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Primary Care Office Education on Resources for Uninsured Patients
Surya Radhakrishnan
The Nuvance Patient Financial Assistance Program offers financial support for income-eligible patients and connections with financial counselors. This project aims to understand how many people who work in primary care know about the Nuvance Patient Financial Assistance Program and to create an educational tool for providers to learn this information for their patients’ benefit.
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Understanding Barriers to Providing Medical Aid in Dying (MAID) to Out-of-State Residents
Gurkiranjit K. Rattu
Act 39 was established in May 2013 to provide individuals with documented terminal conditions the option of MAID (Medical Aid in Dying). Access to this care is now available to out-of-state residents who can establish care with a Vermont provider so long as all aspects of this care occurs in Vermont. Grace Cottage has received many calls from out-of-state residents requesting this care and they have created a program within their limited capacity to absorb new patients. This study was conducted to find out attitudes, current practices, and how receptive current primary care physicians are to extending services to out of state residents.
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What's on my Child's Skin? An Introduction to Pediatric Dermatology for New Parents
Nicole W. Salib
Many new parents come into their primary care offices concerned about their child's skin findings. The majority of these findings are benign and can be treated with OTC medications or conservative treatment. This module is designed to educate new parents on their child's skin lesions, decrease parental anxiety and improve communication between the parent and physician.
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Healthy Snacking Recipes for Improving Healthy Diet Adherence
Shruthi Santhanakrishnan
Diabetes and heart disease are highly prevalent diseases that affect millions of people. Lifestyle changes such as diet and exercise have been shown to be highly beneficial for this patient population in managing their chronic illnesses. As a result, primary care visits centering around these diseases include conversations about diet. Patients in our clinic have reported difficulties adhering to a healthy diet due to cravings for a snack or lack of variety in their meals. This project aims to create a resource and spread awareness of healthy snacking options provided by the American Heart Association to aid patients in healthy diet adherence.
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Inclusive Care Initiative: Creating Safe Spaces for LGBTQ+ Patients
Susanna L. Schuler
This project aims to create a more welcoming environment for LGBTQ+ patients at a family medicine clinic by introducing small, yet meaningful, changes. Interventions include providing pronoun badge cards and updating urine collection instructions. These efforts are designed to signal acceptance, foster open communication, and improve patient comfort, ultimately contributing to more inclusive healthcare experiences for the LGBTQ+ community.
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Organizing Community Resources for Patients with Neurodegenerative Diseases
Ava Siegel
With the rising population age, neurodegenerative diseases, such as Alzheimer's Disease, Parkinson's Disease, and Amyotrophic Lateral Sclerosis, are expected to become increasingly more prevalent in the next few decades. Patients and families dealing with these diseases must manage not only their health, but also added factors including transportation to medical appointments, increased care needed at home, and caregiver support/respite, all on top of the burden of these additional costs. While a variety of programs exist to lessen the onus on patients and families, access to resources, particularly in rural areas of the United States, remains a crucial barrier. To improve knowledge and access to local resources, this project aimed to create a hand-out for patients and family members with neurodegenerative diseases designed to be distributed at family medicine clinics in and around Wells River, VT.
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Mental Health Resources for Pediatric Patients
Deepinder Singh
Mental health concerns in pediatrics patients have been rising since before the pandemic. There are a number of barriers to pediatric patients getting the mental healthcare they need. One of these relates to help-seeking behaviors, where children and families who don't have the right awareness of resources available to them may not be able to seek the care required. This project aimed to create a smartphrase that provides pediatric patients and families with a list of resources for finding a counselor/therapist, mental health crisis resources and other community resources both within Chittenden County and other VT counties, and links to resources about how parents can support their children's brain health at home.
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Early Socialization in Rural Communities
Regan Staudenraus
Early childhood socialization has been connected to positive outcomes for children's behavioral, physical and mental health as they reach school age. Particularly, social-emotional development for pre-kindergarten children is positively impacted by opportunities for peer interactions, including daycares, community events, and parent child programming. The North Country region of New York is considered the most rural region in the state, where children and families are burdened by cost, accessibility, and transportation barriers when seeking peer learning opportunities. This study addresses accessibility and cost determinants through primary care intervention in at risk children.
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Promoting Mindfulness Among Medical Professionals and Patients
Isabella R. Sutherland
Residents and physicians often feel overworked and overwhelmed, neglecting to take time for themselves to practice mindfulness and self-care. Strategies to promote mindfulness among healthcare providers have the potential to improve measures of personal well-being as well as patient outcomes.
From a patient-facing perspective, there is recognition of the utility of mindfulness practices in combatting the impact of chronic disease. However, visits are short, and it’s easy to simply not have time to discuss mindfulness - there is a need for easy-to-access educational resources to provide patients with to review on their own time.
I created a learning module for the residents at my family medicine placement to address both of these issues - to educate on the evidence-based benefits of mindfulness meditation, and to provide them with resources to promote their own mindfulness and the mindfulness of their patients.
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A Resource Guide for Patients to Access Local Dietitian Services
Alyssa Tenney
Patients at the Community Health Center lost access to an on-site registered dietitian (RD). Patients who are interested in dietitian services will need to be directed to other RDs in the community. Many patients and providers do not know all the community resources that are available and what local RDs specialize. This project created a hand-out for patients with a list of resources available in the community, contact information, insurance coverage details and what different sites specialize in.
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Barriers For Patients With Limited English Proficiency On The Usage Of The Electronic Patient Portal
Sofia Toro Alvarez
99.7% of Vermont’s new incoming residents over the last 10 years were Hispanic, Black or African American, Asian, American Indian or Native Hawaiian, however, despite Vermont’s growing diversity, inequities in all fields, including healthcare, continue to affect minorities the most. At Colchester Family Medicine, 6% of patients have limited English proficiency (LEP) and over 10 languages are spoken by this patient population. While interpretation services are often readily available during these patient’s visits, communication before or after their visit is challenging. The electronic patient portal is one of the main resources for patients to not only stay in touch with their provider but also to access their own medical information. However, many LEP patients face barriers preventing them from making use of this resource. As part of this project, a 7-question survey was distributed to LEP patients assessing usage, accessibility, challenges and assistance for setup regarding MyChart. 5 out of 5 LEP patients marked “no” to using MyChart themselves. Language, technological expertise, and lack of guidance on how to activate it were all barriers identified by these patients on the use of the electronic patient portal. A step-by-step guide was designed in both Spanish and French to address the initial language barrier preventing patients from activating their MyChart account. Providing better patient education, expanding interpretation services, and increasing research on LEP patient’s use of the electronic patient portal may help ensure a more equitable and accessible healthcare for all.
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Bridging Language Barriers In Clinical Screening: Leveraging Large Language Models (LLMs) to Generate Bilingual Screening Surveys for Patients with Limited English Proficiency (PLEP)
Tyler VanDyk
This study addresses the critical need for accessible clinical screening in communities with a high incidence of Patients with Limited English Proficiency (PLEP). Recognizing the limitations of existing interpreter services and the scarcity of validated translations for standard clinical surveys like PHQ-9 and GAD-7, we developed a novel approach leveraging Large Language Models (LLMs). Our method utilizes GPT-4 to create bilingual versions of these surveys, which are then formatted into printable PDFs via a Python script and LuaLaTeX compiler. The resulting surveys, validated for translation accuracy and cultural competency, are made accessible through a Google repository. Preliminary results demonstrate that GPT-4 can consistently produce high-quality, culturally sensitive translations in various languages, including Spanish, Arabic, Nepali, and Somali. This innovative approach not only improves the accessibility of clinical screening tools but also enhances the efficiency of medical practice, especially in settings with diverse linguistic needs. Future directions include professional validation of the bilingual surveys and expansion of the repository to encompass a wider range of languages and forms. This study highlights the potential of LLMs in bridging language barriers in healthcare, offering a scalable solution to improve healthcare outcomes for PLEP.
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Trauma Informed Physical Exams
Kathleen Waeldner
Studies show that more than sixty percent of adults have some history of trauma. Many traumatic events occur in childhood, contributing to Adverse Childhood Experiences (ACEs). ACEs have been linked to chronic health conditions, such as cigarette smoking, alcohol use disorder, obesity, and COPD. Further, those with a history of trauma/ACEs utilize healthcare services at higher rates than those without. Primary care professionals are the first line of treatment for these chronic health conditions that so often have etiologies at least partially rooted in trauma. The physical examination is an important component of care in which primary care providers can build trust and safety with their patients.
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Promoting spine health for adolescent athletes
Taylor R. Walker
Based on interviews with local stakeholders in public health and literature review, developed an informational brochure for high school athletes containing prevention and management strategies and resources for low back pain. The aim of this project is to help young athletes stay healthy and live well as they age by promoting spine health.
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Artificial Intelligence for the Primary Care Physician
Trevor Watkins
Artificial Intelligence is an emerging technology set to radically transform primary care. Most clinicians have little available information on the artificial intelligence technologies that will impact their practice in the future and present. To solve this problem, a concise PDF was crafted and shared with clinicians addressing AI basics and currently available AI tools.
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Improving Nutrition Education and Access to Healthy Food for Low-Income Mainers
Jessica Wyn
Many people in Androscoggin county are not able to consistently achieve a diet with the recommended food variety for improving health. Adequate nutrition for improving health outcomes requires access to healthy food at affordable prices, health literacy regarding diet and nutrition concepts, and the skills and access to equipment required to prepare and store food. A lack of resources in any one of these areas can limit a person’s ability to engage in a healthy diet, which increases their risk of developing preventable non-communicable diseases later in life.
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Addressing Problem Gambling in the Advent of Online Sports Betting in Vermont
Sarah Yang
With the legalization of online sports betting in Vermont as of January 11, 2024, residents now have access to commercial sportsbooks such as DraftKings, FanDuel, and Fanatics. As online gambling becomes increasingly rapid, accessible, and immersive, the associated risks for harm to consumers are rising. Problem gambling, a behavior with potential to significantly disrupt one’s well-being, career, and relationships, is recognized as a mental health disorder affecting over 11,600 Vermonters (2.2% of the adult population). The social and economic costs of problem gambling in the United States total approximately $14 billion annually, spanning healthcare, criminal justice expenses, job loss, and bankruptcy. This project introduces a brochure designed to provide primary care patients and physicians with essential, nonjudgmental information on recognizing and managing problem gambling. The brochure aims to raise awareness, educate, and offer support resources to at-risk individuals and their families. Through strategic distribution in primary care settings, this resource seeks to address an urgent public health issue by equipping patients and practitioners with tools to mitigate the impact of problem gambling.
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Culturally Competent Resources Focused on Wellbeing & Mental Health in Vermont's Immigrant Communities
Meron Yishak
Recognizing the unique stressors and barriers immigrants often face, this list compiles a range of culturally-sensitive online & in-person resources here in Vermont. It includes community organizations, hotlines, online platforms, and services working to address the diverse needs of immigrant populations. By empowering immigrants with knowledge of available resources, this guide strives to promote well-being within immigrant communities.
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Brochures & QR codes as an E-Cigarette Informational Tool
Yasamin E. Zamanian
Can a brochure and website with resources about e-cigarettes make a difference in the way that parents speak to their children about e-cigarette use?
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Promoting Cardiovascular Health Through Health Food
George Zhang and Vyha Do
Poor diet is one of the leading causes of cardiovascular disease.
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Patient Satisfaction and Staff Protection
Cole T. Zweber
Front desk, reception, and rooming staff at Middlebury Family Health have experienced an increased degree of patient agitation and frustration since 2020 and the COVID pandemic (this trend of increased violence in healthcare settings is seen nationally as well). This is a source of physical and emotional strain on staff and can contribute to decreased quality of care for all patients. Former projects have addressed the need for increased training and support for staff facing these tense interactions. This project aims to describe the underlying factors and sources of patient agitation, namely access to care for urgent issues, in order to better address their concerns and minimize the burden on staff.
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