthcare issues of inmates have been studied extensively, the health status and medical issues of the reentry offenders, particularly in rural areas have not been previously assessed. Data about health risks, major medical issues, and lifestyle choices among offenders on parole in the rural setting may prove helpful in the identification of preventative measures and development of strategies to promote positive health behaviors among the target population. The aim of this study is to evaluate the health risks among offenders on parole in the Burlington area and guide recommendations towards improving their health outcomes through community and educational initiatives. We also sought to gain a better understanding of the barriers within the rural setting that prevent positive health behaviors among the parolees upon their reintegration into the community

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  Assessing Bullying Behaviors and the Efficacy of Bullying Prevention in Fourth Grade Classrooms

  Amanda Boutrus, Alyson Guillet, Chelsea Harris, Duong Hua, Rola Khedraki, Aaron Maxwell, Prabu Selvam, Jordan Smith, Stephen Contompasis, and Deb Lyons

  Introduction: Bullying has recently gained notoriety as a serious concern across all countries. Bullying is generally acknowledged to be a repeated pattern of abuse communicated to a victim by physical, verbal, or written means which results in bodily harm or emotional injury. Victims of bullying have been shown to be at increased risk for suicide, depression, anxiety, headaches, or difficulty sleeping. Puppets in Education (PiE) is a non-profit organization that uses interactive puppet shows and workshops to educate more than 8,000 children per year about disabilities, cultural diversity, and a wide variety of other issues. By performing its shows in classrooms throughout the state, PiE works to model realistic, challenging situations for children and to provide simple and practical strategies for dealing with them. Focusing our attention on the effects of bullying behaviors in schools, our team worked with PiE and several local fourth grade classes to determine the amount of information children retain from the organization’s bullying prevention program, the effectiveness of the program in addressing and preventing bullying behaviors, and the students’ overall perception of the program.

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  Breathing Easy: Lung Health and Associated Conditions in the Day Care Setting

  Richard Carrick, James Corbett-Detig, Anastasia Coutinho, Justine Hum, Gunter Krauthamer, Sarah Marsh, Gerald Davis, and Rebecca Ryan

  Introduction: Air pollutants are associated with many health risks. Children in the day care environment are uniquely suscept-ible to lung damage, infection, systemic illness & pollutant triggered hypersensitivity reactions. The latest public report by the CDC reports Vermont’s (VT) asthma rate is the high-est in the country at 11.1%. This project compared VT’s day care regulations regarding specific environmental factors linked with health risks to regulations in six surrounding New England states. We sought to assess whether VT’s regulations adequately protect children in day care

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  Community Pediatrics and Growing Kids South Burlington An assessment of collaboration between area pediatricians and integrated services for families of young children in South Burlington, VT

  Leah Carr, Wendy Davis, David Drimmer, Joey Hager, Hannah Foote, Nicholas Koch, Jerry Lee, Elizabeth Meyer, Dane Slentz, and Anjali Varigonda

  Background: It is widely accepted for pediatric and family medicine practitioners to use developmental screening tools for effective identification of children who require additional support. A recent study in Pediatrics reported that between 2002 and 2009, the percentage of pediatricians using standardized screening tools for developmental delay increased from 23.0% to 47.7%. While improvement was found, less than half of pediatricians used these tools. In addition, it is known that early intervention for children requiring extra support is essential for preventing further delay in reaching milestones. Practitioners’ use of screening tools and their collaboration with their community resources can contribute to better delivery of these services and aid in children meeting developmental milestones.