Medicine and Health Sciences Commons^™

How To Analyze Parental Conversation Online: A Computational Stack For Studying Vaccine Hesitancy., Carter Willets Ward

Graduate College Dissertations and Theses

Despite national and international organizations such as the CDC and WHO recognizing the value of vaccines and their importance in addressing public health concerns, there has been a decline in coverage for even the most established vaccines over the past three years. The global COVID-19 pandemic has contributed to this decline via decreases in medical resource accessibility and an increase in vaccine hesitancy. Even before the COVID-19 pandemic, WHO had recognized vaccine hesitancy as one of the top ten threats to public health. In the present work, we introduce a background account of (1) vaccine hesitancy and (2) anti-vax activism, …

Promoting Community Health During The Covid-19 Pandemic, Erik J. Zhang

Family Medicine Clerkship Student Projects

The COVID-19 pandemic has affected aspects of health and community beyond the acute phase of COVID-19 infection, including chronic health conditions, mental health, substance use, food insecurity, access to healthcare, and housing insecurity. Further, existing disparities in these factors and other social determinants of health such as socioeconomic status, education, neighborhood, and physical environment have been exacerbated by the response to the COVID- 19 pandemic. Community members face negative health impacts as a result of the COVID-19 pandemic and response. They should be made aware of community resources for immediate and long-term solutions to the difficulties they experience.

A Cross-Sectional Analysis Of The Predictive Ability Of Pregnancy Intention On Postpartum Contraceptive Use Using The Vermont Phase 8 Pregnancy Risk Assessment Monitoring System (Prams), Hailey Virginia Cray, Jennifer Burroughs Dvm, Mykayla O'Brien, Barbara Walter, Lindsay Aldrich

Master of Public Health Culminating Projects

Objectives:

a) To determine if pregnancy intention predicts postpartum contraception use among women with live births in Vermont.

b) To encourage the ongoing education of sexually active individuals in best practices to reduce unintended pregnancy.

Methods: A cross-sectional survey-based study was conducted using data from the 2016-2018 Vermont Pregnancy Risk Assessment Monitoring System (n=3753 women with a live birth), using frequency tables, crosstabulations, and simple logistic regression.

Results: Of 2,493 responses received for the 2016-18 PRAMS questionnaire, 67.5% indicated that their pregnancy had been intended, and 32.5% indicated that their pregnancy had not been intended or that they were not …

Community Health Interventions To Reduce The Burden Of Radon-Related Lung Cancer, Benjamin Weaver

Family Medicine Clerkship Student Projects

Exposure to radon is the second leading cause of lung cancer in the United States. One in seven homes in Vermont has elevated levels of radon, but most patients are unaware of radon as a risk factor for lung cancer or that radon testing and mitigation services are available to them. To promote increased testing and mitigation of radon we screened patients presenting to a Family Medicine practice in Vermont about whether they had had these services done in their home. We also developed a patient education resource for providers to give to patients who had more questions about radon …

Evaluating Patient And Provider Knowledge Of Safe Pharmaceutical Disposal Procedures In Vermont Through A Public Health And Environmental Lens, Emily R. Straley

Family Medicine Clerkship Student Projects

Patient and provider knowledge of safe pharmaceutical disposal procedures is crucial from both a public health and environmental standpoint. Unfortunately, studies have shown that Vermont residents are largely unaware of safe drug disposal programs in their communities. This project evaluated patient knowledge of drug disposal practices and awareness of safe pharmaceutical disposal procedures at Hinesburg Family Medicine. A short phrase was created to better disseminate information about safe drug disposal in Hinesburg, which can be added to a patient’s after visit summary. Many patients report never discussing medication disposal with their physician. Therefore, increased provider communication regarding leftover and unused …

Implementing An Intimate Partner Violence Screening At A Connecticut Family Medicine Practice, Nikkole Turgeon

Family Medicine Clerkship Student Projects

Intimate partner violence (IPV) is a significant public health problem throughout the United States. The aim of this project was to implement a validated IPV screening form into the work flow of the Newtown Primary Care office and increase awareness about IPV throughout the office. The Hits, Insults, Threatens, Screams (HITS) screening form was implemented and resources from local domestic violence agencies were obtained for the office. A system was set up for patients who screen positive to be referred to the in-house therapist and to local domestic violence agencies. Future steps could include further training and education for the …

Addressing Adolescent And Young Adult Mental Health During The Covid-19 Pandemic, Megan Boyer

Family Medicine Clerkship Student Projects

This quality improvement project at South Burlington Family Medicine aimed to investigate the mental health of individuals ages 13-25 in our practice during the COVID-19 pandemic. Eligible patients received a PHQ-9 questionnaire with two additional questions related to COVID-19. Recommendations for future interventions to serve this population were made based on these preliminary findings, with the goal of doing a full PDSA cycle in the near future.

Quality Improvement: Cervical Cancer Screening Rates Within Hudson Headwaters Health Network, Dylon K. Gookin

Family Medicine Clerkship Student Projects

Nearly 8 out of every 100,000 people are diagnosed with cervical cancer each year. However, powerful screening tools exist that enable us to detect and manage cervical changes before they develop into cervical cancer. In spite of this, cervical cancer screening rates remain low for many providers. This public health project sought to identify and address a cause for low cervical cancer screening rates within the Hudson Headwaters Health Network. A literature review determined that education and mailed invitation letters were proven methods for improving cervical cancer screening rates. Following a review of the local population demographics, West Mountain Health …

Referral Patterns And Service Provision In Child Protective Services: Child, Caregiver, And Case Predictors, Hannah Mead Holbrook

Graduate College Dissertations and Theses

Child maltreatment, and recurrent maltreatment in particular, occurs at an alarmingly high rate. Frequency of reports to Child Protective Services (CPS) is associated with negative psychological outcomes, and children whose reports are unsubstantiated experience similar risk of behavioral, emotional, and substance use disorders as those whose reports are substantiated. Prior research has demonstrated that children with no CPS reports and children with one CPS report showed no significant differences in rates of maltreatment perpetration or substance use in adulthood, suggesting that prevention efforts after one report may have strong merit in reducing negative outcomes in adulthood. However, patterns and risk …

Combating Diabetes In Chittenden County: A Healthcare Provider Referral Campaign To Increase Patient Participation In The Vermont Diabetes Prevention Program, Samantha Magier

Family Medicine Clerkship Student Projects

As of 2016, diabetes affects more than 29 million people in the United States and is the 7th leading cause of death nationwide. In Vermont, 1/10 people are diagnosed with either diabetes or prediabetes, with 6% of Vermonters affected by prediabetes and 5% of Chittenden Country affected by prediabetes. The public health burden of this chronic disease is immense: diabetes costs Vermont an estimated $543 million each year and is the leading cause of kidney failure, lower limb amputations, and adult-onset blindness. Prediabetes occurs when blood sugar is higher than normal but not at the diagnostic threshold of diabetes. Prediabetes …

Vermont Food Insecurity: Implementing Screening Tools And Interventional Assistance At Thomas Chittenden Health Center, Quinn Self

Family Medicine Clerkship Student Projects

Hunger Free Vermont estimates that over 11% of Vermonters experience Food insecurity defined as a lack or access to adequate nutritious food due to lack of money or other resources. Food insecurity has been linked with numerous health problems including obesity, depression, poor school performance, heart disease, anemia and increased number of hospitalizations. Despite the adverse health outcomes associated with food insecurity, primary care providers don't usually screen for it. There are short validate tools to screen with high sensitivity and specificity for food insecurity. The goal of this project was to generate a screening poster for waiting rooms and …

Adolescent Sex Education, Carolyn Payne

Family Medicine Clerkship Student Projects

This project identified a significant need for adolescent sex education and curriculum development in Vermont and the United States. A comprehensive sex education presentation was developed, reviewed by experts in the field, and piloted at The Boys and Girls Club of Burlington. Subjective results were positive and future strategies to teach students, evaluate effectiveness, and expand impact were developed.

Developing A Vermont Nurse Triage Line: A Systems Improvement Project, Andrew D. Kehl

College of Nursing and Health Sciences Nursing Master Project Publications

Nurse Triage Lines (NTL) have been utilized since the 1970s as a healthcare service delivery model. The efficacy of their utilization has been proven in non-acute, mainly primary care settings. During the 2009 H1N1 pandemic in the United States, NTLs proved their efficacy in an acute emergency event. The Minnesota FluLine, the exemplar case study, showed a significant reduction in unnecessary healthcare resource utilization as well as a significant economic cost savings.

This project performed an organizational assessment for the Vermont Department of Health (VDH) focused on implementing an NTL. Through qualitative semi-structured interviews with key informants, key themes surround …

Vitamin D Screening And Supplementation, Christina Cahill

Family Medicine Clerkship Student Projects

Vitamin D helps protect against osteoporosis (by promoting calcium absorption), moderates cell growth, aids in neuromuscular and immune function and reduces inflammation. However, there is insufficient data to access the benefits and harms for screening for Vitamin D deficiency. This study looks at current recommendations for Vitamin D screening and aims to provide information to providers and patients about Vitamin D.

Improving Community Health With Affordable Internet Access, Joshua Jeremy Pothen

Family Medicine Clerkship Student Projects

Internet access is associated with increases in health information seeking and benefits in health statuses. However, many individuals of low socioeconomic status (SES) lack Internet access, thereby creating significant disadvantages from a health perspective. In this project, we describe a potential project for providing affordable Internet access to a neighborhood of Newport, VT containing many SES individuals. This network includes a splash page that provides regular health event promotion and health information dissemination to everyone connecting the network. We then discuss how to determine the impacts of the Internet on multiple aspects of health within the community.

Fighting The Flu - Devising A Novel Approach To Address Patient Concerns With The Seasonal Influenza Vaccine - South Burlington, Vt, Theodore Cisu

Family Medicine Clerkship Student Projects

In Vermont, it is estimated that influenza-like illness is responsible for $8.9 million annually in direct medical costs. The flu vaccination rate ranges from 33% to 56% across the nation, and Vermonters are vaccinated at a rate of approximately 49% each year. This program aims to provide a novel educational material to patients, specifically addressing concerns with the safety of the seasonal influenza vaccine.

Development Of Guidelines For Refugee Screening At Cmmc Family Medicine Residency, Lewiston, Maine, Catherine Hayes

Family Medicine Clerkship Student Projects

Lewiston Maine has the second highest number of refugees in the state of Maine, with 191 total intakes in 2015. Refugee populations face unique health concerns, and providing care for refugees requires education and development of a specialized skill set. This project provided a reference for clinic providers to assist with medical intake screening visits for refugees.