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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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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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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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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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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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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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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.
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Suboxone Starter Guide: Essentials for Healthcare Providers
Molly Greenblat
Suboxone is an affordable, effective, and frequently prescribed medication in the primary care setting. There are many anticipated challenges for patients who initiate medication-assisted treatment (MAT) with suboxone. Having guidance for providers in a single, accessible location has the potential to improve provider confidence with suboxone prescription as well as patient outcomes with MAT.
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Bridging the Gap in Mental Health Training of First Responders
Tyler Hastings
Recent studies have identified a mismatch in the amount of training first responders receive regarding the evaluation, treatment, and transport of patients with psychiatric conditions.
Therein lies the need institute a training system of first responders to include topics of mental illness.
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Addressing the Language Barrier
Steven M. Hepp
There is never enough time for patient education during office visits, this is especially true when using a translator service. Digital resources in many languages could now help improve patient education and outcomes.
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Concussion Reporting and Education: A Public Health Intervention
Nick Jowkar
Abstract
Introduction:
Concussions are a common and serious injury in high school sports, yet underreporting remains a major barrier to timely diagnosis and care. Many student-athletes continue to play through symptoms due to poor understanding of risks or fear of letting down their team. Schools often lack standardized concussion education, especially in areas without robust athletic trainer (AT) support.Methods:
This project developed and distributed an educational brochure aimed at student-athletes to improve awareness of concussion symptoms, risks, and the importance of self-reporting. The brochure was shared with local high school ATs, who were invited to complete a brief survey evaluating the current state of concussion education at their schools and their impressions of the brochure.Results:
Of the 15 ATs contacted, 2 responded. Both reported that their schools do not offer formal concussion education. They rated their confidence that athletes understand concussion risks at 4 out of 5 but acknowledged encountering reluctance to report symptoms (3 out of 5). Both ATs indicated “Maybe” when asked if they would distribute the brochure, whether they felt it would help students better understand concussions, and if they would like additional resources.Discussion:
Though limited in scale, the results highlight gaps in concussion education at the high school level and suggest interest in accessible tools like brochures to support ATs in delivering key information.Conclusion:
This brochure is a small but practical step toward empowering student-athletes with knowledge and promoting safer reporting behaviors in sports environments lacking formal education programs. -
Gender-Affirming Care Signage Pilot
Arya P. Kale
In Vermont, LGBTQ+ adults are more likely to delay health care access than non-LGBTQ+ Vermonters. This project seeks to signal a comfortable and safe space at the South Burlington Family Medicine clinic to increase access to primary care for local trans- and gender diverse patients seeking gender affirming care.
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Xylazine Test Strips: Harm Reduction in Chittenden County
Ruja Kambli
Most opioid use disorder resources in Vermont are concentrated in Burlington. This project focused on harm reduction pertaining to the increase of xylazine-related fatalities in recent years. An educational brochure containing local test strip locations was created for the TCHC community and test strips were given to the office to raise awareness surrounding the opioid epidemic and the dangers of xylazine.
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Assessing Patient Comfort when Discussing Mental Health Topics with Primary Care Providers
Kristin Karpowicz
Mental health concerns, including anxiety and depression, remain critical public health issues. However, the extent to which individuals feel comfortable discussing these topics with their primary care providers (PCPs) varies by community. This study assesses the comfort levels of New Canaan, Connecticut, residents in discussing mental health issues with their PCPs and explores their awareness and use of third-party online platforms for obtaining prescriptions. A short electronic survey was distributed in a primary care clinic, with a subsequent paper survey to increase participation. Findings indicate that most respondents (75%) prefer in-person appointments for mental health discussions, and half have spoken to their PCP about anxiety or depression. Comfort levels were influenced by age, gender, and income, with older individuals and females reporting greater ease in discussing mental health concerns. Awareness of online prescription services was low, with only 14.3% of respondents having used such platforms. The study highlights the need for PCPs to initiate conversations about mental health and adapt their approach to patient preferences. Despite limitations such as a small sample size (n=20) and recruitment challenges, the findings offer valuable insights for improving mental health care accessibility in primary care settings. Future research should explore broader population samples and alternative recruitment strategies.
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ADHD Diagnosis in Adults: When to Refer to a Specialist
Nicholas Q. Khoo
Androscoggin County, Maine, faces a critical shortage in behavioral health care access. With a ratio of one primary care physician per 855 patients and one psychiatrist per 11,625, the need for accessible mental health services is urgent. The recent closure of Community Clinical Services (CCS) at St. Mary’s Hospital—one of the region’s primary psychiatric care providers—has further strained the system. Remaining facilities such as Central Maine Medical Center, Sweetser, and Spurwink are now experiencing increased demand, often resulting in months-long wait times for appointments.
A significant portion of behavioral health referrals in the area are for Attention-Deficit/Hyperactivity Disorder (ADHD), a condition that can be diagnosed by a patient’s primary care provider. However, providers may lack confidence in making this diagnosis independently, contributing to unnecessary specialist referrals and delays in care.
To address this gap, a pocket-sized reference booklet was developed to support providers in diagnosing ADHD. The booklet outlines the diagnostic process and includes key questions to help differentiate ADHD from other conditions with overlapping symptoms. The goal is to distribute this resource to clinics throughout Lewiston and greater Androscoggin County, empowering providers to make timely, accurate diagnoses and ultimately improving access to behavioral health care in the region.
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Patient Education: Colorectal Cancer Screening
Grace Kim
Colorectal cancer is the third most common cancer in the world with good prognosis if treated early, making routine screening essential. However, patients show reluctance to getting colonoscopies due in part to barriers in healthcare literacy, communication, and procedure discomfort.
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Improving Access to Exercise in Rural Vermont
Oliver Karl Koch
Residents of Essex and Orleans Counties face elevated rates of obesity and comorbid chronic diseases. This is at least in part due to lack of physical activity, which is complicated by exercise resources, harsh winters, geographic isolation, and high poverty rates. This project aimed to improve exercise accessibility by enhancing an existing patient education handout. Revisions included simplified language, seasonal activity suggestions, and exercise modifications for different fitness levels.
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