Block Clerkship Projects

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  Increasing Equitable Cardiovascular Disease Screening and Prevention for Women of Low Socioeconomic Status: You First

  Isabel N. Martinez Daniel

  Cardiovascular disease (CVD) continues to be the leading cause of death in females of all ages and races. Given the potential reduction in risk of coronary events with modifiable behaviors, primary care physicians are in a unique position to be able to use shared decision making and patient education to help dramatically reduce the potential burden of cardiovascular disease. Consideration for social determinants of health, such SES, should not be forgotten when aiming to provide adequate and accessible healthcare. Furthermore, the incorporation of unique programs, such as You First, into primary care offices can increase equitable care for patients and aid in risk reduction for many diseases, including but not limited to CVD.

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  Physical Activity Promotion: Connecting Patients To Community Exercise Resources

  Kassandra Mastras

  Regular physical activity is an important lifestyle factor with evidence in preventing and slowing the progression of chronic disease. Treatment of chronic disease in Vermont is estimated to cost over $2 billion annually. However, 40% of adults and 75% of adolescents in Vermont do not get the recommended amount of physical activity, which is one of the leading chronic disease risk factors. This project aims to provide healthcare professionals at Milton Family Practice with the proper tools to assist their patients in starting and maintaining physical activity and to improve patients’ knowledge of what exercise resources are available in their local communities.

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  Raising Awareness of Suboxone’s Impact on Dental Health at Mountain Community Health

  Ellen Mats

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  Interventions vs. Excessive Drinking

  Wendy Memishian

  Vermont has a higher rate of excessive alcohol consumption than the national average, and Chittenden County has the highest rate of excessive drinking in Vermont. The literature shows Brief Interventions done by PCPs may decrease risky alcohol consumption significantly. A module based on statistics, literature on Brief Interventions, and local provider interviews was developed and created in order to educate providers in Vermont and Chittenden county in particular on the data and how to do a Brief Intervention. This may make PCPs more knowledgeable about the issue and more comfortable with providing Brief Interventions on their own.

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  Educational Materials for Low-Barrier Mental Health Intervention in Essex, NY

  Rachel Elizabeth Miles

  Rachel E. Miles summer 2024 AHEC community engagement project undertaken as part of the family medicine clerkship. Sites were Elizabethtown Community Health Center and Smith House Health Center (Willsboro) of Essex County, New York. Preceptor was Dr. Mary Katharine Halloran. Project development and execution centered on development of low-barrier, low-cost, but high-yield mental health interventions and materials that can be distributed by primary care physicians and in community health centers for folks waiting to receive specialized care and/or those who may not have the resources or ability to seek it out.

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  Community Health Interventions to Reduce the Impact of Private Drinking Water Contaminants

  Ian Minearo

  Contaminants, such as arsenic, E. Coli, and gross alpha, is found in soil, bedrock, and water and can seep into private wells and water sources. In addition, copper and lead in older homes can leech into the water in homes over time to due corrosion. In Vermont, 40% of households drink water from a private well while 40% of private drinking water systems tested for contaminants exceeded the drinking water limits. Public water is managed by the towns and state, but private water is the responsibility of the homeowner who may not know if and when they should test their water. Currently, providers are not asking or educating their patients about their home testing nor have the tools to do so. This project hopes to determine who has private well water, if they are testing, and if providers should start screening their patients.

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  Knowledge to Immunity: Guiding Patients on RSV Vaccination

  Hosna Mohabbat

  This project addresses RSV vaccination education at Mountain Community Health by providing clear, accessible materials to inform patients about the vaccine, eligibility, and where to get vaccinated since vaccinations cannot be given on-site. The initiative aims to streamline patient education, reduce physician burden, and improve vaccination rates following the CDC’s recommendation for adults aged 75 and older.

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  Healthcare Provider Education on the Prevention of Suicide and Self-Harming Behaviors in Adolescents

  Khadija Moussadek

  Suicide death rates increased in the US during the COVID-19 pandemic, and Vermont recorded its highest ever suicide death rate in 2021. Recent evidence suggests a relationship between non-suicidal self-injury (NSSI) and suicide attempts, with NSSI increasing the likelihood of future suicide attempts. Over one-third of people who die by suicide saw a physician in the month preceding their death, suggesting primary care providers (PCPs) are well-positioned to identify and intervene with suicide risk. This training module aims to serve as an educational support for PCPs in providing evidence-based care for their patients (10-21 y/o) at risk for intentional self-harming behaviors and reduce their risk for later negative outcomes, including suicide.

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  Modernizing Patient Outreach & Analytics

  Laceyahna Munroe

  It is challenging for providers to understand how patient's engage with different types of communications from their primary care clinic, particularly on a site-to-site basis. This project leverages a simple link-hosting platform, LinkTree, to direct patients to free publicly funded workshops in Diabetes Management. The platform allows simple data to be collected about engagement with the links that are provided to the patients and gives the host clinic an easier way to understand and hone their communication style to best reach different patient populations. In this project we chose a panel of diabetic patients with A1c's >7% to receive a MyChart message with links to workshops about managing diabetes. We were able to connect with key stakeholders and administrators for these programs and develop a greater understanding of the landscape for referrals to free resources for patients. Of 92 patient messages, 6 clickthroughs to the My Healthy Vermont website were recorded in a 7 day period. There are limitless directions for future development and utilization of this tool to reach patients and engage them with their healthcare needs, but thought should also be given to those who may be less inclined to use mobile devices or computers to communicate.

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  Advanced Data Analytics: An Easy-to-use DermGPT for Rural Dermatologic Care

  Aryan S. Naik

  A large proportion of Rutland county's residents live in rural areas. Access to dermatologic care is scarce, and traveling to one is far. Despite these barriers, customizable AI tools can facilitate treatment planning for dermatologic visits at local primary care offices. This can bridge the gap in dermatologic care, giving rural providers rapid and accurate treatment options.

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  Planetary Health: Helping providers and patients prepare for climate change

  Chellam Nayar

  Climate change has been called the greatest global health threat of the 21st century. The effects of changing temperatures and increasing pollution have been shown to increase the incidence and mortality of cardiovascular diseases, affect respiratory health, increase the risk of new infectious disease outbreaks, affect mental health, and exacerbate inequities between those with means and those without. In Vermont, climate change is leading to an increase in average temperatures, more extreme heat events, shorter winters, more storms, poor air quality due to wildfire smoke, an increase in cyanobacteria blooms, and a longer tick season, among others. This project will educate providers on the impacts of climate change on health and provide educational materials for patients on specific planetary health related issues, including tick-borne disease and extreme heat.

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  Health Impacts of Remote Work

  Tin Nhan Nguyen

  Remote work has increased in frequency in the past few years with a notable rise in Connecticut. While working from home has certain benefits, it can also increase the risk of certain physical and mental health issues. An educational pamphlet on the health impacts of remote work with suggestions to reduce negative effects was developed and distributed to community members.

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  Access to Affordable Healthcare and Health Insurance for Small Businesses in Rural Vermont

  Zoe S. Nicozisin

  Employee-sponsored health insurance is the primary model of health insurance in the United States; however, it is increasingly difficult for small businesses to provide employees with comprehensive coverage. Rural communities face numerous health care disparities compared to urban counterparts, including access to affordable health care for small businesses. The highest rate of uninsured working Vermonters comes from those working at small companies (under 50 employees), which is significant because 20% of businesses in Vermont have fewer than 20 employees. Additionally, even when employers can offer insurance, the majority of employees (over 75%) decline enrollment due to high costs. This project explores the financial challenges employers face and contextualizes them to small businesses in Orleans County, Vermont. The outcome was the creation of educational materials to be provided to small businesses in Vermont that include resources on traditional private insurance, Medicaid, independent Direct Primary Care, and health share coverage.

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  Understanding the DASH Diet: A Unique Approach to A Healthy Diet

  Emmanuel O. Ogunlana

  Over 1/4 of Connecticut adults have been told that they have high blood pressure. Poor nutrition is a significant factor in developing hypertension. The Dietary Approach to Stop Hypertension is a highly efficacious, healthy diet that involves the incorporation of many nutritious foods all geared to lower blood pressure. My project aims to provide patient education on the DASH diet by making a concise resource that includes healthy recipes that adhere to the diet.

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  Addressing Age-Related Hearing Changes

  Vennela Pandaraboyina

  UVM Milton Family Medicine practice has a significant patient population of elderly adults who are experiencing age-related hearing loss. Age related hearing loss is very common in people over 65 – it’s the third most common chronic physical condition in the US. However due to both social stigma and a lack of health literacy many of them are not having their hearing changes addressed with appropriate audiology assessments and hearing aids. This project sought to further quantify the patient population in Milton with unaddressed age-related hearing loss by talking to local physicians and deaf, deaf/blind, and hard of hearing advocates. It also involved the creation of a pamphlet that outlines resources for audiologists, and information on what age-related hearing loss is, the risk it poses to one's overall health and how social stigma surrounding hearing aids should be combated.

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  Barbershop Based Hypertension Intervention

  Dhiraj Patel

  Barbershop based hypertension screening and treatment interventions have been substantiated across prior literature as cost-effective and highly efficacious interventions for reducing overall blood pressure in the African American community. Researchers have also begun to explore the applicability of such an intervention to another high risk ethnic group for hypertension: Hispanic and Latino communities. With >30% of Danbury, CT's population being comprised of Hispanic and Latino populations and barbershop interventions for hypertension having already been established in the nearby city of New Haven, CT via Yale Health, this community engagement project aims to take the first step towards establishing similar services here in Danbury via Nuvance Health.

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  Narrative Medicine as Preventative Care: the Role of Reflection in Chronic Disease

  Shrey D. Patel

  Chronic disease and mental health have direct and significant impacts on one another and contribute greatly to public health costs in Connecticut. This project seeks to understand the potential impact of provider-guided reflection and narrativization on the ways in which patients process chronic disease diagnoses.

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  Addressing Confusion Surrounding Imaging for Dense Breasts

  Kara M. Pflaster

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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.