Block Clerkship Projects

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Cyberbullying: A Resource for School-aged Children, Adolescents, and Parents in Milton, Vermont

James K. Rohwer

Cyberbullying occurs when harmful words or actions by one or more persons are intentionally and repeatedly directed against another person in the digital world through text message, social media, e-mail, apps, online video games, forums, etc. Today, more children and adolescents are connected to the internet than ever before, which puts them at risk of becoming victims of cyberbullying. Many victims, as well as parents of victims, may not be familiar with the resources that are available to them in the areas in which they live when concerns of cyberbullying arise. Therefore, the goal of this project was to create a pamphlet with information about cyberbullying, including local resources for victims of cyberbullying, to be made available to children, adolescents, and parents in Milton, Vermont.
Transportation as a Barrier to Healthcare

Melissa Romero

Lack of transportation is large barrier to medical care, particularly in rural areas. Many patients decline medical appointments because they do not have access to a personal vehicle or other transportation resources. Consequences include missed appointments and higher healthcare costs for patients and providers in the future. Solutions will involve educating patients on resources available to them, simplifying access to current programs, introduction of new programs, and the collaboration of public and private entities to provide new services.
Interventions for fall prevention in community-dwelling older persons

Gregory S. Roy

Falls in individuals over the age of 65 is a pervasive problem resulting in significant health and economic burden in our country. Thus, effective fall prevention strategies are an important public health measure, especially in an age group that is growing rapidly. Research has shown a multifactorial approach to fall prevention addressing environmental hazards, strength and balance, medications, and medical comorbidities to be most effective. Despite there being strong evidence to support this, many individuals are unaware of the factors that put them at risk and ways to mitigate them. An educational pamphlet containing evidence-based strategies to reduce fall risk was produced for distribution within the New Milford primary care clinic in New Milford, CT.
Fostering Competent Healthcare for Transgender and Non-binary Patients

Alden York Sacco

Many transgender and non-binary individuals are hesitant to seek medical due to past traumatic encounters with physicians and medical staff, having to educate providers about their bodies, perceived bias, and fear of mistreatment. This reluctance to seek medical care, and even to disclose their transgender status, can result in poorer health outcomes due to delays in diagnosis, treatment, and prevention. An in-office training was designed to introduce clinicians and office staff to health care disparities facing transgender and non-binary people, appropriate pronoun-use and key terminology, strategies for creating a welcoming and gender-affirming environment for trans and non-binary patients, and useful resources and guides that can be used in clinical settings.
Improving Awareness of Transportation Services in Lamoille County

Sienna Searles

This project was aimed to identify and address transportation needs of patients in Lamoille County to their medical appointments. A handout was created, which lists all of the transportation resources in the county that are available to patients. This handout was hung up in patient rooms and in the waiting room at Stowe Family Practice. This intervention was met with support from patients and staff at the clinic.
Acute Respiratory Tract Infections and How to Treat Them

Shivani Seth

Acute respiratory tract infections (ARTIs) are one of the most common clinical encounters in primary care settings and they often lead to antibiotic prescriptions. However, more than 90% of ARTIs are caused by viral syndromes. Evidence has showed that interventions addressed at antibiotic prescription practices for ARTIs are critical to combatting the widespread overuse of antibiotics and increase in antibiotic resistance infections in the US. Providers report pressure from patients to prescribe antibiotics even when they are not clinical indicated and patients have several misconceptions surrounding the clinical course of ARTIs that lead to this behavior. A brochure was developed to address the symptoms and duration of various types of ARTIs, the supportive treatment that can provide relief, and the dangers of antibiotic overuse and resistant infections. This brochure can be used in primary care settings to reduce pressure from patients to provide antibiotics by educating them on antibiotics are rarely indicated for ARTIs.
Screening for Developmental Delays During the Well-Child Visit

Ellen Walker Seyller

Due to recent staffing transitions, family medicine physicians at Newtown Primary Care in Danbury, CT are now managing the care of an increasing number of pediatric patients. The goal of this project was to develop a screening tool to allow practitioners to assess for developmental delays during well-child visits. The tool includes 10-question surveys for ages 1mo, 2mo, 4mo, 6mo, 12mo, 15mo, 2yo, 3yo, or 4yo with a scoring guide and a list of some concerning signs at each stage.
Community-Based Exercise Education During Colder Months

Cole S. Shapiro

Approximately 50% of US adults and 75% of US high school students don't meet recommended weekly physical activity guidelines, and physical activity declines further during colder seasons. Resources describing local suggestions for physical activity should be made broadly available to community members, such as at their primary health care office.
Food Label Made Easy

Hanaa Shihadeh

The use of food labels and adherence to dietary recommendations are important, especially for those with chronic diseases due to the well known relation between chronic disease and poor nutritional habits. Although food labeling has been introduced since 1994 with the aim of combating obesity and diet-related chronic disease in the USA, the rates of food label use among US adults have decreased over the past decade.
A Provider's Guide to Medical Cannabis: THC and CBD. Putting the Evidence to Work for Improved Patient Care

Danielle Smith

Please use abstract uploaded with previous powerpoint
Initiating healthcare agent education in time limited settings

Alan Su

Most patients are willing to have advanced care planning (ACP) discussions with their medical team, even if they may be young and healthy. Yet, time constraints, perceived stigma of conversations surrounding death, and the educational requirement of documentation are known barriers for care providers to have these discussions. Identifying a health care agent (HCA) can be an important first step to continued ACP in the primary care setting. The purpose of this project is to propose a systemic approach to having HCA discussions in a time-efficient manner that can be easily implemented as part of a routine medical interview.
Social Media's Impact on Mental Health in Children & Adolescents

Georges Tahhan
FACTORS INFLUENCING SUBOXONE RELAPSE: A SURVEY IN A NORTHWESTERN VERMONT RURAL PRIVATE FAMILY PRACTICE

Derek W. Tan

The opioid crisis has warranted nationwide attention towards not only the current prescribing patterns of pain medications, but also towards rehabilitating affected members of the community. Current interventions include the use of Suboxone (buprenorphine + naloxone) as well as Subutex (buprenorphine). As the implementation of partial opioid antagonists increase on a statewide level, investigating factors such as drivers of substance relapse are worth considering to further improve adherence to currently available treatment regimens.
Education and expectations for patients with viral upper respiratory infections

Kathryn Thomas

Non influenza viral upper respiratory illnesses are responsible for a significant percentage of sick visits to primary care physicians. Patients who expect antibiotics are more likely to be given them, and this contributes to growing antibiotic resistance. Setting appropriate expectations for the course of a typical upper respiratory infection can reduce repeat visits, and reduce the number of antibiotic prescriptions. Additionally, many over the counter cold and flu remedies do not have a significant impact on cold duration or symptoms. The flyer produced in the course of this project details the average time course for an upper respiratory infection, instructs on what symptoms do warrant a visit to the physician, and describes effective symptom treatments and proven preventative strategies.
When to Bring Your Child to the Emergency Room: a pamphlet for parents

Trina Thornburgh

For decades, emergency departments (EDs) have struggled with overuse. Children who receive their primary care at a community health clinic or who are Medicaid-insured are twice as likely as private practice patients to seek care in the ED. Additionally, many New American families do not have a comprehensive understanding of the US healthcare system. A pamphlet was created as a health literacy intervention for parents to better understand when to call 911, visit the ED, or go to a primary care provider. The pamphlet is being translated into 8 languages commonly spoken by New American families in Chittenden County, VT.
Intermittent Fasting as an Early Intervention in Diabetes and Obesity

Nam Trinh

Intermittent fasting has been a popular diet over the last decade. New research during the last 3 years have been promising and show that it can be an effective diet for patients with diabetes.
Patient Education on Sweetened Beverages: an Interactive and Module-based Approach

Matt Tsai

As sugary beverages continue to contribute to negative health outcomes, there remains a need for efficient, effective patient education in this area. A custom, interactive and reflective web-based module on sugary beverages for adult participants (n=42) was introduced at a rural Vermont outpatient clinic. Built-in quizzes evaluated learning through a pre and post-intervention design. On average, participants improved significantly from a pre-module mean score of 3.00 to a post-module score of 4.33 (p<0.0001). Additionally, participants' average rating of the module's effectiveness was 8.3 out of 10. A module-based approach may be one efficacious solution to improve patient education on sugary beverage consumption.
Increasing the use of Probiotics concurrently with Acute Antibiotic Treatment: A Community Perspective in Newtown, CT

John Vandenberge

Acute antibiotic courses are known to cause gastrointestinal side effects including nausea, bloating, and diarrhea. Patients at Newtown Primary Care in Newtown, CT being treated with antibiotics for upper and lower respiratory infection often present with these side effects. These symptoms may deter patients from taking the full course and promote bacterial resistance, delayed recovery, and increased patient healthcare costs. Safely tolerating antibiotic regimens is important especially in those at high risk for Clostridium difficile colitis. Probiotics have been shown to prevent antibiotic associated diarrhea and effectively balance bacterial species within the gut microbiome. An educational, easy-to-read handout was developed for Newtown patients starting an antibiotic to help maintain gut microflora via naturally fermented foods such as yogurt, kefir, kimchi, and sauerkraut.
Let's put the Kibosh on Cardiovascular Disease

David Viscido

Heart disease is the #1 cause of death in the US. Coronary heart disease (CHD) is the most common form of heart disease. The age-adjusted rate of death due to heart disease is no longer on the decline, and Vermont is not meeting its statewide goals for reducing the death rate due to CHD. The purpose of this project was to reinforce decades-long efforts to educate Vermonters on the modifiable risk factors of heart disease. The hope is to remind people that, though heart disease isn't going away any time soon, we can each make healthy lifestyle changes to reduce our risk of heart disease.
Patient Guide to Access Quality Health Information Online

Danielle Wall

A large percentage of patients use online search engines to access health information. However, there is a large amount of health information online that is unregulated and not evidence-based. As a result patients may acquire health information that is incorrect which may negatively affect patient-provider relationships and patient's healthcare. A brochure was created to highlight safe practices for accessing health information online.
Increasing Awareness of Health Risks Associated with Vaping in Youths

Patricia Wang

E-cigarette and use of electronic nicotine delivery systems is a growing trend among youths in the United States. According to the National Institute of Health 2018 Monitoring the Future Survey, the 10th and 12th grade increases in nicotine vaping are the largest ever recorded for any substance in 44 years of tracking youth drug use. Increasing evidence about the potential health risks of vaping, as well as prediction of future cigarette use or experimentation, underlines the need for more preventative health measures to curtail this growing drug epidemic. The aim of this community health project was the development of an educational fact sheet on vaping as an aid for primary health care providers in Vermont to discuss e-cigarette use with teens, older youths, or their guardians.
A Quick Guide To Eating Healthy with Type II Diabetes

Caleb Lee Watkins

Diabetes is becoming increasingly more prevalent in the U.S. and in the state of Vermont. With an increased prevalence of diabetes and a worsening obesity crisis, the total cost of diabetes management is increasing as well. The population around Bellows Falls, VT has not been spared from this epidemic. Many patients in this region have struggled to make and maintain lifestyle changes, particularly surrounding diet and exercise. Therefore, a one-page, double-sided handout was created to provide easily digestible information to patients about managing their diabetes through proper nutrition.
A Quick Guide To Eating Healthy with Type II Diabetes

Caleb Lee Watkins

Diabetes is becoming increasingly more prevalent in the U.S. and in the state of Vermont. With an increased prevalence of diabetes and a worsening obesity crisis, the total cost of diabetes management is increasing as well. The population around Bellows Falls, VT has not been spared from this epidemic. Many patients in this region have struggled to make and maintain lifestyle changes, particularly surrounding diet and exercise. Therefore, a one-page, double-sided handout was created to provide easily digestible information to patients about managing their diabetes through proper nutrition.
Improving Cardiac Arrest Outcomes with Hands-Only CPR

Ethan Witt

Bystander CPR is one of the most effective and necessary components of cardiac arrest management, increasing survival rates by two to three times. However, rates of bystander CPR are inadequately low. Hands-only CPR has been found to be an effective intervention in the management of cardiac arrest and addresses many of the barriers to bystander CPR.
Mindfulness: an underutilized tool for patients and providers alike

Candice Wolf

A healthy body begins with a healthy mind, and a healthy mind begins with mindfulness. Mindfulness means paying attention on purpose and without judgment. It has been shown to reduce: anxiety, blood pressure, gastrointestinal distress symptoms, PTSD, pain, insomnia, depression, and healthcare cost. 63% of American’s are stressed about the future of the nation, money, work, the political climate, violence, and crime. Primary care providers have the opportunity to introduce patients to mindfulness to compliment and/or potentially replace current alternative pharmacologic options.