Mental and Social Health Commons^™

Associations Among Healthcare Utilization And Binge Drinking, Ethan Grey, Chad Phalon, Anna Greene, Patricia Harmeyer, Kalyn Rosenberg, Cristine Griffing, Tom Delaney

Master of Public Health Culminating Projects

Objective. To examine associations among routine healthcare services and binge drinking in Vermont adults.

Methods. We analyzed a cross-sectional sample of randomly selected 6516 adults who participated in the self-reported 2017 Vermont Behavioral Risk Surveillance System survey. We estimated odds ratios for responses indicative of binge drinking in association with length of time since last routine checkup using a bivariate logistic regression model.

Results. Participants who reported binge drinking were 31% (OR = 0.69, 95% confidence interval [CI] = 0.56, 0.83) less likely to engage in a healthcare visit within the past year controlling for age, employment status, annual household …

Automated Identification Of Unhealthy Drinking Using Routinely Collected Data: A Machine Learning Approach, Levi N. Bonnell, Benjamin Littenberg, Safwan R. Wshah, Gail L. Rose

Larner College of Medicine Faculty Publications

Background: Unhealthy drinking is prevalent in the United States and can lead to serious health and social consequences, yet it is under-diagnosed and under-treated. Identifying unhealthy drinkers can be time-consuming for primary care providers. An automated tool for identification would allow attention to be focused on patients most likely to need care and therefore increase efficiency and effectiveness.

Objectives: To build a clinical prediction tool for unhealthy drinking based solely on routinely collected demographic and laboratory data.

Methods: We obtained demographic and laboratory data on 89,325 adults seen at the University of Vermont Medical Center from 2011-2017. Logistic regression, …

Improving Contraception Among Female Syringe Exchange Clients: A Reproductive Needs Assessment, Gena Zollman

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

Purpose: Women with opioid and other substance use disorders have a high rate of unintended pregnancy and a low rate of effective contraceptive use. Integrating family planning (FP) services into medication-assisted treatment (MAT) clinics has increased rates of initiation and adherence to contraception among this population. This study assesses the reproductive health needs of female clients in a syringe exchange program (SEP)to assess if integrating FP services would improve access to contraception.

Methods: Female clients of a SEP voluntarily completed an anonymous survey to determine demographics, FP needs, and barriers to accessing care, and were compensated with $20 gift cards. …

What's In Your Cup? Increasing Transparency And Confidence In Alcohol Use Screening And Brief Intervention, Dylan C. Koundakjian

Family Medicine Clerkship Student Projects

19% of Vermonters report drinking alcohol at levels which puts their health at risk, but many healthcare providers do not feel confident in addressing their patients' usage. This can stem from lack of experience with alcohol use, worries about stigma, and time constraints. However, data has shown that even 5-15 minute interventional conversations can significantly reduce a patient's risky drinking. This project aims to provide real-world, practical advice for having conversations around alcohol, and provides a conversion chart converting popular alcoholic beverages into standard drink equivalents.

Substance Use Disorder Treatment Decision Aid For Adults In Chittenden County Vermont, Elizabeth V. Mcleod

Family Medicine Clerkship Student Projects

Substance Abuse Disorders (SUDs) are a prevalent public health concern in both the national and local arena resulting in millions of dollars in pubic health costs and loss of life. Navigating the treatment options available in Chittenden County can be time consuming, difficult, and delay treatment. In order to help guide adult patients and their families in Chittenden County along their journey towards recovery from SUDs, a treatment decision aid was developed for choosing the right level of care.

How To Improve A Medication-Assisted Treatment Program For Opioid Use Disorder: First, Look At The Evidence, Collin York

Family Medicine Clerkship Student Projects

The prevalence of Opioid Use Disorder (OUD) in the United States has been described as an epidemic, and rural areas have been affected in particular. A treatment paradigm called Medication-Assisted Treatment (MAT) has been demonstrated to be effective at treating OUD, and more and more rural, primary care clinics are establishing MAT programs. One such clinic is Hudson Headwaters Health Network, a FQHC in Upstate New York. I wrote a literature review and distributed it to staff involved in MAT program design, and I also wrote a practical evidence guide for MAT providers. Providers completed a survey assessing the evidence …

Improving Awareness Of Opiate Support Programs In Lamoille County, Samantha Bissonette

Family Medicine Clerkship Student Projects

Despite Vermont having doubled the rate per 10,000 people ages 18 to 64 receiving Medication Assisted Treatment (MAT) for Opiate Use Disorder (OUD) since 2012, there are still numerous barriers preventing patients from seeking treatment, including confusion about how to go about entering a treatment program, fear of stigma, and many others. Lamoille County has started to expand outreach to people struggling with OUD by having emergency services personnel, outpatient medical offices, and recovery centers hand out a county-specific information card with clear information about how to enter treatment and support programs. This project builds upon this existing initiative.