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Is there an app for that? Introducing Self-Guided Therapy-Based Mental Health Apps in a Primary Care Setting
Althea Jem Darbin Tapales
The prevalence of mental health disorders in Vermont continues to be an economic burden, especially in Addison County. The Addison County, VT Community Health Improvement Plan 2022-2025 identified “Access to Mental Health Services” as the top priority with a general concern regarding the affordability and demand of such services, and shortage of providers in the general community. Consequently, the shortage of mental health services along with the coronavirus pandemic resulted in a mental illness epidemic which led to an accelerated growth of self-guided therapy-based mental health apps. Most apps are affordable, accessible, and prioritize patient privacy which overcomes barriers to traditional mental health treatments such as cost, access, and stigma. Thus, the utilization of mental health apps not only offer a cost-efficient method for delivering empirically supported mental health interventions, but also serve as a potential solution in alleviating the mental health burden due to staff shortages across Vermont. However, such apps continue to be underutilized potentially due to provider and patient uncertainty in the effectiveness or credibility of such methods. Hence, providers, especially in-house psychologists/psychiatrists/behavior health specialists within primary care settings, require further advanced training on the APA framework as a screening tool to further guide the decision-making process around current evidence-based mental health apps and their potential use for low-risk psychiatric patients who are on their waiting list. The primary goal of this project is to generate a handout listing and briefly describing evidence-based and peer-reviewed therapy-based mental health apps that target various psychiatric conditions commonly encountered in a primary care setting in Addison County, VT using the OneMind PsyberGuide database and the updated APA evaluation framework criteria as guides. This handout can then serve as an accessible resource for both providers and patients seeking quality therapy-based mental health apps.
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Improving Access to Snowmobiling Safety Information
Sean Taylor
Snowmobiling is a common activity for rural people in areas like the North Country of New York state. There are inherent risks associated with an activity like snowmobiling, and a primary care office is a location at which patients and their families can be informed of recommendations from professional associations, state laws regarding the activity, and recommendations on safer practices and safety courses that are available. I modified an informational flyer that caters to patients in the Plattsburgh area of New York to try to encourage safer snowmobiling, especially for children.
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Anxiety Screening During At-Risk Ages of Development
Torrance Teng
Anxiety disorders, one of the most prevalent but still underdiagnosed mental health disorders, is often associated with other illnesses, both physical and mental conditions. Studies show that since the COVID-19 pandemic, incidence and prevalence of anxiety disorders have only increased, worsening the quality of life of people all around the world. This project explores the utility of implementing an anxiety screening to both identify at-risk individuals and assess what the perceived benefits of a screening would be from the patient perspective. The goal of this community health project is to help normalize mental health discussions while also promoting the community to obtain help and resources to better understand and cope with their anxiety.
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Alcohol Cessation Resources in Greater Danbury, CT
Rachel M. Thompson
There is an abundance of resources available to residents of the greater Danbury, CT area looking to reduce their alcohol consumption. However, a central repository of this information is lacking, and individuals seeking local services report feeling overwhelmed and confused by their search. This project aims to simplify the journey to getting help by providing patients at New Fairfield Primary Care with a brief physical pamphlet and extensive virtual database describing alcohol abuse and the variety of services available in their region. Supports detailed include medical providers, counselors, holistic therapies, hotlines, lifestyle changes, peer support groups, treatment centers, self-assessment quizzes, and more.
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Current Landscape of Screening for Abdominal Aortic Aneurysms in Females
Maxwell T. Tulimieri and John G. King
There is some controversy over if females are under-screened for abdominal aortic aneurysms (AAAs). The USPSTF 2019 AAA screening guidelines give an I recommendation for females 65-75 who smoke, yet the Society for Vascular Surgery (SVS) highly recommends with strong evidence a 1-time screening ultrasound for men or women age 65-75 with a tobacco history. This project entails a 10-minute recorded PowerPoint educational session for Milton Family Practice providers on the current landscape of AAA screening in females including differing practice guidelines and their histories, cause of said discrepancies, associated cost and insurance coverage, and suggested creative solutions to billing difficulties as well as provider response and feedback.
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Diabetic Foot Wound Care
Richard Q. Vuong
Diabetic foot wound care educational pamphlet developed during the family medicine rotation for 3rd-year medical students. This project was developed in Brookfield, CT.
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Affordable Housing in the Northeast Kingdom
Alayna M. Westcom
Housing is an important social determinant of health for each patient. Affordable housing can be hard to find in many rural areas across the state of Vermont. North Country Hospital identified affordable housing as one of the top community and social needs during the 2021 Community Needs Assessment.
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A Healthier Diet for Weight Loss
hannah White
Many patients presenting to clinic have the goal of weight loss to improve their health as obesity has many comorbidities. Many patients have multiple health concerns like Diabetes Mellitus, Hypertension, Hyperlipidemia, PCOS, or joint pain. Part of the management of their conditions include weight loss, but many patients struggle, for years, to lose weight. A referral to the Metabolic Weight Loss clinic in Newtown, which will provide patients with nutritional information, evidence based diets, medications, exercises, and more, can take up to 1 year to get an appointment. The goal of this project is to provide information to patients in clinic who are hoping to lose weight on strategies, nutritional education, tips and resources.
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Hazardous Materials in Firefighting: Educating the Exposed
Gregory J. Williams
This project interviewed volunteer firefighters at the Warren Fire Department to gain a better understanding of their concerns regarding exposure to chemicals while firefighting. It aims to provide information on mitigating the health risks posed by hazardous chemicals via a brochure.
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Suicide Screening at TCHC
William J. Yakubik III
Vermont is currently battling with a mental health epidemic and one of the consequences of mental illness is suicide and self-harm. According to the Vermont Department of Health Vermont’s suicide rate is higher than the national average and suicide is the 8th leading cause of death in the state. Every part of medicine especially primary care is struggling with providing adequate resources for the demand needed to provide quality mental health care. Thomas Chittenden Health Center (TCHC) is no stranger to these demands and is working on ways to ensure each patient has access to the care they need. The goal of this project was to create a screening tool to increase the ability of all providers to ensure the safety of their patients from self-harm. Utilizing various mental health and suicide screening questions a new screening tool was developed to be used for patients annually or those who have increased risk. This tool will then be used to help clinicians and staff at TCHC identify patients with suicidal ideation and navigate access to resources for those patients.
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Preventive Medicine Screening Measures
Isaac Adams
In order to make progress towards long-term health on a community level, it is imperative to address health needs on a population basis and using a preventive strategy to prevent the development of more serious illness. With this in mind, this project aimed to create a poster providing easy to understand information to patients with regard to health screenings. Specifically, it addressed screenings for diabetes and pre diabetes, colon cancer, lung cancer, and breast cancer.
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Improving Identification of Dermatological Conditions in Skin of Color
Sam Afshari B.S. and Simran Kalsi M.S.
Vermont primary care practitioners are less likely to have experience diagnosing dark skin tones given that the state population is 94.2% white. Only 4.5% of images in general medicine textbooks and 4-19% of images in dermatology textbooks depicted darker skin. Black patients are significantly less likely to see a dermatologist, which highlights the importance of diagnosis at the primary care office.
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The Diabetes Template
Samuel J. Aldous
This presentation describes the construction of a diabetes follow up note template. This template was designed to streamline these visits for practitioners to provide a comprehensive amount of data collection with maximum efficiency. This should allow for more time for practitioners to spend talking to patients and managing their care rather than collecting details from different sections of the patient's chart.
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Improving Home Medication Literacy and Communication
Jeremy Altman
As pharmaceutical companies continue to promote drugs through advertisements on various media, there is a need for physicians to help patients conduct safe and responsible medical research at home. Additionally, polypharmacy leads to potential confusion and medication errors made at home. A list of answers from Frequently Asked Questions has been curated to be added to an "After Visit Summary" to help patients navigate their research on medication from home while they wait to discuss with their physician.
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Improving Dental Health Screening in the Primary Care Setting
Kali Amoah
Oral health is an important part of systemic health that is often overlooked by patients due to various barriers to dental care. Dental caries is a public health crisis and one of the most common chronic diseases globally. Poor oral health and the resulting inflammation caused by oral bacteria is associated with cardiovascular disease, pregnancy complications, poor glycemic control in diabetes mellitus, and many more conditions. The goal of this project is to increase dental health screening in the primary care setting and to provide a list of affordable dental clinics in Vermont that take Medicaid/ Medicare and offer sliding scale payment options. With increased dental health screening in primary care offices, the hope is to detect dental pathology earlier on in the disease course and connect patients with dental clinics that provide affordable dental care.
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The Benefits of Outdoor Recreation and Selected Resources Around Hinesburg VT
Micaila Baroffio
Spending time outside has historically been associated with improved mental and physical health outcomes. However, research has shown that nature-based recreation has been decreasing in recent years. Healthcare providers hold a unique position in the ability to encourage patients to seek improvement in their health. Therefore, this research focused creating a pamphlet to improve awareness of the benefits of outdoor recreation and provide selected resources around Hinesburg VT.
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Tickborne Disease Prevention and Education
Clara Berard
Over the last decade, the incidence of tickborne disease has been increasing in Vermont and across the United States. Many people have questions and concerns about tickborne diseases that their healthcare providers don't have the time or knowledge to answer. By designing a way to efficiently distribute educational materials on tickborne diseases to patients, their questions and concerns can be more easily addressed.
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Improving Lyme Disease Literacy
Eliot Binkerd-Dale
Lyme disease and Tick-borne illnesses are a relevant and growing concern throughout New York State. There is considerable confusion surrounding the diagnosis and treatment of Lyme disease among the general public. This project aims to improve Lyme disease literacy among patients of a Family Medicine practice through after-visit education.
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Implementation LGBTQ+ Health Education Through Case-Based Learning
Bradley A. Blansky
Primary care graduate medical education programs often do not provide adequate training regarding the healthcare needs of the LGBTQ+ population. The purpose of this community project was to develop a case-based teaching session to help provide family medicine residents a basic understanding of LGBTQ+ healthcare. This didactic session was found to be an engaging and effective method of teaching physicians about LGBTQ+ health. Additional work is needed to further train physicians and other healthcare professionals about the challenges faced by marginalized populations in our healthcare system.
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Culturally Sensitive Carbohydrate Sources for Nepalese with Diabetes or Prediabetes
Rachel Bombardier
Over 8,000 refugees have started new lives in Vermont since 1980. Many of these people utilize the Community Health Centers of Burlington, for some this may be their first time navigating America's healthcare system. This is a daunting task due to a multitude of barriers, including missing cultural competencies in various aspects of their care. This project focuses on dietary recommendations for Nepalese patients with prediabetes and type 2 diabetes, specifically carbohydrate sources based on fiber content. Type 2 diabetes is a very prevalent chronic disease that costs Vermont $520 million each year. Understanding healthy food options in a culturally sensitive approach, will allow better care and recommendations for the Nepalese. A Nepalese-focused handout on carbohydrate sources was generated based on local Asian markets that they frequent.
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Promoting exercise in the elderly population through an informative handout
Stephen Brand
Physical activity has been shown to reduce risk of morbidity, mortality and prolongs life expectancy in the elderly population. However, many factors can inhibit one’s ability to exercise, including economic strain. Fortunately, a program known as SilverSneakers provides access to fitness centers and fitness classes designed for seniors which is included with certain eligible Medicare plans. This project aims to promote physical activity in patients aged 65 or greater who may not be aware of the potential access they have to local health clubs in the greater Southern Connecticut area.
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HIV Pre-Exposure Prophylaxis (PrEP): Increasing Awareness in Primary Care
Carl W. Brasch
Primary care is a setting that has great potential for screening and reducing the rate of HIV transmission.
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