Block Clerkship Projects

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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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  Perinatal Depression: Breaking Barriers to Treatment

  Florence Lambert-Fliszar

  Depression in the perinatal period is a common medical issue in Vermont, affecting about 10% of women. Multiple and severe consequences of depression during this time are seen for both mothers and babies, including lower breastfeeding rates, fewer healthcare visits for the child, and psychopathology in the child later on. The goal of this project is to identify and address some of the barriers we currently face in identifying and treating women for depression. Major barriers women encounter in seeking help involve poor recognition of symptoms facing increasing stress of motherhood, stigma, as well as neglecting to attend to mental health preemptively. An educational pamphlet for mothers was developed to address these issues.

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  Breaking the Bank: Cost of Cigarettes in Vermont

  Ryan Erik Landvater

  Smoking is still the leading preventable cause of death in the USA with 75% of current smokers expressing a desire to quit, though a meager 2-3% succeed. Previous research has shown that financial incentives for smoking cessation are among the most efficacious. Vermont has implemented high taxation to these ends, though many smokers still do not grasp the financial burden it poses on their discretionary income. A handout was developed that conveys both the cost of smoking at a pack rate over set time frames and provides potential savings rendered by nicotine replacement therapy. The handout will be made available as part of patient instructions printed via the electronic medical record system used by UVM.

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  Osteoporosis Education: An Insight into Risk Factors & Prevention

  Alan Lee

  In longitudinal studies of women residing in northern latitudes (i.e. Vermont), bone loss was most pronounced during winter months when sun exposure and weight-bearing activities are more limited. Although information about screening and treatments for osteoporosis are widely available to patients, there appears to be a gap in education about risk factors that predispose one to this silent yet deadly disease as well as strategies for prevention according to several community interviews that I conducted. In response to my conversations about osteoporosis, I decided to focus my intervention on educating the community about osteoporosis risk factors, recommended weight-bearing exercises, and the types of foods that contain adequate amounts of vitamin D and calcium. A poster serving as an educational guide was created by compiling information from the National Osteoporosis Foundation and the CDC. The poster will hopefully increase awareness about osteoporosis risk factors and motivate patients (both females and males) to start conversations with their healthcare providers on how to best prevent osteoporosis.

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  Restoring Self-Sufficiency with Suboxone Group Therapy

  Jacob Thomas Lehman

  No different than many other Northeastern states, Maine continues to face an opioid epidemic. Drug-induced deaths continue to rise each year and Lewiston, ME remains no exception. In 2017 Maine saw 418 deaths related to drugs, a number that is only increasing every year. There remains a rising need for effective treatments such as medically assisted therapy. Starting in 2018, the Family Medicine Residency at the Central Maine Medical Center created such a group and began treating patients. The scope of this research is to track improvements in self-sufficiency among patients and to aide in advertisement of the program. Programs like this often remain unknown to those seeking treatment.

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  Exercise Education for the Winter Season

  Benjamin H. Lin

  This project aimed to identify barriers and provide a list of resources within the Addison County community to enhance access to exercise during the winter months.

  Exercise Education for the Winter Season

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  PSA Perspectives

  Kirsten Martin

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  Adolescent and Young Adult Medicine: Supporting An Often Forgotten Population

  Isabelle Mason

  The actions and lifestyle choices adolescents and young adults make have profound effects on their future health and well-being. Unfortunately, these patients are often scarce among family practice lineups, making it difficult for physicians to provide impactful preventative care. This project looks at how to help reach these oft-forgotten patients.

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  Prostate Cancer: Patient Education for Changing Guidelines

  Richard Mendez

  In May 2012 United States Preventative Services Task Force (USPSTF) recommended against prostate cancer screening, Grade D, with no other recommendation for providers. Since prostate cancer continues to be among the most common cancer in the United States among men, patients were exposed to previous guidelines during routine visits and require updated educational materials for primary care visits.

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  Combating Childhood Obesity

  Rebekah Misir

  Assessing childhood obesity in Danbury, CT and combating it through counseling.

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  Window of Opportunity for Opiate Dependence

  Scott C. Mitchell II

  Opiate dependence is a prevalent problem and there is a need for current regional information for those seeking to break opiate dependence. There is a small window of opportunity for these patients to seek and find help before they give up and return to using. This project provides a pamphlet with current resources for opiate dependent individuals to get help in a rapid period of time for the Bangor, Maine area.

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  Incontinence and Pelvic Floor PT in the Primary Care Setting

  Nikolas A. Moring

  Stress incontinence and overactive bladder are two causes of decreased quality of life in the general population. Many patients report a long latency between the onset of symptoms of incontinence and identification and treatment. This project aimed to provide educational materials to both providers and patients about incontinence to help better identify patients who may benefit from pelvic floor physical therapy. Pelvic floor physical therapy has been demonstrated as a safe, non-pharmacological intervention for stress incontinence which may be overlooked in the primary care setting.

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  Understanding Dual Energy X-Ray Absorptiometry (DEXA) Bone Scan Results and Treatments

  Jennifer C. Morris

  Patients come into the St. Albans NOTCH primary care office for a follow-up to their DEXA scan to learn about what their results mean and discuss any questions/concerns. This brochure will help to standardize the information presented by providers about the results.