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Opioid Overdose Deaths In Vermont: Effectiveness Of Buprenorphine Provider Density On Mortality Rates, Noah Chirico, Naw Ruth Doe, Alexandra Mesick, Amy Dubuque, Rachel Cruise, Jan K. Carney Jan 2021

Opioid Overdose Deaths In Vermont: Effectiveness Of Buprenorphine Provider Density On Mortality Rates, Noah Chirico, Naw Ruth Doe, Alexandra Mesick, Amy Dubuque, Rachel Cruise, Jan K. Carney

Master of Public Health Culminating Projects

Background

Since 2017, there has been an increase in the frequency of mortality related to opioids in Vermont. Buprenorphine is a great alternative to traditional opioids because of its efficacy in treating opioid use disorder (OUD), however, it is underutilized by providers due to needing a specific waiver to prescribe it. This project looks at two different angles: is the number of Buprenorphine providers associated with the number opioid related deaths per county?; and does a rural setting in Vermont affect mortality rates due to a possible lack of Buprenorphine providers?

Methods

The incidence of overdose deaths per county to …


Food Insecurity In Vermont Households: An Analysis Of The Association With Tobacco Use, Alcohol Consumption And Physical Inactivity, Hannah R. Kaufman, Kyleigh Savoie, Emily Belanger, Kijonna Bowman, Darren Childs, Hendrika Maltby Jan 2021

Food Insecurity In Vermont Households: An Analysis Of The Association With Tobacco Use, Alcohol Consumption And Physical Inactivity, Hannah R. Kaufman, Kyleigh Savoie, Emily Belanger, Kijonna Bowman, Darren Childs, Hendrika Maltby

Master of Public Health Culminating Projects

Objectives: To assess the relationship between chronic disease risk behaviors: tobacco usage, alcohol consumption, sedentary lifestyle, and food insecurity (FI) among Vermonters. Methods: This cross-sectional study uses a sample (n= 1,378) from Vermont’s 2018 Behavioral Risk Factor Surveillance System (BRFSS). The examined outcome is FI. The predictor measures were defined as at-risk tobacco use, alcohol consumption, and sedentary lifestyles.The following were established as covariates on the association between the dependent and independent variables: income, sex, age, race/ethnicity, and activity limitations. Results: In the unadjusted binomial logistic regression (Table 2), tobacco users were 3.32 times more likely to be food …


Alcohol Consumption Among Cannabis Users In Vermont, Lara Cushman, Florencia Drumwright, Nawar Kareem, Madeleine Mank, Nicholas Milazzo Ms, Victoria Hart Jan 2021

Alcohol Consumption Among Cannabis Users In Vermont, Lara Cushman, Florencia Drumwright, Nawar Kareem, Madeleine Mank, Nicholas Milazzo Ms, Victoria Hart

Master of Public Health Culminating Projects

Objective: To examine the relationship between cannabis and alcohol consumption in Vermont; after the legalization of cannabis in 2018.

Methods: We used Vermont's Behavioral Risk Factor Surveillance System (BRFSS) survey; this data included only participants who had reported alcohol use in the past year (n = 3,781). We used multiple linear regression to compare frequency of cannabis use against days per month of alcohol consumption and binomial logistic to compare regression to the frequency in which cannabis was used against the odds of Heavy Alcohol Consumption (HAC).

Results: We found that low and moderate cannabis users had more days of …


Associations Between Demographic Factors And Suicide Deaths In Vermont: 2015-2019, Isabelle Tomanelli, Lucy Lincoln, Stephanie Stead, Mary Ryan-Eldred, Nick Martin, Sarah Vose Jan 2021

Associations Between Demographic Factors And Suicide Deaths In Vermont: 2015-2019, Isabelle Tomanelli, Lucy Lincoln, Stephanie Stead, Mary Ryan-Eldred, Nick Martin, Sarah Vose

Master of Public Health Culminating Projects

Objectives. To quantify the complex relationships shared between numerous risk factors associated with suicide among Vermont decedents.

Methods. Vermont Electronic Death Registration System (EDRS) data from 2015-2019 were examined through binary logistic regression analyses to examine demographic variables’ ability to predict death by suicide.

Results. In the analysis of 26,738 deaths, significant predictors of suicide among the 535 suicide decedents included rurality (odds ratio [OR] = 1.043; 95% CI = 1.016, 1.071; P = 0.002), divorce (OR = 1.785; 95% CI = 1,396, 2.281; P < 0.001), and higher educational attainment including associate degree (OR = 1.472; 95% CI = 1.033, 2.098; P = 0.032), bachelor’s degree (OR = 1.686; 95% CI = 1.266, 2.247; P < 0.001), master’s degree (OR = 1.812; 95% CI = 1.162, 2.826; P …


The Importance Of Continued Compliance With Completing Advance Directives In An Outpatient Setting, Maegan R. Neilson Jan 2021

The Importance Of Continued Compliance With Completing Advance Directives In An Outpatient Setting, Maegan R. Neilson

Family Medicine Clerkship Student Projects

Despite continued efforts with conversation, guidelines, and even law, studies still show that the compliance with completing advance directives amongst a global patient population remains around 3 in 100. Those in compliance are more often chronically ill, over 65, or in an acute or terminal care setting. The COVID-19 pandemic is evidence that anything can happen and that helping patients adhere to medical wishes should be a top priority for primary care providers and their patients of all ages and health. Because previous studies have proven to be effective in increasing AD compliance when highlighted, this project aims to reignite …


Transgender Healthcare Resources For Clinicians In Vermont, Jeanie Lin Jan 2021

Transgender Healthcare Resources For Clinicians In Vermont, Jeanie Lin

Family Medicine Clerkship Student Projects

Transgender individuals face disproportionate levels of discrimination in healthcare settings and have worse health than their cisgender peers. One major barrier to healthcare reported by transgender individuals is a lack of providers who are sufficiently knowledgeable on the topic. The 2011 National Transgender Discrimination Survey found that half of respondents reported having to teach their providers about their own healthcare. To address this problem in Vermont, transgender healthcare resources were compiled into a single document to be distributed to primary care practices around Vermont.


Follow-Up With New Sga Prescriptions In Burlington, Vt, Obhijit D. Hazarika Jan 2021

Follow-Up With New Sga Prescriptions In Burlington, Vt, Obhijit D. Hazarika

Family Medicine Clerkship Student Projects

No abstract provided.


Improving Communication In Patient Visits Requiring Medical Interpreters, Daniel J. Moroney Jan 2021

Improving Communication In Patient Visits Requiring Medical Interpreters, Daniel J. Moroney

Family Medicine Clerkship Student Projects

Handout for effectively using medical interpreting services.


Motivation For Mat, Jacob Bernknopf Jan 2021

Motivation For Mat, Jacob Bernknopf

Family Medicine Clerkship Student Projects

The goal of this project was to discover a commonality in why patients begin the MAT program. This will hopefully make it easier for future providers to help future patients articulate why they need to make the change in their life. This can be especially beneficial in patients dealing with concurrent stimulant or alcohol use.


Frequently Asked Questions By Patients About Exercise, Julie Evans Jan 2021

Frequently Asked Questions By Patients About Exercise, Julie Evans

Family Medicine Clerkship Student Projects

A significant portion of patient visits at Milton Family Practice are related to one or multiple aspects of metabolic syndrome. Exercise is a common topic during these visits either brought up by patients or providers. This project focused on creating a handout for patient education with answers to commonly asked questions pertaining to exercise and resources in the community.


Opportunities For Patient Self-Reflection During Acute Phase Of Depression Treatment, Millen Abselab Jan 2021

Opportunities For Patient Self-Reflection During Acute Phase Of Depression Treatment, Millen Abselab

Family Medicine Clerkship Student Projects

This project for UVMMC Family Medicine at Hinesburg investigates the acute phase of depression treatment for adult patients and introduces opportunities for patient empowerment during this 4-to-6-week window through de-identified automated text surveys for self-reflection about treatment and pattern tracking contributory to mood. Sample text survey built on Beck Depression Inventory (BDI-II) and deployment of text surveys is based on Mosio. Future interventions can utilize mobile phone apps based on patient response to surveys.


Remaining Active In Vermont Winters, Sarah Kendrick Jan 2021

Remaining Active In Vermont Winters, Sarah Kendrick

Family Medicine Clerkship Student Projects

This project explored the challenges of remaining active during Vermont winter for patients with chronic disease. It further complies resources in the community for maintaining activity levels over the winter months.


Community Resources Addressing Peripartum Depression, Tiffany L. Lao Jan 2021

Community Resources Addressing Peripartum Depression, Tiffany L. Lao

Family Medicine Clerkship Student Projects

Peripartum mood disorders affect a large proportion of new mothers as well as their families, partners, and support systems. This project aims to provide patients with information about peripartum mood disorders as part of their initial prenatal packet. Also included are a list of local community resources specifically addressing peripartum mood disorders for patients seeking additional support outside of their primary care office.


Kangaroo Care In The Community: Creating Antenatal Informational Resources For Providers And Expectant Parents, Emma Dunne Jan 2021

Kangaroo Care In The Community: Creating Antenatal Informational Resources For Providers And Expectant Parents, Emma Dunne

Family Medicine Clerkship Student Projects

Obstetric care providers at the Community Health Centers of Burlington create, implement, and coordinate resources to help support parents through pregnancy, delivery, and child rearing. The COVID-19 pandemic has altered the accessibility of existing resources, exacerbating the need for creative support of prenatal learning, breastfeeding, and postpartum socialization. Regular skin-to-skin contact between newborn infants and their parents is a low-cost, low-risk intervention with demonstrated benefits to breastfeeding, infant and parent physiology, emotional health, and bonding. This project aimed to establish antenatal informational resources for providers and expectant parents about the potential benefits of skin-to-skin care in the community setting.


How Prepped Are Our Providers?: Assessing Vermont Primary Care Providers’ Knowledge And Awareness Of Pre-Exposure Prophylaxis (Prep) Options For Hiv Prevention, Christopher Flynn Jan 2021

How Prepped Are Our Providers?: Assessing Vermont Primary Care Providers’ Knowledge And Awareness Of Pre-Exposure Prophylaxis (Prep) Options For Hiv Prevention, Christopher Flynn

Family Medicine Clerkship Student Projects

In recent years, a number of pre-exposure prophylaxis (PrEP) medications and dosing strategies have become available to patients to help prevent human immunodeficiency virus (HIV) infection. The primary objective of this research was to assess current PrEP awareness and prescribing practices of family medicine providers at the Hinesburg Family Medicine practice in Hinesburg, VT.


The Association Between Relationships With Approachable Adults At School And Non-Suicidal Self-Harm In Vermont High School Youth Identifying As Transgender: A Cross-Sectional Study, Gabe Clarke, Bidur Dahal Ms, Mallory James, Robin Katrick, Casey Rogers Dc, Abby Beerman Jan 2021

The Association Between Relationships With Approachable Adults At School And Non-Suicidal Self-Harm In Vermont High School Youth Identifying As Transgender: A Cross-Sectional Study, Gabe Clarke, Bidur Dahal Ms, Mallory James, Robin Katrick, Casey Rogers Dc, Abby Beerman

Master of Public Health Culminating Projects

Objectives. To explore the association between non-suicidal self-harm (also known as non-suicidal self-injury (NSSI)) in adolescents in Vermont identifying as transgender and relationships with approachable adults at school.

Methods. Responses of self-reported self-harm in adolescents identifying as transgender and the ability to confide in an approachable adult or teacher at school were obtained from the 2019 Youth Risk Behavior Survey (YRBS) (n=18,613). Analysis was conducted using a binary logistic regression at a 95% confidence interval (CI) for the odds ratio (OR) and a best selection process.

Results. Students who identify as transgender and had self-harmed in the past 12 months …


Devoloping A Primary Care Screening Protocol For Post-Miscarriage Depression, Sean Muniz Jan 2021

Devoloping A Primary Care Screening Protocol For Post-Miscarriage Depression, Sean Muniz

Family Medicine Clerkship Student Projects

Spontaneous abortions occur in 20-33% of pregnancies, and 10-30% of these women have clinically significant depression. These women are often unscreened by either PCPs or OBs for depressive symptoms. We developed a screening protocol using the PHQ-2 to assess for depression in patients who have had a spontaneous abortion. The protocol utilizes a nursing care manager to follow up with patients who either were seen in the ED or self report spontaneous abortions to the PCP office. Follow up phone calls should be made within 2 weeks and at 6 weeks post spontaneous abortion, with offers for in-person follow-up given …


Family Medicine Community Project, Daniel Castro Jan 2021

Family Medicine Community Project, Daniel Castro

Family Medicine Clerkship Student Projects

The goal of this project is to improve diet and nutrition literacy in the community. Though Vermont ranks low in the US in terms of obesity, it is still estimated the 60% of Vermonters are either overweight or obese. This represents an area of need in terms of improving diet and nutrition education to combat obesity, the health issues it produces, and the subsequent strain on the medical system


Addressing Exercise And Physical Therapy In Older Patients In Colchester, Vt, Adam Morehead Jan 2021

Addressing Exercise And Physical Therapy In Older Patients In Colchester, Vt, Adam Morehead

Family Medicine Clerkship Student Projects

Participation in physical activities remains low among much of the older adult population, particularly during the winter months. Many individuals who are active during warmer times of the year become more sedentary during the winter, and this physical inactivity can contribute to declining health. This project sought to develop a simple brochure outlining several simple exercises that can be performed safely at home without equipment to be distributed to patients at wellness visits to encourage indoor exercise.


The State Of Sleep: What Keeps Vermont Up At Night?, Magalie Carey Jan 2021

The State Of Sleep: What Keeps Vermont Up At Night?, Magalie Carey

Family Medicine Clerkship Student Projects

No abstract provided.


Medication-Assisted Withdrawal And Alcohol Use Disorder Treatment In The Ambulatory Setting, Jacob Okie Weiss, Javad Mashkuri Md, Marissa Patrick Aprn Jan 2021

Medication-Assisted Withdrawal And Alcohol Use Disorder Treatment In The Ambulatory Setting, Jacob Okie Weiss, Javad Mashkuri Md, Marissa Patrick Aprn

Family Medicine Clerkship Student Projects

Alcohol use disorder (AUD) represents a significant burden of disease in central Vermont, but receives little attention and resources compared to other drivers of morbidity and mortality. As part of a community health improvement project, primary care providers in central Vermont were surveyed regarding current practices and perceived barriers related to the effective treatment of AUD. 69% of respondents reported treating alcohol withdrawal syndrome (AWS) and 83% reported treating AUD. Respondents indicated concern about the safety and efficacy of the medications they currently prescribe and expressed interest in learning about other evidence-based treatments for AWS and AUD. The most frequently …


Setting Expectations For Mental Healthcare Referral, Emily Bennett Jan 2021

Setting Expectations For Mental Healthcare Referral, Emily Bennett

Family Medicine Clerkship Student Projects

Patients are referred to mental health care by their primary care providers, but there is often a misunderstanding of what that process looks like. This project aimed to understand the referral process and create improvements that will help patients stay engaged to improve their mental wellbeing.


Promoting Measles Prevention And Awareness, Elizabeth P. Lanata Jan 2021

Promoting Measles Prevention And Awareness, Elizabeth P. Lanata

Family Medicine Clerkship Student Projects

No abstract provided.


Patient Perceptions On The Covid-19 Vaccine, Claudia E. Russell Jan 2021

Patient Perceptions On The Covid-19 Vaccine, Claudia E. Russell

Family Medicine Clerkship Student Projects

With COVID-19 cases and deaths on the rise in Vermont and nationally, it will be important for as many people who are able to receive the COVID-19 vaccines when available. The WHO considers vaccine hesitancy to be a major threat to public health. This study aims to examine patient attitudes and concerns regarding the COVID-19 vaccine. An informational brochure about the recently approved Pfizer and Moderna vaccines was then distributed to all participants.


Increasing Patient Access To Lgbtq+ Healthcare Through Expanding The Vermont Diversity Health Project, Rachel Harrison Jan 2021

Increasing Patient Access To Lgbtq+ Healthcare Through Expanding The Vermont Diversity Health Project, Rachel Harrison

Family Medicine Clerkship Student Projects

Numerous studies have documented various disparities in health outcomes and barriers to healthcare access for LGBTQ+ individuals. One major way to combat this is to increase access to healthcare for LGBTQ+ patients and increase provider knowledge of how to best care for them. Through expanding the Vermont Diversity Health Project database of providers and having providers participate in LGBTQ+ Best Practices trainings (both hosted by Pride Center of Vermont), we may reduce LGBTQ+ health disparities in our local community.


Nutritional Barriers For Patients With Diabetes: A Quality Improvement Project, Emma C. Levine, Taylor D. Marquis Jan 2021

Nutritional Barriers For Patients With Diabetes: A Quality Improvement Project, Emma C. Levine, Taylor D. Marquis

Family Medicine Clerkship Student Projects

The goal of this study was to look at health care providers perspectives on what the nutritional barriers patients with diabetes faced and compare that with the patient's perspectives. We also assessed patients knowledge on certain foods and if they have carbohydrates. We used this information to create a Notecard that could be given to patients.


Patient Attitudes And Education About The Covid-19 Vaccine, Zeynep Tek, Faith Wilson, Claudia Russell Jan 2021

Patient Attitudes And Education About The Covid-19 Vaccine, Zeynep Tek, Faith Wilson, Claudia Russell

Family Medicine Clerkship Student Projects

We gave patients a survey about if they were interested in receiving the COVID-19 vaccine and if not why across three different sites in Vermont and Connecticut. We also made and handed out a pamphlet about commonly asked questions about the vaccine and what the state's distribution plan was. A majority of patients were interested in the getting the vaccine, and those who were unsure were worried about the long term side effects.


Covid-19 Vaccine Information And Patient Opinions, Faith E. Wilson, Zeynep Tek, Claudia Russell Jan 2021

Covid-19 Vaccine Information And Patient Opinions, Faith E. Wilson, Zeynep Tek, Claudia Russell

Family Medicine Clerkship Student Projects

As the COVID-19 vaccine becomes available in Vermont, many patients have questions about the safety and efficacy, who it will be available for, when they can expect to get the vaccine, if their doctor would recommend it for them. These important questions are taking valuable time during already short patient visits, and as information is constantly evolving it is difficult to give a concise answer to many questions. This project outlined the basics of the vaccine and answered many FAQs.


Evaluating Patient And Provider Knowledge Of Safe Pharmaceutical Disposal Procedures In Vermont Through A Public Health And Environmental Lens, Emily R. Straley Jan 2021

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 …


Streamlining Teledermatology In Primary Care, Hakeem Yousef Jan 2021

Streamlining Teledermatology In Primary Care, Hakeem Yousef

Family Medicine Clerkship Student Projects

The use of telemedicine as a tool to aid in seeing patients has increased dramatically since the onset of the COVID-19 Pandemic. Skin problems are one of the many medical issues seen via telemedicine, and many patients and providers may find some difficulty maneuvering through this new age of technology