Medicine and Health Sciences Commons^™

The Impact Of Stress During Adolescence And The Prevalence Of Pediatric Obesity, Olatunbosun Olakunri, Venkat Venkataraman

Rowan-Virtua Research Day

Obesity is a chronic condition that can be attributed to myriad factors including socioeconomic status, biological risk factors, and various environmental factors. These factors can be considered stress factors, and exposure to various levels of stress can impact the development of stress within the pediatric patients. The purpose of this study is to assess the association between the environmental, mental, social, physical, and psychological stress adolescents are exposed to and how they contribute to the prevalence of pediatric obesity throughout the United States. Understanding these risk factors can help us as a community and most importantly as clinicians develop better …

The Effect Of Using A Meal Tracking Smartphone Application In Overweight And Obese Adolescents With Prediabetes Or Type 2 Diabetes To Improve Bmi And Hba1c, Lauren Torhorst

Evidence-Based Practice Project Reports

Obesity has become one of the most common chronic pediatric illnesses worldwide and is closely linked to the onset of prediabetes and subsequent Type 2 Diabetes (T2D); therefore, preventing and treating childhood obesity has become a high priority (Hampl et al., 2023). The purpose of this Evidence-Based Practice (EBP) project is to lower Glycosylated Hemoglobin A1c (HbA1C) and Body Mass Index (BMI) in overweight and obese youth with prediabetes and T2D using a meal tracking smartphone application. The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was utilized to pilot this project between two pediatric endocrinology offices located in Southeast Wisconsin. …

Improvements In Appropriate Placement Of Dental Sealants After Implementation Of A Clinical Decision Support System, Joanna Mullins, Ryan Brandon, Nicholas Skourtes, Elsbeth Kalenderian, Muhammad Walji

Student and Faculty Publications

BACKGROUND: Dental sealants are effective for the prevention of caries in children at elevated risk levels, and increasing the proportion of children and adolescents who have dental sealants on 1 or more molars is a Healthy People 2030 objective. Electronic health record (EHR)-based clinical decision support systems (CDSSs) have the ability to improve patient care. A dental quality measure related to dental sealant placement for children at elevated risk of caries was targeted for improvement using a CDSS.

METHODS: A validated dental quality measure was adapted to assess a patient's need for dental sealant placement. A CDSS was implemented to …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

Adolescent Substance Use: Standardizing Screening Methods In Clinical Practice, Bryan D. Shin

Family Medicine Clerkship Student Projects

Adolescent substance use is a highly pervasive issue that strongly correlates with increasing depression and anxiety rates. Standardized screening tools for substance use, such as the CRAFFT or the Screening to Brief Intervention Tool, are freely available but not widely utilized for every patient encounter in clinical practice. This project aimed to improve standardization of substance use screening at a primary care clinic located in Castleton, Vermont through implementation of the CRAFFT tool as an automatically-loaded form in each adolescent encounter note. The goal was to improve substance use detection rates by facilitating efficient incorporation of standardized screening into the …

Increasing Access Of Outpatient Therapeutic Services For Adolescents With Persistent Symptoms After Sport-Related Traumatic Brain Injury, Natalie J. Bales

Family Medicine Clerkship Student Projects

Persistent symptoms lasting at least 21 days after initial traumatic brain injury occur in about 15-20% of adolescents. Initial assessment of concussions can be done using the SCAT5 and a wide variety of other standardized assessment tools. However, there are striking gaps in standard clinical procedure for follow-up care for athletes who have persistent symptoms. Furthermore, there are many issues with accessibility to therapeutic services including long wait times that prevent timely referral to those services. This pilot intervention was implemented at the University of Vermont to address those issues by providing a hotline resource for families to use and …

Promoting Safe Sex Practices And Sexually Transmitted Infection Prevention In The Adolescent Population In Ridgefield, Ct, Gina Jin

Family Medicine Clerkship Student Projects

Adolescents are a uniquely at-risk population for the spread of preventable sexually-transmitted infections. Direct lifetime medical costs of sexually transmitted infections (per CDC) is nearly $16 billion in the United States. Nearly half (46%) of all new STIs in the country occur among young people (ages 15-24). Because of this, effective STI prevention in the adolescent population is important and should be further investigated.

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.

Integrating Community Into Middle School Sexual Education, Sierra Miller, Margaret Aitken

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Problem Statement: Most middle school sexual education does not include parents or community members. Evidence shows family and community attitudes towards sex and sexuality are significant factors in adolescent risky sexual and health practices.

Background: Comprehensive sex education (CSE) reduces risky sexual practices and negative health outcomes. National and local organizations have identified CSE as a public health goal. CSE works best when culturally relevant and the community is involved.

Methods: Interviews with the health educator identified community needs. Resources were created in line with the current curriculum focusing on sex education, its importance, and how to talk about …

How To Have The “Vape Talk” With Adolescent Patients, Helen Gandler

Family Medicine Clerkship Student Projects

Recent years have shown a dramatic increase in the popularity of electronic vapor products, which include e-cigarettes, vapes, vape pens, e-cigars, e-hookahs, hookah pens, and mods. While emerging data shows that adolescents are becoming more aware of the dangers posed by these products, more than 3.6 million US youth still use e-cigarettes. As of February 18, 2020, a total of 2,807 hospitalized e-cigarette, or vaping, product use-associated lung injury (EVALI) cases or deaths in the United States have been reported to CDC.

This project had two goals: to create a tool to help facilitate discussions between providers and their adolescent …

Identification And Management Of Adolescent Alcohol Use: Screening And Motivational Interviewing, Kelsie L. Berger

Evidence-Based Practice Project Reports

Adolescent alcohol consumption is a serious health problem in the United States. Alcohol is the most widely used substance, and it continues to be the drug of choice for adolescents (CDC, 2018). Over 7 million adolescents and approximately 30 percent of high school students in the U.S. that admit to drinking more than a few sips of alcohol in the past 30 days (NIAAA, n.d.). Underage alcohol use can lead to many complications such as social, school, and legal problems, and when initiated early in life is associated with the development of alcohol use disorder (NIAAA, n.d.). The purpose of …

Adolescent And Young Adult Medicine: Supporting An Often Forgotten Population, Isabelle Mason

Family Medicine Clerkship Student Projects

The actions and lifestyle choices adolescents and young adults make have profound effects on their future health and well-being. Unfortunately, these patients are often scarce among family practice lineups, making it difficult for physicians to provide impactful preventative care. This project looks at how to help reach these oft-forgotten patients.

The Facts - Your Choice: Std Risk Information For The Adolescent Patient, J C. Gwilliam

Family Medicine Clerkship Student Projects

Sexual health education is one of the factors that has led to a dramatic drop in adolescent pregnancy since the 1990s. Paradoxically, though, rates of sexually transmitted-infections (STI) in the adolescent population during that period soared. The educational deficit appears to be a lack of understanding of both short- and long-term health risks that STIs pose, and conflation of contraceptive effectiveness with STI prevention. This project sought to develop an inexpensive, office-based education product that would aid practitioner-adolescent patient discussion and facilitate follow-up in the family medicine setting.

Rutland City Public School At Risk Youth Mentorship, Michael J. Marallo

Family Medicine Clerkship Student Projects

This after school program’s purpose is to address the unique challenges of Rutland, VT Middle/High School students with multiple psychosocial risk factors (as determined by comparison to the ACE questionnaire) through mentorship, health and life skills education, and by guiding the development of positive coping skills. Activities will allow for self-expression outside of the classroom in a safe environment. Focus will be placed on assisting paraeducators and teachers with meeting goals that are appropriate for each individual student.

Mindfulness As An Effective Strategy For Anxiety Relief In Adolescent Patients, Desiree N. Dibella

Family Medicine Clerkship Student Projects

Anxiety disorders affect 6.8 million adults over the age of 18 in the United States, and anxiety disorders are the most common mental health illness in children.

Risk Factors for anxiety disorders in young adults include the following: -Shyness, or behavioral inhibition, in childhood -Being of the female sex -Having few economic resources -Exposure to stressful life events in childhood -Anxiety disorders in close biological relatives -Parental history of mental disorders -Elevated afternoon cortisol levels in the saliva Teens and young adults increasingly suffer from anxiety disorders with the CDC reporting the rate of anxiety disorders among 3 to 17 …

Prevalence Of Sexual Abuse Among Women Seeking Gynecologic Care In Germany, Ursula Peschers, Janice Du Mont, Katharina Jundt, Mona Pfurtner, Elizabeth Dugan, Gunther Kindermann

Elizabeth Dugan

OBJECTIVE: To estimate the prevalence of sexual abuse among patients seen for gynecologic care in Germany. METHODS: A short anonymous questionnaire was distributed to 1157 women attending a gynecologic outpatient clinic at a large urban teaching hospital. Data collected using the questionnaire included patient characteristics, sexual abuse history, and screening practices. Women who reported that they had been abused were asked if they had ever discussed the issue with their gynecologist. RESULTS: A total of 1075 questionnaires were returned, for a response rate of 92.9%. Almost half (n = 479 [44.6%]) of the women surveyed reported that they had been …

Adolescent Prescription Drug Abuse: An Overview Of Current Data, Tavis Cowan Md

Family Medicine Scholarly Works

Prescription drug abuse among adolescents is a growing and increasingly lethal problem. Recent survey studies show a concerning increase in abuse and poor awareness among users, parents, and medical providers. Access to prescription drugs of abuse is often through relatives’ supply of medications. Categories of abused drugs include opiates, stimulants, and benzodiazepines. Methamphetamine is a special case as prescription-only pseudoephedrine can drastically change patterns of abuse. Awareness programs are emerging for youths, parents, community members, and medical providers; but data on effectiveness of these interventions is not yet available.

Early Course Of Nicotine Dependence In Adolescent Smokers, Chyke Doubeni, George Reed, Joseph Difranza

Chyke A. Doubeni

OBJECTIVE: The goal was to characterize the early course of nicotine dependence. METHODS: Data were collected from 1246 sixth-graders in a 4-year (2002-2006) prospective study using 11 individual interviews. Subjects were monitored for 10 symptoms of dependence by using the Hooked on Nicotine Checklist. The bidirectional prospective relationship between the intensity of dependence (number of symptoms) and smoking frequency was examined by using cross-lagged analyses. RESULTS: Of the 370 subjects who had inhaled from a cigarette, 62% smoked at least once per month, 53% experienced dependence symptoms, and 40% experienced escalation to daily smoking. Smoking frequency predicted the number of …