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Building point of care ultrasound experience in a rural primary care network
Jamie A. Cyr
Point-of-care ultrasonography (POCUS) is a safe, noninvasive and accessible diagnostic technique. In the outpatient setting POCUS enables improve access to timely care, raises patient satisfaction, and reduces the need for costly tests. While application of POCUS is well established in the emergency department and intensive care unit, its use in ambulatory medicine is still emerging. Prior literature has shown that while many rural care offices have access to POCUS equipment, however, the technology is not being used to its full potential. Prior family medicine projects have identified barriers to the use of ultrasound in rural Vermont outpatient clinics. A lack of training was identified as the largest barrier to POCUS use in both 2019 and 2022. In this work we organized and hosted two POCUS training sessions focused on topics that could be utilized in the ambulatory care setting. Each participant attended one training. To assess the efficacy of our trainings, participants took a survey before and after trainings. Participants were asked to rate their confidence performing POCUS exams, their perceived utility of POCUS in their practice, their perceived utility of POCUS exam quick guides to refresh skills and their predictions as to how patients would perceive POCUS exams. We found that while there was no significant difference identified for perceived utility of POCUS in practice or predicted utility of quick guides, a single POCUS training session did result in a significant increase in reported confidence performing POCUS exams and prediction of a positive patient perception of POCUS exams.
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Evaluation of a Vaccine Selection Tool in a Primary Care Clinic
Olivia Darko
An interactive vaccine selection tool was created to help patients in a primary care clinic identify which vaccines they should talk to their healthcare provider about getting for the fall/winter 2023 season. Opinions on the vaccine selection tool were gathered from a survey.
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Increasing Accessibility to Adaptive Sports Through Patient Education
Dennis Dea
Physical health is a crucial component to one's overall wellbeing, playing a significant role in independence and day-to-day function. This, in turn, has further downstream effects on one's mental health, social integration, and emotional wellbeing. As such, when one experiences a physical injury that impairs their ability to function, it is important as clinicians to identify areas in which we can best support these patients where pharmacologic intervention cannot. Adaptive sports, in turn, has been shown to improve quality of life, social integration, and physical health of those post-injury. This project sought to provide further education and resources to patients who have, or may be seen, in the Hinesburg family clinic.
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Caring for Caregivers
Lily Deng
Aging populations and chronic conditions have shifted care from hospital settings to community and family settings, caregiver burden is increasing. This project was focused on understanding the factors that impact the wellbeing of caregivers of patients with chronic conditions/cancer. Focus is also on identifying barriers to accessing support and increasing awareness of available community support resources.
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Naloxone Community Engagement Project
Olivia E. Domingue
This abstract focuses on the distribution of naloxone from Milton Family Medicine, a family medicine practice in rural Vermont. By interviewing representatives involved in the distribution of naloxone throughout the state, I pinpointed ways to best advertise naloxone to the patient community in Milton, provide information around harm reduction practices and naloxone administration and simultaneously dispel stigma regarding overdose prevention.
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Over-The-Counter Approval of Progestin-Only Pills
Hannah Grace Donovan
Most women in the United States use contraception at some point in their life. While there are many types of short- and long-acting reversible birth control options available via prescription, the oral contraceptive pill (OCP) remains the most used reversible contraceptive agent. The proportion of those using an OCP is inversely proportional with age; more specifically, people who can get pregnant between the ages of 15 and 29 use OCPs most frequently. However, people in this age range may face increased barriers to obtaining contraception, such as cost, insurance, social and familial factors, policy, transportation, and access to healthcare. In June of 2023, the FDA approved a progestin-only pill called OPill for over-the-counter sale. However, due to the nature of being available without a prescription, it is hypothesized that there is a lack of targeted information available for young adults to decide whether this is the right option for them without the traditional formal counseling by a medical practitioner. This community health project sought to bridge this educational gap by creating a booklet, colloquially known as a zine, that will be distributed to students at the University of Vermont. A study design has been proposed to evaluate the effectiveness of this intervention and to evaluate areas for further study and improvement.
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Colorectal Cancer Screening in the Primary Care Setting: Community Outreach to Improve Screening Rates
Liberty J. Dupuis
Colorectal cancer remains a leading cause of death from cancer in men and women in the U.S. and worldwide. Screening for colorectal cancer beginning at age 45 offers the opportunity for early intervention and decisive treatment for precancerous colon polyps as well as the early identification of cancer. This project aims to assess preferences around recommendations for colorectal cancer screening tests amongst a group of primary care providers as well as barriers that are commonly cited to those providers by patients who do not undergo or complete screening. The results of the provider survey were used to make recommendations for decreasing barriers to screening including setting timelines for returning take-home tests, improving instructions for testing, and expanding the number of referral sites for colonoscopy to reduce wait times. Additionally, an intervention involving patients who had not completed recommended colorectal cancer screening was implemented in the form of a letter advising patients of the current screening recommendations and informing them that a FIT test had been ordered for them to complete at their convenience.
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Expanding Awareness of Air Quality and Health Impacts in the Clinical Setting
Caitlin Early
Smoke from Canadian wildfires has greatly impacted the air quality in Vermont this year, 2023. Poor air quality can lead to an increase in inflammatory reactions in the body, for example increasing asthma and COPD exacerbations and causing symptoms in those with cardiovascular disease. This project aimed to improve awareness of the negative health impacts of poor air quality, particularly for those patients with existing lung and heart disease, those of older age, and children. This intervention sparked conversation between patients and providers to discuss symptoms, medication refills, and recommendations for poor air quality days. With lines of communication open and as more research on the impacts of wildfire smoke is completed, providers at the Hinesburg Family Medicine Clinic will be able to share more information and guidelines with their patients.
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Increasing Narcan Distribution in a Primary Care Setting
Charlotte Evans
Opioid use and overdoses are an ongoing health issue in Maine, especially in the Lewiston/Auburn metropolitan area. While Maine has a robust Narcan distribution system, it is not frequently given out in primary care settings. Though interviews and an anonymous survey, it seems the reason behind this is multifaceted, so multiple interventions were created to target both patient awareness and education and provider screening and prescription, with the goal of increasing distribution in this setting.
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Nutritional Literacy: Enhancing Community Health Through Pamphlet Education
Jordan Franco
Research suggests that individuals with limited nutritional literacy may struggle to make informed decisions about their food choices. Such individuals could derive benefits from targeted interventions aimed at enhancing their comprehension and utilization of nutrition label information. This project addresses this issue by enhancing the nutritional literacy of local food pantry clients through the distribution of an informative pamphlet designed to improve their understanding of nutrition.
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Ordering Urgent Imaging In Outpatient Primary Care
Amanda Galenkamp
Current imaging order sets in EPIC allow for STAT (<48 >hours) or routine (4-6 weeks) radiology scheduling. Patients requiring urgent imaging often are not scheduled in a timely fashion and either re-present to the office or the ED. The goal of this project was to provide a standard operating procedure to providers and staff for patients requiring urgent imaging.
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Integrating Artificial Intelligence into the Mental Health Landscape
Luke Giangregorio
The capabilities of the mental healthcare system have been vastly outpaced by present mental health demands. Chatbots are an innovative, self-engaging, adjunctive solution that might help mitigate system-wide implementation failures in access and offer real-time support instead of just being stuck on a long provider waitlist.
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Pamphlet of Preventative Immunization and Screening Recommendations for Adult Women
Annie Glessner-Fischer
This project seeks to consolidate common immunization recommendations and preventative screening recommendations for adult women 18 years and older, based on the U.S. Preventative Services Task Force and Centers for Disease Control and Prevention recommendations. This resource should be offered to patients of the primary care office, with the goal of providing information in a concise and approachable manner that allows patients to review general recommendations on their own, generate questions or express concerns about their health, and encourage patients to advocate for their own health and well-being. With this intervention, the broader goal is to increase immunization rates and adherence to recommended screenings in order to catch and address preventable health conditions sooner.
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Promoting Music Therapy Referrals for Neurodivergent Children
Benjamin M. Glickman
Music therapy is perhaps an underutilized, underfunded, and undervalued part of the tool kit available to physicians, parents and children with ASD and other developmental disabilities within Clinton County. There are opportunities to increase referrals for music therapy for children receiving care at the CVPH Family Medicine Center and within the county.
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Provider Education on Annual B12 Levels in Patients on Metformin
Callan Gravel-Pucillo MMS
Education of primary care providers about the current recommendations, guidelines, and caveats surrounding obtaining annual B12 levels in patients on metformin to screen for deficiency. Education was based off of informal survey results assessing providers' current practices and the preferred medium through which they wanted to recieve educational content. Educational content was presented in a flowchart format for ease of use and distributed at both practice sites for providers to hang at their workstations.
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Addressing Distinct Health Needs of People with Disabilities
Tyler A. Harkness BS
One in five adults (21%) in the state of Connecticut is living with a disability of some kind, whether it be intellectual or physical. When compared to people without disabilities, people with disabilities are at increased risk for adverse health outcomes such as diabetes, cardiovascular disease, and depression; are more likely not to be able to see a physician due to cost; and have worse self-rated health. Barriers to addressing these disparities are two-fold: primary care physicians lack sufficient guidance on health needs of people with disabilities, and caretakers, who are often either family members or conservators, find themselves stretched thin with responsibilities. To address these two groups of individuals, an interactive infographic was created using the online tool called Venngage. Infographics have been shown to be an effective way to communicate health information to wide populations of people. The infographic features introductory text, key statistics on disability health in the state of Connecticut, and hyperlinks to resources for health care providers and caregivers. Qualitative interviews confirmed the need for such an infographic as a way to close equity gaps and improve health education. The infographic is published online and available to local healthcare providers and community organizations. Next steps include validating the infographic via surveys and focus groups.
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Contraceptive Education and Resource Provision in Male-dominated Rural Family Medicine Clinic
Christine E. Horn
Many women, particularly adolescent women, are uncomfortable discussing sexual health and contraception options with male providers and prefer to see female providers; however, in rural areas, there are barriers to seeing female providers including low physician density, long travel distances to clinics, and long waitlists. The project's primary goal was to bridge the knowledge gap surrounding contraception among adolescents in a rural area of Vermont, the Mad River Valley, while ensuring that healthcare providers at the local male-dominated family medicine office, CVMC Mad River, are equipped with up-to-date information regarding contraception prescribing recommendations. The project entailed 1) creation of a handout for patients with easily comprehendible information regarding contraceptive options as well as additional educational resources, 2) presentation of the current recommendations regarding contraceptive prescribing practices to the physicians at CVMC Mad River to increase their comfort as well as the quality of their recommendations for patients. Special attention was given to ensuring that the content was age-appropriate, inclusive, and culturally sensitive, catering to the diverse needs of the target demographic.
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Travel Medicine in Primary Care
Morgan Howlett
Many people will choose to travel at some point in their life. Primary care providers can be well suited to care for patients prior to travel, however this is often a less common component of their day-to-day work so they may be less familiar with travel related resources. This project aimed to evaluate available resources and create an informational handout and an EPIC dot phrase for providers to utilize when providing travel related care.
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Pamphlet for identifying anxiety and initial coping strategies
William Hsu
Anxiety affects up to 1/3 of the population in their lifetime. The geriatric population is especially susceptible to anxiety due to comorbid conditions and limitations in mobility. Anxiety is also difficult to identify, with mental health literacy with regards to anxiety being limited. This project aims to education patients on common symptoms of anxiety and at home interventions that can be initiated with helping to manage anxiety.
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Weighty Words: Addressing Weight Bias in Primary Care
Jharna Jahnavi
Weight bias in healthcare impacts a great proportion of patients. In some ways, weight bias often goes unaddressed compared to other forms of discrimination and spans across diverse groups of people resulting a double burden of bias in patients with intersecting marginalized identities. It is essential that providers and healthcare workers are better trained in building inclusivity for patients of all weights and body types to improve healthcare access and acceptance. Patients who experience weight bias in the office are less likely to return for routine preventative care and less likely to feel safe and comfortable with their providers. This project addresses issues in cultural competency as well as medical practice transformation (AHEC scholars core topics)
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Promoting Safe Sex Practices and Sexually Transmitted Infection Prevention in the Adolescent Population in Ridgefield, CT
Gina Jin
Adolescents are a uniquely at-risk population for the spread of preventable sexually-transmitted infections. Direct lifetime medical costs of sexually transmitted infections (per CDC) is nearly $16 billion in the United States. Nearly half (46%) of all new STIs in the country occur among young people (ages 15-24). Because of this, effective STI prevention in the adolescent population is important and should be further investigated.
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Healthy Food Access and Education
Elizabeth Kelley
Providing resources and educational materials to families about healthy foods
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