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Addressing COVID-19 Vaccine Hesitancy
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.
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Safe Sleep for Newborns: An Addition to the Infant Care Guide
Charlotte B. Gemes
Many parents at Community Health Center of Burlington have questions about infant care after their baby is born and do not know where to turn to find the answers, An Infant Care Guide is therefore being developed to help new parents on basic topics. The section "Safe Sleep for Newborns" was developed and added to already developed chapters to provide parents the basics on safe sleep.
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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.
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Patient Education: Low-Carb Substitutes for Pre-diabetes Management
Keira L. Goodell
At Milton Family Practice in Milton, VT, individuals diagnosed with pre-diabetes are referred to a clinical nutritionist and sent home with patient instructions about blood sugar and carbohydrates. For those who decline a meeting with the clinical nutritionist, the patient instructions are not an adequate substitute. This project focused on the creation of a SmartPhrase to be added to patient instructions outlining common high-carbohydrate foods and options for lower-carb alternatives.
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Exercise as a Tool for Treating Anxiety and Depression
Lizzi Hahn
In addition to its important role in the maintenance of physical health, exercise has been shown to have numerous benefits for mental health. Recent studies indicate that even brief engagement in physical activity can make a positive impact on the treatment of pre-existing anxiety and depression - as well as the prevention of future symptoms. Despite this relationship between exercise and emotional wellness, regular activity in the United States is still exceedingly low, and exercise remains an underused tool by healthcare providers in the treatment of their patients’ anxiety and depression. The goal of this project was to assess patient engagement in and barriers to exercise, as well as their understanding of its benefits for mental health as perceived by providers at CVPH Family Medicine Center, and to create a patient-centered resource emphasizing the significance of physical activity in reducing the burden of anxiety and depression.
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Evaluation of growth in clinical genetics competency among PCPs participating in the UVMHN Genomic DNA Testing Program
Christina Hansen
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.
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Increasing Patient Access to LGBTQ+ Healthcare through Expanding the Vermont Diversity Health Project
Rachel Harrison
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.
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Harm Reduction in Family Medicine
Tess Hickey
In Lewiston, Maine the opioid epidemic is a public health crisis resulting in overdose-related deaths, infectious disease transmission, and public health costs. Harm reduction through resources such as syringe service centers, peer counseling, and Narcan distribution can help negate the negative health impact of substance use disorder. This project focused on creating a list of local harm reduction resources for providers so they can educate patients on how to be as safe as possible when using substances.
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Exercise and Physical Therapy in the Elderly
William Holden
There are many current barriers to participating in exercise and physical therapy in the elderly. Using reputable online resources, we created a handout containing a list of exercises that can be completed safely at home without equipment. It was designed for elderly individuals, as inactivity tends to increase with age and this population is particularly vulnerable to the deleterious effects of inactivity. The strength and flexibility exercises primarily target the back, hips and core, common problem areas in the elderly. The handout will contain links to further resources for more in-depth physical therapy exercises and will be tailored for administration in a primary care setting.
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Reach Out and Read Awareness and Utilization at the Community Health Centers of Burlington
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.
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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.
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Combating Seasonal Affective Disorder in Vermont
Prasanna Kumar
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.
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Nutritional Barriers for Patients with Diabetes: A quality improvement project
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.
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Assessing Patient Perceptions of Pre-Visit Methods to Reduce Wait Time and Provider Burden
Vinh H. Le
Due to multiple factors, patients at ambulatory settings tend to experience long appointment wait times, negatively impacting patient satisfaction and overall well-being. One proposed solution is to use pre-visit data collection to simplify check-in and screening processes at the office. This project surveyed patients at Brookfield Primary Care & Pediatrics regarding quantitative wait time data and qualitative perceptions on the proposed solution. It was found that a majority of patients are open to using pre-visit online forms to reduce wait times.
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Transgender Healthcare Resources for Clinicians in Vermont
Jeanie Lin
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.
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Dental Basics for the PCP
Tierra Lynch
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.
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COVID-19 Vaccination: Educating Patients on Vaccine Availability and Distribution Plans in Lewiston, ME
Erick MacLean
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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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.
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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.
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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.
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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.
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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.
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