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Migrant Farm Workers Flu Clinic
Alice Peng
Vermont's dairy industry relies heavily on migrant workers. These migrant farmworkers are mostly Latino and undocumented thus ineligible for health insurance. The Open Door Clinic in collaboration with UVM Extension Bridges to Health and Colchester Family Practice provided free satellite flu clinics to Northern Vermont Latino dairy farmworkers. This project served 12 dairy farms and vaccinated 48 farmworkers.
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A Motivational Interviewing Approach Toward Mask Wearing in Franklin County, Vermont
Ashleigh N. Peterson
COVID-19 has caused significant morbidity and mortality in Vermont and worldwide since the start of the pandemic. Wearing cloth face masks has been proven to limit viral spread, but few studies have quantified how many people are wearing masks or what their reasons are for doing so. This study aimed to assess and encourage mask use in Franklin County, Vermont by piloting an in-office motivational interviewing intervention at a primary care office.
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Physical Activity Level in School-aged Children during COVID-19
Tran Phuong
Due to COVID-19 restrictions, school-aged kids are not engaging in normal physical activities per usual, such as physical education class and team sports. This paper addresses the health concerns and community perspectives of decreased physical activity in pre teens and teens during this pandemic. Further, it provides recommendations to stay active for 60 minutes a day of moderate to vigorous exercise.
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Increasing Oral Health Care for the Elderly in Plattsburgh, NY
Megan E. Prue
Poor oral hygiene can have many adverse systemic effects in the elderly, including aspiration pneumonia. This project explored ways to increase dental care in the elderly, with the aim of decreasing rates of pneumonia along the way.
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Improving Community Understanding of Lyme Disease Prevention and Treatment in the Age of Misinformation in Digital Media
Olivia E. Quatela and Samuel Raszka
Approximately 30,000 cases of Lyme disease are reported to the CDC annually, but the CDC estimates that 300,000 individuals in the US become infected. The average cost of Lyme disease is $3,000 per patient over the course of the disease costing the US healthcare system approximately $1 billion per year ($712m – $1.3b). An additional $1 billion is spent annually on treating post-treatment Lyme disease syndrome. Despite the prevalence of Lyme disease and the availability of credible patient education materials, misconceptions and knowledge gaps are still evident among community members, media sources, and some providers. There is a need for continued community education and recommendations for evidence-based treatment for this disease.
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Coping Skills for Daily Life: Cost-Effective Strategies to Prevent and Address Mental Health Disorders
Shae Ian Rowlandson
Mental health disorders, along with their associated cost and negative outcomes, have continued to persist in Vermont and have become one of the largest, growing challenges to public health in the United States. Unfortunately, Vermont does not appear to have enough resources or providers to optimally address it. Concurrently, coping strategies of minimal cost that have the potential to prevent or address mental health disorders may often be underutilized or misconstrued by the population. A pamphlet providing information on evidenced, cost-effective coping strategies was designed and distributed to providers and patients to enable patients with the skills to help themselves and adapt to their mental health needs, independently.
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Adverse Childhood Experiences: Raising Awareness & Creating Easier Access to Resources
Christina Sanchez-Grew
Adverse Childhood Experiences (ACEs) such as abuse, neglect, and witnessing household dysfunction are common throughout the United States and are occurring in our own communities. ACEs impose immediate health risks to children but also are associated with poor health outcomes in adulthood including higher rates of cancer, heart disease, chronic lung disease, obesity, depression and substance use. The goal of this project was to contribute to prevention strategies for ACEs. This was accomplished by using flyers to raise awareness and educate the community on the prevalence and outcomes of ACEs, and by using QR codes to make parenting resources easily accessible.
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Safe Disposal of Unused Pharmaceuticals in Vermont
Sarah E. Sherman
This community project aimed to research local infrastructure for the safe disposal of unused pharmaceuticals and provide a user friendly summary to be made available to patients. In doing so, the long term goal was to increase participation in drug disposal programs to improve the health of the community by decreasing drug diversion, use of expired medications, and improper disposal resulting in environmental accumulation.
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The Green House Project: Accessible, Empowering and Sustainable Communities for the Elderly
Jessica Sikka
Many members of our geriatric community face challenges in attending appointments with their healthcare providers. The many barriers to healthcare that these patients face can range from financial to physical ones. Home health visits have become an invaluable resource for these patients. However, home healthcare is an expensive resource that many patients cannot afford. The Green House Project aims to empower elders and patients with barriers to healthcare, who thrive in the home health setting, by building communities where patients are treated with equality and mutual respect regardless of economic status.
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Transportation is a barrier to accessing primary care in Vermont
Max L. Silverstein
Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. Rural patients are especially vulnerable to transportation barriers; in Chittenden County specifically, older adults surveyed reported difficulty with transportation, with 69% delaying medical appointments due to transportation barriers. Based on data collected in this study, even among patients at South Burlington Family Medicine, distance from the office is correlated with declining important medical appointments.
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Transportation is a barrier to accessing primary care in Vermont
Max L. Silverstein
Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. Rural patients are especially vulnerable to transportation barriers: In Chittenden County specifically, older adults surveyed reported difficulty with transportation, with 69% delaying medical appointments due to transportation barriers. Based on the data collected in this study, even among patients at South Burlington Family Medicine, distance from the office is correlated with declining important medical appointments.
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Transition of Care for Newly Homed Individuals
Kayla Sturtevant
Homeless individuals often do not receive the appropriate level of health care to manage multiple otherwise controllable medical conditions. Continuity of care is often a challenge. Individuals may temporarily establish care with a provider but become lost to follow up when they move away or establish permanent housing. They can become lost to follow up for other reasons as well, including relapse, an inflexible work schedule, mental illness and many others.
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Reducing No Show Rate In the Primary Care Setting
Heng Tan
Healthcare systems consumed 17.7 % of the U.S. GDP. Efficiently using clinical resources is critical. No-show appointments decrease the provider’s productivity, increases healthcare costs, and limits the health clinic’s effective capacity. Address patients with history of no show with targeted questionnaire and provide corresponding support can not only decrease the rate and improve the efficiency of health care but also decrease unnecessary emergency and urgent care visits
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Barriers to Exercise: Patients with Diabetes in Washington County
Joshua Bruce Taylor
According to the Vermont Department of Health physical inactivity is one of the three main behaviors that predisposes patients to cancer, heart disease/stroke, lung disease, and type 2 diabetes, which result in over 50 percent of deaths among Vermonters. Washington County has a higher rate of overweight adults than the statewide average, making exercise an important component to healthier living. Barriers to exercise, especially among patients with diabetes, impose serious health ramifications for the residents of Washington County, and avenues must be made available to circumvent these barriers.
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Managing Chronic Low Back Pain
Joseph Michael Teague Mr.
Chronic Low Back Pain remains a leading reason for ambulatory care visits, a leading primary diagnosis for ambulatory care visits, a leading cause of global burden, and the leading cause of lost workdays in the US. US Health expenditures for adults with chronic low back pain total over 102 billion. Chronic low back pain increases the risk of unemployment, poverty, obesity, smoking, and depression. Physical therapy (PT) and cognitive behavioral therapy (CBT) have been proven to reduce chronic low back pain intensity and duration, improve function, reduce healthcare utilization and cost, and reduce sick time. This project investigated community resources to promote patient education and participation in PT and CBT, with an emphasis on low cost at home options.
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PPI Deprescribing Practices for GERD in Primary Care Offices In Western CT
Angela Troia
Proton pump inhibitors (PPIs) are considered the mainstay of medical therapy for gastroesophageal reflux disease (GERD). PPIs have become widely accessible to patients as many of them are currently available over the counter and require no prescription. While PPIs are highly effective at reducing stomach acid, they are not without risks. Short term uses of PPIs are generally well tolerated and involve little risk; however, chronic use of PPIs is associated with significant side effects including diarrhea, impaired B12 absorption, hypomagnesemia, clostridium difficile infection, hip fractures and pneumonia. Currently, the American Academy of Family Physician recommends that PPIs be used only when there is an appropriate diagnosis, at the lowest effective dose and shortest duration of therapy, with a typical regimen lasting 2-12 weeks. Yet even with these guidelines patients are often kept on PPIs for months or years without adequate diagnostic reason. To promote improved PPI management a better understanding of deprescribing and tapering practices amongst primary care physicians must be rendered. The aim of this project is to determine the barriers that prevent PPI deprescribing in cases of GERD.
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Addressing Barriers to Physical Activity in Vermont's Geriatric Population
Stephanie Udawatta
A wide array of barriers exist which prevent many geriatric patients from engaging in regular physical activity. This project addresses the barriers unique to Vermont's population of geriatric patients and explores potential solutions.
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Resource to address pandemic-related anxiety and depression for pregnant patients in Vermont
Mohammed Wali
The 2019 novel coronavirus (COVID-19) has led to patient deaths, strained health care systems, and economic uncertainty. Distress during pregnancy can lead to adverse outcomes for both parent and baby. A patient-friendly handout was created for pregnant patients to offer reassurance, incorporate mind-body recommendations to address stress, and offer screening tools to empower them to address mood concerns with their obstetric providers in the COVID-era.
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Implementing an Educational Resource on Cannabidiol (CBD) for Patients in Western Connecticut
Michael H. Weber
An educational handout on cannabidiol (CBD) was created and implemented into a family medicine practice in Western Connecticut. The handout described the basics of CBD including production, legality status in Connecticut, efficacy in treating certain conditions, and consumer considerations when purchasing CBD.
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Pilot study: healthcare cannabis assessment
Nicole Wershoven
Due to state legalization and increased access to cannabis, there is increasing use of cannabis in Vermont and nationwide. Cannabis is used medically for certain qualifying conditions in Vermont in addition to recreationally. In a recent study they found 45% of adult primary care patients in Vermont had used cannabis in the last year and only 18% of patients reported their clinician as being a good source of information regarding cannabis. Educating clinicians about cannabis is critical for quality comprehensive patient care. The objective of this project was the development of a short survey to deploy to primary care clinicians throughout the state to get a baseline assessment of their medical understanding of cannabis, in order to create specific learning opportunities to expand their knowledge of medicinal cannabis.
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Community Lyme Disease Education
Tim Woodin
Lyme disease education is lacking in the primary care setting. Proper patient education lowers healthcare costs, and helps clear confusion surrounding this disease.
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Barriers to Smoking Cessation in Patients Enrolled in Suboxone Treatment Programs
Thomas L. Arnell
Cigarette smoking is the leading cause of preventable death and disease in the United States, accounting for more than 480,000 deaths every year. The prevalence of tobacco use among substance abuse treatment program enrollees is substantially higher than that of the general population, with recent estimates ranging between 75-97%. The aim of this project was to identify specific barriers to smoking cessation in patients enrolled in suboxone treatment programs in Franklin County, VT. The most commonly cited barriers among survey responders were related to fear of the effects of tobacco withdrawl, while the most important barrier was related to fear of increased desire to use drugs following smoking cessation.
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Ensuring Adequate Recognition and Care for Lyme Disease
Menna Awadalla
Lyme disease is a common issue in the Northeast United States, particularly in New Milford, Connecticut. Lyme is a readily treatable condition generally requiring a simple 2-3 week course of antibiotics. However, if patients cannot identify their symptoms and thus, do not come in for treatment, then that puts them at risk for developing chronic Lyme disease and fatal sequelae as a result. This project focuses on informing the local public about this issue by providing essential information regarding signs/symptoms, treatment, prophylaxis, and complications of Lyme disease.
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