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Implementation LGBTQ+ Health Education Through Case-Based Learning
Bradley A. Blansky
Primary care graduate medical education programs often do not provide adequate training regarding the healthcare needs of the LGBTQ+ population. The purpose of this community project was to develop a case-based teaching session to help provide family medicine residents a basic understanding of LGBTQ+ healthcare. This didactic session was found to be an engaging and effective method of teaching physicians about LGBTQ+ health. Additional work is needed to further train physicians and other healthcare professionals about the challenges faced by marginalized populations in our healthcare system.
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Culturally Sensitive Carbohydrate Sources for Nepalese with Diabetes or Prediabetes
Rachel Bombardier
Over 8,000 refugees have started new lives in Vermont since 1980. Many of these people utilize the Community Health Centers of Burlington, for some this may be their first time navigating America's healthcare system. This is a daunting task due to a multitude of barriers, including missing cultural competencies in various aspects of their care. This project focuses on dietary recommendations for Nepalese patients with prediabetes and type 2 diabetes, specifically carbohydrate sources based on fiber content. Type 2 diabetes is a very prevalent chronic disease that costs Vermont $520 million each year. Understanding healthy food options in a culturally sensitive approach, will allow better care and recommendations for the Nepalese. A Nepalese-focused handout on carbohydrate sources was generated based on local Asian markets that they frequent.
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Promoting exercise in the elderly population through an informative handout
Stephen Brand
Physical activity has been shown to reduce risk of morbidity, mortality and prolongs life expectancy in the elderly population. However, many factors can inhibit one’s ability to exercise, including economic strain. Fortunately, a program known as SilverSneakers provides access to fitness centers and fitness classes designed for seniors which is included with certain eligible Medicare plans. This project aims to promote physical activity in patients aged 65 or greater who may not be aware of the potential access they have to local health clubs in the greater Southern Connecticut area.
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HIV Pre-Exposure Prophylaxis (PrEP): Increasing Awareness in Primary Care
Carl W. Brasch
Primary care is a setting that has great potential for screening and reducing the rate of HIV transmission.
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Healthy Affordable Food in Milton, VT
Nicholas D. Brunette
Access to healthy affordable food is a common issue in nationally and in Vermont. This project aims to provide resources for patients and families at Milton Family Practice who need access to healthy food options.
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Healthy Affordable Food in Milton, VT
Nicholas D. Brunette
Food insecurity disproportionately affects those of lower socioeconomic status and ultimately leads to poorer health and excess healthcare expenditures. Providing local and online resources for healthy affordable eating to patients of Milton Family Practice may help address some of these concerns.
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Implementation of an Ultrasound Screening Program in a Rural Family Medicine Practice for Abdominal Aortic Aneurysms
Rachel Carpenter
The American Academy of Family Physicians (AAFP) supports the USPSTF recommendation of a one-time screening assessment of all men aged 65 to 75 years old who have ever smoked for an abdominal aortic aneurysm (AAA) via ultrasonography – grade B recommendation. Despite this, few eligible patients are referred specifically for screening and many patients that are screened only have it performed as an incidental finding of other indications for imaging. AAA screening, when done, has demonstrated up to a 40% reduction in AAA specific deaths and a 3% reduction in all cause mortality after 13 years follow up. The initiation of ultrasound use in a primary care clinic has the potential to not only increase AAA screening but also lead to more widespread use of this imaging modality on a comprehensive level.
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Barriers to Head and Neck Cancer Treatment in Rural Populations
Amy K. Chang
Head and Neck cancer (HNC) patients have unique outcomes and resource needs. They often experience debilitating speech, nutrition, respiratory, and psychological problems, requiring a multidisciplinary team. Additionally, they also require more support in terms of alcohol and tobacco support, whether that be an addiction medicine specialist or a support group. The coordination of these specialists is difficult in a rural setting with limited resources. Furthermore, HNC is more prevalent in developing countries and rural populations due to use of known etiological factors like tobacco and alcohol. The combination of high prevalence and low resources in rural populations may lead to suboptimal treatment and worst outcomes.
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Community Services for Patient Referral Document
Jett Choquette
Patients have a need for referral to a variety of services that directly relate to their health and wellbeing that are not generally included in the traditional referral system of healthcare networks. These services include (but are not limited to) social work support, pandemic support, elderly services, LQBTQ+ services, intimate partner violence services, functional medicine, and substance use disorder and mental health support and treatment. Because these services are not part of the traditional healthcare referral system, healthcare providers may not have an up-to-date list of organizations and programs in the community that could provide these needed services. This is especially important in the current era when there has been increased turnover of healthcare workers at all levels leading to low institutional/community knowledge. To address this need, a community service patient referral document was developed after interviewing healthcare workers in the community and reviewing patient needs throughout the family medicine clerkship to inform resource selection.
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Trust Your Gut: Promoting gut health through updated nutrition education
Christina Cobb
Physician time and nutrition education are limited, yet lifestyle changes, including healthy eating, are often the primary intervention for both preventing & managing chronic conditions, such as cardiovascular disease, hypertension, and type 2 diabetes. There is growing evidence of the importance of gut health & the microbiome’s link to several aspects of health, including the immune system, mental health, and metabolic syndrome. Through collaboration with two dietitians, a "promoting gut health" patient handout was created and existing nutrition handouts were updated to reflect current dietary recommendations.
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Primary Care Management of Alcohol Withdrawal
Julie Connor
Alcohol use disorder (AUD) is prevalent yet undertreated in rural Vermont. Approximately half of those with AUD who stop drinking experience alcohol withdrawal. Alcohol withdrawal can range from uncomfortable to life threatening symptoms. Untreated alcohol withdrawal can also lead to recurrence of alcohol use. The mainstay for management of alcohol withdrawal has been inpatient or intensive outpatient programs. However, there are barriers to accessing these programs including availability of beds, patient reluctance, lack of transportation, not knowing about these programs, and cost. Primary care management of alcohol withdrawal is safe, accessible and has the potential to reduce symptoms of alcohol withdrawal, improve engagement with treatment for alcohol use disorder, and reduce alcohol related health complications. In this project, a patient instruction sheet and self-assessment of withdrawal symptoms to be used as part of a protocol for primary care management of alcohol withdrawal.
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A Quality Improvement project on Gender Affirming Hormone Therapy for transgender patients in a rural Vermont clinic
James S. Contompasis
A Quality Improvement project on Gender Affirming Hormone Therapy for transgender patients in a rural Vermont clinicA Quality Improvement project on Gender Affirming Hormone Therapy for transgender patients in a rural Vermont clinic that provided protocols and consent forms for masculining therapy to the practitioners at that clinic who wish to prescribe gender affirming hormone therapy (GAHT)
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IPV: Why Don’t We Screen for Those Committing Acts of Violence?
Hannah K. Cook
State of the evidence for screening for IPV in men or those who are committing acts of violence.
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Adolescent Anticipatory Guidance
Anna M. Corbalan
This project focuses on creating an educational resource specifically for adolescents and young adults regarding the anticipatory guidance for this age group. Although adolescence is generally a healthy time for most, many health or social problems will start or peak during this time. Therefore, it is a crucial time to incorporate preventive guidance and increase health literacy to avoid unhealthy chronic behaviors in adulthood.
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Covid-19, Cold, Flu? What To Know and What To Do
Ryan Cournoyer
A review of Covid-19 symptoms vs the common cold and influenza. Discusses what to do if you think you are sick and when to seek medical care. Helping prevent community Covid-19 transmission and influx of mildly symptomatic patients into primary care clinic and emergency rooms.
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Basic At-Home Exercises for Common Areas of Pain
Willie Dong
Physical Therapy (PT) is often the first-line management for subacute MSK pain seen in the primary care setting. For various reasons patients may be opposed going to PT. For patients that are interested, there is often a latent period before an appointment can be made. Providing resources, including a pamphlet, with all-inclusive, simple at-home exercises may help to accelerate recovery.
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Increasing Awareness and Understanding of the Health Assistance Program: A Patient Resource
Arley Donovan
The Health Assistance Program (HAP) through the University of Vermont Medical Center/Porter Medical Center is a resource for patients in the Network who are struggling to pay for expensive but effective and clinically appropriate medications like injectables for diabetes, anticoagulation drugs or inhalers due to cost, underinsurance or interruption in insurance. The HAP/UVMMC Mail Order Pharmacy helps eligible low- and middle-income families who make at or below 400% of the federal poverty limit get prescription medications at no cost, even if they have insurance. Lack of awareness and understanding about this program by patients and providers could potentially lead to patients self-discontinuing important medications due to cost when they do not have to. This in turn may lead to worsening outcomes and unnecessary emergency room visits and hospitalizations.
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Increasing Awareness and Understanding of the Healthcare Assistance Program: A Patient Resource
Arley Donovan
The Health Assistance Program (HAP) through the University of Vermont Medical Center/Porter Medical Center is a resource for patients in the Network who are struggling to pay for expensive but effective and clinically appropriate medications like injectables for diabetes, anticoagulation drugs or inhalers due to cost, underinsurance or interruption in insurance. The HAP/UVMMC Mail Order Pharmacy helps eligible low- and middle-income families who make at or below 400% of the federal poverty limit get prescription medications at no cost, even if they have insurance. Lack of awareness and understanding about this program by patients and providers could potentially lead to patients self-discontinuing important medications due to cost when they do not have to. This in turn may lead to worsening outcomes and unnecessary emergency room visits and hospitalizations.
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Improving Patient Education Surrounding Imaging Modalities
Tayler Drake
Musculoskeletal complaints are among the most common problems seen in family medicine clinics. Patients may expect that every musculoskeletal complaint requires imaging, however, they may leave the clinic without a referral to radiology. This discrepancy between reality and expectation may strain the patient-provider relationship. The goal of this project is to educate patients regarding imaging modalities and when it is appropriate for imaging to be ordered in the workup of a musculoskeletal complaint.
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Mammography among Nepali New Americans
Rose Eiduson
This presentation describes an effort to increase uptake of mammograms among Nepali New Americans at the Community Health Centers of Burlington, VT. After interviewing the Medical Director and hearing from patients about barriers to mammography, an infographic and Powerpoint slide was created and will eventually be translated into Nepali. Future efforts to improve uptake of mammography could include a preventative care course for New Americans and/or a coordinator assigned to preventative care efforts.
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Circumcision for the Male Infant: Patient Education and Cultural Humility
Grace E. Eisenbiegler
Male circumcision is a religious and cultural decision that has become increasingly medicalized. Many families make decisions about circumcision based on culture and family without true informed consent. There is a need for unbiased information, prior to delivery, about circumcision, so that families may make an informed decision that is right for them. A one page document was created as an addition to the clinic's pregnancy guide with information on risks and benefits of circumcision, complications associated with the uncircumcised penis, cultural significance, and care of the uncircumcised penis.
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