Block Clerkship Projects

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Screening for Food Insecurity in New Milford, CT

Liana K. Mathias

Food insecurity is defined as a lack of consistent access to enough food for an active, healthy life. Litchfield county, home to New Milford, CT, suffered severe economic changes over the Covid-19 pandemic. The number of food insecure households, represented by those requesting food from local food pantries, skyrocketed. This study demonstrates the importance of screening for food insecurity in primary care. A 3-part screen is implemented in a primary care setting to better assess those at risk and connect them to resources and local food services.
Exercising With Osteoarthritis

Kayla Menendez
Words Without Weight

Lucy Merriam

BMI and weight loss are frequently recommended to patients but how weight is talked about with patients can have a negative effect on how they look at their bodies and health. The purpose of this project was to describe ways to discuss health with patients in a body positive way.
Attitudes Towards the COVID Vaccine

Micheal Mikheal

This project was done to assess the attitudes towards COVID vaccination in Berlin, Vermont. A survey was utilized to inquire if participants have received or were willing to receive the COVID vaccine. It also gathered details regarding which sources participants received their information regarding the vaccine.
Telemedicine after the COVID-19 Pandemic: A Quality Improvement Project

Alexis B. Miller

This project evaluates patient and provider preferences and perspective on the future of telemedicine use in primary care as we emerge from the COVID-19 pandemic. As our healthcare system adapted to the COVID-19 pandemic, use of telemedicine surged practically overnight. The pandemic created a necessity for rapid innovation in telemedicine, including accessibility and insurance coverage. As we begin to emerge from the COVID-19 pandemic and more events move back to in-person, what does this mean for the future of telemedicine? This project surveyed patients attending both in-person and telemedicine primary care appointments to assess their satisfaction, preferences for in-person versus telemedicine, and if this changes for them based on the type of visit. This project also interviewed primary care providers about their perspective on the future of telemedicine as we begin to emerge from the COVID-19 pandemic.
Inclusive Local and Online Resources to Stay Active During the COVID-19 Pandemic

Collin B. Montgomery

The COVID-19 pandemic has interrupted daily life in an innumerable amount of ways. Through gym closures and overcrowded, unsafe public spaces, maintaining exercise routines and reaching physical activity recommendations is increasingly difficult for many people. As a result of this, there has been an increasing emphasis on at home exercise and routines people can do at home. However, many of these resources are not inclusive of populations such as the elderly, people with disabilities, and the otherwise deconditioned as the exercises can be too strenuous or require specific equipment. The goal of this project was to compile a list of online and local resources in the Greater Burlington Area to help facilitate physical activity for all populations during the COVID-19 pandemic, and to include a short, intuitive walkthrough of a few exercises that can be done from the home in a chair.
Addressing Exercise and Physical Therapy in Older Patients in Colchester, VT

Adam Morehead

Participation in physical activities remains low among much of the older adult population, particularly during the winter months. Many individuals who are active during warmer times of the year become more sedentary during the winter, and this physical inactivity can contribute to declining health. This project sought to develop a simple brochure outlining several simple exercises that can be performed safely at home without equipment to be distributed to patients at wellness visits to encourage indoor exercise.
Improving communication in patient visits requiring medical interpreters

Daniel J. Moroney

Handout for effectively using medical interpreting services.
Devoloping a Primary Care Screening Protocol for Post-Miscarriage Depression

Sean Muniz

Spontaneous abortions occur in 20-33% of pregnancies, and 10-30% of these women have clinically significant depression. These women are often unscreened by either PCPs or OBs for depressive symptoms. We developed a screening protocol using the PHQ-2 to assess for depression in patients who have had a spontaneous abortion. The protocol utilizes a nursing care manager to follow up with patients who either were seen in the ED or self report spontaneous abortions to the PCP office. Follow up phone calls should be made within 2 weeks and at 6 weeks post spontaneous abortion, with offers for in-person follow-up given if they screen positive.
Where are you hiding, sugar? (Sugar content of popular drink and snacks, with suggestions for healthier alternatives)

Ashta Narain

Two flyers, with associated dotphrases, on the actual sugar content of popular drink and snack foods were created. Also provided is information about the long-term impact of sugar on our bodies over time from local dieticians, and healthier alternative food and drink choices with less sugar content.
Challenges with Diet during the COVID Pandemic

Cinduja Nathan

The ongoing COVID-19 pandemic has had a tremendous impact on many individual's lives and their families. It has caused many people to change their lifestyles and daily routines. This project focuses on how diet has changed during the COVID pandemic and explores the reasons for these diet changes. 23 patients from the Central Vermont Medical Center were given surveys and their responses were analyzed and recorded. Out of the 23 patients, 20 patients reported that they noticed a change in their diet as a result of COVID 19. Of the 20 patients who noticed a change in their diet, 5 reported that their diet was more healthy, 11 reported that their diet was less healthy and 4 noted a balance of healthy and unhealthy changes during the pandemic. The two most frequently cited reasons for diet changes included going to the grocery store less often and engaging in compulsive eating. Understanding how diet is being affected during this pandemic is extremely important. The impact of temporary changes in diet due to the pandemic can result in permanent lifestyle changes that can result in health consequences and a number of chronic diseases, including coronary heart disease, stroke, diabetes, and some cancers.
Improving Access to Meditation and Mindfulness for the Management of Anxiety, Stress, and other Chronic Diseases of Chronic

Jesse Naumann and Alex Cohen

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.
The Importance of Continued Compliance with Completing Advance Directives in an Outpatient Setting

Maegan R. Neilson

Despite continued efforts with conversation, guidelines, and even law, studies still show that the compliance with completing advance directives amongst a global patient population remains around 3 in 100. Those in compliance are more often chronically ill, over 65, or in an acute or terminal care setting. The COVID-19 pandemic is evidence that anything can happen and that helping patients adhere to medical wishes should be a top priority for primary care providers and their patients of all ages and health. Because previous studies have proven to be effective in increasing AD compliance when highlighted, this project aims to reignite the successful workflow of incorporating advance care planning into non-acute outpatient visits.
Resources to Decrease Social Isolation in the Elderly

Alexandra Novelli

Social isolation has significant negative impacts on both the physical and mental health of the elderly. Older Vermonters face additional barriers to social engagement including living in a rural environment, lack of access to transportation, and financial barriers. The aim of this project was to provide information about opportunities for social engagement for older individuals by distributing a pamphlet at Colchester Family Practice in Colchester, VT.
Lifestyle Changes in Diabetes Management using Smartphone apps

Michelle Oberding

Type II Diabetes is a prevalent and costly disease in the state of Vermont. Making lifestyle changes decreases Hemoglobin A1c levels and the long term risk of complications from diabetes. Longitudinal programs help maintain these important changes but these programs are not always readily available. Using free smartphone apps may be an alternative for maintaining lifestyle changes.
Dry Eye: Patient Education

Mark Oet

Recent literature has shown increased incidence of dry eye and eye strain symptomatology during the COVID-19 pandemic, coinciding with an increase in screen time for almost all populations. This project aims to address this observation at a community level by creating a patient-friendly education pamphlet for Newtown Primary Care about dry eye and digital ocular strain based on American Academy of Ophthalmology guidelines.
Community Attitudes Towards Covid-19 Vaccination

John P. O'Keefe

Vaccination is a very valuable tool in combating the public health crisis of COVID-19 and will be essential in reducing transmission rates and deaths due to the pandemic. Public willingness to receive the vaccination in large polls has stayed well below the ~95% of the population needed to achieve herd immunity against the virus. Here were survey Vermonters to determine their attitudes towards receiving the vaccine and what sources of information patients use to inform themselves about the different vaccines available.
Diabetes Education and Exercise

Emily H. Oliver and Lauren Coritt

This project seeks to explore the current local options and resources for community members receiving care at Brookfield Primary Care in Brookfield, Connecticut. Furthermore, this project provided a pamphlet to increase provider and patient awareness about free and low-cost resources within the local community to encourage diabetic patients to increase their activity level. Ideally, this project will also break down notions that 'vigorous' exercise is the only good way to exercise.
Assessing and Improving Awareness of Safe Prescription Drug Disposal in Hinesburg, Vermont

Kaitlyn Peper

Millions of Americans misuse prescription drugs each year and over half of these people obtained a prescription from friends or family. Additionally, medications that are disposed of improperly lead to contamination of the environment. This project aimed to assess awareness of proper medication disposal amongst patients at Hinesburg Family Practice and to increase communication with patients regarding options for prescription drug disposal in Hinesburg, Vermont.
Screening for Disordered Eating Among High-Risk Groups

Julia B. Purks

Many patients with disordered eating will not present with objective manifestations such as low BMI, physical exam findings, or electrolyte abnormalities. Among patients that meet DSM-V criteria for an eating disorder, the majority do not fit criteria for anorexia nervosa or bulimia nervosa, but instead fall into a category known as "Otherwise specified feeding and eating disorders." As such, it can be difficult to identify these patients. This project proposes adding 2 validated screening questions to outpatient intake forms, or incorporating them into patient visits, to identify disordered eating among high-risk groups.
Low-cost At-home Cardio Solutions for Patients During the Covid-19 Pandemic

Anna G. Quinlan
Resource Guide for Autism Spectrum Disorders

Jennifer Risi

Children with autism spectrum disorder and their families have numerous needs for health and social support. The system through which they receive this support is complex and foreign to many parents. Interactions with patients and their families have made it clear that many of them do not know what resources are available to them or how to access these resources. Furthermore, healthcare provides frequently do not have the time to educate patients fully during visits. To address this, we created an educational pamphlet that acts as a resource guide for families with various unmet needs which can be handed out at primary care offices in Chittenden County.
Patient Perceptions on the COVID-19 Vaccine

Claudia E. Russell

With COVID-19 cases and deaths on the rise in Vermont and nationally, it will be important for as many people who are able to receive the COVID-19 vaccines when available. The WHO considers vaccine hesitancy to be a major threat to public health. This study aims to examine patient attitudes and concerns regarding the COVID-19 vaccine. An informational brochure about the recently approved Pfizer and Moderna vaccines was then distributed to all participants.
Patient Knowledge and barriers to care for their Type 2 Diabetes Mellitus (DM) Condition

Diana A. Salama

This project is investigating the patient knowledge and barriers that may be present which may contribute to a lack of effective care of their Type II Diabetes condition. This project is also investigating key components which may improve patient-centered care.
The Cures Act: How can we alleviate patient confusion and provider workload?

Michela Salusti Simpson

This project aimed to develop a better understanding of patient and provider needs at all UVMMC family medicine and urgent care offices in regards to the new Cures Act. Data was gathered via a 8 question multiple choice survey and we had 24 provider responses. Most providers have found that they are receiving more phone calls from patients with questions in regards to their medical notes or results since the enactment of the Cures Act. Providers mentioned common patient questions are about imaging results, CBC, and electrolytes. Nearly half of providers noted they have changed the way in which they write notes since the Cures Act and all providers felt that a handout with tips to interpret lab results would be helpful.