Digital Commons Network^™

Cigarette Smoking Cessation Tool, Pavan K. Anant

Family Medicine Clerkship Student Projects

In 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.

Empowering Patients Undergoing Speculum Exam, Sarah Caffry

Family Medicine Clerkship Student Projects

No abstract provided.

Improving Care For Lgbtq+ Patients, Justin Henningsen

Family Medicine Clerkship Student Projects

LGBTQ+ patients are at higher risks for many health conditions. Providers and staff are not always comfortable supporting conversations about gender and sexuality. In this project, I provided training to staff members of Hardwick Area Health Center on risks and best practices.

Evaluation And Modeling Of Factors Associated With Urine Drug Testing Appointment Absences, Sherry Xu

Graduate College Dissertations and Theses

Why doesn’t a patient show up for their appointment? Is it too far? Are there too many appointments? Or something else? Urine drug testing clinics often observe patient scheduled visit absenteeism, and this can be used as a data source to answer our questions and explore other potential correlations between factors. With a well-developed electronic health data system, a retrospective study was performed on a large data set collected between January 2019 and December 2021 across the U.S. and more than half a million patient encounters; it contained nearly a year of quarantine, and pandemic status was also analyzed as …

Evaluation And Modeling Of Factors Associated With Urine Drug Testing Appointment Absences, Rui Xu

Graduate College Dissertations and Theses

Why doesn’t a patient show up for their appointment? Is it too far? Are there too many appointments? Or something else? Urine drug testing clinics often observe patient scheduled visit absenteeism, and this can be used as a data source to answer our questions and explore other potential correlations between factors. With a well-developed electronic health data system, a retrospective study was performed on a large data set collected between January 2019 and December 2021 across the U.S. and more than half a million patient encounters; it contained nearly a year of quarantine, and pandemic status was also analyzed as …

Evaluation And Modeling Of Factors Associated With Urine Drug Testing Appointment Absences, Rui Xu

Graduate College Dissertations and Theses

Why doesn’t a patient show up for their appointment? Is it too far? Are there too many appointments? Or something else? Urine drug testing clinics often observe patient scheduled visit absenteeism, and this can be used as a data source to answer our questions and explore other potential correlations between factors. With a well-developed electronic health data system, a retrospective study was performed on a large data set collected between January 2019 and December 2021 across the U.S. and more than half a million patient encounters; it contained nearly a year of quarantine, and pandemic status was also analyzed as …

Doxypep, Angela E. Russo

Family Medicine Clerkship Student Projects

No abstract provided.

Using Narrative Medicine To Address Healthcare Stigma In Washington County, Vermont, Finlay Pilcher

Family Medicine Clerkship Student Projects

Stigma is a barrier to good health for people with certain medical conditions and non-medical circumstances. The purpose of this project is to use stories from members of the Washington County Community to advocate for the use of narrative medicine to mitigate healthcare stigma. A 10-minute recording was shared of an interview with someone with opioid use disorder during the presentation. Afterwards, healthcare professionals were asked whether the presentation, including the recording, impacted their percetion of narrative medicine and its clinical utility.

Contraceptive Education And Resource Provision In Male-Dominated Rural Family Medicine Clinic, Christine E. Horn

Family Medicine Clerkship Student Projects

Many women, particularly adolescent women, are uncomfortable discussing sexual health and contraception options with male providers and prefer to see female providers; however, in rural areas, there are barriers to seeing female providers including low physician density, long travel distances to clinics, and long waitlists. The project's primary goal was to bridge the knowledge gap surrounding contraception among adolescents in a rural area of Vermont, the Mad River Valley, while ensuring that healthcare providers at the local male-dominated family medicine office, CVMC Mad River, are equipped with up-to-date information regarding contraception prescribing recommendations. The project entailed 1) creation of a …

Attention Deficit Hyperactivity Disorder: What Caregivers Should Know, Linda L. Cui

Family Medicine Clerkship Student Projects

ADHD is a common neurodevelopmental disorder. Caregivers of children recently diagnosed with ADHD often have many questions about ADHD and how to best support their children. This project aims to provide educational materials that can be distributed to patients during or after a clinical visit.

Implementing A Patient Resource Guide On Intimate Partner Violence (Ipv) At A Connecticut Primary Care Practice, Mahima R. Poreddy

Family Medicine Clerkship Student Projects

Intimate partner violence is an ongoing public health crisis in the United States. According to the Connecticut Coalition Against Domestic Violence, nearly 39,000 victims were served in 2021, which was a 5% increase from the year prior. As intimate partner violence continues to affect numerous lives in Connecticut and across the nation, the risks of seeking assistance in these situations prevent those experiencing domestic violence from accessing support services. The cost of intimate partner violence can range from an increase in health care utilization to restricted access to safe housing. The Ridgefield Primary Care practice does not currently have educational …

Screening For Areca (Betel) Nut & Quid Use, Gabriela Sarriera Valentin Ms

Family Medicine Clerkship Student Projects

Standardized screening tools for patients who use betel quit and areca nut products do not currently exist. Given the increased risk of oral and oropharynx cancer development in this patient population, increasing awareness of this practice could result in decreased morbidity and mortality. The purpose of this project is to (1) increase provider awareness of this cultural practice and its associated health consequences, (2) to develop a screening tool, and (3) to propose suggested follow-up when concerning lesions are identified.

Improving Knowledge Of Contraceptive Options In Teenage Male Populations, Anthony Quach

Family Medicine Clerkship Student Projects

Despite a plethora of contraception available on the market, nearly 50% of pregnancies in Vermont are unintended. Currently, most educational initiatives aimed at improving contraceptive usage are targeted towards individuals with uteruses, and not their partners with penises. Both qualitative and quantitative data suggest that there are significant gaps in this latter population’s knowledge about contraception for various reasons like limited contraceptive education within formal sexual education in schools, lack of parental and/or physician discussions about contraception, and various complex social and cultural factors. This intervention aims to bridge the knowledge gap in this population by using an educational pamphlet. …

Surgical And Non-Surgical Gender Euphoria Options For Bottom Dysphoria, Hunter Myers, Neeki Parsa

Family Medicine Clerkship Student Projects

No abstract provided.

Improving Primary Care Competency In Gender Affirming Care, Kae Luci Ravichandran

Family Medicine Clerkship Student Projects

No abstract provided.

Improving Cardiovascular Health In Low Socioeconomic Status Women Through The Vermont You First Program, Bradley M. Anair

Family Medicine Clerkship Student Projects

Cardiovascular disease is the leading cause of death in men and women in the United States. Low socioeconomic status women are in a unique position because cardiovascular disease morbidity and mortality is higher in lower socioeconomic status groups, and the risks of cardiovascular disease are often underappreciated in women. This project aimed to improve cardiovascular health in low socioeconomic status women through increasing awareness of the Vermont You First program. This program covers the cost of screenings for cervical cancer, breast cancer, and heart disease for low socioeconomic status women. They also offer lifestyle perks to improve cardiovascular health. This …

Weighty Words: Addressing Weight Bias In Primary Care, Jharna Jahnavi

Family Medicine Clerkship Student Projects

Weight bias in healthcare impacts a great proportion of patients. ­In some ways, weight bias often goes unaddressed compared to other forms of discrimination and spans across diverse groups of people resulting a double burden of bias in patients with intersecting marginalized identities. It is essential that providers and healthcare workers are better trained in building inclusivity for patients of all weights and body types to improve healthcare access and acceptance. Patients who experience weight bias in the office are less likely to return for routine preventative care and less likely to feel safe and comfortable with their providers. This …

Obtaining A Gender-Affirming Sexual History With Gender Nonconforming And Transgender Patients, Gabriela Bosmenier Cruz

Family Medicine Clerkship Student Projects

This project introduces a methodology to change how providers ask the 5 P's of a sexual history using gender-affirming language. Obtaining a gender-affirming sexual history will improve sexual health care, especially with gender nonconforming and transgender patients. Taking time to discuss sexual health and function can lead to prompt identification of sexual problems, risk-taking behaviors, and infection prevention. Using appropriate language to communicate with all patients can lead to better doctor-patient relationship.

Association Of Urine Findings With Metabolic Syndrome Traits In A Population Of Patients With Nephrolithiasis, Virginia L. Hood, Kevan M. Sternberg, Desiree De Waal, John R. Asplin, Carley Mulligan, Peter W. Callas

Larner College of Medicine Fourth Year Advanced Integration Teaching/Scholarly Projects

1. Background The odds of nephrolithiasis increase with more metabolic syndrome (MetS) traits. We evaluated associations of metabolic and dietary factors from urine studies and stone composition with MetS traits in a large cohort of stone-forming patients.

   Methods Patients .18 years old who were evaluated for stones with 24-hour urine collections between July 2009 and December 2018 had their records reviewed retrospectively. Patient factors, laboratory values, and diagnoses were identified within 6 months of urine collection and stone composition within 1 year. Four groups with none, one, two, and three or four MetS traits (hypertension, obesity, dyslipidemia, and diabetes) were evaluated. …

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Barriers To Implementation Of Point-Of-Care Ultrasound In Primary Care: Interval Change, Joel Feier

Family Medicine Clerkship Student Projects

No abstract provided.

Peri-Operative Optimization: Social Determinants Of Health, Adam F. Kohutnicki

Family Medicine Clerkship Student Projects

This project investigated how clinicians at a rural Vermont family medicine practice observed various social determinants of health (SDOH) of their patient population affected patients' preparedness for surgery. Two clinicians involved in the community, a practicing family medicine physician and a practicing social worker, were interviewed to collect qualitative data on how various SDOH they have observed through their clinical practice have influenced patients' preparedness for surgery. This information was then utilized to create a "dot-phrase" that clinicians can use as part of a patient's pre-operative visit in the outpatient setting to assess SDOH and plan subsequent targeted interventions to …

A Quality Improvement Project On Gender Affirming Hormone Therapy For Transgender Patients In A Rural Vermont Clinic, James S. Contompasis

Family Medicine Clerkship Student Projects

A Quality Improvement project on Gender Affirming Hormone Therapy for transgender patients in a rural Vermont clinicA Quality Improvement project on Gender Affirming Hormone Therapy for transgender patients in a rural Vermont clinic that provided protocols and consent forms for masculining therapy to the practitioners at that clinic who wish to prescribe gender affirming hormone therapy (GAHT)

Cervical Cancer Screening In The Lgbtq+ Community: Dispelling Common Misconceptions And Improving Patient Comfort, Rebecca B. Rawlings

Family Medicine Clerkship Student Projects

LGBTQ+ patients are more likely to forgo cervical cancer screening due to common misconceptions/misguidance about who needs screening and increased likelihood to experience emotional and/or physical discomfort during screening visits. This project aims to educate LGBTQ+ patients about cervical cancer screening and provide them with tools to improve their experiences during screening visits.

Accessibility And Normalization Of Wearable Pronoun Identification In Healthcare Professionals, Dinukie-Chantal Perera

Family Medicine Clerkship Student Projects

Healthcare can be an incredibly intimidating machine to all demographics of patients. One uniquely challenged group are patients who are gender diverse, trans, and/or gender nonconforming. This group of patients experiences systemic discrimination through institutional practices embedded in healthcare.

Gender affirming care can be improved on many levels, but one straightforward and actionable way to support gender diversity and demonstrate enthusiasm and awareness for the community is to encourage the use of pronoun pins/ labels in individuals willing to use them.

Community Services For Patient Referral Document, Jett Choquette

Family Medicine Clerkship Student Projects

Patients have a need for referral to a variety of services that directly relate to their health and wellbeing that are not generally included in the traditional referral system of healthcare networks. These services include (but are not limited to) social work support, pandemic support, elderly services, LQBTQ+ services, intimate partner violence services, functional medicine, and substance use disorder and mental health support and treatment. Because these services are not part of the traditional healthcare referral system, healthcare providers may not have an up-to-date list of organizations and programs in the community that could provide these needed services. This is …

Listen To Her Heart: Bridging The Gap In Recognizing, Preventing, & Treating Ascvd In Women, Stephen J. Foley

Family Medicine Clerkship Student Projects

Atherosclerotic cardiovascular disease (ASCVD) is traditionally considered a male disease, yet it is the leading cause of death in women. This may be associated with the significant lack of research of ASCVD in women, leading to poor recognition, diagnosis, prevention, and treatment. The American Heart Association reports that a majority of women experience prodromal symptoms more than one month before a heart attack or stroke, and these symptoms are often underestimated. This project intends to help address the question: How can earlier detection of ASCVD risk in women reduce missed signs of acute myocardial infarction/stroke and thereby reduce preventable ASCVD …

Transgender Care Within Family Medicine: Focusing On Feminizing Hormone Therapy, Stellar Levy

Family Medicine Clerkship Student Projects

Transgender populations experience health disparities and barriers related to gender identity or expression. Many people who identify as transgender avoid or delay care because of perceived or real transphobia and discrimination by health care providers and institutions. Providers may benefit from easy access to information about people who identify as transgender and their health needs.

Resources For Lgbtq+ Patients, Elie Kaadi

Family Medicine Clerkship Student Projects

Many LGBTQ+ patients face issues when seeking care from their primary care providers as well as specialists. This could be due to lack of information that is taught during medical education as well as lack of information that is available to the public.

This project aims to provide helpful information for both physicians and patients that is relevant for the care of LGBTQ+ patients.

Adolescent Anticipatory Guidance, Anna M. Corbalan

Family Medicine Clerkship Student Projects

This project focuses on creating an educational resource specifically for adolescents and young adults regarding the anticipatory guidance for this age group. Although adolescence is generally a healthy time for most, many health or social problems will start or peak during this time. Therefore, it is a crucial time to incorporate preventive guidance and increase health literacy to avoid unhealthy chronic behaviors in adulthood.

Implementation Lgbtq+ Health Education Through Case-Based Learning, Bradley A. Blansky

Family Medicine Clerkship Student Projects

Primary care graduate medical education programs often do not provide adequate training regarding the healthcare needs of the LGBTQ+ population. The purpose of this community project was to develop a case-based teaching session to help provide family medicine residents a basic understanding of LGBTQ+ healthcare. This didactic session was found to be an engaging and effective method of teaching physicians about LGBTQ+ health. Additional work is needed to further train physicians and other healthcare professionals about the challenges faced by marginalized populations in our healthcare system.