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Circumcision for the Male Infant: Patient Education and Cultural Humility
Grace E. Eisenbiegler
Male circumcision is a religious and cultural decision that has become increasingly medicalized. Many families make decisions about circumcision based on culture and family without true informed consent. There is a need for unbiased information, prior to delivery, about circumcision, so that families may make an informed decision that is right for them. A one page document was created as an addition to the clinic's pregnancy guide with information on risks and benefits of circumcision, complications associated with the uncircumcised penis, cultural significance, and care of the uncircumcised penis.
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Addressing Post –COVID-19 Pandemic Depression
Aria Elahi
This community project explores the impact of the COVID-19 pandemic on mental health, particularly focusing on depression, and introduces an intervention in the form of a pamphlet distributed at Newtown Primary Care. The pamphlet addresses individuals experiencing worsened depression due to the pandemic, regardless of COVID-19 infection status, and includes the PHQ-2 and PHQ-9 screening questionnaires for self-assessment. Insights from interviews with Newtown Primary Care were instrumental in designing the pamphlet.
Results reveal that the pandemic has substantially affected patients' mental health, increasing the need for resources. Patients diagnosed with pre-existing depression experienced worsening symptoms due increased stressors due to the pandemic compounded by current socioeconomic and health problems.
The pamphlet advises patients to take PHQ-2 and PHQ-9 tests and share results during primary care visits for further discussion. It offers mental health resources such as hotlines, including the Substance Abuse and Mental Health Services Administration National Hotline and National Suicide Prevention Hotline. Notably, the pamphlet highlights Nuvance Health's COVID Recovery Program for lingering post-COVID symptoms that impact mental health.
Ultimately, the pamphlet seeks to bridge gaps in mental health support, encourage and empower patients to seek help, and raise awareness about available resources with the aim of improving mental health outcomes.
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Home Exercise for Patients With Limited Access and Resources
Justin L. Esteban
Patients with limited resources and who are socioeconomically disadvantaged, don’t have the time or resources available to partake/pursue exercise. Having a home workout program may prove to be beneficial to patients who don't have access to a gym, equipment, or are otherwise constrained by time.
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Mapping Pediatric Vaccination Schedule
Mialovena C. Exume
Taking care of a child can be daunting and parents/guardians/families often report not being sure of what vaccinations their child might need and when. This project aims to provide a map of the pediatric vaccination schedule from birth to 18 months. This project also provides a booklet to help families track vaccination in the hopes of increasing vaccination adherence and providing education on routine recommended childhood vaccines.
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Referred by your PCP
Lud H. Eyasu
A complication of a small or new primary care office is difficulty in providing additional support for patients outside of the office visit. Some referral center do not assist patients referrals for mental health providers and services. This project set out to create a list of in-network psychiatrists that can be distributed to patients at a New Canaan, CT primary care office to facilitate these patients' quest to find a mental health provider.
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Colorectal Cancer Screening Options
Juwairiyyah Fatima
Colorectal cancer is a leading cause of mortality in the United States. The USPTF recommends screening starting at age 45. Many options exist for colorectal cancer screening. This project explores the use of a handout explaining the various screening tests available to patients as a means of improving screening rate in one primary care clinic population.
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Supporting Caregivers of Patient with Dementia
John E. Fernan
Being a caregiver for an adult with dementia can be a demanding job. In 2021, an estimated 11 million family members provided 16 billion hours worth of care to people with Alzheimer’s and other dementia. Beyond the financial burden, the strain of caregiving also increases risk for emotional stress and can take a toll on physical and mental health. The goal of this project was to help reduce caregiver stress by increasing awareness of support resources. A template in the EMR was created to compile a list of these resources along with general caregiving tips. This template was made available to family medicine providers to share with patients who care for someone with dementia.
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Listen to Her Heart: Bridging the Gap in Recognizing, Preventing, & Treating ASCVD in Women
Stephen J. Foley
Atherosclerotic cardiovascular disease (ASCVD) is traditionally considered a male disease, yet it is the leading cause of death in women. This may be associated with the significant lack of research of ASCVD in women, leading to poor recognition, diagnosis, prevention, and treatment. The American Heart Association reports that a majority of women experience prodromal symptoms more than one month before a heart attack or stroke, and these symptoms are often underestimated. This project intends to help address the question: How can earlier detection of ASCVD risk in women reduce missed signs of acute myocardial infarction/stroke and thereby reduce preventable ASCVD hospitalizations? This project also hopes to increase physician and patient awareness of and engagement with the VT Dept. of Health's "You First" program to provide supplemental heart health screens and services for women.
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Increasing Awareness of Pharmacologic Interventions for Smoking Cessation
Jeremy Frank
Smoking is a large cause of morbidity and mortality in the healthcare system. Many patients are interested in quitting smoking but have not found an effective strategy that works for them. There have been times when patients have been receptive to a discussion regarding medication assisted cessation but ultimately were not prescribed any medications from their provider. Despite the fact that it has been proven that pharmacotherapy increases the chances of smoking cessation. The goal of this community health project is to create a change within the healthcare system by providing evidenced based recommendations regarding pharmacologic treatment in smoking cessation for both providers and patients to ultimately decrease the burden of smoking within this community.
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Improving IPV Screening & Access to Resources for Patients in Primary Care
Daniel J. Fried
Primary care providers can improve their screening protocols for intimate partner violence (IPV) and how they connect resources to their patients.
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Improving Housing-Insecurity Screening In A Rural Primary Care Setting
Heather G. Giguere
Housing-insecurity and homelessness have a direct impact on individual health, and are well established causes of premature morbidity and mortality (6). Screening for housing-insecurity leads to earlier identification, and more extensive engagement of services, which can help to mitigate the individual and public health ramifications of these social determinants of health (8). The aim of this project was to improve the screening process for housing-insecurity within an rural primary care setting.
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The File of Life: A Lifeline for First Responders in Fairfield County, CT
Brittany Gilmore
During a medical emergency, it can be difficult for first responders to obtain crucial medical information about their patients for a variety of reasons. The patient may be unconscious, have an altered mental status, or simply not know their medical history. This project aimed to increase awareness of the File of Life program, which many local Fire and EMS departments are implementing to improve their ability to deliver life-saving care.
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Tackling Access to a Healthier Life
Edom Alemayehu Girma
Obesity is a known risk factor for complications during childhood and later in adult life. While numerous factors play a role in the prevalence of obesity, this project focused on better intervention for obesity management in the family medicine clinic located in Plattsburgh, NY. Interviews and literature searches were conducted to determine possible strategies to better assist patients in attaining their sustainable weight loss goals and an overall healthier lifestyle.
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Long Phone Wait Times at Newtown Primary Care
Krystal Gopaul
Getting an appointment with a PCP has historically always been challenging but at Newtown Primary Care long wait times on the phone when booking an appointment is also frequently cited as a local challenge. This project explores phone wait times as well as patient, staff and provider perspectives on challenges accessing primary care appointments at Newtown Primary Care.
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Improving Mental Health Access in a Rural Setting via Telehealth
Timothy W. Greenfield
There are several barriers patients face when accessing mental healthcare in rural areas including: lack of internet, lack of resources, and stigma.
Local options are limited, and patients face barriers such as access to transportation.
These factors position telehealth as a unique, tangible solution for patients in the community.
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Improving Access to Medication Assisted Treatment for Opioid Use Disorder in a Rural Emergency Department
Warren Grunvald
Opioid Use Disorder (OUD) is a growing epidemic throughout the United States and Maine has not been sparred by this. As the Emergency Department is a frequent location for people with OUD to interact with physicians it has been targeted as an opportunity to initiate Medication-Assisted Treatment (MAT) with Suboxone. This project details an effort to streamline this process and improve outcomes for patients interested in MAT.
Improving access to medication assisted treatment for opioid use disorder in a rural Emergency Department
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Improving access to medication assisted treatment for opioid use disorder in a rural Emergency Department
Warren Grunvald
Opioid Use Disorder (OUD) is a growing epidemic throughout the United States and Maine has not been sparred by this. As the Emergency Department is a frequent location for people with OUD to interact with physicians it has been targeted as an opportunity to initiate Medication-Assisted Treatment (MAT) with Suboxone. This project details an effort to streamline this process and improve outcomes for patients interested in MAT.
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Anticipatory Guidance on Breastfeeding Support in Vermont
Ian Guertin
Breastfeeding is an optimal source of nutrition for babies and has health benefits. Vermont strives to support families in meeting their breastfeeding goals. This project developed anticipatory guidance that can be given to prenatal patients about breastfeeding support resources in Vermont.
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Addressing Diabetes Education in Chittenden County
Varun Gupta
The percent of adults in Chittenden County with diabetes who have received diabetes education was short of national goals. To gather more information about the problem, a NP and 2 diabetic patients were interviewed. A educational handout was created to address some of the concerns brought up that reflect some of the unmet educational needs.
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Polypharmacy And Fall Risk Education In Elderly Adults
Mohamad K. Hamze
The primary care office is often the setting for medication management and risk-reduction and PCPs frequently reconcile and manage the prescriptions of numerous specialists who see a patient separately. For patients >65, one must consider the necessity of prescribed medications that may contribute to increased fall risk in this age group. Patients themselves may be uncertain of the types of medications they may be taking that potentially put them at increased risk for falls or adverse outcomes of falls. Thus, they may benefit from easily accessible educational materials on commonly-prescribed medications in these categories so that they may work with their physician to make informed decisions on their medication regimens.
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Addressing Maladaptive Coping Mechanisms in Response to External Stressors and Negative Affective States in Primary Care Settings
Matthew C. Hanna
Individuals respond to negative affective states, including depression and bipolar disorder, and external stressful events with a wide variety of adaptive and maladaptive coping mechanisms or a mixture of both. Maladaptive coping mechanisms include substance use and binge eating, as well as avoidance or withdrawal behaviors. Understanding how patients respond to external stressors and adapt to negative affective states, including depression and hypomania, via questionnaires seeking to elucidate coping mechanisms is of utmost importance to recognize patients at risk of substance use, binge-eating, and other maladaptive behaviors. Only through explicit identification of these mechanisms can providers work with patients to take steps to mitigate negative health effects of maladaptive coping behaviors via targeted patient education and formation of collaborative partnerships with patients.
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Keep an Eye On Your Ocular Health: The Importance of Routine Eye Exams
Kiana Heredia
When it comes to scheduling preventive health screening exams, eye exams are often overlooked. Individuals may not understand the importance of their ocular health, and many assume a basic vision screening is comprehensive. However, that is not the case and eye diseases are common and can go undetected for a long period of time before symptoms appear. Seeing a licensed optometrist or ophthalmologist for comprehensive eye exams is important for detecting eye disease in the early stages when treatment is available to prevent vision loss is most effective.
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Overcoming Barriers to Care in the Treatment of Opioid Use Disorder
Max C. HoddWells
There are many barriers to care when it comes to the treatment of opioid use disorder (OUD), and patients often require significant resources to achieve success. Patients requiring treatment for OUD at Central Maine Medical Center in Lewiston, Maine are often enrolled in an intensive outpatient clinic (IOP), which requires access to certain technology, transportation to appointments, and time-intensive counseling, among other things. The demands of IOP are important for successful and holistic treatment, but it presents unique challenges to socioeconomically disadvantaged patients who have limited resources.
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Anxiety Screening in Pediatric Populations
Shubhankar Joshi
This project is aimed to elucidate guidelines for addressing newly changed recommendations for pediatric anxiety. Similar to the depression screening PHQ2, we hope to establish/develop a similar questionnaire that would serve as a quick screening tool and then further steps for treatment and recommendations on anxiety diagnosis.
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