Public Health Projects, 2008-present

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  PCP Attitudes: Understanding of Cancer Risk from CT Imaging

  Kenneth Allen, Caitie Beattie, Noah Manz, Max Pendleton, Chloe Ruscilli, Chloe Ruscilli, Zaymee Syeda, and Eli Zettler

  Background: The use of ionizing radiation in medical imaging has revolutionized the ability to diagnose and treat illness. While it is difficult to measure the risk associated with low-level radiation exposures, estimates can be made by extrapolating data from atomic-bomb survivors. Based on these estimates, the American College of Radiology has recommended steps that clinicians can take to minimize risk for patients.​ Studies evaluating knowledge of radiation risk have so far focused on physicians in emergency and surgical settings, finding potential gaps of significance. This study seeks to establish radiation-safety knowledge possessed by primary-care providers in the state of Vermont. Methods: A structured survey was created to assess primary-care providers' (PCPs) attitudes, practices, and knowledge about ordering CT scans and sent to PCPs within the UVMMC Health Network. Results: Survey results demonstrated a widespread lack of knowledge of CT risk. Out of a maximum score of 5 on the knowledge assessment portion, the average test performance was 2.2. Average test scores were tabulated against graduation year from medical school, self-rated familiarity and knowledge with CT imaging, and levels of training in this specific area. No comparisons reached statistical significance (p<0.05). Conclusion: Despite differences in training, familiarity with CT, and professional titles, there remains a lack of knowledge regarding CT radiation safety. Further research and advancements in CT knowledge, along with increased education for medical professionals, are necessary.

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  Understanding barriers to equitable care for people with intellectual and developmental disability

  Alexia Amaio, Dalton David, Michael Greenberg, Thomas Khodadad, Harsimran Multani, Sarah Pfreundschuh, Selin Tukel, Leena Ziane, and Thomas Griffin PhD

  Background: Approximately 14% of the U.S. population live with an intellectual and/or developmental disability (IDD). Individuals with IDD face barriers to accessing equitable healthcare, contributing to health disparities. In collaboration with Special Olympics Vermont (SOVT), this study aims to identify and understand the barriers individuals with IDD encounter when seeking healthcare. The findings will help inform strategies to improve access and promote equity. Methods: A Redcap survey including 16 multiple-choice and 2 open-ended questions was designed to understand the barriers to equitable care for individuals with IDD. Surveys were distributed via the SOVT email list and at an SOVT athletic event. Survey participants, including athletes and their parents/guardians, were offered the opportunity to share thoughts via Zoom interview or in-person interview at the athletic event. Qualitative themes were identified following review of interview notes. Descriptive statistics and Chi square analysis were conducted in R Studio Version 4.4.2. Results: Analysis of qualitative interviews yielded 5 major themes revolving around communication difficulties based on quotes from athletes/caregivers. Survey results for multiple-choice questions demonstrated room for improvement in several areas. Most notably, respondents reported overwhelming negative experiences with communication and positive experiences with access to care and provider availability. Conclusion: Despite positive responses regarding healthcare logistics, additional work is needed on provider training and ensuring patients with IDD are communicated with effectively and appropriately. Interviewees frequently remarked on feeling overlooked during appointments. Future directions include developing such training and implementing it for all medical providers.

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  Understanding the Challenges and Motivations for Dentists to Practice in Rural Vermont: A Study on Recruitment and Retention in Windham County

  Kartheek Batch, Alison Chivers, Aaron Dees, Kiersten Donovan, Matthew Mullen, Estefania Obando, Harjas Sabharwal, Marty Hammond, and Carolyn Taylor-Olsen M.D.

  Background: Rural populations often experience limited access to healthcare due to a shortage of providers, financial constraints, and logistical barriers. Windham County in Southeast Vermont exemplifies these challenges, with only 50 dentists per 100,000 people compared to the national average of 60 per 100,000. The objective of this project is to identify the barriers to recruiting and retaining dentists in rural Vermont, focusing on understanding what factors motivate dentists to practice in underserved areas and what obstacles discourage them. Methods: This study incorporated a literature review, interviews with rural dentists in Windham County, and surveys of dental residents at the University of Vermont. Interviews identified challenges such as geographic isolation, financial pressures, staffing shortages, and integration difficulties within rural communities. Survey responses provided additional insights into perceptions of rural practice, highlighting both barriers and motivators for recruiting and retaining dentists in underserved areas. Results: Key barriers to rural dental practice included the high cost of dental education, low Medicaid reimbursement rates, and limited professional support networks. However, several dentists cited a strong sense of community and personal fulfillment from serving a close-knit population as positive factors that improve retention. Conclusion: Analysis of the survey responses suggests that targeted financial incentives, community integration efforts, and support networks may help attract more dental professionals to Windham County and similar rural areas.

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  Community-Sponsored Cannabis Education for Older Vermonters: An Investigation of Community Needs and Available Resources

  Ivan Davis, Raihan Kabir, Benjamin Koren, Maxime Lapointe-Gagner, Isabel Thomas, Merisah Trisciuzzi, Serena Verma, Andrew Warfied, Abigail Hielscher PhD, Mahat Abdullahi, Camille Bakoulis, and Amy Carmol

  Background: Cannabis use among older adults is increasing, driven in part by recreational-use legalization and evolving norms. Considering the public health impact of substance-related resources, this study investigated how community service providers are informing older adults in Vermont about cannabis. Methods: Non-medical service organizations in Chittenden County were identified in partnership with United Way of Northwest Vermont. Representatives from 58 eligible organizations were contacted. Descriptive categorical data from a seven-question, multiple-selection survey were summarized. Results: Thirteen organizations completed the survey. Forty-six percent predominantly served older adults (>50%); none offered information on cannabis. Substance-related resources were largely distributed by organizations that provided basic needs (50%) and/or community services (60%). There was overlap between organizations currently sharing substance-related materials and those interested in providing information on cannabis if made available: most sites with nicotine materials (75%) and all sites with opioid and alcohol resources indicated interest. Overall, most organizations (62%) indicated a readiness to distribute materials on cannabis education. Conclusion: Organizations serving older Vermonters lack educational resources on cannabis. However, most organizations engaged in substance education express an interest in incorporating information on cannabis. Targeted distribution of cannabis-related materials is a feasible public health solution.

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  Understanding Veterans’ Preferences for Firearm Safety Conversations: Developing Culturally Conscious Approaches to Suicide Prevention

  Joseph Du, Shannon Bennet, Taylor Krause, Jaime Rodriguez, Carlos Montejo, Amir Zafaranian, Nick Jowkar, and Sean Britton

  Background: United States military veterans suffer a disproportionately high suicide rate compared to the general population. Firearms represented the majority of lethal means involved in successful suicide attempts in veterans from 2001 to 2022. Communication with firearm owning patients is often difficult with a prevalent distrust of providers during interviews. For the provider, lack of training can lead to hesitancy approaching the topic. Once provided training, providers self-report more confidence speaking to the topic. Methods: A survey and interview guideline were designed using data from a literature search focusing on veteran suicide and firearm owning cultural competency. Data collection was performed with community partners and a convenience sample of veterans, active military, and reservists. Raw data was coded for thematic similarities and trends in themes were analyzed for formal results. Results: 11 total valid responses were obtained. Physician questioning is preferred when there are concerns on safety at home. Veterans are generally in favor of lethal means safety discussions, emphasizing the need for safe and secure storage, especially when children are present in the household. Participants preferred nonconfrontational language that emphasizes firearms being discussed in the same tone as other lethal means like medications. Participants also prefer conversations with trusted providers who have knowledge of veteran culture and of firearms safety. Conclusion: Themes are supported by existing literature on the general population. Further studies should include a larger sample and focus on elucidating cultural touchpoints that firearm owning veterans would find relatable to create and disseminate lethal means safety resources.

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  Antibiotic Stewardship in Vermont: Prescribers’ Attitudes and Perceptions

  Andries Feder; Arya Kale; Saim Ali; Francisco Cordero; Erin Manogaran; Martin Briche; Ranya Moshashaian; Sarah Chiavacci; Patsy Kelso PhD; Allison Lafferty MD; and Jan K. Carney MD, MPH

  Background: Antibiotic stewardship is essential for minimizing the adverse effects of inappropriate prescribing, including the emergence of drug-resistant pathogens and iatrogenic C. Difficile infection. In collaboration with the Vermont Department of Health, we surveyed Vermont prescribers' perceptions and attitudes towards antibiotic resistance and stewardship initiatives. Methods: We conducted a statewide survey of 82 practicing prescribers in Vermont, distributed via messaging from the Vermont Department of Health. Regression models were used to analyze statistically significant trends. Results: Respondents included physicians, nurse practitioners, dentists, and physician assistants. Most respondents (85%) agreed that antibiotic resistance was a concern for their practice. However, fewer (52.5%) agreed that inappropriate prescribing was an issue in their practice. Physicians had the highest proportion of respondents who disagreed that inappropriate antibiotic prescribing was a concern in their practice, but had the highest share agree that antibiotic resistance was a concern. Conclusion: Healthcare providers’ perception that inappropriate prescribing is not an issue in their workplace presents a challenge for implementing effective antibiotic stewardship measures. Out of all proposed interventions, most respondents (86%) indicated that instruction on how and when to de-label a penicillin allergy in the medical record would be a useful stewardship strategy. Targeted educational interventions, specialty-specific guidelines, and regional collaborations within the medical community can better improve antibiotic stewardship.

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  Healthcare Workforce Implications of State Reproductive Health Policies

  Varsha Pudi, Jeremiah Bates, Jonathon Woo, Kristin Reed, Ian Kent, Oliver Koch, Nicholas Khoo, and Claudia Tarrant

  Background: Since the 2022 Dobbs decision there has been an increase in self-managed medication abortions, out of state travel to obtain abortions, and heightened burden in states where abortion remains legal. Concurrently, applications to OBGYN residency programs in abortion-restricted states declined. There is a need to understand medical provider preparedness and willingness to manage complications of self-managed abortions, and to examine the potential impacts to healthcare workforce development. Methods: Surveys were developed for practicing health professionals and trainees, with input from representatives of the target audiences. Surveys were distributed to Vermont Primary Care Providers (PCPs), including MDs, APRNs, and PAs, as well as medical trainees (UVM medical students and residents). Data were analyzed using Stata analytical software and Excel. Results: We explored generational differences in attitudes regarding reproductive healthcare. Younger generations reported greater familiarity with potential complications following a medication abortion, stronger interest in learning more about these complications, and a greater willingness to expand their scope of practice to ensure safe access to care while PCPs born between 1945-1964 (Baby Boomers) reported less familiarity and interest. Respondents reported that state-based reproductive policies influence their decisions regarding where they would practice. Conclusion: These data highlight the influence of reproductive healthcare policy on the career decisions of current and future healthcare providers, and underscore the impacts on provider scope of practice, training priorities, and career decisions across generations. Adapting PCP training and continuing education to respond to emerging legislation will be required to ensure access to safe reproductive healthcare.

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  Barriers and Facilitators to Improving Free Menstrual Product Distribution in Vermont Schools Post-Legislation

  Rhea Puthumana, Claire Baptiste, Nicki Nikkhoy, Julia Hurley, Mikayla Howie, Kimberly Bau, Sulekha Kilas, and Nancy Kaplan MS

  Background: Lack of menstrual product access forces female students, particularly trans and non-binary students, to face social and emotional distress, possibly resulting in educational gaps. Vermont’s recent legislature (Title 16: Education Chapter 031) designated menstrual products to be accessible in both women's and gender-neutral bathrooms at no cost; schools are responsible for cost, and school nurses primarily handle implementation. Methods: We conducted a literature review and interviewed two Vermont school staff members involved in implementation. We then surveyed Vermont school nurses to assess their experiences with implementing period product access in compliance with the legislation. Frequencies and chi-squared tests were used to analyze the data. Results: Among 89 school nurses (93% female, 64% aged 40-59), 66% were aware of the original Vermont legislation, primarily through the Vermont State School Nurses Association (58%). Awareness of the initial Vermont legislation is significantly associated with the presence of products in any bathrooms (p<0.01). Of those aware, 66% also knew of the legislative update mandating products in gender-neutral bathrooms, with a strong association between awareness and availability in these spaces (p<0.001). Facilitators for providing products include school budget (62%), staff support (56%), classroom discussions (49%), and working with facilities (45%). Barriers include lack of funding (41%) with some nurses relying on community donations (23%) or purchases out of pocket (17%) to sustain access. Product misuse (21%) and improper disposal (7%) were also noted as areas of concern. Conclusion: Legislation implementation has been hindered by awareness and funding. Additional efforts to raise awareness are recommended.

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  Assessing Cancer Prevention Knowledge During COVID-19 Pandemic

  Robert Anthony Adamian, Lily Deng, Nicholas W. Krant, Trevor AR McDonald, Natalie Qin, Ally Sarkis, and Althea Jem Darbin Tapales

  In response to the COVID-19 pandemic, adjustments in the provision of health care resources have caused a significant decrease in cancer screenings. These missed screenings may have considerable impacts on patients, health care practitioners and health systems.

  In addition to the importance of resuming timely screening, studies have shown that a large portion of cancer deaths stemming from breast, skin, and colorectal cancer are preventable by risk factor modification at the patient level.

  Many people remain uncertain of how best to prevent cancers, despite general awareness of concerns.

  Raising awareness can empower patients to reduce their risk factors for developing breast, skin and colorectal cancer.

  It has been shown that increased knowledge of colorectal cancer screening leads to increased participation in early screening, which can lead to better overall outcomes.

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  Initial Assessment of a Suicide Prevention Resource for Vermont Primary Care

  Sam Afshari, Eliot Binkerd-Dale, Zain Chaudry, Varun Gupta, Morgan Howlett, Colleen McCarthy, Benjamin N. Price, and Rebecca B. Rawlings

  Suicide is the second leading cause of death for Vermonters ages 10-44. Studies have shown that of those who die from suicide 45% have seen their primary care provider in the month prior to their death and only 20% saw a mental health provider.

  To help strengthen suicide risk screening in primary care, a group of Larner College of Medicine students partnered with Chittenden Accountable Community for Health to curate a suicide prevention informational resource to be used in Vermont's primary care practices to promote universal suicide screening.

  We then surveyed users of the tool to assess its utility and identify barriers to suicide screening within their practices.

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  Age Well: Home Health Care Shortages in Northwestern VT during the COVID-19 Pandemic

  Jeremy Altman, Matthew Breseman, Edom Alemayehu Girma, Alexander M. Kubacki, Louisa Moore, Amanda Nattress, Noah Sorkow, and Kristen Wright

  As of February 2021, there have been over 26.6 million cases and over 450,000 deaths in the United States due to COVID-19. Since the outbreak, a critical focus in the healthcare system has shifted towards protection of healthcare providers as well as vulnerable patients such as the elderly. The growing shortages of providers has resulted in a growing need for home health care (HHC). Beyond HHC addressing this workforce gap, evidence has shown a reduction in emergency department (ED) visits, hospital admissions and a 14- million-dollar savings in healthcare cost. While the role of HHC has been crucial for the efficacy of the healthcare system, like many other sectors, the COVID-19 pandemic has resulted in unforeseen challenges. According to a 2020 survey conducted by Home Health Care News, 92% of HHC agencies have lost a substantial amount of revenues due to shortage of resources in addition to an increase in patient and caregiver anxiety.

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  Motivators for Convalescent Plasma Donors during the COVID-19 Pandemic

  Betsy Assoumou, Natalie J. Bales, Amy K. Chang, Hannah K. Cook, Kiana Heredia, and Colby J. Fischer

  This study will seek to explore the motivators for convalescent plasma donors during the COVID-19 pandemic.

  In 2020, the global pandemic caused by SARS-CoV-2 increased donations of transfusion products, particularly convalescent plasma from COVID-19 survivors that is used to provide passive antibody immunity to those infected. Convalescent plasma therapy has been identified as one of the only therapies for COVID-19 beyond supportive care.

  Much of the current research focuses on the current motivators of whole blood and plasma donations, commonly citing altruistic motivations, knowing someone who has previously donated, and social media influence as common motivators for donations.

  It is important to explore not only what motivates COVID-19 survivors to initially donate plasma, but also the motivations of repeat donors. By gaining a greater understanding of what these motivators are, we may be able to convert these convalescent plasma donors to regular blood donors.

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  Addressing Food Insecurity Within New American Communities in Vermont

  Lorena Ayoub, Carl W. Brasch, Aria Elahi, Justin L. Esteban, Juwairiyyah Fatima, Brianna J. Spano, Sean Wang, and Erik J. Zhang

  Food insecurity is defined as not having safe, nutritious, or culturally appropriate foods available, or having limited ability to acquire these foods/uncertainty as to when one can acquire these foods.

  Reasons for food insecurity can be multifactorial such as language barriers, unfamiliar foods, and limited information about food environments.As a result, many turn to processed and energy- dense foods, contributing to the development of chronic diseases.

  Food banks and local food shelves provide supplemental food assistance to residents and communities in need. However, with diverse New American populations living within the same community, it is challenging to determine which foods best fit their needs.

  Vermont has welcomed 535 refugees in the last 4 years. Many of these new Americans currently reside in Winooski and Burlington. This study seeks to address the issues of mental health, food insecurity, access to the food shelf, and food preferences within the New American communities located in Winooski, Vermont.

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  Perceptions of Mask Use During the COVID-19 Pandemic

  David Bachoy, Clara Berard, Nicholas D. Brunette, Sadie M. Casale, Tonya Conley, Krystal Gopaul, Tyler Landman, and Rhys Niedecker

  The CDC recommends covering of the face and nose during the COVID-19 pandemic as a primary mitigation strategy for viral transmission. Masks minimize the number of viral particles emitted by the wearer; mask use serves to reduce the effects on population transmission.

  Mask wearing behaviors have been shown to vary across different groups like gender identity, however, differences between people with and without lung disease have yet to be explored.

  Goal: Examine perceptions, attitudes, and behaviors related to mask use during the COVID-19 pandemic of those with and without lung disease nationally.

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  Health Benefits Are Associated With Employment Status For People With Intellectual Disabilities

  Rachel Bombardier, Mialovena C. Exume, Jeremy Frank, Timothy W. Greenfield, Kaela Mohardt, Nathan Schweitzer, and Devan Spence

  Recent studies demonstrate that people with developmental disabilities are at increased risk for preventable illnesses. In our study, we examined several variables suspected to be major contributing factors, with emphasis on job security and employment. The development of sheltered workshops was initially an attempt to promote employment opportunities for people with intellectual and developmental disabilities (IDD), though at subminimum wages.

  We explored whether these workshops allow for adequate community and healthcare engagement that is necessary for overall health and wellbeing. We designed a study that allowed us to statistically compare health-related data among states that eliminated sheltered workshops with those continuing this practice. These results were compared with internally available data (N=79) at Champlain Community Services (CCS), a specialized employment organization in Vermont serving people with IDD. We quantified health outcomes based on Medicaid standards which include annual wellness visits with a PCP, annual dental visits, and ensuring individuals are up to date on vaccinations. Additionally, we quantified other predictors for general wellbeing including current smoking status and body mass index (BMI).

  The results of our study indicated that people with IDD from states that have eliminated sheltered workshops tend to have better health outcomes with notable exemplary outcomes in consumers involved with CCS.

  We anticipate the results of this study will assist organizations, such as CCS, by articulating the impact of sheltered workshops on people living with IDD and receiving subminimum wage.

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  Bridging the Gap: Improving the relationship between social service organizations and healthcare providers

  Gabriela Bosmenier Cruz, Linda L. Cui, Liberty J. Dupuis, Ian Guertin, S. Halsey, Ying K. Loo, Finlay Pilcher, and Joaquin Reategui

  In Vermont, a significant social determinant of health is rurality. Barriers to healthcare services include distance to providers, lack of integration with social services, and failure to recognize community needs.

  Integration and robust collaboration between healthcare and social services can likely improve outcomes for individuals who have high utilization of both categories of services.

  Understanding relationships between healthcare and social services may provide an important framework for translating interventional research to rural communities to improve health equity.

  Project Goal: To understand barriers affecting collaboration between social service providers and community health providers in order to promote research-based improvements in health outcomes in rural populations.

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  Vermont School Districts Meal Service Response to COVID-19

  Stephen Brand, Will D. Buick, John E. Fernan, Gina Jin, Rebecca Lapides, Jennifer Lor, Paul McCleary, and Timothy L. Long

  The COVID-19 pandemic has posed many challenges worldwide, including lack of food access and security. Food insecurity in Vermont has increased from 18% to 24% since the outbreak of the pandemic.

  Food insecurity among families with school-aged children puts children at risk for developmental delays, poor social functioning, and poor academic performance.

  The goal of this project is to identify the challenges that the COVID-19 pandemic has posed for meal distribution services in school districts across Vermont, recognize the adaptations that were made by schools to address these challenges, and determine which adaptations had positive effects to encourage widespread implementation of these and other strategies to maximize food security for school-aged children nationwide.

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  Attitudes Toward Informational Health Videos among People with Intellectual Disabilities

  Sydney M. Cardozo, Julie P. Connor, Jake Ermolovich, Tyler A. Harkness BS, Anneliese Lapides, Jack F. Mangan, Nicole Obongo, and Maxwell T. Tulimieri

  An intellectual disability (ID) can be defined as a limit to a person's ability to learn and function in daily life when compared to an expected level. Due to these differences, a person with ID can face more challenges in daily life, including those that impact their health.

  Special Olympics Vermont (SOVT) is an organization that hosts athletic events and competitions for people with an ID. We worked with them to formulate a plan for providing educational resources for people with an ID.

  We created educational videos with corresponding one-page pamphlets containing material and imagery that was relatable to the athletes with ID, to inspire positive changes in their health habits.

  We hypothesized that if content and material relatable to SOVT athletes were incorporated into health education videos, then athletes would learn more about healthy habits that they could apply to their lives.

  We created surveys that evaluated the reception of the educational videos, whether athletes learned from the videos, and if they planned on incorporating what they learned into their lives.

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  Improving the Accessibility and Efficacy of the UVMMC CHNA to Populations Experiencing Homelessness

  Rachel Carpenter, Jamie A. Cyr, William Kim, Megala Loganathan, Weida Ma, Dinukie-Chantal Perera, Sean Taylor, and William J. Yakubik III

  Under provisions in the Affordable Care Act, tax-exempt hospitals are required to conduct a triennial Community Health Needs Assessment (CHNA) to identify and prioritize the health needs of the community served. UVMMC is preparing to conduct the 2022 CHNA and is exploring best outreach approaches to marginalized or historically underrepresented populations within Chittenden and Grand Isle counties.

  Research Question: What actions can be taken to effectively understand the diversity of needs in the homeless population of Chittenden County?

  Hypothesis: The current CHNA incompletely captures how health barriers are disproportionately experienced by the homeless population in Chittenden County.

  Goals: Identify best practices and tailor outreach methods to better assess the needs of the homeless population.

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  No Fall Too Small: Assessing Barriers to Fall Prevention Programs

  Christina Cobb, Arley Donovan, Heather G. Giguere, Arjune Singh Nibber, Brian L. Shaw II, Aathman Swaminathan, and Ryan Warner

  In Vermont, 1/3 of adults 45 years or older fell in the year 2018, statistically above the national average, which has not changed since 2012. Of those who fell, 34% experienced an injury after their fall.

  Evidence-based interventions and fall prevention programs effectively reduce falls, and these programs aimed at reducing falls appear to reduce fractures. In fact, it has been shown that exercise intervention reduces fall risk by 30%.

  Our review of the literature highlighted that there are numerous barriers to accessing fall prevention programs, including loss of independence, transportation, cost, and lack of interest. With this in mind, we investigated the potential barriers to accessing and attending fall prevention programs in Vermont.

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  Naturopathic Medicine in Vermont's Healthcare System: A Thematic Analysis

  Trevor D. Coles, Tayler Drake, Rose Eiduson, Daniel J. Fried, Max C. HoddWells, Simran Kalsi M.S., Mahima R. Poreddy, and Clifford A. Reilly

  Naturopathic Medicine is a system of health care that utilizes education, natural medicines, and natural therapies to support and stimulate a patient's intrinsic self-healing processes and prevents, diagnoses, and treats human health conditions, injuries, and pain.

  There are 5 accredited schools of naturopathic medicine in the US and 2 in Canada. Naturopathic physicians were recognized as primary care providers (PCP) in 2009. There are 355 NDs licensed in VT, and 88 NDs with a VT address. 81% participate in Medicaid.

  OBJECTIVE: To explore the role of naturopathic physicians in Vermont's healthcare system

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  Addressing the Needs of Sara Holbrook Community Center Caregivers

  Stephen J. Foley, Shubhankar Joshi, Ankrish Milne, Izabella Ostrowski, William Robinson, John A. Steinharter MS, Rachel A. Wayne, and Alayna M. Westcom

  Previous research: parental stress can negatively impact behavioral and cognitive development of children.

  Each year, over 4,000 people use SHCC resources: preschool, after school care, teen programs, food shelf, ESL services, etc.

  SHCC supports families at the center itself, but many families still experience difficulties at home that contribute to caregiver stress.

  The purpose of this study: understand the needs of the caregivers of students who attend SHCC and propose actionable solutions to address the top identified needs.

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  Assessment of SNAP Utilization and Accessibility in Vermont

  Amanda Galenkamp, Mohamad K. Hamze, Elie Kaadi, Elise A. Prehoda, W. Evan Shaw, Nicole A. Walch, Shari J. Zaslow, and Paula Tracy

  Food insecurity exemplifies one of the many public health crises that the COVID19 pandemic both exposed and amplified. In 2019 an estimated 10.5% of households (13.7 million households) were food insecure as determined by the US Department of Agriculture (USDA) including 5.3 million children. In 2020 this number increased to 15.6% of households, including 17.0 million children as projected by Feeding America. Food insecurity in children, especially in infancy, is associated with the development of obesity and hyperlipidemia, highlighting the necessity of federal and state food assistance programs.

  We believe that increased funding for SNAP incentive programs and wireless EBT devices for Farmers will result in a longitudinal and sustainable increase in produce consumption among low income individuals in VT. We hypothesize such changes will ultimately result in improved health outcomes and decreased burden on Vermont Medicaid systems.

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  Analyzing the Outcomes of a Comprehensive Pain Management Program

  Alia Johnson, Joshua Kohan, Cole Lutz, Patrick McClurg, Grace Merritt, Warrick Sahene, and Katie Tang

  An integrative and comprehensive approach to pain management seeks to advance patient outcomes with respect to quality of life, pain management, mindfulness, and physical function. This biopsychosocial approach is an evidence-based medicine modality that has been executed to be cost-effective and targeted to meet individual patient values. Participants can enroll in integrative pain intervention modalities to treat their chronic ailments; examples include Acceptance and Commitment Therapy, PT, OT, nutrition, reiki, hypnosis and yoga. In a systematic evaluation of integrative health projects, Turk et al. concluded interdisciplinary programs yielded better outcomes than traditional pain treatments.

  This project tested the hypothesis that the UVMMC Comprehensive Pain Program produces beneficial patient outcomes with respect to pain management. We evaluated pre- and post- patient physical function, levels of anxiety, fatigue, sleep disturbance, and social role engagement.

  Based on our data, we believe further investigation into the benefits of Integrative Medicine is warranted for the advancement of patient outcomes with respect to pain management.

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  What’s Going on with E-cigarette use in Vermont High Schools?

  Fay Abdullah, Elizabeth Baumgartner, Delaney Curran, Noorin Damji, Madeline Fritz, Catherine Gereg, Ray Mak, Shayan McGee, Alex Crimmin, and David Kaminsky

  The use of electronic cigarettes (e cigarettes) has become popular practice among teenagers in the United States. E cigarettes have been marketed as a “healthier” alternative to traditional cigarettes and include several flavor options to make them more appealing to teenagers. However, studies have shown that e cigarettes are still harmful, leading to addiction, nausea, vomiting, headache, and upper airway irritation. Most recently, the outbreak of severe lung illnesses is believed to be related to e cigarette use; the CDC and FDA are investigating the cause of this outbreak.