Medicine and Health Sciences Commons^™

Grant Application: Health Practitioners’ Perspective On Caring For Older Adults In Rural Maine – A Pilot Study, Jessica Harnisch, Allie Stanley, Amanda Langley, Jordan Beall

Health Practitioners' Perspective On Caring For Older Adults In Rural Maine

IPEC Mini-grant application for funding of UNE student project Health Practioners’ Perspective on Caring for Older Adults in Rural Maine. This pilot study was designed to identify challenges and determine potential solutions for Maine practitioners delivering health care to rural Maine’s aging population. UNE students from several healthcare professions partnered to interview physicians, physician assistants, nurse practitioners, social workers, occupational therapists, and physical therapists caring for community-dwelling older adults in Rural Maine. The student researchers then analyzed the interviews and identified themes.

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …

Health In Housing - Exploring The Intersection Between Housing & Health Care, Bill J. Wright, Grace Li, Keri B Vartanian, Maggie Weller

Articles, Abstracts, and Reports

No abstract provided.

Re-Framing Informal Family Caregiving, Magdalena T. Ornstein-Sloan

Dissertations, Theses, and Capstone Projects

Informal family caregivers are the backbone of the long-term care system, providing an estimated 80% of the long-term care in the United States. Caregivers provide care to people with disabilities, the ill and older adults, often with little to no outside assistance from the formal long-term care system. Although caregivers receive attention in the academic literature, mainstream media and within public policy and services development, caregiver services continue to remain underutilized. The focus on service provision has various goals, including the desire to lessen the burden caregivers experience by providing services so they can provide care at home longer than …

Assessing The Twinning Model In The Rwandan Human Resources For Health Program: Goal Setting, Satisfaction And Perceived Skill Transfer, Esperance Ndenga, Glorieuse Uwizeye, Dana R. Thomson, Eric Uwitonze, Joel Mubiligi, Bethany L. Hedt-Gauthier, Michael Wilkes, Agnes Binagwaho

Dartmouth Scholarship

Because of the shortage of health professionals, particularly in specialty areas, Rwanda initiated the Human Resources for Health (HRH) Program. In this program, faculty from United States teaching institutions (USF) "twin" with Rwandan Faculty (RF) to transfer skills. This paper assesses the twinning model, exploring USF and RF goal setting, satisfaction and perceptions of the effectiveness of skill transfer within the twinning model.

Generational Differences In Practice Site Selection Criteria Amongst Primary Care Physicians., Christopher Duffrin Phd, Mches, Molly Cashion Mph, Doyle M. Cummings Pharmd, Lauren Whetstone Phd, Jonathon Firnhaber Md, Gary Levine Md, Ricky Watson Md, Msph, Aaron Lambert Md

Marshall Journal of Medicine

ABSTRACT

Background and Objectives: Generational differences are often viewed as shaping the overall attitudes and actions of different age cohorts. It is essential to understand the motivations and generational differences in primary care physicians for efforts to recruit, retain, and educate the future physician workforce. Determining what factors most influence different generations of primary care physicians when choosing a practice site is essential to build our future primary care system. This study examined generational differences in the factors that attracted primary care physicians to their current practice.

Methods: A survey instrument was mailed to all active members of the North …

Factors Associated With Unmet Needs Among African-American Dementia Care Providers, P. J. Desin, Allison M. Caban-Holt, Erin L. Abner, Linda J. Van Eldik, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Racial and ethnic minorities currently comprise 20% of the U.S. population; in 2050, this figure is expected to rise to 42%. As a result, Alzheimer’s disease (AD), the 5th leading cause of death for people aged 65 and older, is likely to increase in these groups. Most dementia caregiving for these populations comes from family and friends, especially among families with lower socioeconomic status. A convenience sample of 30 African-American dementia caregivers was interviewed to determine unmet needs. Participants expressed a limited desire for formal services, such as support groups, legal advice, case management, and homemaker services. Instead, commonly expressed …

Oral Health Intervention: A Multifaceted Approach To Improve Oral Health Care During Pregnancy, Tabitha Ford, Gregory Frechette, Sruthi Sakamori, Caleb Seufert, I-Hsiang Shu, Patrick Silveira, Wendy Davis, Kristin Fontaine

Public Health Projects, 2008-present

Introduction:

Early Childhood Caries (ECC) is the most common chronic disease of childhood

Mothers’ oral health status is a strong predictor of the oral health status of their children

2009:

Vermont spends $2.7 million treating children ages 0-5 with Early Childhood Caries

2012:

Vermont lifts the $495 Medicaid cap on reimbursement for a woman’s dental care during pregnancy and up to 60 days after delivery

American College of Obstetrics and Gynecology (ACOG) Guidelines on prenatal dental care are published

2013:

74% of surveyed Vermont providers treating pregnant women are unaware of the Medicaid change

82% of these providers are not …

Vermont Adolescent Perception Of Barriers To Smoking And Cessation, Kathryn Anderson, Aniruddha Bhattacharyya, Nicholas Kovacs, Nicole Mendelson, Gayathri Prabhakar, Andre Robinson, Rebecca Ryan, David Kaminsky

Public Health Projects, 2008-present

Introduction: Despite a decline in youth smoking rates over the past decade, thirteen percent of Vermont high school students still smoke (Vermont Youth Risk Behavior Survey, YRBS, 2013). Smoking and nicotine exposure at an early age can have detrimental effects on brain development and lead to long term, sustained tobacco use (Arrazola et. al 2015). It was our goal to characterize the barriers to cessation for these adolescents. Some important factors suggested by the literature include living with someone who smokes (50% of VT teen smokers report a parent or guardian who smokes) and having a close friend who smokes …

Addressing The Opioid Crisis In Vermont: Lessons Learned From Primary Care Physicians, Tim Henderson, Molly Markowitz, Adam Petchers, Brittany Rocque, Andrew Sheridan, Nathanial Sugiyama, Lyndsey Wyatt, Elizabeth Cote, Charles Maclean, Jan Carney

Public Health Projects, 2008-present

Background:

Opioid Misuse in Vermont:

The number of Vermonters seeking treatment for opioid abuse is increasing, particularly in Chittenden County.

Emergency department visits and deaths related to opioid misuse continue to increase, both locally and nationally.

Opioid Addiction Treatment:

The Drug Addiction Treatment Act (2000) was passed to allow physicians to prescribe buprenorphine-naloxone for opioid addiction, termed Office-Based Opioid Therapy (OBOT).

OBOT has been shown to be a highly effective treatment for opioid addiction.

The Hub and Spoke model was implemented in Vermont to connect specialty treatment centers with outpatient OBOT providers.

Project Goal: To identify barriers to providing OBOT …

Characterization Of Hypertension Risk Factors At The Committee On Temporary Shelter, Lindsey M. Eastman, J. Curtis Gwilliam, Ethan R. Harlow, Adrienne R. Jarvis, Jacob Korzun, Michael K. Ohkura, Samantha M. Siskind, Brianna L. Spencer, Tim Coleman, Virginia L. Hood

Public Health Projects, 2008-present

Introduction: The health of homeless populations is at risk due to a high prevalence of undiagnosed hypertension (HTN) and cardiovascular disease (CVD). The interaction of housing and socioeconomic status with the risk factors for HTN and CVD remains unclear. Prevention of HTN through a healthy diet, exercise, adequate sleep, and avoidance of tobacco has been well described, but financial limitations and competing priorities for shelter and food make blood pressure (BP) control difficult for this population. By characterizing the risk factors and awareness of hypertension within the homeless population at the Committee on Temporary Shelter Daystation (COTS) in Burlington, Vermont, …

Assessing The Need For A Social Worker At The Chittenden Emergency Food Shelf, Grace Adamson, Moshe Bitterman, Sherilyn Destefano, Susannah Kricker, Richard Mendez, Tyler Wark, Nina Xue, Kelly Saunders, Judith Christensen

Public Health Projects, 2008-present

Introduction: Chittenden Emergency Food Shelf (CEFS)

• Largest direct service emergency food provider in Vermont Serves over 12,000 people/year
• Works to alleviate hunger through grocery services, hot meals, and home delivery
• Offers a culinary job training program

CEFS seeks to understand client need for assistance in accessing/coordinating additional public assistance services and resources. Could CEFS improve its services by staffing a social worker on site?

Project Goal: Collect data from CEFS users to assess current need for in-house social worker to assist with diverse needs beyond emergency food assistance.

Slipping Through The Cracks: Receptivity Of Healthcare Professionals To An Electronic Screening Tool For Human Trafficking, Jennifer Albert, Kenyon Bolton, Gilana Finogenov, Mateen Hakim, Julia Shatten, Abishag Suresh, Soriaya Thura, Stephen Wheat, Edith Klimosky, Ted James

Public Health Projects, 2008-present

Introduction:

Human trafficking is the exploitation of an individual through force or coercion, for labor or services, including commercial sex.

Healthcare providers are uniquely positioned to encounter trafficked people.

Prior research has found a need for increased sensitivity in identifying trafficked persons in healthcare settings, and for provider education about the issue.

Effects Of Art Intervention On Pediatric Anxiety And Pain In The Medical Setting, Ashley L. Deeb, Miles W. Grunvald, David A. Leon, Anton Manyak, Lindsay R. Miller, Kelsey M. Veilleux, Lisa H. Wang, Buffy F. Dekmar, Rebecca Schwarz, Shaden Eldakar-Hein

Public Health Projects, 2008-present

Introduction: Hospitalization and illness can be a painful and stressful time for a child. There may be anxiety over procedures and inpatient stays disrupt normal routines. Previous research found that for pre-school aged children, having parents around, having the help of the hospital staff, and playing an active role in alleviating their fears were the most helpful in reducing anxiety. Another study found that visual creative expressions can be meaningful experiences for young adult cancer survivors. Additionally, there is abundant literature on formal art therapy and its favorable effects on children in the hospital, however, there are fewer studies investigating …

Nutrition In Early Childcare Programs: The Benefits And Barriers, Patrick Cruden, Timothy Flanagan, Emily Forbes-Mobus, Xiaoyu Lu, Alison Mercier, Siyeon A. Seong, Yazen Qumsiyeh, Alison Howe

Public Health Projects, 2008-present

Introduction:

1 in 5 Vermont children experience food insecurity. Inadequate nutrition threatens cognitive, social, and emotional development in the first years of life.

49.1% of Vermont children arrive at kindergarten underprepared. It has been shown that undernourished children have reduced activity levels and withdraw from their environment, removing them from critical learning opportunities and social interactions.

Supporting the provision of healthy food in early childcare programs may help address the issue of food insecurity and promote healthy childhood development.

Currently, there are no existing data on both Vermont childcare providers and parents of these children on their perceptions of the …

Implementing A Fitness And Nutrition Program For Special Olympics Athletes, Andrea Blood, Shannon Brady, Liam Donnelly, Do Young Gwak, Charlotte Hastings, Astia Roper-Batker, Kasra Sarabakhsh, Stephen Shenouda, Justin Graham, Stephen Contompasis

Public Health Projects, 2008-present

Introduction:

Only 17-30% of individuals with ID meet the recommendations for daily exercise

Populations of individuals with ID have higher BMI, lower cardiovascular fitness and lower muscle strength compared to the general population

Individuals with ID also have many dietary challenges necessitating nutritional education and interventions

One study following four athletes with ID, showed that pairing athletes with and without (unified sports) resulted in a positive change in social self-concept for athletes with ID

Given the above, we:

Created a 6-week pilot training and nutrition program for Special Olympics Vermont (SOVT).

Paired athletes with ID with college athletes without ID …

Parental Perceptions Of Oral Health And School-Based Dental Sealant Programs, Laura Donnelly, Peter Evans, Ian Grant, Allicia Imeda, Daniel Kula, Clare Park, Hao Fang Wu, Julie Cole, Kristin Fontaine, Wendy Davis

Public Health Projects, 2008-present

Introduction:

Community Health Needs Assessment (University of Vermont Medical Center, 2013)

Identified oral health in pediatric population as a primary concern

Barriers to dental care cited: access, affordability, education School-Based Sealant Program (SBSP)

Dental sealants are an evidence-based method of cavity prevention

CDC strongly recommends delivery via SBSPs

Few Vermont schools have such a program

Vermont Medicaid State Plan amendment allows dental hygienists to bill without on-site dentist (2015)4

Unique opportunity to pilot an SBSP

Pilot program implemented by the University of Vermont Medical Center Community Health Improvement

Goal: sustainable model able to be replicated in Vermont schools Pilot School …

Living In Recovery:Perceptions Of Health Care And Comorbidities In Rural New England, Theodore Cisu, Elizabeth Doughty, Rahul Gentyala, Kathleen Olson, Kishan Patel, Taylor Wolfgang, Richard Yun, Gary Decarolis, Jill Jemison

Public Health Projects, 2008-present

Introduction:

Alcohol and Drug Abuse: In the USA, abuse of tobacco, alcohol, and illicit drugs is costly, exacting more than $700 billion annually in costs related to crime, lost work productivity, and health care.

9% of Vermont residents and 8% of US residents report alcohol or illicit drug abuse, and 10% of US adults consider themselves to be in recovery from drugs or alcohol.

Health Care and Recovery: Persons with drug addictions are approximately twice as likely to suffer from mood and anxiety disorders compared to the general population.

Aside from mental health disorders, other common comorbidities include dental problems, …

Uvm Tobacco Use And Attitudes After Implementation Of A Tobacco-Free Policy, Christina Cahill, Elizabeth Carson, Eric Day, Melissa Rafferty, Saraga Reddy, Anthony Sassi, Eric Schmidt, Tom Delaney, Burton Wilcke, Jan K. Carney

Public Health Projects, 2008-present

Introduction: Widespread public health initiatives have led to falling smoking rates. Currently, 1,620 U.S. colleges have adopted smoke-free policies. In August 2015, the University of Vermont (UVM) adopted a tobacco-free policy that bans all forms of tobacco use on university property. The purpose of this study was to compare tobacco use and attitudes before and after policy implementation.

Lake Champlain Water Quality: A Study Of Public Awareness, Perceptions, And Behavior, Kelley Collier, Tridu Huynh, Michael Ialeggio, Colby Kearl, Autumn Reilly, Dana Ribaudo, Elaine Wang, Razelle Hoffman-Contois, Andrew Chevrefils, Jan Carney

Public Health Projects, 2008-present

Introduction: Lake Champlain serves as a major source of drinking water and a prime recreational area in Vermont. The Vermont Department of Health actively monitors Lake Champlain water quality, generates informational resources, and issues restrictions and advisories as necessary. Key water quality issues include: blue-green algae blooms (BGAB), combined sewer overflow (CSO), mercury-based fish consumption advisories, and suitability for recreational use. Determining public awareness of Lake Champlain water quality, and how perceptions of Lake Champlain water quality influence behavior, are essential to improving communication with at-risk and underinformed populations.

Naturopathic Physician Attitudes And Practices For Vaccination And Primary Care In The State Of Vermont, David Arsanious, Paul Baresel, Stephanie Brooks, Rachel Carson, Vicenta Hudziak, Stephen Maurer, Kelsey Sullivan, Chris Finley, Sarah Mccarthy, Jan Carney

Public Health Projects, 2008-present

Introduction:

Recent increase in measles cases has sparked vaccination controversy.

Naturopathic physicians (NDs) have been recognized as primary care providers by VT since 2012.

It is not well understood how NDs address vaccination with patients.

Our goal was to determine how Vermont NDs address vaccines and preventative care with their patients.

Facilitators And Barriers To Prescribing Preexposure Prophylaxis (Prep) For The Prevention Of Hiv, Theresa B. Flanagan, Margaret M. Graham, Tihn T. Huynh, Derek L. Luzim, Alexandra K. Miller, David M. Nguyen, Yueyue Shen, Peter Jacobsen, Jerry Larrabee

Public Health Projects, 2008-present

Background:

What is PrEP and who gets it?

PrEP is the use of medication by individuals to prevent HIV contraction, approved in 2012 after demonstrating safety and efficacy in the iPrEx study and Partners PrEP2 trials.

HIV infection risk is 92% lower in patients using PrEP.

Truvada®, a combination of tenofovir and emtricitabine taken orally daily, is the only approved PrEP regimen and is intended to compliment other prevention strategies such as condoms.

HIV negative-individuals at risk for exposure to HIV have been identified as men who have sex with men (MSM), IV drug users, heterosexuals who have unprotected sex …

Models For Hsv Shedding Must Account For Two Levels Of Overdispersion, Amalia Magaret

UW Biostatistics Working Paper Series

We have frequently implemented crossover studies to evaluate new therapeutic interventions for genital herpes simplex virus infection. The outcome measured to assess the efficacy of interventions on herpes disease severity is the viral shedding rate, defined as the frequency of detection of HSV on the genital skin and mucosa. We performed a simulation study to ascertain whether our standard model, which we have used previously, was appropriately considering all the necessary features of the shedding data to provide correct inference. We simulated shedding data under our standard, validated assumptions and assessed the ability of 5 different models to reproduce the …

Harvesting Health: A Community-Based Participatory Evaluation Of The Veggie Rx Program, Natalie Royal, Kristin Brown, Fanny Rodriguez, Bianca Fernandez, Leticia Valle, Elizur Bello

Articles, Abstracts, and Reports

No abstract provided.

The Digital Age: Reminder And Confirmation Preference In Blood Donation, Michael Chung, Catherin Hayes, Peter Hyson, Y-Lan Khuong, Saurabh Patel, Brett Powers, Emily Ryan, Ryan Schmoldt, Jan Carney, Mark Fung

Public Health Projects, 2008-present

Introduction:

It is widely accepted that individuals are more likely to comply and follow through with responsibilities when reminded and asked to confirm their commitments. With the American Red Cross’ access to fast and affordable communication and this notion in mind, there is potential to develop new recruitment strategies and better methods of ensuring blood donation commitments.

In particular, understanding modes of communication with the donor population can have significant implications: avoiding loss of follow up, improving donor experience, and ensuring appropriate use of resources and staff; therefore, the American Red Cross is interested in understanding demographic differences among those …

Vermont Restaurant Owner & Manager Perspectives On Creating Heart-Healthy Kids Meals, Elisabeth Lucas, Mary K. Lopiccolo, Lauren Haggerty, Apoorva Trivedi, Alex Jacobson, Daniel Trigg, Taylor Sommer, Carolyn Payne, Tina Zuk, Paula Tracy

Public Health Projects, 2008-present

Introduction: The prevalence of sugar sweetened beverages and fried foods combined with a lack of healthy children’s menu options has contributed to the obesity epidemic among young Americans. Recent legislation in New York City and San Francisco instituted strict nutritional requirements on children’s menu items.

We performed a cross-sectional study that focused on independently owned restaurants with printed children’s menus in Vermont. We investigated the nutritional content of children’s menu items, restaurant owner and manager perspectives on customer ordering habits, and barriers that restaurants would face if they made children’s menu items healthier.

Predictors Of Engagement In Community-Based Therapy For Youths With Mood And Anxiety Disorders, Hailey S. Saunders

Electronic Thesis and Dissertation Repository

The First Episode Mood and Anxiety Program (FEMAP) aims to identify and treat youths with mood and anxiety disorders. This research sought to identify factors associated with engagement in FEMAP, based on extensive data collected by FEMAP researchers. A logistic regression model was built from candidate variables using purposeful selection. Of the 366 participants offered treatment, 87% engaged in FEMAP. Quantity of alcohol consumed per occasion, gender, and anxiety sensitivity were found to be significant predictors of engagement. Gender and anxiety sensitivity interacted with each other such that at low anxiety sensitivity levels, the odds of engaging in FEMAP for …

Sex Offending And Serious Mental Illness: Directions For Policy And Research, Andrew Harris, William Fisher, Bonita Veysey, Laura Ragusa, Arthur Lurigio

Arthur J. Lurigio

Over the past decade, two rapidly evolving areas of criminal justice practice have garnered increasing attention from policy makers, practitioners, and researchers: the management and treatment of justice involved individuals with serious and persistent mental illness, and the challenges of managing the perceived societal risk presented by sex offenders. Yet, whereas each of these issues has independently attracted significant attention, the nexus between them has remained largely unexamined. Matters of concern include the manner in which individuals with serious mental illness may be disproportionately affected by the expanding range of restrictions placed on those with sexual offense histories, the demands …

Reorienting Adolescent Sexual And Reproductive Health Research: Reflections From An International Conference, Kristien Michielsen, Sara De Meyer, Olena Ivanova, Ragnar Anderson, Peter Decat, Céline Herbiet, Caroline W. Kabiru, Evert Ketting, James Lees, Caroline Moreau, Deborah L. Tolman, Ine Vanwesenbeeck, Bernardo Vega, Elizabeth Verhetsel, Venkatraman Chandra-Mouli

Publications and Research

On December 4th 2014, the International Centre for Reproductive Health (ICRH) at Ghent University organized an international conference on adolescent sexual and reproductive health (ASRH) and well-being. This viewpoint highlights two key messages of the conference - 1) ASRH promotion is broadening on different levels and 2) this broadening has important implications for research and interventions – that can guide this research field into the next decade. Adolescent sexuality has long been equated with risk and danger. However, throughout the presentations, it became clear that ASRH and related promotion efforts are broadening on different levels: from risk to well-being, from …

United States Acculturation And Cancer Patients’ End-Of-Life Care, Alexi Wright, Heather Stieglitz, Yankel Kupersztoch, M. Elizabeth Paulk, Yookyung Kim, Ingrid Katz, Francisco Munoz, Rachel Jimenez, Jan Mutchler, Lorna Rivera, Anthony Back, Holly Prigerson

Lorna Rivera

Background: Culture shapes how people understand illness and death, but few studies examine whether acculturation influences patients’ end-of-life treatment preferences and medical care.

Methods and Findings: In this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n = 171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19- item scale developed to assess the degree of ‘‘Americanization’’ in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers’ USAS scores predicted patients’ …