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Pap Smear Compliance Study at EMMC, Bangor Maine
Do Gwak
Many factors contribute to the accurate reporting of pap smear compliance in patients population. The factors identified during the study are system failure of EMR to track pap smear records and lack of communication among different clinics.
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Identifying Barriers to Healthcare Access for the Somali Population at CMMC
Matteen Hakim
The city of Lewiston has a significant Somali population, but that population is very poorly represented in the patient population at CMMC and the Family Medicine Residency (FMR). This project was meant to elucidate the Somali perspective on this discrepancy in order to share it with physicians at the FMR as a first step towards fixing the divide.
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Williston, VT: Evaluating Child Lead Screening Rates and a Potential Exposure
Ethan R. Harlow
The CDC recommends that all 1-and 2-year-old children be screened for lead and that the most effective measure for mitigating lead poisoning in children is through primary prevention. This study evaluates lead screening rates at a Family Medicine Clinic in Williston, VT and seeks to gather community perspective on a potential failure of primary prevention in the town.
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Increasing Naloxone Distribution in VT Emergency Departments
Olivia M. Harris
Fatalities caused by overdose from opioids are increasing in Vermont. Evidence shows that Naloxone safely and effectively reverses the effects of opioids in overdose. This project aims to determine why physicians in VT Emergency Departments are not consistently distributing Naloxone to all patients with an overdose, and to increase awareness and implementation of this practice.
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A Multi-System Approach to Help Prevent Teen Suicide in the Upper Valley: A Focus on the LGBTQ Community
Charlotte V. Hastings
LGBTQ adolescents are at much greater risk of committing suicide as compared to their straight and cisgender peers. This project focused on connecting various community organizations working on teen suicide and compiling a list of resources so that primary care providers might play a more pivotal role in providing mental health support to the Upper Valley’s LGBTQ teens.
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Development of Guidelines for Refugee Screening at CMMC Family Medicine Residency, Lewiston, Maine
Catherine Hayes
Lewiston Maine has the second highest number of refugees in the state of Maine, with 191 total intakes in 2015. Refugee populations face unique health concerns, and providing care for refugees requires education and development of a specialized skill set. This project provided a reference for clinic providers to assist with medical intake screening visits for refugees.
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Williston, VT: Increasing the Awareness of Hypertension Implications and Sequelae
Tinh Thanh Huynh
Hypertension is the most common reason for health office visits in the US and for the use of prescription drugs. Many patients fail to truly understand the diagnosis of high blood pressure and the various health consequences that comes with poor regulation such as cardiovascular disease, stroke and renal disease. This project was aimed to increase patient education on the implications of hypertension and its complications.
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Suboxone Treatment in Caribou, ME: Evaluating Barriers and Engaging with Mid-Level Providers
Michael Ialeggio
The Medication Assisted Recovery (Suboxone) program in Caribou, ME was started in 2004 as a cooperative endeavor by Aroostook County Mental Health Center and "Pines Health Servies". Since its inception, the program has experienced provider attrition. This project aimed to evaluate barriers to becoming and remaining a provider of Opiate Replacement Therapy, and to engage and inform local mid-level providers who will soon be eligible to become providers under the Comprehensive Addiction and Recovery Act passed in July 2016.
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Broadening perspectives on the management of chronic pain
Daniel Ianno
Complementary and alternative treatments are often overlooked when managing patients with chronic pain. Given the prevalent problem of prescription opioid abuse, narcotics should be avoided in the treatment of chronic pain if possible. When appropriate, practitioners should ensure patients have explored a wide variety of pain relief therapies prior to initiation of narcotics for the treatment of chronic pain. Increasing awareness and understanding of complementary and alternative therapies among practitioners and patients will hopefully help to mitigate the perceived need for narcotics in the treatment of chronic pain.
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Injury Prevention in Adolescent Female Athletes in Western Connecticut
Allicia Imada
Sports are the leading cause of injury in adolescents and can have long-term psycho-social and physical consequences especially in adolescent females. To increase knowledge and awareness of injuries and injury prevention in adolescent female athletes a short workshop was presented to 56 adolescent field hockey players who improved by 31.1% correct on knowledge based surveys from information in the talk and took home pamphlets. Hopefully in the future the workshops can be expanded to other athletes and sports, and specific information about injury prevention programs that have been shown to decrease injury rates an be shared with the community.
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Improving Annual Influenza Vaccination Through Patient Education
Benjamin Jorgensen
Influenza, commonly called the flu, is a seasonal respiratory virus which circulates each year and causes mild to severe illness which can lead to hospitalization and even death. Despite the advent of the flu vaccine during the Second World War, flu-related illness is the 8th leading cause of death in the United States. Each year the severity of flu in the United States is affected by many factors including characteristics of the circulating virus, timing of the season, how well the vaccine matches the season’s active strains of virus, and vaccination rates. The annual vaccination rates remain low despite public awareness of the illness and the vaccine. Therefore, educational material is a necessary step toward supplying patients with information regarding the need for, effectiveness, safety, and availability of influenza vaccines.
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Chronic Pain Management: Local Resources and Education
Colby Russell Kearl
Many patients with chronic pain are not aware of many treatment options and local resources available to them. Local providers know these resources, but often are not able to convey such vital information to patients due to time constraints. Educational handouts are often provided to patients allowing them to take time outside the clinical encounter to explore other options and resources.
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Regulating Kids' Meals to Combat Childhood Obesity
Y-Lan Khuong
Obesity is an epidemic crossing genders, ages, socioeconomic status, geography, and race/ethnicity. In Vermont, 11.3% of 10 to 17-year old are considered obese, thereby increasing risk for numerous health issues. One contributing factor is an increased tendency to eat away from home. This project aims to provide qualitative evidence regarding response to policy setting nutritional standards for kids' meals in Vermont restaurants.
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Calcium Supplementation
Jani M. Kim
Calcium supplementation is recommended for patients with osteopenia or osteoporosis to prevent further bone density loss. However, recent studies have shown associations between high calcium supplementation and increased cardiovascular disease and kidney stones. This study looks into current recommendations for calcium supplementations in light of these new findings.
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Improving Pediatric Oral Health through the Primary Care Physician
Sarah King
Dental health is an important part of pediatric growth and development. Childhood dental caries represent the most common childhood disease, more than four times as common as asthma and seven times as common as hay fever. In the state of Vermont in 2009-2010, 34% of children in grades 1-3 had a history of dental caries. Furthermore, patients of low socioeconomic status, racial or ethnic minorities and patients with disabilities bear a much greater burden of pediatric dental caries. This project aimed to improve pediatric oral health at Milton Family Practice through an educational handout, and to provide resources for finding a dentist, particularly for patients with Medicaid insurance or who are uninsured.
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Test Your Knowledge: STI Questionnaire and Education
Talia Kostick
Project aims to improve education concerning sexually transmitted infections (STIs) in the teenage patient population of Springfield Health Center Family Practice. Teenage patients were found to only cite pregnancy prevention, and not STI prevention, when asked by medical providers why they should use condoms.
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Addressing Transportation Barriers to Healthcare in Windham County, VT
Susannah Kricker
Limited access to transportation presents a significant barrier to obtaining health care for residents of Windham County, Vermont. This project, created in collaboration with the community health team at Grace Cottage Hospital in Townshend, VT, offers a comprehensive outline for a transportation assistance program in the region. It takes a multifaceted approach to overcoming barriers created by financial constraints and limited transportation resources.
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Accessible Contraceptive Education in VT
Alyssa Kwok
Trying to understand options for contraception can be challenging given the myriad of complex options. Providers at CHCB requested a tool with a user-friendly format that takes the varying health literacy of their diverse patient population into account. It needed to contain key features such as efficacy, pros, cons, and usability. The goal of the tool is to be a visual aid for providers that will assist them in helping patients make informed decisions about contraception.
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The Urologic Referral: from the patient's perspective
Troy R. Larson
Nearly 20 million visits to an Urologist occur annually in the U.S. Most urologic providers are older males. Although the most common patient seeing an Urologist is an older male, a significant number of patients do not fit within these demographics. The field of Urology entails discussion and treatment of personal and sensitive health issues, thus some patients may prefer or would be most comfortable with their physician to process similar like qualities.
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The Importance of Collecting an Accurate Family Medical History
Danielle T. Leahy
Family medical history has been recognized as an important non-modifiable risk factor for many chronic diseases including cardiovascular disease, diabetes, and even several types of cancer. However, a number of studies have shown that patients’ recall of their family history is often inaccurate and missing important information such as family members’ age at onset or diagnosis of a disease. Additionally, there is substantial variation regarding how often family physicians are actually obtaining FMH during visits. Patients’ understanding of the importance of obtaining an accurate FMH and even their perception of familial risk of common chronic diseases is also highly variable based on personal experiences and education.
Therefore, to assist physicians in acquiring a more accurate and detailed family medical history from patients it would appear that patients need to be educated on why collecting this information is an important part of understanding of their own health and risk for developing diseases. In addition, patients should be given the opportunity and the tools necessary to gather their family medical history prior to the scheduled visit with their physician, allowing the patient more time to have a conversation about health history with their family members. The purpose of this project was to design and implement an educational handout about the importance of collecting an accurate family medical history in addition to creating a form for patients to record their family medical history.
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Confronting Barriers to Exercise in Patients with Chronic Health: Community Health improvement project in the Lewiston/auburn Area Concerns
Marie R. Lemay
The CDC recommends at least 150 minutes of moderate-intensity aerobic activity every week, but most individuals with chronic disease do not reach this goal despite its numerous health benefits. Research has shown that scheduled exercise programs and exercise partners help individuals to sustain their exercise goals. Using this premise of group mentality individuals affected from cancer at the Dempsey center and patients attending CMMC’s diabetes group in Lewiston ME were polled about exercise self –efficacy and barriers to exercise. Subsequently, a one-time walking event was offered to the diabetes group and a phone-tree was introduced to one yoga class at the Dempsey Center in an attempt to encourage commitment to exercise.
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Transportation as a barrier to access to care in Bangor and the surrounding Penobscot County area
David A. Leon and David A. Leon
The focus of this project was to assess issue with transportation as a potential barrier to accessing health care in Bangor, Maine. This pilot project involved interviews with community members and providers, as well as evaluated the needs in terms of transportation for accessing primary care. Research regarding this need was conducted through anonymous patient surveys, conducted by the author, and was used to guide the recommendations for future interventions that would address transportation issues in Bangor and the Penobscot County area.
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Increasing Provider Understanding: Somalian Population of Lewiston-Auburn
Christina Litsakos
The Somalian refugee population of Lewiston, Maine has grown in size since 2001 and continues to flourish in this once struggling city. Increasing provider understanding of this unique population will help foster the delivery of optimal primary care to minority patients. As one of the core values of family medicine, understanding our patients beyond their illness is paramount to providing quality health care.
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Optimizing Transitional Care Management
Mary Katherine LoPiccolo
Since the institution of the Transitional Care Management billing codes by the Centers for Medicare and Medicaid Services in 2013, primary care practices nationwide have worked to meet expectations and provide high-quality care to patients upon discharge from hospitalization. In St. Albans, Vermont, the complexity of preparing for successful transitions of care has challenged family medicine providers and supporting staff. Thus, this project sought to provide a structured process by which the primary care team may communicate with inpatient staff, the patients, and each other and collect information required to ensure smooth transitioning of the patient back into the setting of their "medical home."
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