Block Clerkship Projects

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  Patient Guide to Managing Post-Meal Blood Sugar for Metabolic Health

  Sarah Pfreundschuh

  Diabetes and prediabetes are highly prevalent metabolic conditions with significant public health and personal costs. Lifestyle modifications are widely recognized to play a key role in improving the management of such conditions and may prevent their progression. However, the conveyance of specific lifestyle modifications to patients with diabetes and prediabetes is often limited during standard primary care visits, and not all patients are able to meet with a Registered Dietician (RD) or Certified Diabetes Educator (CDE). Access to concise, generalizable educational materials that can easily be distributed to patients through the electronic medical record system is accordingly a valuable tool for primary care providers. This project involved collaboration with two local RDs, one of whom is also a CDE, to create one such educational material with simple tips for improving post-meal glucose control.

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  A multi-modal approach to blood pressure control in the Washington county population

  Neelia E. Abadi

  Hypertension continues to be a prevalent condition in Washington County and throughout the state of Vermont, contributing to significant cardiovascular risk. Many individuals remain unaware of their blood pressure status, are less motivated to address moderately elevated readings, or do not engage in regular monitoring. These factors all give rise to suboptimal management. To address these challenges, this project implemented two interventions focused on the Washington County community and the CVMC Family Medicine – Waterbury clinic. A patient-facing blood pressure guide was developed and integrated into Epic for provider use, and a community education booth was held outside a local pharmacy. These initiatives aimed to increase awareness, empower patients to take an active role in blood pressure management, and provide practical, accessible guidance for those that were willing to make health-promoting changes.

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  Resource Guide for Pregnancy-Related Mental Health Disorders

  Adama Aja

  Pregnancy-related mental health disorders, such as postpartum depression (PPD), postpartum psychosis (PPP), and perinatal or postpartum mood and anxiety disorder (PMAD), affect a significant portion of new mothers in the United States. Rural areas such as Milton, Vermont, face unique challenges, including a shortage of mental health providers and limited access to specialized postpartum care. This resource guide will aid in early identification and intervention that is crucial to preventing severe outcomes for both mothers and their infants.

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  Access to Food, Access to Health : A Resource Guide for Food Insecurity in Windham County, VT

  Lajla Badnjevic

  Food insecurity in Windham County has increased from 12.3% in 2019 to 13.6% in 2023. Research shows a strong link between food insecurity and increased risk of cardiovascular conditions, including hypertension, heart disease, and stroke. Individuals already living with these conditions are also more likely to experience food insecurity, often at more severe levels. In Vermont, poor diet is one of three key behaviors contributing to four major diseases—cancer, heart disease and stroke, type 2 diabetes, and lung disease—which together account for over 50% of deaths statewide. These chronic illnesses also place a significant financial strain on the healthcare system, with national costs projected to reach trillions in the coming decades. In response, I developed a comprehensive pamphlet that brings together information on food insecurity, local food assistance programs, and how individuals can access support. The pamphlet is distributed by clinical staff to patients who screen positive for food insecurity, offering clear, actionable information. It serves as a convenient, offline resource that brings key information together in one place, complete with phone numbers and guidance for getting started. The goal is to empower patients to engage with available resources and support informed, patient-centered conversations within the clinical setting. Results of the project have yet to be studied.

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  Tick Safety in Newtown CT

  Claire Baptiste

  Connecticut is a high-risk area for tick bites. Blacklegged tick (Ixodes scapularis) is the primary vector of Borrelia burgdorferi, the bacteria responsible for Lyme disease o Fairfield County reports the second-highest number of Lyme disease cases in the state. Ticks are active from early spring to late fall, overlapping with high outdoor activity seasons o June is peak nymphal stage of blacklegged ticks. Despite public education efforts, many patients remain unaware of when to seek medical care after a tick bite, as well as best practices for tick prevention and removal. There is a clear need for enhanced local education to improve early intervention and reduce the risk of complications.

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  T2DM and the Somali Population

  Tanner Baroni

  The Somali population is at a higher risk for developing T2DM and lack adequate resources to help them with this diagnosis. This project looked into making these resources more readily available.

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  Assessing Patient Satisfaction in Direct Primary Healthcare: A Rural Community Health Initiative

  Kartheek Batchu

  In rural Newport, Vermont, a designated Health Professional Shortage Area, access to affordable primary care is limited, contributing to higher healthcare costs and poorer outcomes. This Community Health Improvement Project evaluated patient satisfaction with Blue Spruce Health’s direct primary care model, which minimizes insurance reliance to enhance accessibility and care quality. A 20-question survey was distributed to patients across three locations (Newport, St. Johnsbury, Williston), assessing demographics, communication, value, insurance-based system comparisons, satisfaction, and marketing testimonials. Interviews with Dr. Umair Malik and Chelsea Hamel, RN, highlighted direct care’s benefits, including reduced bureaucracy and increased patient interaction time. Initial survey results suggest high satisfaction with accessibility and care quality, potentially guiding service expansions (e.g., in-house diagnostics) to reduce external healthcare reliance. The project faced challenges like small sample size and response bias from self-selecting participants. Future efforts could expand the survey and quantify cost savings. This initiative, aligned with the AHEC focus area of Medical Practice Transformation, demonstrates direct primary care’s potential to address rural healthcare shortages, lower costs, and improve patient outcomes, offering a scalable model for underserved communities.

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  Appropriate Use of Healthcare Services: A Patient Education Initiative

  Timothy E. Baugh

  Many patients struggle to determine when and where to seek medical care. This is especially present in those with limited health literacy, language barriers, or unfamiliarity with the U.S. healthcare system. This can lead to the misuse, underutilization, or overutilization of primary care and other healthcare services, which contributes to excessive healthcare spending, crowding, and poorer long-term outcomes. This project employed a mixed-methods approach to assess provider perceptions of patient understanding regarding appropriate healthcare utilization. A survey and clinical vignette-based assessment were distributed to staff at a primary care outpatient clinic to identify common areas of confusion. In response to the findings, an educational poster was developed in English and translated into Spanish, visually outlining appropriate uses for primary care, urgent care, telehealth, emergency departments, and other healthcare services. The poster is designed as a template to be adapted into additional languages and serves as a tool to improve health literacy and reduce misutilization. The project highlights the need for multilingual, culturally sensitive patient education to enhance navigation of the U.S. healthcare system.

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  Lyme Disease Education

  Caitlin Beattie

  Lyme disease is an emergent health issue in Vermont. Unfortunately, misinformation about Lyme risks, transmission, and treatment is very common. This project aims to provide factual information about Lyme to ease anxiety, reduce antibiotic resistance, and encourage patients to seek treatment when appropriate.

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  Expanding Awareness of Buprenorphine-ER for Treatment of Opioid Use Disorder

  Shannon Bennett

  Vermont has made significant progress since the start of the opioid crisis, with a growing number of patients receiving treatment for opioid use disorder. However, there have still been barriers to medication adherence in patients being treated with oral buprenorphine. Many of these difficulties have been addressed with the recent development of extended-release injectable buprenorphine. Given its recent emergence in health clinics, many patients aren’t aware of its availability, necessitating more accessible patient education materials.

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  Transportation Options for Mad River Patients

  Jake Bleau

  UVM is closing the Mad River family medicine clinic in May of 2025. Many patients at this clinic, particularly elderly patients who live alone, already struggle with transportation to their medical appointments due to distance from the clinic and inability to drive themselves. This project was to create a flyer that the clinic may distribute to their patients that highlights two of the most widely used options for transportation to medical appointments. This flyer will be handed out to patients from now, January 2025, until the closure of the clinic.

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  Development and Distribution of Narcan (Naloxone) Information Cards

  Marina Cannon

  Access to naloxone has been associated with fewer opioid overdose deaths. One way to increase the safety of opioid use is to increase knowledge about where to get naloxone.

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  Identifying Mental Health in Sports Medicine

  Cassandra Chin

  This project examines how sports injuries affects mental health and identifies key psychological concepts related to injury and restriction from sport. From interviews with community members and providers, a screening questionnaire was created to start a conversation around mental health in injured athletes with the goal of destigmatizing the topic, identifying struggling patients, and offering appropriate resources.

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  Encouraging Shared Clinical Decision-Making to Expand HPV Vaccination Rates in 18-26-year-old Patients

  Alison E. Chivers and Alison Chivers

  The HPV vaccination series is a safe and efficacious public health tool for prevention of cervical, anal, vulvar, vaginal, penile, and oropharyngeal cancers, yet rates of HPV vaccination in rural Vermont lag behind those of the greater state. This community health improvement project involves distribution of an HPV vaccine informational handout to male and female patients between the ages of 18 and 26 years. The primary objective of this work being to increase awareness of the safety, efficacy and availability of the HPV vaccination series for individuals over the age of 18. This project seeks to empower patients to engage in conversations with providers regarding their healthcare preferences with the ultimate goal of enhancing patient-centered decision making and promoting better health outcomes.

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  Updated Guidelines for Pre-Op Exams by the PCP

  William Clark

  This project involved developing and distributing educational materials on the 2024 Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery. By providing key updates to staff, the initiative aimed to enhance provider awareness and support evidence-based perioperative decision-making.

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  Increasing Utilization of Optometrists in Diabetic Eye Care

  Elliot Culleen

  Diabetes is a metabolic condition that continues to be increasing in prevalence. Of the various end-organ effects that diabetes has, diabetic retinopathy is an area that needs more attention in the primary care setting. Diabetes is the leading cause of new onset blindness in patients 25-64. Additionally, of patients with known diabetes, only 60% receive regular screening care to assess for diabetic retinopathy. The reasons for this are not well elucidated, but with interviewing eyecare providers in the surrounding region of Milton, VT the consensus was there is a lack of providers and a lack of patient education. This project seeks to increase patient awareness of local eye care providers through an up-to-date list of providers accepting new patients, and the creation of a poster to be hung in patient rooms informing them of the need for yearly diabetic eye exams.

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  Silencing the Silent Killer: The Importance of At-Home Blood Pressure Monitoring and Community Resources to Improve Access

  Elle G. Cunningham

  Hypertension continues to be a highly prevalent and costly medical condition in the United States. Approximately half of adults in the US have hypertension, and 1 in 3 have hypertension but are unaware of it. The negative impacts of hypertension occur over time, so patient monitoring of blood pressure provides the opportunity for early intervention, but less than half of patients who should monitor their blood pressure at home do so. This project implements the distribution of an educational pamphlet to patients with hypertension who do not regularly monitor blood pressure at home in a community health setting. This intervention was shown to be effective in increasing patient awareness of the health impacts of hypertension, importance of monitoring blood pressure at home, and compliance with at-home blood pressure monitoring.

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  Increasing MyChart Awareness and Utilization in Plainfield, Vermont

  Oona Davies

  Patients of The Health Center in Plainfield, Vermont have limited access to the patient portal, MyChart, and providers do not have time to provide education during office visits. Access to and utilization of MyChart facilitates patient engagement, care coordination, caregiver involvement, and patient-provider communication. Patient access to electronic health record information has been found to improve medication adherence, improve blood sugar and blood pressure control, and reduce admissions. To address this, pamphlets with portal sign-up instructions were distributed in the clinic visit rooms and posters with QR code linked to the MyChart registration website were placed in the waiting room. These pamphlets and posters will give providers and staff a simple way to help their patients gain access and facilitate conversations about MyChart.

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  Quality Improvements for Closing the Loop in Diabetic Eye Care Management

  Caroline R. Duksta

  There is an opportunity to improve closed loop communication of care plans across organizations and specialists. The concept of this project is to foster patient engagement through healthcare education and leverage that engagement to address areas of identified weaknesses in collaboration. If successful, this could improve communication and coordination of care plans.

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  Clinic in the Community Outreach

  Andries Feder

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  Improving Mental Health Among Residents of Lewiston-Auburn, Maine, by Facilitating Access to Exercise-Related Resources

  Jonathan Palmer Fee

  Mental illness represents a significant public health challenge, particularly in rural areas like Androscoggin County, Maine, which faces high rates of depression, sedentary lifestyles, and a shortage of behavioral health providers. Addressing these interconnected issues is crucial for improving community well-being. This project aimed to empower residents of Lewiston-Auburn to enhance their mental health through increased physical activity, offering a cost-effective intervention independent of clinical infrastructure limitations. The intervention involved creating and distributing a two-sided, three-leaf informational pamphlet at the Central Maine Medical Center Family Medicine Residency Clinic. Written at a basic reading level, the pamphlet educates readers on the multi-factorial mental health benefits of exercise, cites official activity recommendations, and provides a compiled list of accessible, low-cost local and online physical activity resources. This resource is available for patients to take or can be provided by clinicians, streamlining patient education on exercise benefits and resources. Direct measurement of the intervention's impact is ongoing due to the project timeline. However, initial feedback from clinicians indicates the pamphlet has potential to increase access to exercise-related resources. The project hypothesizes that providing this accessible information will lead to increased physical activity among some readers, subsequently yielding mental health improvements such as reduced symptoms of depression and anxiety, improved mood, and stress reduction. While acknowledging limitations such as the pamphlet's inherent inability for personalization, this project offers a valuable, immediate step towards addressing urgent community health needs where resources are scarce. Future directions could explore broader health benefits or target specific populations.

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  HTN in Hinesburg: Improving Patient Management of Hypertension

  Jacquelyn Ferguson

  One in four Vermont adults have been told they have hypertension. Hypertension, or high blood pressure, increases risk for heart disease and stroke, which are leading causes of death in the U.S. and in Vermont. Lifestyle changes that can improve hypertension may include changing eating habits. This project focused on improving patient management of blood pressure through education and outreach efforts in Hinesburg, VT.

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  Prevention Through Education: Advancing Women’s Health Through Screening Awareness

  Emma Fleming

  Preventive healthcare is essential in improving women’s health outcomes, yet adherence to screening guidelines remains inconsistent, partly due to rapidly evolving recommendations. To address this challenge, this patient-friendly handout was created outlining essential screening guidelines, their purpose, and the appropriate timing based on age and risk factors. This resource was designed to empower individuals to participate actively in their preventive care, highlighting the importance of accessible health information and the role of patient education in bridging gaps in healthcare delivery.

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  Chronic Pain Management in Primary Care: Adaptive Sports in Medicine

  Lindsey A. Gleason

  Chronic pain affects over 50 million adults in the U.S., contributing to reduced quality of life, poor mental health and increased healthcare utilization. Primary care physicians (PCPs) play a critical role in managing chronic pain through both pharmacologic and non-pharmacologic means. While there is a need for more robust research on the impact of exercise on chronic pain conditions, data suggests that exercise is likely to result in improvements in pain and function through breaking the cycle of pain, sedentary behavior, and worsening disability. This project aims to connect patients living with chronic pain with Vermont Adaptive, a nationally recognized organization that empowers individuals with disabilities through inclusive sports and recreational programming. To streamline referrals, a dedicated EPIC dot phrase (.chronicpainadaptsport) has been developed, enabling PCPs to efficiently promote physical activity in a supportive, accessible environment.

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  Accessing and Utilizing Medical Interpreters in a Rural Setting

  Michael Greenberg

  Medical interpreters are a vital resource for people with limited English-proficiency (LEP) but can be under utilized in rural settings. This project aims to provide interprofessional education in accessing and utilizing medical interpreters in a rural primary care clinic.