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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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Skin Cancer Prevention
Jameson T. Loyal
The state of Vermont has one of the highest incidences of skin cancer, and in particular melanoma, in the entire country. In fact, melanoma is the fifth most common cancer diagnosed in Vermont. The purpose of this project is to determine the impact of skin cancer on the state of Vermont and to develop a patient-centered educational brochure in which to educate patients on skin cancer and ways to prevent it. Through interviews with subject experts it is clear that one of the best ways to prevent skin cancer is through education. The informational brochure on skin health met a need in the family medicine clinic. Moreover, a survey was created to determine patients’ knowledge on the topic of skin cancer as well as to determine the effectiveness of the brochure. Finally, an abbreviated version of the brochure as well as a skin lesion history and description form was created for the electronic medical record.
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Improving Breastfeeding Support at a Multi-Service Federally Qualified Health Center
Elisabeth P. Lucas
A student project exploring how breastfeeding is addressed among different patient care teams in a federally funded clinic and using Electronic Health Record data to determine patient needs. Future recommendations included.
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Improving patient understanding of low back pain in the primary care setting
Xiaoyu Lu
Low back pain (LBP) is the most common type of pain reported by U.S. adults across all age groups and is the leading cause of disability worldwide. Up to 80% of individuals will experience LBP at some point in their lives. 411 patients ages 20-98 were seen over a one-year period for LBP at Castleton Family Health Center in Rutland County, Vermont. Patients and providers both saw a benefit to having educational materials on LBP in the office.
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Chronic Pain: Decreasing Dependence on Opioids
Derek Luzim
An estimated 100 million Americans suffer from chronic pain. A substantial number of them have been prescribed opioid medication for pain management. Evidence has accumulated that opioid medication is inefective for long-term pain control, and that it is associated with increased risk of overdose and accidents, diversion, dependence and misuse. Doctors are increasingly attempting to reduce levels of opioid use in their patients, and some patients with chronic pain are reluctant to decrease their use. This project aimed to provide information to both doctors and patients about this issue.
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Addressing Language Barriers When Working With New American Patients
Molly A. Markowitz
According to the Office of Refugee Resettlement, between the years of 1989-2013, 6310 refugees have settled in Vermont. Studies have found that when non-English speaking patients receive professional interpreting services, there is an increase in the recommendation of preventive health services and a decrease in the investigative tests utilized. Currently at UVMMC, there isn't an easy and accessible way for healthcare providers to obtain health information in different languages for patients. Thus, the aim of this project was to create an easy and accessible way for healthcare providers to access health information in different languages and then promote its utilization.
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Assessing Access to Smoking Cessation Resources in Rural Populations
Tristan McKnight
Smoking is a modifiable risk factor for cardiovascular disease. Upstate New York has a high adult smoking rate of 20.9%, compared to a New York state rate of 16.2% and a national rate of 18.1%. The Affordable Care Act has increased resources available that can help smokers quit, including tobacco use screenings, cessation interventions and stop smoking counseling; however, several patients that smoke are unaware of the resources available to them when they are ready to stop smoking. Multiple Cochrane Reviews on the effectiveness of smoking cessation programs demonstrate that some cessation interventions are more effective than others; however, some cessation resources remain unavailable to upstate New Yorkers.
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Reducing Falls: Merging Research and Community Resources
Alison Mercier
1/3 of older adults over the age of 65 fall, 10% of these falls can lead to serious injuries like hip fractures. The average length of life for someone who fractures their hip is 6 months. The risk and reasons for falling are multifactorial and often take a long time to assess. There are a few evidence based recommendations for reducing fall risk, yet a lack of awareness of these recommendations, and community resources to address this need. This project aimed to create a standardized assessment tool based on literature research and available community resources to facilitate fall risk assessment targeted at the most vulnerable population, and risks that have proven interventions.
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Evaluation of Screen Time in Children
Mohammad Mertaban
An evaluation of screen time and media use in children. This project looks to education healthcare practitioners about the effects of current media practices in the United States on children. A presentation was given to healthcare practitioners at a family medicine practice and a brochure was created to distribute to families in the waiting room. Practitioners reported an increase in knowledge regarding the subject of screen time in children, an increase in their comfort level in in discussing these effects with patients, and increase in their ability to effectively communicate the media guidelines of the American Academy of Pediatrics.
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Patient Education: Assessing the Barriers to Utilize & Create Effective Educational Resources for Type 2 Diabetes Mellitus (T2DM)
Alexandra K. Miller
Despite a myriad of diabetic information, group classes and diabetic patient educators, patient’s with poorly controlled diabetes persist. Educating patient's on diet and lifestyle modifications are particularly challenging for the patient and provider and making the changes are even harder. The use of printed patient education material in a primary care setting and referral practices to diabetic educators was evaluated by distributing a brief survey to staff in a primary care office. The convenience sampling showed that some staff did not offer printed materials at all and patient's seldom requested these resources. The referral practices and preference of counseling patient's on diet and exercise was provider specific. Practice guidelines may benefit patient's and increase participation in group classes and prevention programs that focus on behavioral changes, diet and lifestyle modifications.
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Evaluating patient literacy to improve health outcomes in Milton, VT
Lindsay R. Miller
Health literacy is one aspect of overall literacy that has an enormous impact on patient health outcomes, including knowledge of disease, health markers, general health status, and number of hospitalizations, among others. More than 1/3 of the US population has basic or below basic health literacy status. In Chittenden County, diabetes and heart disease deaths are higher than the state average; these diseases require complex personal care and management. Health care providers working at Milton Family Practice in Milton, VT, often noted that patients were often unwilling to disclose literacy issues and there were often problems communicating instructions to patients when providers were unaware of their literacy status/abilities. Residents working at Milton Family Practice were given three simple screening questions that were validated to assess patients' health literacy status with good sensitivity and specificity. These questions are quick and easy to use and avoid many issues with embarrassment or stigma. Residents were also provided local community resources to refer patients to who may benefit from additional help, including the Milton Public Library and the Milton Family Community Center.
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