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Increasing Access of Outpatient Therapeutic Services for Adolescents With Persistent Symptoms After Sport-related Traumatic Brain Injury
Natalie J. Bales
Persistent symptoms lasting at least 21 days after initial traumatic brain injury occur in about 15-20% of adolescents. Initial assessment of concussions can be done using the SCAT5 and a wide variety of other standardized assessment tools. However, there are striking gaps in standard clinical procedure for follow-up care for athletes who have persistent symptoms. Furthermore, there are many issues with accessibility to therapeutic services including long wait times that prevent timely referral to those services. This pilot intervention was implemented at the University of Vermont to address those issues by providing a hotline resource for families to use and obtain faster and easier referrals to outpatient therapeutic services based on individual persistent symptoms.
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Transitioning to ASQ Online at Colchester Family Medicine
Katie Barker
Development screenings are an important part of well-child visits for early identification of a developmental delay. Early identification and appropriate intervention allow for better functional outcomes for patients, preventing the worsening of a delay. Currently, only 38% of these screenings are completed at Colchester Family Medicine. With the aid of Help Me Grow, a national organization dedicated to connecting families to community resources to allow children to reach their full potential, Colchester Family Medicine should transition to ASQ online, an online version of its current screening tool. This would increase completion rates, improve accuracy of results and allow for a better experience for both the patient and their families, and the providers.
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Screening for PTSD in Veterans and Expanding Awareness of PTSD Resources
Audree S. Baroni and Bradford Clark
PTSD is a prevalent mental health disorder that is especially prominent in the veteran population. Often veterans go without diagnosis and subsequently without treatment due to lack of awareness, screening, and a stigma they will loose benefits from the VA. This project aimed to identify the number of veterans with PTSD and provide alternative treatment methods for symptom management.
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Screening for PTSD in Veterans and Expanding Awareness of PTSD Resources
Audree S. Baroni and Bradford Clark
Veterans are at an increased risk for PTSD however widespread screening is currently not being done, so disease is going unrecognized and untreated. There are many reasons for this, including stigmatization within the military, access to care, and unknown resources. We looked at PTSD screening within the veteran population in Berlin, VT and provided resources to local providers.
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Migrant Farmworker Health in Windham County
Shea A. Bellino
There is a significant population of migrant farmworkers, especially H2A visa holders, in Windham county with limited access to health care compared to peers in Addison and Chittenden counties. Health care is delivered to migrant farmworkers across Vermont via a volunteer-based program coordinated by the University of Vermont Extension known as Bridges to Health. Given the proximity of Grace Cottage to H2A farmworkers, it is reasonable to explore ways of increasing access for this patient population, including raising awareness of Bridges to Health.
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Obtaining a Gender-Affirming Sexual History with Gender Nonconforming and Transgender Patients
Gabriela Bosmenier Cruz
This project introduces a methodology to change how providers ask the 5 P's of a sexual history using gender-affirming language. Obtaining a gender-affirming sexual history will improve sexual health care, especially with gender nonconforming and transgender patients. Taking time to discuss sexual health and function can lead to prompt identification of sexual problems, risk-taking behaviors, and infection prevention. Using appropriate language to communicate with all patients can lead to better doctor-patient relationship.
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Pamphlet to Promote Patient Education on Hypertension and Diabetes
John J. Braidt
Diabetes and hypertension are prevalent in the United States, and are among the most common reasons for office visits. Control rates for hypertension have dropped in the past 5 years owing, in part, to medication non-compliance, perceptions of poor locus of control and self-efficacy, limited health care literacy and knowledge. Concerns regarding adverse effects of medications are also prevalent. This project seeks to improve patient knowledge of hypertension and present an argument for medication compliance.
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Ambulance Service Coverage in Rural Coventry, Vermont
Katelynn Briere
Ambulance service coverage is made difficult by the rural landscape of many Vermont towns. Discrepancies in quality and cost of ambulance service providers can make it difficult for town administrators to decide which service would be best for their town. This decision is even more important in towns like Coventry, Vermont where there is no in-town ambulance service. Providing town administrators with informative documents is one way to assist them in the decision making process.
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Patient Rights to Prescription Glasses
Louis Briones
Uncorrected Refractive Error (URE) accounts for vision loss in millions of Americans. Eyeglasses are the simplest and safest way to correct refractive errors. Prescription eyewear coverage is not universally covered across most health insurance policies. This project details Medicare and Vermont Medicaid coverage for Prescription Glasses. Also included is information outlining where to buy affordable frames and organizations in Vermont that can help acquire prescriptions not covered by insurance.
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A Template for Gender-Affirming Care Referrals with Consideration for Patient Safety and Privacy
Seth Brownmiller
Family Medicine - South Burlington provides quality care to gender diverse individuals, yet no standard referral process for patients to receive gender-affirming care at the practice exists. Furthermore, whenever a provider is referring a patient for gender care, there are important considerations for what information should be included in the referral. This project sought to create a referral template for gender care that incorporated questions regarding patient privacy and safety.
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Increasing Tickborne Disease Awareness Through Local Community Organizations and Businesses
John S. Burke
Tickborne illnesses are on the rise and continue to present a public health challenge to the Rutland Community. Classically, education on tickborne disease has been provided by healthcare providers, specifically through primary care. However, many individuals still lack access to primary care providers and therefore are not being provided important information on these potentially debilitating illnesses. This project's goal is to provide information on tickborne illnesses to local businesses and outdoor organizations so that those who lack access to primary care are still getting the education they need.
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Utilization of POCUS in Family Medicine at CMMC
Jacob P. Cappiello
Maine has a significant portion of patients who live in a rural area far from doctor’s offices and medical centers. Combined with a low SES population where transportation issues are common, POCUS can be an invaluable tool in an FM practice to reduce the number of appointments, and travel needed, for patients in need of healthcare. Access to Care was the number two health priority in the Franklin County community health needs assessment. This project surveyed family medicine practitioners at CMMC about their experience with, clinical use of, and willingness to continue education in POCUS. This survey had few respondents but found a low utilization of POCUS in Family Medicince practice and a high interest in POCUS continuing education. A POCUS quick reference was created and distributed to FM practitioners at CMMC.
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Continuity of Care in Rural Surgical Patients
Sydney M. Cardozo
Continuity of care is an integral part of patient care and is important for reducing morbidity and mortality following hospitalizations. Medical errors are common during transitions of care, and are most frequently caused by lack of suitable discharge planning and poor communication between surgical teams, patients, and primary care physicians. This project aims to create a new standardized note template for surgery teams to use when discharging patients, with the goal of augmenting communication and efficiency during transitions of care within and outside the UVM Health Network.
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Prescription Stimulants: Preventing Misuse Among Adults with ADHD
Sadie M. Casale
Stimulant drugs are a cornerstone in the treatment of Attention Deficit and Hyperactivity Disorder (ADHD) and are being prescribed at increasing rates. The safe prescription and use of these drugs by providers and patients alike is critically important to appropriately treating ADHD and preventing misuse. This presentation discusses how patients can be educated on the uses of stimulants and provides information on what to do in case of overdose. Additionally, resources for providers are provided to continue improving awareness of at-risk patients and community resources available to them.
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Screening for PTSD in Veterans and Expanding Awareness of PTSD Resources
Bradford R. Clark and Audree S. Baroni
The prevalence of veterans with PTSD not known in Hinesburg, Vermont. Primary care providers should be aware of available resources for veterans in the state of Vermont for alternative therapeutic modalities.
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Attention Deficit Hyperactivity Disorder: What Caregivers Should Know
Linda L. Cui
ADHD is a common neurodevelopmental disorder. Caregivers of children recently diagnosed with ADHD often have many questions about ADHD and how to best support their children. This project aims to provide educational materials that can be distributed to patients during or after a clinical visit.
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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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