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Expanding Awareness of TBI Resources in the North Country
Nicholas W. Krant
Disability, emotional dysregulation and financial stress are only some of the issues that many patients who suffer TBI encounter. While resources are available to alleviate some of these burdens on patients who suffer TBI in New York's North Country, patients often struggle to find these resources. This project endeavors to create a resource for patients, family members and practitioners to find available resources.
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Patient Pamphlet for Basic Lab Values
Robert A. Adamian
As a result of lab results being immediately available to patients online, many patients experience unnecessary anxiety when viewing their results before speaking with their physician. Misleading lab values and increased patient concerns lead to more time spent by physicians answering messages on EPIC, which adds to the burden of public health costs. To combat this, a double-sided pamphlet was made with quick high yield facts about lab data that patients can use for information in the time between seeing their results and communicating with their doctor.
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Improving Cardiovascular Health in Low Socioeconomic Status Women through the Vermont You First Program
Bradley M. Anair
Cardiovascular disease is the leading cause of death in men and women in the United States. Low socioeconomic status women are in a unique position because cardiovascular disease morbidity and mortality is higher in lower socioeconomic status groups, and the risks of cardiovascular disease are often underappreciated in women. This project aimed to improve cardiovascular health in low socioeconomic status women through increasing awareness of the Vermont You First program. This program covers the cost of screenings for cervical cancer, breast cancer, and heart disease for low socioeconomic status women. They also offer lifestyle perks to improve cardiovascular health. This intervention will help alleviate the financial obstacle that low socioeconomic status women face in achieving optimal cardiovascular health.
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Improving Healthcare for Coptic Egyptian Migrants
Lorena Ayoub
There is very little known about Coptic Egyptian migrant health in the current literature. Exploring health beliefs and behaviors in regard to seeking medical care is important. Additionally, understanding how the Coptic church plays a role in healthcare is essential as many Coptic individuals believe spirituality influences physical health.
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Transportation to Little Rivers Health Clinic in Wells River, Vermont
Anupama Balasubramanian
Transportation to healthcare appointments is one of the biggest challenges that rural patients face. Currently, there are no resources available to patients at Little Rivers Health Care that can help them with transportation-related knowledge. This project aims to create a guide that improves patients' understanding of the options they have available in getting to their appointments.
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Increasing Access of Outpatient Therapeutic Services for Adolescents With Persistent Symptoms After Sport-related Traumatic Brain Injury
Natalie J. Bales
Persistent symptoms lasting at least 21 days after initial traumatic brain injury occur in about 15-20% of adolescents. Initial assessment of concussions can be done using the SCAT5 and a wide variety of other standardized assessment tools. However, there are striking gaps in standard clinical procedure for follow-up care for athletes who have persistent symptoms. Furthermore, there are many issues with accessibility to therapeutic services including long wait times that prevent timely referral to those services. This pilot intervention was implemented at the University of Vermont to address those issues by providing a hotline resource for families to use and obtain faster and easier referrals to outpatient therapeutic services based on individual persistent symptoms.
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Transitioning to ASQ Online at Colchester Family Medicine
Katie Barker
Development screenings are an important part of well-child visits for early identification of a developmental delay. Early identification and appropriate intervention allow for better functional outcomes for patients, preventing the worsening of a delay. Currently, only 38% of these screenings are completed at Colchester Family Medicine. With the aid of Help Me Grow, a national organization dedicated to connecting families to community resources to allow children to reach their full potential, Colchester Family Medicine should transition to ASQ online, an online version of its current screening tool. This would increase completion rates, improve accuracy of results and allow for a better experience for both the patient and their families, and the providers.
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Obtaining a Gender-Affirming Sexual History with Gender Nonconforming and Transgender Patients
Gabriela Bosmenier Cruz
This project introduces a methodology to change how providers ask the 5 P's of a sexual history using gender-affirming language. Obtaining a gender-affirming sexual history will improve sexual health care, especially with gender nonconforming and transgender patients. Taking time to discuss sexual health and function can lead to prompt identification of sexual problems, risk-taking behaviors, and infection prevention. Using appropriate language to communicate with all patients can lead to better doctor-patient relationship.
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Patient Rights to Prescription Glasses
Louis Briones
Uncorrected Refractive Error (URE) accounts for vision loss in millions of Americans. Eyeglasses are the simplest and safest way to correct refractive errors. Prescription eyewear coverage is not universally covered across most health insurance policies. This project details Medicare and Vermont Medicaid coverage for Prescription Glasses. Also included is information outlining where to buy affordable frames and organizations in Vermont that can help acquire prescriptions not covered by insurance.
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Utilization of POCUS in Family Medicine at CMMC
Jacob P. Cappiello
Maine has a significant portion of patients who live in a rural area far from doctor’s offices and medical centers. Combined with a low SES population where transportation issues are common, POCUS can be an invaluable tool in an FM practice to reduce the number of appointments, and travel needed, for patients in need of healthcare. Access to Care was the number two health priority in the Franklin County community health needs assessment. This project surveyed family medicine practitioners at CMMC about their experience with, clinical use of, and willingness to continue education in POCUS. This survey had few respondents but found a low utilization of POCUS in Family Medicince practice and a high interest in POCUS continuing education. A POCUS quick reference was created and distributed to FM practitioners at CMMC.
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Continuity of Care in Rural Surgical Patients
Sydney M. Cardozo
Continuity of care is an integral part of patient care and is important for reducing morbidity and mortality following hospitalizations. Medical errors are common during transitions of care, and are most frequently caused by lack of suitable discharge planning and poor communication between surgical teams, patients, and primary care physicians. This project aims to create a new standardized note template for surgery teams to use when discharging patients, with the goal of augmenting communication and efficiency during transitions of care within and outside the UVM Health Network.
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Prescription Stimulants: Preventing Misuse Among Adults with ADHD
Sadie M. Casale
Stimulant drugs are a cornerstone in the treatment of Attention Deficit and Hyperactivity Disorder (ADHD) and are being prescribed at increasing rates. The safe prescription and use of these drugs by providers and patients alike is critically important to appropriately treating ADHD and preventing misuse. This presentation discusses how patients can be educated on the uses of stimulants and provides information on what to do in case of overdose. Additionally, resources for providers are provided to continue improving awareness of at-risk patients and community resources available to them.
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Building point of care ultrasound experience in a rural primary care network
Jamie A. Cyr
Point-of-care ultrasonography (POCUS) is a safe, noninvasive and accessible diagnostic technique. In the outpatient setting POCUS enables improve access to timely care, raises patient satisfaction, and reduces the need for costly tests. While application of POCUS is well established in the emergency department and intensive care unit, its use in ambulatory medicine is still emerging. Prior literature has shown that while many rural care offices have access to POCUS equipment, however, the technology is not being used to its full potential. Prior family medicine projects have identified barriers to the use of ultrasound in rural Vermont outpatient clinics. A lack of training was identified as the largest barrier to POCUS use in both 2019 and 2022. In this work we organized and hosted two POCUS training sessions focused on topics that could be utilized in the ambulatory care setting. Each participant attended one training. To assess the efficacy of our trainings, participants took a survey before and after trainings. Participants were asked to rate their confidence performing POCUS exams, their perceived utility of POCUS in their practice, their perceived utility of POCUS exam quick guides to refresh skills and their predictions as to how patients would perceive POCUS exams. We found that while there was no significant difference identified for perceived utility of POCUS in practice or predicted utility of quick guides, a single POCUS training session did result in a significant increase in reported confidence performing POCUS exams and prediction of a positive patient perception of POCUS exams.
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Naloxone Community Engagement Project
Olivia E. Domingue
This abstract focuses on the distribution of naloxone from Milton Family Medicine, a family medicine practice in rural Vermont. By interviewing representatives involved in the distribution of naloxone throughout the state, I pinpointed ways to best advertise naloxone to the patient community in Milton, provide information around harm reduction practices and naloxone administration and simultaneously dispel stigma regarding overdose prevention.
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Over-The-Counter Approval of Progestin-Only Pills
Hannah Grace Donovan
Most women in the United States use contraception at some point in their life. While there are many types of short- and long-acting reversible birth control options available via prescription, the oral contraceptive pill (OCP) remains the most used reversible contraceptive agent. The proportion of those using an OCP is inversely proportional with age; more specifically, people who can get pregnant between the ages of 15 and 29 use OCPs most frequently. However, people in this age range may face increased barriers to obtaining contraception, such as cost, insurance, social and familial factors, policy, transportation, and access to healthcare. In June of 2023, the FDA approved a progestin-only pill called OPill for over-the-counter sale. However, due to the nature of being available without a prescription, it is hypothesized that there is a lack of targeted information available for young adults to decide whether this is the right option for them without the traditional formal counseling by a medical practitioner. This community health project sought to bridge this educational gap by creating a booklet, colloquially known as a zine, that will be distributed to students at the University of Vermont. A study design has been proposed to evaluate the effectiveness of this intervention and to evaluate areas for further study and improvement.
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Colorectal Cancer Screening in the Primary Care Setting: Community Outreach to Improve Screening Rates
Liberty J. Dupuis
Colorectal cancer remains a leading cause of death from cancer in men and women in the U.S. and worldwide. Screening for colorectal cancer beginning at age 45 offers the opportunity for early intervention and decisive treatment for precancerous colon polyps as well as the early identification of cancer. This project aims to assess preferences around recommendations for colorectal cancer screening tests amongst a group of primary care providers as well as barriers that are commonly cited to those providers by patients who do not undergo or complete screening. The results of the provider survey were used to make recommendations for decreasing barriers to screening including setting timelines for returning take-home tests, improving instructions for testing, and expanding the number of referral sites for colonoscopy to reduce wait times. Additionally, an intervention involving patients who had not completed recommended colorectal cancer screening was implemented in the form of a letter advising patients of the current screening recommendations and informing them that a FIT test had been ordered for them to complete at their convenience.
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Expanding Awareness of Air Quality and Health Impacts in the Clinical Setting
Caitlin Early
Smoke from Canadian wildfires has greatly impacted the air quality in Vermont this year, 2023. Poor air quality can lead to an increase in inflammatory reactions in the body, for example increasing asthma and COPD exacerbations and causing symptoms in those with cardiovascular disease. This project aimed to improve awareness of the negative health impacts of poor air quality, particularly for those patients with existing lung and heart disease, those of older age, and children. This intervention sparked conversation between patients and providers to discuss symptoms, medication refills, and recommendations for poor air quality days. With lines of communication open and as more research on the impacts of wildfire smoke is completed, providers at the Hinesburg Family Medicine Clinic will be able to share more information and guidelines with their patients.
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Increasing Narcan Distribution in a Primary Care Setting
Charlotte Evans
Opioid use and overdoses are an ongoing health issue in Maine, especially in the Lewiston/Auburn metropolitan area. While Maine has a robust Narcan distribution system, it is not frequently given out in primary care settings. Though interviews and an anonymous survey, it seems the reason behind this is multifaceted, so multiple interventions were created to target both patient awareness and education and provider screening and prescription, with the goal of increasing distribution in this setting.
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Ordering Urgent Imaging In Outpatient Primary Care
Amanda Galenkamp
Current imaging order sets in EPIC allow for STAT (<48 >hours) or routine (4-6 weeks) radiology scheduling. Patients requiring urgent imaging often are not scheduled in a timely fashion and either re-present to the office or the ED. The goal of this project was to provide a standard operating procedure to providers and staff for patients requiring urgent imaging.
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Pamphlet of Preventative Immunization and Screening Recommendations for Adult Women
Annie Glessner-Fischer
This project seeks to consolidate common immunization recommendations and preventative screening recommendations for adult women 18 years and older, based on the U.S. Preventative Services Task Force and Centers for Disease Control and Prevention recommendations. This resource should be offered to patients of the primary care office, with the goal of providing information in a concise and approachable manner that allows patients to review general recommendations on their own, generate questions or express concerns about their health, and encourage patients to advocate for their own health and well-being. With this intervention, the broader goal is to increase immunization rates and adherence to recommended screenings in order to catch and address preventable health conditions sooner.
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Promoting Music Therapy Referrals for Neurodivergent Children
Benjamin M. Glickman
Music therapy is perhaps an underutilized, underfunded, and undervalued part of the tool kit available to physicians, parents and children with ASD and other developmental disabilities within Clinton County. There are opportunities to increase referrals for music therapy for children receiving care at the CVPH Family Medicine Center and within the county.
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