ScholarWorks @ UVM

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  Reducing Benzodiazepine Use for the Treatment of Insomnia and Supporting Nonpharmacological Therapies

  UnChan Pyon

  Short-term Project

  Most medical organizations recommend against the use of benzodiazepine use for the treatment of insomnia, especially in the elderly. However, the percentage of the adult population on benzos increase with age: 7.5% in adults ages 51-64; 9% in adults over 65. Alternative therapies for insomnia, including online CBT, require more commitment than taking a medication so many patients opt for medication. This project aims to increase awareness of benzodiazepine use for insomnia and provide support for nonpharmacological therapies.

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  Evaluating the Effectiveness of a Smoking Cessation Support Group

  Holly Bachilas

  Short-term Project

  Smoking rates nationally have declined over the past several decades, however, tobacco use in the North Country of upstate New York remains higher than the national average. Group discussion programs have been shown to be more effective for smoking cessation than pharmacologic efforts alone. A 7-week smoking cessation support group was started in Glens Falls, New York using the Butt Stops Here curriculum. Participants were encouraged to also use pharmacologic methods as directed by their medical providers. Participants completed a brief survey before and after the program. Participants generally felt less motivated, but more equipped to quit after the seven weeks. One participant out of eight was able to quit entirely and 7/8 participants were able to decrease their level of tobacco use. A larger sample size is needed before conclusions can be drawn about the effectiveness of this smoking cessation support group.

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  Determination of Return to Play in Infectious Mononucleosis

  Tessa R. Barclay

  Short-term Project

  Splenic rupture is a rare, but potentially life-threatening, complication of infectious mononucleosis. Splenic rupture is generally uncommon four weeks after infection onset, however given the long incubation period and prodromal symptomatology characteristic of infectious mono, it can be difficult to determine an individual patient's risk in the clinical setting. Additionally, diagnostic labs have high false negative rates in the first 1-2 weeks of infection. To help alleviate diagnostic uncertainty and protect patients against outcomes such a splenic rupture, an evaluation and consolidation of the available literature yielded a simplified schematic of advisable activity levels for each stage of infection.

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  Prostate Cancer Screening Guidelines: Providing Patient Education

  Michael Burton

  Short-term Project

  The United States Preventative Services Task Force (USPSTF) is planning to update their prostate cancer PSA screening guidelines to a category C from category D grade. This could potentially lead to confusion among both providers and patients as they have become accustomed to the previous guidelines and there has always been much discussion among providers about whether to offer the test. This project seeks to provide information to patients about the upcoming change so that they are more informed and able to better participate in discussion with their doctor about the pros and cons of PSA testing.

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  Improving Sleep: Promoting Sleep Hygiene Techniques

  Katherine Clifford

  Short-term Project

  About one third of adults in the U.S. get insufficient sleep, defined as less than 7 hours of sleep per 24 hour period, with similar statistics in Chittenden County, Vermont. Poor sleep/insomnia is a common complaint of patients visiting their primary care providers, and has many important consequences for physical and mental health. While sedative hypnotic medications and over the counter sleep aids are commonly used, they have many important side effects. Cognitive behavioral therapy for insomnia (CBT-I), which includes sleep hygiene techniques, is recommended as an effective, first line nonpharmacologic intervention for chronic insomnia. This project sought to create an educational patient handout to promote sleep hygiene techniques, a behavioral intervention aimed to improve sleep in the patient population at Hinesburg, VT.

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  Smoking Prevention Program for Adolescents: A Hands-on Approach

  Sean Closs

  Short-term Project

  This project is an initial pilot idea for hands-on experiences to reinforce smoking prevention in adolescents. The proposed idea is to have students specifically those identified 'at-risk', being given opportunities to interact with pathology specimens on-site at the hospital, introduce spirometry, and real-world panel discussions. The resources of the hospital provide a unique opportunity for promotion of this public health goal.

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  Management of Mental Health Illness: an Actionable Non-Pharmacologic Approach

  Cody J. Couperus

  Short-term Project

  Mental health illness is a pervasive and incurs tremendous cost onto society. Patients benefit from a multi factorial approach to treatment including non-pharmacological methods. This project includes development of a handout utilizing compiled resources and motivational interviewing to facilitate patient use of these interventions.

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  Adult Oral Health Access and Advocacy

  James Duguay

  Short-term Project

  Many adults lack adequate preventative oral healthcare due to multiple factors. Oral health is important due to its effects on systemic health as well as for quality of life issues.

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  Routine Immunizations in Chester, VT

  Wyll T. Everett

  Short-term Project
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  Alcohol Support Groups: Alternative to the AA Model

  Tim Fields

  Short-term Project

  Alcohol abuse accounts for 88,000 deaths and $249 billion annually in the United States. At this point there is not a great evidence based model for the best form of group support. While AA and the twelve step model is the most frequently used group format, it has many limitation especially in small Vermont towns. This proposes an alternative model designed to work well in smaller communities.

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  PSA Screening in Lewiston Maine

  Francis G. Gause IV

  Short-term Project

  PSA Screening Patient Information for 2017 guidelines

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  Intimate Partner Violence: Updated Screening Tool and Approach to Screen Positive Patients

  Michael J. Hall

  Short-term Project

  Intimate partner violence screening is recommended in all women of child-bearing age. Ensuring validated screening tool utilization and employing strategies to identify risk while providing non-judgmental support is critical to identifying patients and optimizing appropriate resource referral.

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  High Dose Influenza Vaccine Utilization at Inland Hospital in Waterville, Maine

  Margaret Klepack

  Short-term Project

  High-dose influenza vaccines are approved by the FDA for use in adults 65 years and older and have been shown to reduce the morbidity and mortality of influenza. However, the pharmacy manager and infection preventionist at Inland Hospital in Waterville, Maine identified the vaccine was not widely utilized at the institution's out-patient practices. This project reviewed the current literature on the high-dose vaccination and provided an educational presentation to family doctors about the evidence supporting the use of the high-dose vaccination. Data were collected from each practice of the number of high-dose influenza vaccines administered in the 2016-2017 and the 2017-2018 flu seasons.

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  LGBTQ Inclusiveness in the Primary Care Setting

  Joseph J. Lahey

  Short-term Project

  Despite public health efforts in recent years to provide additional care to the LGBTQ community, many health disparities still exist. It is difficult to address these problems due to the lack of organized data being received from health care institutions. Many medical offices have failed to provide a comfortable environment for LGBTQ individuals. This project illustrates a presentation given to staff at a primary care office on how to make the clinical environment more inclusive to LGBTQ individuals in order to provide adequate care.

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  Provider Opinion: Should We Screen and Counsel Parents of Teen Drivers Regarding Texting/Distracted Driving?

  Daniel Lambert

  Short-term Project

  Adolescent texting and driving has been directly responsible for the deaths of 11 teenagers every day. 33% of teenagers in Vermont admit to texting and driving making it one of the most prevalent risky behaviors in their age group. Currently there is no routine screening recommendation for parents with adolescent drivers addressing texting and driving. Mobile application information can improve parental monitoring and prevent texting and driving habits from forming in adolescents.

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  Breaking the Bank: Cost of Cigarettes in Vermont

  Ryan Erik Landvater

  Short-term Project

  Smoking is still the leading preventable cause of death in the USA with 75% of current smokers expressing a desire to quit, though a meager 2-3% succeed. Previous research has shown that financial incentives for smoking cessation are among the most efficacious. Vermont has implemented high taxation to these ends, though many smokers still do not grasp the financial burden it poses on their discretionary income. A handout was developed that conveys both the cost of smoking at a pack rate over set time frames and provides potential savings rendered by nicotine replacement therapy. The handout will be made available as part of patient instructions printed via the electronic medical record system used by UVM.

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  Osteoporosis Education: An Insight into Risk Factors & Prevention

  Alan Lee

  Short-term Project

  In longitudinal studies of women residing in northern latitudes (i.e. Vermont), bone loss was most pronounced during winter months when sun exposure and weight-bearing activities are more limited. Although information about screening and treatments for osteoporosis are widely available to patients, there appears to be a gap in education about risk factors that predispose one to this silent yet deadly disease as well as strategies for prevention according to several community interviews that I conducted. In response to my conversations about osteoporosis, I decided to focus my intervention on educating the community about osteoporosis risk factors, recommended weight-bearing exercises, and the types of foods that contain adequate amounts of vitamin D and calcium. A poster serving as an educational guide was created by compiling information from the National Osteoporosis Foundation and the CDC. The poster will hopefully increase awareness about osteoporosis risk factors and motivate patients (both females and males) to start conversations with their healthcare providers on how to best prevent osteoporosis.

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  Prostate Cancer: Patient Education for Changing Guidelines

  Richard Mendez

  Short-term Project

  In May 2012 United States Preventative Services Task Force (USPSTF) recommended against prostate cancer screening, Grade D, with no other recommendation for providers. Since prostate cancer continues to be among the most common cancer in the United States among men, patients were exposed to previous guidelines during routine visits and require updated educational materials for primary care visits.

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  Combating Childhood Obesity

  Rebekah Misir

  Short-term Project

  Assessing childhood obesity in Danbury, CT and combating it through counseling.

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  Recommendation for Routine Prenatal Screening for Hepatitis C

  Althea L. Morrison

  Short-term Project

  Hepatitis C prevalence and incidence are on the rise, both nationally and in Vermont. This project aims to assess the feasibility and potential benefit of implementing routine prenatal Hepatitis C screening, as opposed to screening only patients who fall within the high exposure risk category. Routine prenatal screening is a simple and cost effective means of increasing the early detection and treatment of Hepatitis C.

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  Patient Education: Importance of Diabetic Foot Care

  John Paul Nsubuga

  Short-term Project

  Diabetes is about the leading causes of mortality in united states, estimated to cause greater than 80,000 deaths annually. With the ongoing obesity epidemic, the prevalence and incidence of this debilitating disease is on the rise. Diabetes the leading cause of non-traumatic lower extremity amputation in United states. These amputations are often preceded by infected non-healing foot ulcers. It is therefore of at most importance to continue educating diabetic patients on proper foot care management to prevent ulcer formation. This project aims to create a patient educational brochure about the importance of proper diabetic foot care, while providing easy to follow guidelines that will go a long way in helping prevent diabetic ulcers.

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  A Patients Guide To Back Pain

  Russell R. Reeves

  Short-term Project

  Lower back pain is debilitating problem that impact millions of Americans every year. Despite the widespread and recurrent nature of this problem, many patient are unaware of nonpharmacologic steps they could take to reduce their pain and prevent recurrences. This project looks to present a pamphlet informing patients in central Vermont about steps they can take to alleviate their pain and where to find physical therapy.

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  Identifying Food Insecurity and Increasing Access to Nutrition in Brandon, VT

  Jacob B. Reibel

  Short-term Project

  Food insecurity is a significant problem in Vermont affecting over 10% of the population in 2016. Access to nutrition is an important social determinant of health with long term implications for our communities. In order to increase awareness of existing infrastructure to reduce food insecurity in Rutland County, a resource guide was created with information about local food pantries, community dinners, and assistance obtaining 3SquaresVT benefits.

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  Halting Progression of Stasis Dermatitis: Community Perspectives and Strategies for Prevention

  Allison B. Robbins

  Short-term Project

  Complications of stasis dermatitis including venous ulcers, osteomyelitis, and cellulitis all significantly increase morbidity and mortality of disease. Progression beyond stasis dermatitis and avoidance of the aforementioned complications are preventable with patient education and adherence to basic therapies including compression stockings and lifestyle modification. Therefore the goals of this project were to: assess the community’s understanding of stasis dermatitis and their awareness of its complications; use this information to help healthcare providers tailor their preventative health counseling accordingly; and provide education for patients on stasis dermatitis, its complications, and therapies/behavioral changes to prevent disease progression.

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  Optimizing Inhaler Technique

  Ruby L. Russell

  Short-term Project

  Studies show that correct patient technique using inhalers is correlated to the number of times they are taught and reminded by a health care professional. As a step toward addressing this problem, I propose increasing inhaler use teaching, utilizing EMR tools as well as online modules, and increasing the comfort of providers with teaching inhaler use. This may be achieved through the use of PRISM dot phrases titled .INHALERNAME, accessing teaching videos during a patient visit, and having patients demonstrate technique at each visit.