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Adult Oral Health Access and Advocacy
James Duguay
Many adults lack adequate preventative oral healthcare due to multiple factors. Oral health is important due to its effects on systemic health as well as for quality of life issues.
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A Patient Centered Intervention to Promote Primary Care Based Screening for Diabetic Retinopathy
William B. Earle
Diabetic Retinopathy is the leading cause of blindness in patient's age 25-74 in the world. Onset of disease is insidious and early intervention is the only way to reduce morbidity. On average only 60% of diabetic's get an annual eye exam, but in the Western Connecticut Health Network (WCHN) that number is closer to 32%. This project sought to educate and encourage patients to take advantage of a new tele-medicine, primary care based diabetic retinopathy screening program starting at Brookfield Family Medicine (part of the WCHN).
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A Patient's Guide to Smart Research
Zachary Winston Ehret
Patients may not know where to look when researching a health issue. This may lead them to resources that are not supported by research and may become an issue for their own health. Some websites may be filled with medical jargon, which can potentially exacerbate anxiety about a particular condition or cause concern for unrelated health issues. A handout compiling a list of resources would be helpful to providers and beneficial to patients.
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Alcohol Support Groups: Alternative to the AA Model
Tim Fields
Alcohol abuse accounts for 88,000 deaths and $249 billion annually in the United States. At this point there is not a great evidence based model for the best form of group support. While AA and the twelve step model is the most frequently used group format, it has many limitation especially in small Vermont towns. This proposes an alternative model designed to work well in smaller communities.
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Shingles & Pneumococcal Vaccines: Recommendations for Older Adults
Benjamin Flinn
As the immune system tends to weaken over time, patients aged 50+ begin having increased risk for certain potentially preventable diseases, especially shingles and pneumonia. Although there are vaccinations to protect against these diseases, there are many significant barriers preventing patients from receiving the vaccines that they need, including potentially confusing guidelines, concerns over risks, and recent changes to vaccine recommendations. This project aims to produce a clear and concise educational brochure to help overcome some of these barriers, and to drive patient-provider conversation about their vaccine recommendations.
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A Physician's Guide to Motivational Interviewing
Anthony J. Gallegos
Recommending lifestyle changes to patients is a crucial part of a primary care physician's role. Guiding patients to make behavioral change is a challenge physicians must face on a daily basis, and based on current literature, it can be delivered more effectively in the form of motivational interviewing as opposed to traditional advice-giving. This project aims to provide physician's with a quick reference guide to Motivational Interviewing to display at their desk, as well as a template to be filled out with the patient detailing their plans for change. Together, these tools can improve the delivery of advice, and strengthen physician-patient relationships to more effectively achieve long-term health goals that require a behavioral change from the patient.
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PSA Screening in Lewiston Maine
Francis G. Gause IV
PSA Screening Patient Information for 2017 guidelines
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Improving Access to Mental Health Care for Trauma Patients
Kassandra Gibbs
It can be difficult to locate a mental health provider in Vermont. Consequently, many individuals with mental illnesses look to their primary care physicians to fill this gap. This project highlights difficulties faced by patients with PTSD and complex PTSD in Chittenden and Addison counties in finding a therapist or psychiatrist. A resource handout was created with instructions on how to find a therapist in VT and a list of practitioners in Addison and Chittenden counties who specialize in trauma. In addition, a patient information sheet that answers some questions about PTSD and complex PTSD and also provides a list of mindfulness exercises that can be used by patients while they are waiting to find a mental health practitioner.
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Incorporating Naloxone Education Into Routine Primary Care
Eli Goldberg
Opioid overdoses are a growing public health concern in Vermont and nationwide. Naloxone can save the life of someone who overdoses, if those around them know how to use it. This project investigates the feasibility of offering naloxone education as an element of routine primary care encounters with patients who do not use opioids themselves.
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Radon: An Opportunity for Preventative Health
Kathryn Grenoble
Radon is a colorless and odorless radioactive gas produced by the natural decay of uranium in rock and soil. Long term exposure to radon gas is the leading cause of lung cancer among non-smokers, and the second leading cause over all after smoking. Children exposed to unsafe levels of radon are particularly vulnerable because smaller lungs and faster respiratory rates are thought to result in higher radiation doses compared with adults. One in eight homes in Vermont contain unsafe levels of radon gas compared with one in fifteen homes nationally. Radon gas exposure is not currently addressed as a preventative health measure in primary care clinics. This intervention was aimed at creating a radon resource document embedded as a “smart phrase” in EPIC enabling clinicians to rapidly provide clear information for patients without encumbering time constrained appointments. The intent is to equip providers with a tool for introducing the topic of radon at pediatric well visits and give patients access to additional information included in their After Visit Summaries.
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ACEs and Resilience: Increasing patient knowledge of Adverse Childhood Experiences and stress coping techniques
Mary Griffin
At The Health Center, a federally qualified health center in Plainfield, Vermont, providers have begun an initiative to screen patients during routine clinic visits for their Adverse Childhood Experiences score. In a population subject to the social, economic, and health-related challenges of rural Vermont, providers have identified the screening process as a vital tool for better understanding their patients' health. To better aid in both provider comfort and patient education during said interactions, a pamphlet was created to guide provider conversations concerning ACEs. The pamphlet details information about ACEs and health consequences, the importance of the relaxation response in dealing with toxic stress, and the ways in which we can help foster resilience in children.
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Intimate Partner Violence: Updated Screening Tool and Approach to Screen Positive Patients
Michael J. Hall
Intimate partner violence screening is recommended in all women of child-bearing age. Ensuring validated screening tool utilization and employing strategies to identify risk while providing non-judgmental support is critical to identifying patients and optimizing appropriate resource referral.
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Lyme Disease Prevention
Russell D. Himmelstein
This project focused on Lyme Disease prevention, specifically for cub scouts from 5-10 years of age and their families.
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Diabetic Eating at the Dollar Store
Lee Hiromoto
Ideas on following a diabetic diet using ingredients from a dollar store.
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Postpartum Contraception Education
Erin E. Hunt
The current standard of practice for postpartum contraception in Plattsburgh, NY, as well as much of the United States, is initiation of contraception at the standard 6 week postpartum visit. However, many women may be better suited for immediate postpartum contraception while still hospitalized in labor and delivery. Long acting reversible birth control (LARC), including hormonal IUDs, copper IUDs, and progesterone implants, were the contraception types focused on in this project. Family medicine residents at CVPH reported low confidence in postpartum contraception as a whole. Furthermore, they reported limited knowledge on immediate postpartum contraception. The primary aim of this project was to expand the resident knowledge base on postpartum contraception and encourage them to consider immediate postpartum contraception in certain patients via an educational session.
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Seasonal Affective Disorder in Vermont
Hannah Johnson
A large proportion of major depression in Vermont has a seasonal pattern. The most common form of Seasonal Affective Disorder is winter depression. Several evidence-based treatments exist for SAD including light therapy, CBT, and antidepressant medications. Adjunct therapies, like exercise and social interaction, can also help patients feel better during the winter. In the primary care setting, an educational handout/poster will aid in educating patients about SAD and treatment options, and encourage them to seek help.
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Shingrix: Educating Patients on the New Shingles Vaccine
Sarah Natasha Jost
Herpes zoster (shingles) is a viral infection that results in a painful rash and has a myriad of long-term complications, including post-herpetic neuralgia- chronic pain that does not resolved despite resolution of the rash. Over the last 20 years, incidence of shingles has increased by nearly 50% and now there are 2 vaccines available to prevent shingles. Shingrix was approved by the FDA in 2017 and has garnered public attention for its efficacy. I developed a brochure that gives patients information about shingles, Shingrix, and answers some frequently asked questions.
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Addressing Exercise Education in Clinton County, NY
Amanda M. Kardys
In Clinton County, NY residents state that obesity, chronic disease, physical inactivity and low wages are top concerns. Many of these identified problems are tightly integrated and exacerbated by a lack of exercise education in this population. To address this, an exercise education pamphlet was created to be distributed to individuals in the community. The pamphlet focuses on discussing barriers such as time and cost of exercise, as well as enabling individuals with stretching information and local resources.
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Promoting health literacy about added sugars, with a focus on patients with limited English proficiency
Megan Kawasaki
Excess consumption of added sugars has been linked to the development of obesity, diabetes, and cardiovascular disease. The sequelae of such health conditions accrue significant public health costs - both in terms of healthcare spending as well as associated co-morbidities and mortality. Chittenden County, Vermont is home to at least 6,300 new Americans, many of whom have limited English proficiency (LEP). Although office visits can provide crucial advice regarding proper nutrition, written resources available for LEP patients are lacking. This project aimed to meet that need through development of an infographic-rich handout that both promotes healthier grocery store choices and educates patients about added sugar. While it can be useful to those at all literacy levels, the heavy use of visuals was intended specifically to make the handout accessible for those with little to no English proficiency.
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Assessing Barriers to Mental Health Treatment
Britta J. Kilgus
It has been well established that individuals with mental illness and substance use disorders face numerous barriers to accessing adequate health care treatment including inability to pay, lack of insurance coverage, lack of provider availability, and stigma. The 2016 Community Health Needs Assessment for Washington County, Vermont identified substance use and mental health as priority health needs for the county. The purpose of this project was to evaluate the specific barriers individuals with mental health and substance use disorders are experiencing in Waterbury, Vermont. A survey was distributed to patients being seen at Waterbury Family Practice with behavioral health or substance use disorder diagnoses. The results demonstrated that approximately half of respondents felt they experienced barriers to treatment. The most commonly sited barriers were financial difficulty and lack of provider availability.
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Physical Activity and Fall Prevention in Older Adults, an Educational Intervention
Caleb Daniel Knight
Falls in adults over 65 years of age constitute a significant health burden in our country, and this age group is growing rapidly. Falls are addressed with a multifactorial approach, addressing comorbidities, medications, and the physical environment, however, an effective point of intervention accessible by most older adults is physical activity. A brief educational presentation about the morbidity and mortality associated with falls, and the protective effects of physical activity, was provided to Meadowbrook Healthcare subacute nursing home residents in Plattsburgh, NY. Questions were encouraged and answered afterwards, and copies of the presentation were left for the residents to review in hopes of increasing motivation to participate in the Meadowbrook Healthcare rehabilitative classes and exercises.
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ACE’s Contextualization for Healthcare Workers
Nektarios Konstantinopoulos
There is a well-established causative relationship between Adverse Childhood Experiences (ACE’s) and pathology. Despite strong supporting evidence, some healthcare workers are unaware of how deep this relationship is. I conducted an educational session surrounding ACEs targeting healthcare workers in an attempt to contextualize the relationship between ACE’s and consequent disease.
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LGBTQ Inclusiveness in the Primary Care Setting
Joseph J. Lahey
Despite public health efforts in recent years to provide additional care to the LGBTQ community, many health disparities still exist. It is difficult to address these problems due to the lack of organized data being received from health care institutions. Many medical offices have failed to provide a comfortable environment for LGBTQ individuals. This project illustrates a presentation given to staff at a primary care office on how to make the clinical environment more inclusive to LGBTQ individuals in order to provide adequate care.
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Provider Opinion: Should We Screen and Counsel Parents of Teen Drivers Regarding Texting/Distracted Driving?
Daniel Lambert
Adolescent texting and driving has been directly responsible for the deaths of 11 teenagers every day. 33% of teenagers in Vermont admit to texting and driving making it one of the most prevalent risky behaviors in their age group. Currently there is no routine screening recommendation for parents with adolescent drivers addressing texting and driving. Mobile application information can improve parental monitoring and prevent texting and driving habits from forming in adolescents.
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