Family Medicine Clerkship Student Projects

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  Community-Based Exercise Education During Colder Months

  Cole S. Shapiro

  Short-term Project

  Approximately 50% of US adults and 75% of US high school students don't meet recommended weekly physical activity guidelines, and physical activity declines further during colder seasons. Resources describing local suggestions for physical activity should be made broadly available to community members, such as at their primary health care office.

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  Food Label Made Easy

  Hanaa Shihadeh

  Short-term Project

  The use of food labels and adherence to dietary recommendations are important, especially for those with chronic diseases due to the well known relation between chronic disease and poor nutritional habits. Although food labeling has been introduced since 1994 with the aim of combating obesity and diet-related chronic disease in the USA, the rates of food label use among US adults have decreased over the past decade.

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  A Provider's Guide to Medical Cannabis: THC and CBD. Putting the Evidence to Work for Improved Patient Care

  Danielle Smith

  Short-term Project

  Please use abstract uploaded with previous powerpoint

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  Initiating healthcare agent education in time limited settings

  Alan Su

  Short-term Project

  Most patients are willing to have advanced care planning (ACP) discussions with their medical team, even if they may be young and healthy. Yet, time constraints, perceived stigma of conversations surrounding death, and the educational requirement of documentation are known barriers for care providers to have these discussions. Identifying a health care agent (HCA) can be an important first step to continued ACP in the primary care setting. The purpose of this project is to propose a systemic approach to having HCA discussions in a time-efficient manner that can be easily implemented as part of a routine medical interview.

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  Social Media's Impact on Mental Health in Children & Adolescents

  Georges Tahhan

  Short-term Project
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  FACTORS INFLUENCING SUBOXONE RELAPSE: A SURVEY IN A NORTHWESTERN VERMONT RURAL PRIVATE FAMILY PRACTICE

  Derek W. Tan

  Short-term Project

  The opioid crisis has warranted nationwide attention towards not only the current prescribing patterns of pain medications, but also towards rehabilitating affected members of the community. Current interventions include the use of Suboxone (buprenorphine + naloxone) as well as Subutex (buprenorphine). As the implementation of partial opioid antagonists increase on a statewide level, investigating factors such as drivers of substance relapse are worth considering to further improve adherence to currently available treatment regimens.

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  Education and expectations for patients with viral upper respiratory infections

  Kathryn Thomas

  Short-term Project

  Non influenza viral upper respiratory illnesses are responsible for a significant percentage of sick visits to primary care physicians. Patients who expect antibiotics are more likely to be given them, and this contributes to growing antibiotic resistance. Setting appropriate expectations for the course of a typical upper respiratory infection can reduce repeat visits, and reduce the number of antibiotic prescriptions. Additionally, many over the counter cold and flu remedies do not have a significant impact on cold duration or symptoms. The flyer produced in the course of this project details the average time course for an upper respiratory infection, instructs on what symptoms do warrant a visit to the physician, and describes effective symptom treatments and proven preventative strategies.

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  When to Bring Your Child to the Emergency Room: a pamphlet for parents

  Trina Thornburgh

  Short-term Project

  For decades, emergency departments (EDs) have struggled with overuse. Children who receive their primary care at a community health clinic or who are Medicaid-insured are twice as likely as private practice patients to seek care in the ED. Additionally, many New American families do not have a comprehensive understanding of the US healthcare system. A pamphlet was created as a health literacy intervention for parents to better understand when to call 911, visit the ED, or go to a primary care provider. The pamphlet is being translated into 8 languages commonly spoken by New American families in Chittenden County, VT.

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  Intermittent Fasting as an Early Intervention in Diabetes and Obesity

  Nam Trinh

  Short-term Project

  Intermittent fasting has been a popular diet over the last decade. New research during the last 3 years have been promising and show that it can be an effective diet for patients with diabetes.

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  Patient Education on Sweetened Beverages: an Interactive and Module-based Approach

  Matt Tsai

  Short-term Project

  As sugary beverages continue to contribute to negative health outcomes, there remains a need for efficient, effective patient education in this area. A custom, interactive and reflective web-based module on sugary beverages for adult participants (n=42) was introduced at a rural Vermont outpatient clinic. Built-in quizzes evaluated learning through a pre and post-intervention design. On average, participants improved significantly from a pre-module mean score of 3.00 to a post-module score of 4.33 (p<0.0001). Additionally, participants' average rating of the module's effectiveness was 8.3 out of 10. A module-based approach may be one efficacious solution to improve patient education on sugary beverage consumption.

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  Increasing the use of Probiotics concurrently with Acute Antibiotic Treatment: A Community Perspective in Newtown, CT

  John Vandenberge

  Short-term Project

  Acute antibiotic courses are known to cause gastrointestinal side effects including nausea, bloating, and diarrhea. Patients at Newtown Primary Care in Newtown, CT being treated with antibiotics for upper and lower respiratory infection often present with these side effects. These symptoms may deter patients from taking the full course and promote bacterial resistance, delayed recovery, and increased patient healthcare costs. Safely tolerating antibiotic regimens is important especially in those at high risk for Clostridium difficile colitis. Probiotics have been shown to prevent antibiotic associated diarrhea and effectively balance bacterial species within the gut microbiome. An educational, easy-to-read handout was developed for Newtown patients starting an antibiotic to help maintain gut microflora via naturally fermented foods such as yogurt, kefir, kimchi, and sauerkraut.

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  Let's put the Kibosh on Cardiovascular Disease

  David Viscido

  Short-term Project

  Heart disease is the #1 cause of death in the US. Coronary heart disease (CHD) is the most common form of heart disease. The age-adjusted rate of death due to heart disease is no longer on the decline, and Vermont is not meeting its statewide goals for reducing the death rate due to CHD. The purpose of this project was to reinforce decades-long efforts to educate Vermonters on the modifiable risk factors of heart disease. The hope is to remind people that, though heart disease isn't going away any time soon, we can each make healthy lifestyle changes to reduce our risk of heart disease.

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  Patient Guide to Access Quality Health Information Online

  Danielle Wall

  Short-term Project

  A large percentage of patients use online search engines to access health information. However, there is a large amount of health information online that is unregulated and not evidence-based. As a result patients may acquire health information that is incorrect which may negatively affect patient-provider relationships and patient's healthcare. A brochure was created to highlight safe practices for accessing health information online.

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  Increasing Awareness of Health Risks Associated with Vaping in Youths

  Patricia Wang

  Short-term Project

  E-cigarette and use of electronic nicotine delivery systems is a growing trend among youths in the United States. According to the National Institute of Health 2018 Monitoring the Future Survey, the 10th and 12th grade increases in nicotine vaping are the largest ever recorded for any substance in 44 years of tracking youth drug use. Increasing evidence about the potential health risks of vaping, as well as prediction of future cigarette use or experimentation, underlines the need for more preventative health measures to curtail this growing drug epidemic. The aim of this community health project was the development of an educational fact sheet on vaping as an aid for primary health care providers in Vermont to discuss e-cigarette use with teens, older youths, or their guardians.

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  A Quick Guide To Eating Healthy with Type II Diabetes

  Caleb Lee Watkins

  Short-term Project

  Diabetes is becoming increasingly more prevalent in the U.S. and in the state of Vermont. With an increased prevalence of diabetes and a worsening obesity crisis, the total cost of diabetes management is increasing as well. The population around Bellows Falls, VT has not been spared from this epidemic. Many patients in this region have struggled to make and maintain lifestyle changes, particularly surrounding diet and exercise. Therefore, a one-page, double-sided handout was created to provide easily digestible information to patients about managing their diabetes through proper nutrition.

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  A Quick Guide To Eating Healthy with Type II Diabetes

  Caleb Lee Watkins

  Short-term Project

  Diabetes is becoming increasingly more prevalent in the U.S. and in the state of Vermont. With an increased prevalence of diabetes and a worsening obesity crisis, the total cost of diabetes management is increasing as well. The population around Bellows Falls, VT has not been spared from this epidemic. Many patients in this region have struggled to make and maintain lifestyle changes, particularly surrounding diet and exercise. Therefore, a one-page, double-sided handout was created to provide easily digestible information to patients about managing their diabetes through proper nutrition.

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  Improving Cardiac Arrest Outcomes with Hands-Only CPR

  Ethan Witt

  Short-term Project

  Bystander CPR is one of the most effective and necessary components of cardiac arrest management, increasing survival rates by two to three times. However, rates of bystander CPR are inadequately low. Hands-only CPR has been found to be an effective intervention in the management of cardiac arrest and addresses many of the barriers to bystander CPR.

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  Mindfulness: an underutilized tool for patients and providers alike

  Candice Wolf

  Short-term Project

  A healthy body begins with a healthy mind, and a healthy mind begins with mindfulness. Mindfulness means paying attention on purpose and without judgment. It has been shown to reduce: anxiety, blood pressure, gastrointestinal distress symptoms, PTSD, pain, insomnia, depression, and healthcare cost. 63% of American’s are stressed about the future of the nation, money, work, the political climate, violence, and crime. Primary care providers have the opportunity to introduce patients to mindfulness to compliment and/or potentially replace current alternative pharmacologic options.

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  OSA STOP-BANG Screening Tool

  Seth E. Wolf

  Short-term Project
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  Postpartum Family Planning: Increasing awareness among patients of the health benefits of spacing pregnancies and options for postpartum birth control

  Hannah Woodruff

  Short-term Project

  Short-interval pregnancies are associated with significant health risks for mothers and infants. The majority of short-interval pregnancies are unplanned. Education about postpartum fertility, health benefits of spacing pregnancies, and postpartum birth control options may provide an opportunity for improved health outcomes.

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  How to Improve a Medication-Assisted Treatment Program for Opioid Use Disorder: First, Look at the Evidence

  Collin York

  Short-term Project

  The prevalence of Opioid Use Disorder (OUD) in the United States has been described as an epidemic, and rural areas have been affected in particular. A treatment paradigm called Medication-Assisted Treatment (MAT) has been demonstrated to be effective at treating OUD, and more and more rural, primary care clinics are establishing MAT programs. One such clinic is Hudson Headwaters Health Network, a FQHC in Upstate New York. I wrote a literature review and distributed it to staff involved in MAT program design, and I also wrote a practical evidence guide for MAT providers. Providers completed a survey assessing the evidence guide.

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  Contraception Health Notes at Brookfield Family Practice

  Nana Agyepong

  Short-term Project

  The Brookfield Family Practice office sees a variety of patients, including women that are of reproductive age. The topic of contraception and contraception choices is always very relevant. My preceptor makes all of his own patient education handouts and expressed the need for an up to date handout on contraception choices for his own use and for the practice in general.

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  Advantages of Point of Care Ultrasound over Traditional Imaging

  Khaled H. Al Tawil

  Short-term Project

  Ultrasound has been found to be a valuable diagnostic tool for ruling in or out serious and common medical conditions. The advent of Point of Care Ultrasound (POCUS) provides trained primary care providers the technology to gather immediate data for clinical decision making and to move patient care down the correct clinical pathway in a timely and more cost effective manner. This tool has been shown to assist in motivational interviewing by giving real time evidence to the patient. This technology has the potential to significantly enhance access for patients in rural communities where diagnostic centers and specialty care can be geographically and financially challenging.

  The purpose of this retrospective study is to identify the benefits of the use of handheld ultrasound versus in the rural Primary Care setting to rule in/rule out specific diagnoses: The scope of diagnoses or ruled out pathologies for the purpose of this study will consist of the following: Deep Vein Thrombosis (DVT)/Abdominal Aortic Aneurysm (AAA)/Joint Effusion/Hydronephrosis/ Tendinopathy/ Thyroid disease/ Cysts--specifically subdural or liver cyst/Rotator cuff injury/ Cholecystitis.

  POCUS was introduced in the Hudson Headwaters Network in 2015 when the Network purchased units for their primary and urgent care clinics and trained clinicians began providing this service at no cost to patients. This quality improvement project is a retrospective chart review to document time to diagnosis, time to initiation of intervention if appropriate, any additional diagnostic evaluation, related subspecialty referrals and care and location of any out of office care provided in relation to site where POCUS was performed.

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  Patient Education: Exercise for Weight Loss

  Alexa R. Arvidson

  Short-term Project
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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.