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  Attitudes Towards Telehealth at the South Burlington Family Practice

  Alexandra Elizabeth Kuzma

  In this project, we explore the attitudes of the patient population of South Burlington Family Practice concerning telehealth. To assess the attitudes towards telehealth in the South Burlington Family Medicine Practice patient population, we distributed a brief anonymous survey following telehealth appointments to patients. I focused my intervention on what patients mentioned the most for concerns about a telehealth visit- lack of a physical exam. I made an infographic addressing how to do a thorough physical exam over telehealth to educate providers and ultimately improve patient satisfaction.

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  Telemedicine in Rural NY: What Comes After COVID-19

  Sylvia Lane

  Despite ever increasing access to technology, prior to the COVID-19 2020 pandemic, telehealth has had a slow uptake. This pandemic has shown that telehealth can break boundaries and provide access to healthcare in non-traditional ways. In the rural community of Clinton County, NY, there are higher than average rates of ED visits, obesity, and chronic preventable illnesses. Despite greater than average insurance coverage, this population is not accessing preventative healthcare. Though telehealth appears to be a cure to these issues, the ever-evolving system has found many barriers that were not previously considered. 1 in 5 of these patients does not have access to broadband internet and a large majority cannot afford smart devices. This project aimed to collect telemedicine initiatives that creatively address these barriers and allow for use of technology to improve healthcare for all patients of this community. A comparison of different initiatives in the fields of transitional care, pediatrics, mental health services, and high risk chronic care was created for the health care administrators of the CVPH Family Medicine Clinic.

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  Genitourinary Effects of Smoking in Men: An Alternative Approach to Smoking Cessation Through Patient Education

  Michael J. Lawrence

  Smoking remains a prominent problem in Vermont, especially outside Chittenden County. The genitourinary effects of smoking tend to be poorly appreciated among patients. This presents an opportunity for further patient education and incentivization to quit. This project focused on the genitourinary effects of smoking in men, specifically highlighting how smoking increases risk of bladder cancer, poorer outcomes in prostate cancer, and a higher risk of erectile dysfunction. The project culminated in creation of an educational poster intended for display in patient bathrooms in a medical setting.

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  Vaping: What Are the Risks?

  Matthew Eric Lebow

  In recent years there has been a precipitous rise in the number of individuals using e-cigarettes or vaping devices. According to the Vermont Department of Health, in 2016, there were 22,000 adults who used e-cigarettes. However, even more, concerning was that there were approximately 3,000 high school Vermonters who used electronic vaping products. The dangers around vaping products are multifactorial, including the lack of perception of harm by youth, the risk of nicotine addiction, ease of access, and the potential harms including chemicals, contaminants, and metals.

  Even more concerning has been the rise of E-Cigarette and Vaping Produce Use- Associated Lung Injury Outbreak (EVALI). To date, there have been nearly 2,700 hospitalized cases of EVALI, including 34 in Vermont. While there are several hypotheses for what causes EVALI, what is known is that most cases involved vaping products with THC, particularly from informal sources.

  The goal of this project was to set the foundation for information dissemination regarding vaping in Vermont and the risk factors for EVALI.

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  Addressing Pandemic-Related Barriers to Fitness

  Kyle Leonard

  Obesity is a persistent concern in Clinton County, New York. Over one-third of children and over two-thirds of adults in the county are classified as either overweight or obese. Obesity is associated with many adverse health outcomes, including all-cause mortality, cardiovascular disease, osteoarthritis, diabetes, and various cancers. Moreover, increased prevalence of obesity leads to increased healthcare costs for those affected, amounting to tens of billions of excess dollars spent annually. As a result of the pandemic, several fitness centers in the Plattsburgh area had closed for good, leaving many residents without access to fitness. Many of those residents had been drawn to these centers due to affordable access or public funding. Now, only a few centers have reopened, all of which may pose financial barriers for Plattsburgh residents to access them. Further, many residents are unaware that some facilities have reopened in the first place. This project aims to provide patients at the Plattsburgh Family Medicine clinic with information on accessing fitness in the era of the Covid-19 pandemic, either through home fitness programs or with operating fitness centers. Additionally, this project aims to inform patients of various incentives from health insurance providers to encourage physical activity in the community.

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  Assessing Provider Perspectives of Transportation Difficulties for Patients at Hinesburg Family Medicine

  Evan Thor Lowry

  This project aimed to assess provider perspectives on transportation difficulties at the UVMMC Hinesburg Family Medicine Clinic. Vermont has an aging population, which is above the national average. Many older patients, lower socioeconomic patients, and patients with disabilities have a hard time making their appointments due to transportation challenges. This study surveyed the experiences of providers with this issue and found that patients routinely mention issues with getting transportation to the facility. To help with this, the author created a list of transportation resources that providers and staff can use for patients at Hinesburg Family Medicine.

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  Maintaining Oral Health in the Era of COVID-19

  Kelly MacPherson and Sameer Alidina

  Access to oral healthcare can be challenging for many patients and limited accessibility has been further amplified during the COVID-19 pandemic. Poor oral health is linked to several health complications and insurance coverage for dental care can be restrictive or nonexistent. Recent surveys show that many Vermonters of low-income status feel that their oral health is in poor condition. This project aims to review current barriers to maintaining oral health and propose potential solutions for patients during the COVID-19 pandemic at Milton Family Practice. Two handouts for patients were created, as well as one handout and a smartphrase within the electronic medical record for primary care providers to further assist with oral health maintenance.

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  Accessing Healthcare in the Era of COVID-19 for Youth Experiencing Homelessness

  Ray Mak

  Youth experiencing homelessness face multifactorial challenges in obtaining adequate health literacy. The COVID-19 pandemic has increased the need for healthcare as well as heightened confusion with the spread of health misinformation. This project aims to provide a step-by-step guide for when youth should seek medical treatment for COVID-19 to avoid unnecessary medical costs.

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  Healthcare Gaps in Migrant Farmer Populations

  Elena P. Martel

  Various healthcare gaps have been identified in migrant farmer population, including preventative care, continuity of care for chronic conditions, occupational hazards and work related injury, and mental health services. Barriers to accessing care include lack of transportation, non-English speaking populations, and lack of education regarding US healthcare systems. For this project, flu vaccines were provided to migrant farmers at their homes throughout Vermont. Over 250 vaccines were provided by the Vermont Department of Health. Future directions include annual mobile flu clinics, continuing this model for Covid vaccines, and implementing a global health course for fourth year medical students aimed at addressing migrant farmer healthcare needs.

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  Conversations about safe firearm storage with patients: why and how

  Rose Martin

  This project outlines the need for firearm safe storage counseling in the medical encounter and provides some evidence-based suggestions regarding how to approach conversations about safe firearm storage with patients.

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  Increasing Influenza Vaccination Access among Migrant Farmworkers on Dairy Farms in Northern Vermont

  Allyson R. Miller

  An immediate need exists to provide influenza vaccination to migrant workers on dairy farms in Northern Vermont as vaccination is not accessible to the farmworker population within the current framework that exists. The importance of widespread distribution of the influenza vaccine, especially during the COVID-19 pandemic, has been established but significant barriers to access prevent the migrant farmworker population from receiving the vaccine.

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  Lifestyle Changes During the COVID-19 Pandemic and Their Impacts on Cardiovascular Disease Risk Factors

  Francis T. Mtuke

  The COVID-19 Pandemic has been particularly stressful for a wide array of patients, which has manifested in a number of ways. At the Brookfield Primary Care Clinic in Brookfield, CT, one of the ways that this was most prominent was through the change in the way patients exercised and ate. The impact this will have down the line is unknown, but this study aimed to assess the degree to which these changes have permeated the lives of patients.

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  Emphasizing Year-Round Physical Activity of Seniors in Vergennes, Vermont

  Carley R. Mulligan

  Many senior citizens in the Vergennes community are active in the spring, summer, and fall with various activities, community groups, and walking. However, in the winter with colder temperatures and less sunlight, these activities are difficult to maintain, even more exacerbated by the current Covid-19 pandemic. Encouraging maintenance of physical activity throughout the winter months in Vermont is difficult, but can provide many benefits to these individuals both physically and mentally.

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  Finding the Silver Linings of the Cyberattack

  Kathleen R. O'Hara and Leah Miller

  Our project aimed to identify the effects of the UVM Health Network cyberattack and subsequent month-long network downtime on the South Burlington Family Medicine providers and clinic staff. We interviewed staff members about positive adaptations made by the team during the downtime, and inquired whether they planned to keep maintaining any of these changes once the electronic systems returned.

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  Assessing Telehealth as a Mode of Healthcare Delivery

  Ambrose Orr and Adrian Berg

  With the rise of the COVID-19 Pandemic many healthcare providers are emphasizing video messaging software to maintain ongoing patient care while respecting health guidelines that recommend social distancing and isolation measures. It is a known issue that while some patients may face barriers to healthcare in the form of transportation and timing of appointments, others might encounter barriers in the form of lack of internet access. This project seeks to identify the level of patient access to this model of healthcare and assess overall satisfaction and patient attitudes towards this adaptation.

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  The Primary Care shortage in Vermont and Medical Student Interest in Primary Care

  Kenneth Michael Palanza

  The state of Vermont is currently faced with a primary care workforce shortage. There are currently not enough primary care physicians to meet the states needs and the problem is expected to get worse. The primary care physician workforce is aging, there is an inability to recruit primary care providers to Vermont, and there is stagnant interest of medical students in fundamental primary care fields such as family medicine. The aim of this project is to examine the barriers medical students identify that decreases their interest in pursuing a career in primary care, specifically family medicine, and how systematic changes can be implemented to lead to increased interest in the field and future practice in Vermont.

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  The Primary Care shortage in Vermont and Medical Student Interest in Primary Care

  Kenneth Michael Palanza

  The state of Vermont is currently faced with a primary care workforce shortage. There are currently not enough primary care physicians to meet Vermont's needs and the problem is expected to get worse. The primary care physician workforce is aging, there is an inability to recruit primary care providers to Vermont, and there is stagnant interest of medical students in fundamental primary care fields such as family medicine. The aim of this project is to examine the barriers medical students identify that decreases their interest in pursuing a career in primary care, specifically family medicine, and how systematic changes can be implemented to lead to increased interest in the field and future practice in Vermont.

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  Healthcare Provider Awareness of Food Insecurity Resources in Berlin, VT

  Melanie P. Parziale

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  Migrant Farm Workers Flu Clinic

  Alice Peng

  Vermont's dairy industry relies heavily on migrant workers. These migrant farmworkers are mostly Latino and undocumented thus ineligible for health insurance. The Open Door Clinic in collaboration with UVM Extension Bridges to Health and Colchester Family Practice provided free satellite flu clinics to Northern Vermont Latino dairy farmworkers. This project served 12 dairy farms and vaccinated 48 farmworkers.

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  A Motivational Interviewing Approach Toward Mask Wearing in Franklin County, Vermont

  Ashleigh N. Peterson

  COVID-19 has caused significant morbidity and mortality in Vermont and worldwide since the start of the pandemic. Wearing cloth face masks has been proven to limit viral spread, but few studies have quantified how many people are wearing masks or what their reasons are for doing so. This study aimed to assess and encourage mask use in Franklin County, Vermont by piloting an in-office motivational interviewing intervention at a primary care office.

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  Physical Activity Level in School-aged Children during COVID-19

  Tran Phuong

  Due to COVID-19 restrictions, school-aged kids are not engaging in normal physical activities per usual, such as physical education class and team sports. This paper addresses the health concerns and community perspectives of decreased physical activity in pre teens and teens during this pandemic. Further, it provides recommendations to stay active for 60 minutes a day of moderate to vigorous exercise.

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  Increasing Oral Health Care for the Elderly in Plattsburgh, NY

  Megan E. Prue

  Poor oral hygiene can have many adverse systemic effects in the elderly, including aspiration pneumonia. This project explored ways to increase dental care in the elderly, with the aim of decreasing rates of pneumonia along the way.

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  Improving Community Understanding of Lyme Disease Prevention and Treatment in the Age of Misinformation in Digital Media

  Olivia E. Quatela and Samuel Raszka

  Approximately 30,000 cases of Lyme disease are reported to the CDC annually, but the CDC estimates that 300,000 individuals in the US become infected. The average cost of Lyme disease is $3,000 per patient over the course of the disease costing the US healthcare system approximately $1 billion per year ($712m – $1.3b). An additional $1 billion is spent annually on treating post-treatment Lyme disease syndrome. Despite the prevalence of Lyme disease and the availability of credible patient education materials, misconceptions and knowledge gaps are still evident among community members, media sources, and some providers. There is a need for continued community education and recommendations for evidence-based treatment for this disease.

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  Coping Skills for Daily Life: Cost-Effective Strategies to Prevent and Address Mental Health Disorders

  Shae Ian Rowlandson

  Mental health disorders, along with their associated cost and negative outcomes, have continued to persist in Vermont and have become one of the largest, growing challenges to public health in the United States. Unfortunately, Vermont does not appear to have enough resources or providers to optimally address it. Concurrently, coping strategies of minimal cost that have the potential to prevent or address mental health disorders may often be underutilized or misconstrued by the population. A pamphlet providing information on evidenced, cost-effective coping strategies was designed and distributed to providers and patients to enable patients with the skills to help themselves and adapt to their mental health needs, independently.

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  Adverse Childhood Experiences: Raising Awareness & Creating Easier Access to Resources

  Christina Sanchez-Grew

  Adverse Childhood Experiences (ACEs) such as abuse, neglect, and witnessing household dysfunction are common throughout the United States and are occurring in our own communities. ACEs impose immediate health risks to children but also are associated with poor health outcomes in adulthood including higher rates of cancer, heart disease, chronic lung disease, obesity, depression and substance use. The goal of this project was to contribute to prevention strategies for ACEs. This was accomplished by using flyers to raise awareness and educate the community on the prevalence and outcomes of ACEs, and by using QR codes to make parenting resources easily accessible.