Matthew Charles Hill Brandt
Utilization of a poster in a primary care exam room advertising Physical Therapy Exercise Evaluations in an effort to help patients overcome barriers to exercising. The goal of the project is to capture people in the contemplative/preparatory stage of behavior change and help them reach the action and maintenance phases to improve health.
The 21st Century Cures Act enacted new protocols in Spring 2021 requiring all patient notes and reports to be made available electronically as soon as they are finalized. In order to study the initial impact of this change on physician burden, a survey was sent out to Burlington, VT providers to assess impacts to their workflow.
Refugees experience profound hardship in their home-country, displaced country and throughout the period of re-settlement. Experiences like direct or indirect exposure to traumatic events, torture, sexual abuse and stigmatized refugee identity post-resttlement are major risk factors for the development of mental health coniditions inlcuding PTSD, depression and psychosis. Despite major risk factors for the development of mental health conditions, culturally-specific mental health stigma persists as a major barrier to addressing mental health among refugees. This project emphasizes techniques and self-education that can be utilized to improve mentah health screening and identification among refugee patients in Vermont.
Anna B. Chamby
Primary and secondary prevention are vitally important mainstays of primary care. Every well visit at Newtown Primary Care involved some discussion of preventive health screening and services and relied on patient recall or EHR document search for last screening/intervention dates. We aimed to find ways to make use of wait times for in-office visits that could also potentially improve efficiency during patient encounters and help educate patients about preventive health measures.
Kelly J. Chan
Stroke is one of the leading causes of mortality and disability in the USA. Underlying conditions such as hypertension, diabetes and cardiovascular disease predispose an individual to increased risk of stroke. In addition, the Covid-19 pandemic presents many challenges to these patients in terms of active health management and maintenance. A screening tool was developed to assess patient patterns of lifestyle behavioral changes measured by modifiable risk factors for stroke (medical condition management, diet, exercise, and smoking habits).
Improving Access to Meditation and Mindfulness for the Management of Anxiety, Stress, and other Chronic Diseases
Alex Cohen and Jesse Naumann
Chronic diseases can have an enormous burden on not only an individual’s quality of life, but their economic output as well. The challenge is that many patients with a chronic disease are not fully treated despite many different medications and doctor’s appointments. Mindfulness is an extremely beneficial tool that can be used as an adjunctive treatment for different chronic health diseases including anxiety, depression, insomnia, chronic pain, and many others. An enormous barrier is that many patients are unsure about what mindfulness truly is, and where one can go about accessing mindfulness resources. Our goal was to create a quick and easy smart phrase that providers can add to any after-visit summary that provides basic information about mindfulness, different resources to access free mindfulness meditations, and our own unique 8 minute mindfulness meditation for patients to try free of charge.
Kangaroo Care in the Community: Creating antenatal informational resources for providers and expectant parents
Obstetric care providers at the Community Health Centers of Burlington create, implement, and coordinate resources to help support parents through pregnancy, delivery, and child rearing. The COVID-19 pandemic has altered the accessibility of existing resources, exacerbating the need for creative support of prenatal learning, breastfeeding, and postpartum socialization. Regular skin-to-skin contact between newborn infants and their parents is a low-cost, low-risk intervention with demonstrated benefits to breastfeeding, infant and parent physiology, emotional health, and bonding. This project aimed to establish antenatal informational resources for providers and expectant parents about the potential benefits of skin-to-skin care in the community setting.
Nutrition plays a crucial role in development of diseases that are the leading causes of morbidity and mortality in the Unites States. However, due to reasons such as time limitations, lack of clear guidelines, and what seems like a sense of hopelessness felt by providers and patients alike upon lack of results, discussions around nutrition may lack in frequency, consistency, and/or adequacy of duration, Research shows that flexibility of mindset, as well as achievability and sustainability of nutritional goals, play a key role in achieving success in weight This project proposes a three-page document that can potentially help primary care providers support and monitor nutritional behavioral changes determined by their patients.
Prevalence of mental health issues has increased during the time of COVID-19. There are many contributing factors to consider, the main one reported has been social isolation due to quarantine precautions. Members of the community have spent extended periods of time at home and away from their loved ones during this pandemic. Many patients have reported many life events occurring including deaths in the family without the ability to even mourn with their family members. This has taken a toll on the community, especially in Vergennes where this small tight knit community that has relied on its tight social bonds for wellness. There has been a trend of depressive symptoms rising in the community as well as an increase in reported anxiety. There is a shortage of mental health services through therapists and psychiatrists during this time, and a possible solution is the use of technology, specifically phone apps to aid with mental health concerns for members of the community who are unable to meet with a specialist. This project consists of a handout containing 7 apps for mental wellbeing reviewed by the Anxiety and Depression Association of America (ADAA).
Brad R. Fiske
Conversion of research protocol into QI project at Norwalk Community Health Center. Goal is to implement waist circumference as a vital sign.
This project is a continuation from the Addressing COVID-19 Vaccine Hesitancy project. As time has progressed since the Pfizer, Moderna, and Johnson & Johnson vaccine were first distributed in the United States, more individuals are getting vaccinated. However, there is still many individuals who are hesitant to get the COVID-19 vaccine. CDC has been addressing this by encouraging medical providers to educate their patients about COVID-19 and the COVID-19 vaccines. With the recall and resumption of Johnson and Johnson, engaging in conversations about the mRNA vaccine technology, efficacy, and safety of the vaccines may help reduce public hesitancy. An educational handout that was created by a prior medical student was distributed at the Brookfield Family Practice. A survey was created and distributed to the patients. The survey looked at patients’ demographics, if patients were vaccinated, and whether the handout provided guidance in understanding more about COVID-19 and the vaccines.
Aram S. Garewal
COVID-19 vaccine hesitancy in the United States is a major roadblock in the fight against a raging pandemic. Education on mRNA vaccine technology, efficacy, and safety may help reduce public hesitancy. An educational handout was created and distributed at the Brookfield Family Practice to help alleviate COVID-19 vaccine hesitancy in the local community.
Updating Evidence-Based Patient Education Resources for Sleep: Sleep Hygiene and Benzodiazepine Discontinuation
Carolyn Geraci and Madeline Fritz
There is a major need for patient education around the topics of sleep hygiene and benzodiazepine sleep aid discontinuation in the family medicine clinic setting. Current patient-focused educational materials need updating and are not comprehensive enough. We therefore created new handouts and smartphrases which integrate into the electronic medical record system with the goal of educating patients on these topics.
Evaluation of growth in clinical genetics competency among PCPs participating in the UVMHN Genomic DNA Testing Program
Recently UVM Health Network Family Medicine practices have implemented “The Genomic DNA Test” pilot program to begin a concerted effort toward offering genetically informed primary care to all patients. The program aims to increase the number of participating primary care providers stepwise over time. However, some providers may find integration of genomic testing and discussion of clinical genetics issues with patients to be challenging given the relatively recent change toward emphasis on these topics in medical training curricula. The aim of this project was to develop a pilot survey to gather information from current participating providers about how participation in the genomic testing program has influenced their personal knowledge of and comfort with clinical genetics topics and patient counseling.
Increasing Patient Access to LGBTQ+ Healthcare through Expanding the Vermont Diversity Health Project
Numerous studies have documented various disparities in health outcomes and barriers to healthcare access for LGBTQ+ individuals. One major way to combat this is to increase access to healthcare for LGBTQ+ patients and increase provider knowledge of how to best care for them. Through expanding the Vermont Diversity Health Project database of providers and having providers participate in LGBTQ+ Best Practices trainings (both hosted by Pride Center of Vermont), we may reduce LGBTQ+ health disparities in our local community.
obhijit d. hazarika
Catrina Hood and Jacob Shaw M.D.
The Reach Out and Read (ROR) program is an evidence-based model of literacy promotion used to deliver anticipatory literacy guidance and books to parents and caregivers of children, ages 6 months through 5 years, at well child visits with Primary Care Providers (PCP's). The objective of this project was to assess provider familiarity with and utilization of ROR at the Community Health Centers of Burlington (CHCB) via anonymous survey.
Smoking Cessation Associated Weight Gain: The Role of Diet and Exercise Counseling in Quitting Smoking
Benjamin D. Kagan
Weight gain is a common unintended consequence of quitting smoking due to a combination of physiologic and behavioral factors. Counseling focused on diet and exercise reduces weight gain associated with smoking cessation. Reduction of weight gain related to smoking cessation maximizes the health benefit of quitting tobacco.
Seasonal Affective Disorder (SAD) is a cyclical pattern of depression-like symptoms that occur during the winter months. In Vermont, SAD is estimated to affect up to 10% of individuals. An informational flyer was developed that explained the symptoms of SAD, what the treatment options are, and then linked individuals with local resources for wellness activities in Chittenden County using QR codes in order to prevent SAD. The flyer was distributed at the Community Health Care Centers of Burlington South End office. The flyer was met with enthusiasm and will be given out to patients at the end of this season and into the fall.
Elizabeth P. Lanata
Emma C. Levine and Taylor D. Marquis
The goal of this study was to look at health care providers perspectives on what the nutritional barriers patients with diabetes faced and compare that with the patient's perspectives. We also assessed patients knowledge on certain foods and if they have carbohydrates. We used this information to create a Notecard that could be given to patients.
Transgender individuals face disproportionate levels of discrimination in healthcare settings and have worse health than their cisgender peers. One major barrier to healthcare reported by transgender individuals is a lack of providers who are sufficiently knowledgeable on the topic. The 2011 National Transgender Discrimination Survey found that half of respondents reported having to teach their providers about their own healthcare. To address this problem in Vermont, transgender healthcare resources were compiled into a single document to be distributed to primary care practices around Vermont.
Oral health is a key component of overall systemic health. However, dental care remains a severely under met need in healthcare today, especially in rural settings. Thus, the primary care physician may find herself presented with a variety dental pathology and may feel underprepared for this challenge.
The purpose of this project is to develop concise, evidence based resources regarding the identification, stabilization, and management of common dental pathologies for the primary care physician. Additionally, a database of local resources for patients including basic oral care and local dental clinics for those without insurance will be compiled. This project will seek collaboration with local dental offices to provide expertise and feedback, and to foster an inter-professional dialogue. Preliminary responses from clinic staff has been overwhelmingly positive.
COVID-19 Vaccination: Educating Patients on Vaccine Availability and Distribution Plans in Lewiston, ME
In December 2020, the U.S. Food and Drug Administration issued emergency use authorizations for two COVID-19 vaccines. Many patients at the Central Maine Medical Center Family Medicine Residency clinic had questions related to the vaccines and the plans for vaccine distribution in Maine. With the prevalence of misinformation related to the COVID-19 vaccines on the internet, there existed a need for accurate, easily understandable information to assist with patient education about the vaccines.
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