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Expanding Access to Affordable Nutrition through Shelf-Stable Recipes in Brandon, Vermont
Shannon M. Wasley
Short-term Project -
Marijuana Use with Prescription Medication: Patient Education
Oliver Young
Short-term ProjectMarijuana use in Vermont has increased in recent years across all patient populations, but there is little understanding of the effects of marijuana use on medications. Vermont has the highest percentage of marijuana use in the country, and Windham county is among the highest in the state. Marijuana is metabolized by CYP450 enzymes in the liver, which are also responsible for metabolizing many other medications like SSRIs, benzodiazepine, blood thinners, opioids, beta-blockers, statins, and seizure medications. Marijuana can increase side effects and decrease the effectiveness of medications, which may be dangerous. The wide variety of medications, including the most prescribed medication in the US (statin), paired with the common use of marijuana means there is likely overlap in the populations who use both. This project aimed at educating patients at Grace Cottage Hospital in Townshend, VT, about risks of marijuana with prescriptions with the hope that it start conversations between patients and providers. Results of the project have yet to be studied.
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Addressing Mental Health and Intentional Self-Harm in Afghan Patients
Muhammad H. Zeb
Short-term ProjectRefugee and immigrant populations in the United States are at an elevated risk for a variety of mental health challenges. Post-traumatic stress, social isolation, experiencing racism, and elevated unemployment are among the correlates of increased mental health risks, including self-harming and suicidal behaviors. Among other factors, recent Afghan refugees or immigrants may encounter these issues due to the limited experience and resources available for healthcare providers working with them. To support healthcare providers in delivering care that is evidence-based and culturally appropriate, an educational resource was developed for identifying and then providing initial care for the mental health needs of the Afghan population. Following a literature review, multiple experts in working with Afghan patients (psychiatrists, other mental health providers, and primary care physicians) were interviewed about providing assessment and treatment services for this population. This information was consolidated to create an educational resource that can be delivered as a self-directed E-Learning module to be broadly distributed. The expectation is that these materials will support healthcare and other providers in their efforts to deliver high-quality, culturally informed mental health care for the Afghan refugee population.
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Improving Mental Health Accessibility in South Burlington
Leena R. Ziane
Short-term ProjectIndividuals in South Burlington continue to face difficulties accessing mental health services. Common barriers such as cost, wait time, and lack of cultural competence contribute to this difficulty. Exacerbation of mental health directly correlates to physical health. This project aims to address these barriers by developing a comprehensive handout highlighting available mental health resources counteracting each of these barriers and promoting inclusivity of diverse needs.
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Assessing accessibility in the primary care setting for people with disabilities in CT
Anika Advant
Short-term ProjectAccessibility goes beyond ADA compliance. It involves physical accessibility, and employing practices that allow and providing a space for people of all abilities to safely and freely seek medical care without judgement, shame, or barriers.This project aims to understand the current state of accessibility at the New Canaan Primary Care Office in CT, and to make recommendations for the health organization to increase accessibility for people with disabilities.
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Cigarette Smoking Cessation Tool
Pavan K. Anant
Short-term ProjectIn Vermont, tobacco use disorder is a pervasive problem that closely rivals national averages. The Cigarette Smoking Cessation Tool seeks to identify patients with significant motivation to quit smoking cigarettes' and aims to connect them with appropriate local resources and clinic advocates.
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De-Escalation Training for Office Staff
Robin Tucker Angier
Short-term ProjectOffice staff at Middlebury Family Health have experienced an increase in patient agitation, aggression, and verbal abuse since the start of the COVID pandemic. This project was aimed at providing the staff with de-escalation education to better serve themselves and their patients, as well as to decrease overall burnout and decreased quality of mental health.
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Provider Perspectives on Implementation of CDC Guidelines for Opioid Maintenance Therapy
Anayis M. Antanesian
Short-term ProjectThe opioid epidemic remains a complex and significant public health crisis in the United States, impacting millions with opioid use disorder (OUD). Despite efforts to raise awareness and address individual risks, high rates of opioid overdose persist, underscoring the need for more extensive and integrated prevention and management approaches. Primary care providers play a pivotal role in lowering opioid-related mortality and improving patient outcomes through office-based treatments; however they face numerous challenges in prescribing opioids. To explore these barriers, a survey was distributed to providers, aiming to assess their views, comfort levels in prescribing opioids for chronic pain, and perceived ease of implementing CDC guidelines into their practice. As part of this project, a poster summarizing guidelines was created which could be conveniently referenced and would align with the clinic providers' preferences for prescribing opioids in the setting of maintenance therapy.
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Visual aids for setting up patient portal in rural primary care practice
Georgia A M Babb
Short-term ProjectWith the use of the patient portal as a tool for patient-provider communication becoming increasingly integral to patient care, and it's becoming more important to ensure all patients have equal access regardless of any potential barries. In clinical visits, it's not uncommmon to observed conversations about portal use, including patient’s expressing having difficulties setting up the patient portal. Discussions with the team at Middlebury Family Health and the patient population, showed a gap in patient instructions or guides to setting up their patient portal. This work aimed to solve this barrier by creating and implementing visual aids to assist with portal activation.
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Bringing Stop the Bleed Training to the Community
Connor Barton
Short-term ProjectThis project evaluates the training in bleeding control and its necessity within the community. With the rise in violence towards healthcare workers and gun violence in the United States, blood loss remains the leading preventable cause of death in violent situations. The "Stop the Bleed" course aims to educate the public on bleeding control techniques, equipping them to save lives. This project involved surveying residents at CVPH Family Medicine regarding their confidence in bleeding control methods before and after undergoing "Stop the Bleed" training. The objective was to enhance their proficiency and comfort with these techniques, allowing them to then bring these skills to the greater community.
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Safe Storage: prevention of Drug Misuse and Overdose with Locked Medication Bags
Emily Claire Battle
Short-term ProjectSafe storage of medications is critical to public health and safety in the state of Maine as well as across the country. Current public health efforts target education and prevention of accidental ingestion of medication by children and animals at home. This has become especially important in Maine with the increasing prevalence of substances used for treatment of opioid use disorder, as well as increasing prevalence of other non-prescription substances including fentanyl, cocaine, and methamphetamine. In Lewiston, Maine, interviews with public health leaders, patients, and providers at the Family Medicine Residency at Central Maine Medical Center reiterated concerns for the security of vital medications which are frequently lost or stolen, especially in those struggling with housing insecurity. This project attempted provide an intervention to promote public education, prevent substance misuse and overdose, and encourage patient-provider discussions about safe storage. This project entailed a didactic session to educate Family Medicine residents on the importance of safe medication storage, dissemination of locked medication bags to residents and behavioral health professionals, and placement of an educational display in the patient waiting room of the Family Medicine residency.
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Older Adult Interpersonal Violence
Haley Nicole Bayne
Short-term ProjectOlder adult interpersonal violence educational poster for healthcare workers developed during the family medicine rotation for 3rd-year medical students. This project was developed in Newtown, CT.
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Reimagining the World of Healthcare: Implementing Artificial Intelligence into Family Medicine Practice
Julia Bernier
Short-term ProjectThere is a significant shortage of primary care providers in the United States. Studies have found that a significant factor leading to primary care physician burnout is from overload from bureaucratic tasks, including charting. The use of Abridge, an AI service that records patient visits via audio and formulates a patient note, eliminates the need for the physician to document patient conversations during the visit, reducing physician burn-out and allowing more time to focus on the patient’s needs.
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Quality Improvement of X-Ray Imaging for Unspecified Chronic Knee pain and Suspected knee osteoarthritis in the Primary Care Setting
Ty E. Bever
Short-term ProjectAlthough a comprehensive history and physical exam are the mainstays of initial evaluation, plain X-rays are clinically indicated for chronic knee pain of greater than 6 weeks duration and acute traumatic pain in patients who meet specific evidence-based criteria, according to the American Academy of Family Physicians (AAFP). However, there remains significant variation in what radiographic protocols are used in clinical practice, specifically in terms of what radiographic views are ordered and whether the imaging is performed with the patient weight-bearing (WB) or non-weight-bearing (NWB). In fact, several studies have shown that non-weight-bearing knee radiographs are frequently ordered by general practitioners for chronic knee pain and suspected osteoarthritis despite evidence that WB images are more sensitive and accurate in the assessment of joint space narrowing. Therefore, evaluation of chronic knee pain with the use of NWB radiographs has the potential to delay diagnosis and management of early osteoarthritis (OA), lead to less accurate grading of the severity of OA and delay in specialist referral, and contribute to an increase in repeat imaging during specialist consultation.
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Utilizing a Community Resource for Diabetes Lifestyle Management
Max Breidenstein
Short-term ProjectGrace Cottage Family Health & Hospital identified diabetes as a level one priority for community health improvement. VeggieVanGo is a program hosted at schools and hospitals hosted by the Vermont Foodbank which provides fresh produce to those in needs. Lifestyles modifications are essential for diabetes management including consuming fresh produce. This project sought to increase awareness of the role of diet in diabetes management for patients at Grace Cottage Hospital who may use the VeggieVanGo program.
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Disaster Preparedness and Chronic Health Conditions
Jackson Bressor
Short-term ProjectWith recent years bringing severe storms and flooding to Vermont more frequently, community members need to be more prepared than ever to overcome these disasters. Individuals with chronic health conditions face a unique set of challenges in these events, and require an extra level of planning. This pamphlet will outline some key steps for anyone with a chronic health condition to prepare for a disaster, with specific recommendations for individuals with diabetes and kidney disease.
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Healthcare Against Human Trafficking: Promoting Identification and Support
Michaela Busch
Short-term ProjectThrough direct correspondence with providers and community partners in Lewiston, ME, human trafficking was identified as a prevalent issue not receiving enough attention. These discussions revealed lack of provider knowledge as a limiting factor in potential victims receiving resources and support. This project aims to address and shrink this knowledge gap via informational sessions, resident training, and partnering with nearby nonprofits who work to provide support to victims.
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Barriers to Advance Directive Completion in Burlington, VT
Avery James Campbell
Short-term ProjectAdvance directive completion is lacking in the United States. Patients at a family medicine practice in Burlington, VT were surveyed to assess barriers to advance directive completion. An intervention was created and imposed to improve advance directive completion.
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Nonoperative Management of Hip Osteoarthritis
Hikmat R. Chmait
Short-term ProjectChronic hip pain is an extremely common condition, significantly impacting the quality of life and mobility of affected individuals. The dissemination of comprehensive guidelines on nonoperative management of chronic hip osteoarthritis (OA) is essential for enhancing the quality of care provided by primary care providers (PCPs). These guidelines should encompass evidence-based recommendations on physical therapy, pharmacologic interventions, and lifestyle modifications tailored to the individual patient's needs. By equipping PCPs with standardized, accessible information, we can ensure consistent and effective management of chronic hip OA, ultimately improving patient outcomes and reducing the burden on specialized healthcare services. Enhanced education and resources for PCPs are imperative to bridge the gap in current practice and promote the optimal nonoperative care of patients with chronic hip OA.
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Improving Eye Care in Diabetic Patients in Vermont
Ashfi Chowdhury
Short-term ProjectDiabetic retinopathy is the leading cause of blindness in working age adults worldwide, yet up to 90% of vision loss can be prevented through early detection and timely treatment. In Vermont, approximately 8.5% of adults have diabetes, with less than 60% receiving regular eye exams. This project aims to address the knowledge gap and improve eye care among diabetic patients by creating and distributing an educational postcard. The postcard provides crucial information about the differences between various eye exams, along with guidance on where to seek care, which will enhance patient awareness and promote regular eye checkups.
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Patient Education on Long Term Anticoagulation Options
Hayden J. Christensen
Short-term ProjectMany patients with chronic conditions require long-term anticoagulation. Often they aren't sure of their options and have questions regarding their eligibility for Direct Oral Anticoagulants (DOACs) versus Warfarin. Here, a patient handout was developed to address common questions and assist in the decision making process when long-term anticoagulation is initiated.
These projects were completed by students in the University of Vermont Family Medicine Clerkship. Block Clerkship Projects were completed during a five-week period, while Longitudinal Clerkship Projects were completed over the course of a 12-month longitudinal clerkship.
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