Medicine and Health Sciences Commons^™

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 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.

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 …

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 …

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 …

Prostate Cancer: Screening, Current Guidelines And Patient Education, Timothy F. Flanagan

Family Medicine Clerkship Student Projects

Recent changes in prostate cancer screening guidelines may create an opportunity for patient education. By creating a succinct hand-out on prostate cancer screening, providers enable their patients to understand screening, and provide sites with opportunities for further learning.

Reducing Falls: Merging Research And Community Resources, Alison Mercier

Family Medicine Clerkship Student Projects

1/3 of older adults over the age of 65 fall, 10% of these falls can lead to serious injuries like hip fractures. The average length of life for someone who fractures their hip is 6 months. The risk and reasons for falling are multifactorial and often take a long time to assess. There are a few evidence based recommendations for reducing fall risk, yet a lack of awareness of these recommendations, and community resources to address this need. This project aimed to create a standardized assessment tool based on literature research and available community resources to facilitate fall risk assessment …

Child Obesity Education: Sugar In Common Snacks, David M. Nguyen

Family Medicine Clerkship Student Projects

Causes of childhood and adolescent obesity are multi-factorial: sugary beverages, snack foods, portion size, activity level, environmental factors, socio-cultural factors, family factors and psychological factors to name a few. There are both immediate and long-term health effects for childhood obesity. Ultimately, it plays an economic burden with an estimated national medical cost of obesity-related illnesses in adults to be 209.7 billion. This pamphlet is an easy to read resource with the purpose of educating parents and adolescents about the hidden sugar in everyday snacks.

Emr Optimization Of Home Health, Rahul R. Gentyala

Family Medicine Clerkship Student Projects

Home Health is a service that provides a variety of healthcare needs to those who are unable to get out of their home due to an illness, injury, or disability. Currently paper copies are in use for Home Health, which are harder to document, decreases efficiency, and increases error. Incorporating this into EMR will go a long way to solving these issues.

Accessing Reliable Health Information On The Internet, Nathaniel Sugiyama ,Ms3

Family Medicine Clerkship Student Projects

In a low socioeconomic farming town at a rural family medicine clinic in upstate NY, I wanted to find a way to help reduce barriers to healthcare and help patients take an active role in their health using free internet resources. My idea was to help connect patients with reliable health information without needing to travel to the clinic, understanding that some patients may be limited in their ability to travel, take time off from work or afford the copays/expenses associated with seeing their providers. As such, I chose to investigate access to the internet, the ways in which users …

Caught Between The Lines, Moshe Bitterman

Family Medicine Clerkship Student Projects

The Patient-Centered Medical Home (PCMH) is a model of primary care that combines teamwork and information technology to improve care, improve patient care experiences, and reduce health care cost.This project, conducted at the Hardwick Area Health Center, focused on quality improvement by exploring the patient experience in communicating with the health center by telephone.

Regulating Kids' Meals To Combat Childhood Obesity, Y-Lan Khuong

Family Medicine Clerkship Student Projects

Obesity is an epidemic crossing genders, ages, socioeconomic status, geography, and race/ethnicity. In Vermont, 11.3% of 10 to 17-year old are considered obese, thereby increasing risk for numerous health issues. One contributing factor is an increased tendency to eat away from home. This project aims to provide qualitative evidence regarding response to policy setting nutritional standards for kids' meals in Vermont restaurants.

Tackling Obesity In Rural Vermont, Abishag Suresh

Family Medicine Clerkship Student Projects

Obesity is a growing epidemic across the United States. It affects rural areas such as those in Vermont deeply. An intervention addressing this problem using a health and exercise brochure was undertaken. Future direction will need to fully address the effectiveness of this intervention and take on other goals.

Confronting Barriers To Exercise In Patients With Chronic Health: Community Health Improvement Project In The Lewiston/Auburn Area Concerns, Marie R. Lemay

Family Medicine Clerkship Student Projects

The CDC recommends at least 150 minutes of moderate-intensity aerobic activity every week, but most individuals with chronic disease do not reach this goal despite its numerous health benefits. Research has shown that scheduled exercise programs and exercise partners help individuals to sustain their exercise goals. Using this premise of group mentality individuals affected from cancer at the Dempsey center and patients attending CMMC’s diabetes group in Lewiston ME were polled about exercise self –efficacy and barriers to exercise. Subsequently, a one-time walking event was offered to the diabetes group and a phone-tree was introduced to one yoga class at …

Evaluating Access And Barriers To Mindfulness Among Opioid-Dependent Patients In Bangor, Maine, Gwendolyn E. Warren, Jia Xin Jessica Huang

Family Medicine Clerkship Student Projects

Mindfulness has been shown to aid in addiction recovery and can help prevent relapse. The Family Medicine Center & Residency Program at Eastern Maine Medical Center (EMMC) in Bangor, Maine has provided mindfulness resources to their opioid-dependent patients; however, the center has no quantitative data on the current understanding and utilization of mindfulness techniques among this patient population. A survey tool was created and distributed to opioid-dependent patients in the clinic to identify barriers to practicing mindfulness. The collected data was submitted by one of the clinic providers in a grant proposal. Grant funding could go toward addressing these barriers.

Integrated Care: Improving Coordination Of Care Between Primary Care And Psychiatric Services, Eunice Fu

Family Medicine Clerkship Student Projects

The majority of the highest utilizers of medical care are affected by mental health issues, yet multiple studies have shown that PCPs have mixed success in recognition and management of mental illness on their own. An integrated model of primary and mental healthcare is ideal to increase acceptability and availability of mental health services. However, there is a growing body of research demonstrating high rates of dissatisfaction with primary-specialty communication. Northwestern Counseling and Support Services has implemented a new care coordination model to address barriers to collaboration in Franklin and Grand Isle Counties. This project summarizes results of the 1-year …

Diabetes And Your Eyes: The Importance Of Annual Eye Exams, I-Hsiang Shu

Family Medicine Clerkship Student Projects

Diabetes is the leading cause of blindness in the United States. With diabetes, one has a 25 times higher risk of blindness than the average American and each year in the US, there are more than 12,000 new cases resulting from diabetes. This significant risk of developing blindness is because diabetic eye changes often occur silently, without symptoms, until it is too late and permanent damage to your eye has already occurred. The two most important things a diabetic can do for eye health is to properly manage blood sugars and receive an annual dilated eye exam from an eye …

Resources For Moms: Opiate Use In Pregnancy, Amy Schumer

Family Medicine Clerkship Student Projects

Substance use in pregnancy is not uncommon and the use of substances increases the risk of complications during pregnancy. In Vermont, opiate use in pregnancy is increasing as well as the number of people seeking treatment for opiate misuse. This project was designed to give pregnant mothers using opiates an idea of what to expect during their pregnancy as well as the resources that are available to them in the Springfield, VT area.