Medicine and Health Sciences Commons^™

Navigating Post-Covid A Guide For Young Adults Recovering From Mild To Moderate Cases Of Covid-19, Chesley Ferris

Muskie School Capstones and Dissertations

COVID-19 is a new strain of the Human Coronavirus. There are many types of Human Coronavirus, with COVID-19, or the Coronavirus Disease, being discovered in December 2019. COVID-19 is classified as a mild to severe upper respiratory illness. It can affect people differently, with some being asymptomatic, or having no symptoms, and others having mild, to moderate or severe symptoms. Symptoms can also present differently in each person. One person may not have the same symptoms as another.The virus is easily transmittable, meaning it can travel from person to person quickly and easily. This is why it is important to …

Substance Use Prevention: Communication And Strategies To Reduce Alcohol, Marijuana, And E-Cigarette Use Among College Students, Emily Bauer

Muskie School Capstones and Dissertations

Substance use among college students impacts universities, communities and student outcomes across the United States. Based on the Monitoring the Future study (MTF), college students have a higher prevalence of past 30-day alcohol use at 63% than their non-college peers (59%) (2016). Nearly one-third of college students (32%) have had five or more drinks in a row in the past two weeks (2016). Monthly marijuana use for college students has remained steady at 22% (2016). Electronic cigarette (e-cigarette) use is 6.9%, which is gaining in popularity but still lower than traditional cigarettes (8.9%) (2016). There are many prevention communication strategies …

Identifying Challenges Different Provider Group Encounter In Managing Opioid Use Disorder, Chinonye Anumaka

Muskie School Capstones and Dissertations

The Centers for Disease and Control (CDC) describes opioid use disorder (OUD) also known as opioid addiction as the problematic pattern of opioid use leading to clinically significant impairment or distress. In 2016, about 2.1 million people were diagnosed of OUD in the US. In Maine, York County has the third highest drug overdose response and had 166 deaths occurring between 2012-2016. York County is a designated medically underserved area and has a shortage of provider workforce and limited treatment infrastructure. To further understand the challenges providers in York County encounter in managing patients with OUD, 6 focus groups was …

A Guide For Assessing Older Adults’ Needs On Maine Islands, Beatrice Byrne

Muskie School Capstones and Dissertations

This template may help Maine island communities identify older adults’ needs and island resources, in order to allow older adults to age in the island communities.

Three interviews with island health leaders, one community conversation with older islanders, and one pilot test provided information about what to include in the template.

The template includes a demographic survey, guides for conducting semi-structured interviews and group conversations with older adults and caregivers, a guide and worksheet for analyzing the data, a guide for assessing community resources, a guide for dissemination, and a list of additional resources.

Urine Cotinine In Children And Parental Behavior Modification: A Pilot Study, Teresa Lachance

Muskie School Capstones and Dissertations

“Urine Cotinine in Children and Parental Behavior Modification” was designed by Dr. Deirdre Burns, a pediatrician at the Barbara Bush Children’s Hospital (BBCH). It was implemented as a pilot study to determine whether urine cotinine testing in children who are admitted to the hospital for respiratory illness and tracking parental smoking behaviors over time was feasible. Parents were given a brief survey to assess their current smoking behaviors and to understand their readiness to quit smoking. They received smoking cessation materials provided by the Breathe Easy Coalition of Maine. These materials outline information about second-hand and third-hand smoke, and encourage …

Development Of Health Education Materials To Prevent Sexually Transmitted Infections Among University Of Southern Maine Students, Lily Parenteau

Muskie School Capstones and Dissertations

The purpose of this project was to develop health education materials that can be used to educate college students about the risks, symptoms, and prevention measures associated with chlamydia and gonorrhea infections, as well as provide information about current disease information in the state of Maine.

A Secondary Analysis In Support Of The Community Health Needs Assessment For Oasis Free Clinics, Jillian Wheeler

Muskie School Capstones and Dissertations

Oasis Free Clinics offer free medical and dental services to uninsured, low income adults living in Sagadahoc County, Maine (with the exception of the town of Richmond) and the towns of Brunswick, Freeport, and Harpswell in Cumberland County and Durham in Androscoggin County. Oasis has filled a critical need in providing affordable health care to the working poor with the absence of Medicaid expansion in the state of Maine. The clinic offers wellness checks, women's wellness, prenatal care, chronic disease management, limited mental health counseling, a prescription assistance program and dental care.

Oasis Free Clinics will conduct a Community Health …

Analysis Of The Efforts Of Urban And Rural Health Systems To Achieve Accountable Care Organization Target Goals For Dilated Eye Exams In Individuals With Diabetes, Michele Gilliam

Muskie School Capstones and Dissertations

This capstone project was designed to understand and analyze the completion rates for diabetic dilated eye exams within four different health systems participating in the MaineHealth Accountable Care Organizations (ACO). This research is valuable within the current US health care climate as health care providers have sought to evaluate the cost of care in terms of their value to payers. Moreover, many providers have elected to join the ACO in order to demonstrate better outcomes, improve the cost of care and to share programmatic content and tools to standardized care. Within this capstone, system level workflows and processes were evaluated …

Population Health Improvement Through Coordination Of Care, Trevey Davis

Muskie School Capstones and Dissertations

The objective of this Capstone Project is to work with the Mercy Gap in Care Coordinators (GCCs) to document the value of the care coordination at Mercy Health System. A key element of this project was to develop a workflow diagram alongside the GCC in order to track patient outcomes. Additionally, the team developed a system for documenting patient outcomes that is crucial to measuring the impact of care coordination. From the data collected there are a number of outcomes that can be measured. The number of patients who are contacted for screening is measurement of patient experience. Following initial …

Access To Oral Health For Children On Mainecare In The Lakes Region Towns Of Bridgton, Casco, Sebago, And Naples, Carissa L. Parent

Muskie School Capstones and Dissertations

Although we know that children covered by Medicaid often do not receive needed dental services, the extent of the problem in Maine is not fully understood. In particular, rural communities in Maine may face challenges for families to access dental services for their children given low reimbursement rates and fewer available providers. This project addresses these gaps in knowledge by examining MaineCare- funded utilization and dental care access for children with MaineCare in four rural Maine towns in the Lakes Region.

Policy Considerations For Community Health Workers In An Era Of Health Reform, Sara Kahn-Troster

Muskie School Capstones and Dissertations

In order to better understand how CHWs are being integrated in state health reform initiatives, including facilitating care coordination, enhancing access to community-based services, and addressing social determinants of health, the author, working in collaboration with the National Academy for State Health Policy (NASHP), developed a nation-wide scan of CHW policy activity, published online as State Community Health Worker Models in February, 2015. The CHW chart gives a comprehensive look at how states are utilizing CHWs as part of quality improvement, health care reform, and expanded models of public health.

Portland Bicycle Share Health Impact Assessment, Nicole A. Anderson

Muskie School Capstones and Dissertations

The findings of this project have shown the potential health impact for implementing a bike share program in Portland, including improved air quality and rates of physical activity for bike share users. The recommendations to create the most health-conscious bike share program include basic requests of the bike share vendors that will provide the program to Portland including: recommending the use of helmets, distributing bike share stations throughout the City, tracking bicycle crashes, tracking minutes of physical activity, etc. The findings and recommendations show the importance of a potential bike share program, while creating a program that is safe and …

Issues Of Sovereignty In Wabanaki Communities And Impacts On Health Outcomes, Ralph E. Cammack

Muskie School Capstones and Dissertations

The purpose of this capstone is to explore how Wabanaki communities of Maine experience sovereignty as it relates to the dominant culture of Maine and how this interaction has led to current health outcomes and disparities. I do this by examining how the communities view sovereignty and understanding how internalized anger impacts these communities.

An Inventory Of Community Wellness Programs In Biddeford, Maine, A Silver

Muskie School Capstones and Dissertations

This report highlights wellness initiatives from the perspective of two population segments: those with chronic condition, or those who may be at risk for chronic conditions, and high-risk populations, which this project defines as those living below the federal poverty level who engage in behaviors that potentially lead to avoidable health problems. The rationale was that these groups require extensive resources and that it would be easier to identify gaps in community wellness support for these populations.

Using Chipra Immunization Measures For Primary Care Quality Improvement: Leveraging Registry Data From The State Of Maine’S Immunization Information System To Calculate Practice-Level Quality Measures, Kyra Chamberlain

Muskie School Capstones and Dissertations

This report describes key challenges and successes of a federally-funded, cross-organizational effort to use registry data from the State of Maine’s Immunization Information System to calculate childhood and adolescent immunization measures in support of a nine-month, multi-practice learning collaborative which resulted in significant increases in immunization rates and adoption of recommended immunization-related office system procedures. Also highlighted are lessons learned about promoting the use of standardized immunization measures for quality improvement (QI), supporting primary care practices in using and understanding data for QI activities, and emphasizing the value of public-private collaboration in achieving shared goals.

Substance Abuse Trends In Maine: State Epidemiological Profile 2014, Tim Diomede

Muskie School Capstones and Dissertations

This report takes into account the primary objectives of the Office of Substance Abuse and Mental Health Services (SAMHS): to identify substance abuse patterns in defined geographical areas, establish substance abuse trends, detect emerging substances, and provide information for policy development and program planning. It also highlights all the prevention priorities identified in the SAMHS strategic prevention plan: underage drinking, high-risk drinking among 18-25 year olds, misuse of prescription drugs among 18-25 year olds, and marijuana use in 12-25 year olds; as well as monitors the progress being made to address these priorities. This report includes data available through December …

Blood Pressure Monitoring Of Hypertensive Patients In Primary Care: Barriers And Facilitators To Ambulatory, Office, And Home Blood Pressure Monitoring In The Context Of The Triple Aim, Elizabeth Andrews

Muskie School Capstones and Dissertations

Hypertension represents a population health issue in that many patients are misdiagnosed and over-or-under medicated. Research has indicated that overestimating the true blood pressure by 5 mmHg leads to over 30 million Americans being inappropriately treated with blood pressure medication (Handler, 2009). Blood pressure measurements taken in the office are often inaccurate due to patient behaviors, improper technique, and observer errors, yet providers are still using this method to diagnose hypertension. Therefore, considering other methods of blood pressure for the diagnosis and management of hypertension is important to the healthcare quality for millions of Americans.

The main objective of this …

Development Of An Evidence‐Based Implementation Plan For A System‐Wide Anticoagulation Management Service, Sarah Varney

Muskie School Capstones and Dissertations

The Mercy Health System of Maine (MHSM) is a large healthcare system located in Southern Maine. It consists of three inpatient campuses, one level II Emergency Department, four Express Care centers, seven Primary Care locations and an array of specialist practices. The organization has identified a need for improved management of anticoagulation therapy within the system as a large number of patients are receiving anticoagulation therapy throughout all of the various healthcare access sites. In order to address this need, MHSM seeks to implement a system‐wide, standardized approach for managing patients receiving anticoagulation therapy.

An Analysis Of Employment Policies And Their Effect On Work-Life Balance For Caregiving Parents Of Children With Special Needs, Sara Panella

Muskie School Capstones and Dissertations

This capstone addresses the work-­‐life conflict facing employed caregiver parents with special needs children by 1) identifying what employed parents of children with disabilities need from their employer in order to achieve a work-­‐life balance that improves economic security and emotional well-­‐being, and 2) evaluating how well policies address those needs. An investigation of work-­‐family conflict and stress among parents of special needs children is conducted by examining the current literature and conducting interviews with caregivers to explore their work-­‐life balance needs. Policy recommendations are provided, based on an analysis of public and workplace policies currently in use and policy …

Closing The Rural Mortality Gap? An Examination Of 10-Year Cardiovascular Mortality Trends In Washington And Aroostook Counties, Maine, Christy Daggett

Muskie School Capstones and Dissertations

This study examines a significant reduction in cardiovascular disease (CVD) mortality1 in two rural, white, low-income counties in Maine over 1999-2009: Washington County and Aroostook County. Two similar counties with similarly high rates of CVD mortality– Penobscot and Piscataquis - were selected as comparators. The study considers different factors known to correlate with CVD mortality, including behavioral risk factors, co-morbid conditions, insurance coverage, and social determinants of health.

Variables To Predict Risk Of Hospital Readmission, Julie I. Carroll

Muskie School Capstones and Dissertations

As the healthcare industry transitions toward accountable care and payment reform, creative approaches to healthcare is imperative. Poorly coordinated care and shorter hospital stays have resulted in higher rates of readmissions. This has large implications for hospitals and health systems.

Evidence-Based, Best Practice Workplace Interventions To Reduce Overweight And Obesity Rates Among Employees In One Maine Organization: Identification Of Strategic Models, Joanna Aronica

Muskie School Capstones and Dissertations

Wellness programs have evolved over several decades and a great deal of research has been conducted to measure the efficacy of the programs. The goal of this capstone is to explore obesity in the workplace and its impact on chronic disease in one Maine organization and to identify innovative and best practice, evidence based interventions that will reduce the risk.