Mental and Social Health Commons^™

Increasing Patient Awareness And Education Surrounding Prescription Weight Loss Medications, Anirudh A. Hirve

Family Medicine Clerkship Student Projects

Obesity is a growing problem in the United States. While it remains important for clinicians to emphasize health supportive behaviors including dietary modification and exercise when counseling patients, the advent of new weight loss medications has created a need for patient education materials regarding these interventions for a growing number of patients who request them at primary care visits. This project created a smart phrase in the electronic medical record summarizing weight loss medications currently available on the market to transform patient counseling and enable better shared decision making between patients and providers.

Dinner Table Talks: How Healthy Eating Behavior And Body Positivity Start At Home, Megala Loganathan

Family Medicine Clerkship Student Projects

Body dysmorphia, eating disorders, and unhealthy eating behaviors all share a large sociocultural component. A family medicine practice is the perfect place to start educating patients about their attitudes surrounding food and how the effects of their relationship with food and their bodies can be felt in the home environment. Hearing many patients share that their mental and physical health struggles stemmed from how they learned to perceive things as children inspired me to take advantage of the trickle down effects of patient education. The goal of this project is to make and distribute a pamphlet that addresses ways to …

Community Resilience In Vermont After The 2023 Flooding Event, Alex Poniz

Family Medicine Clerkship Student Projects

Between July 10th-11th 2023 Vermont experienced catastrophic flooding after receiving prolonged heavy rainfall of up to 9” over 48 hrs. Damage from the 2023 event rivals the historic destruction of Hurricane Irene in 2011 and is exceeded only by the Great Vermont Flood of 1927, an event predating modern flood controls. We collected oral histories from Vermonters to better understand their lived experience of the flood and its impacts, and identifed common themes related to community and individual resilience.

Screening For Ptsd In Veterans And Expanding Awareness Of Ptsd Resources, Audree S. Baroni, Bradford Clark

Family Medicine Clerkship Student Projects

PTSD is a prevalent mental health disorder that is especially prominent in the veteran population. Often veterans go without diagnosis and subsequently without treatment due to lack of awareness, screening, and a stigma they will loose benefits from the VA. This project aimed to identify the number of veterans with PTSD and provide alternative treatment methods for symptom management.

Caring For Patients At Risk Of Suicide In Vermont, Lindsay R. Aldrich

Family Medicine Clerkship Student Projects

Suicide is the 9th leading cause of death in Vermont among all age groups. 34% of people who died by suicide had a primary care visit for their mental health within the last year. As a response to this statewide issue, I assisted Richmond Family Medicine’s application for this year’s Suicide-Safer Care Mini-Grant.

Creation Of A Parent-Directed Toolkit To Prevent Youth Vaping, Corinne Webb

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

Purpose: Vaping rates among adolescents are at an all-time high. Misperceptions about the harms of vaping may limit parents’ ability to impact youth vape use. This project developed and tested an evidence-based toolkit to educate parents of adolescents about the risks of vaping.

Methods: The toolkit’s creation was informed by published evidence and multimedia content delineating the scope of the vaping crisis. The toolkit was reviewed and revised by content experts. Pre- and post-implementation assessments were created and tested with faculty members, public health professionals, teachers, and parents. Assessments were utilized to evaluate parental vaping knowledge before and after implementation …

Improving Mental Health Documentation Through Education: An Intervention For Level Of Care Utilization System (Locus) Use In Psychiatric Crisis Placement, Lauren Ozimek

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

Purpose: The Community Mental Health Act (1963) created crisis stabilization units to lessen burdens of emergency departments addressing psychiatric crises. Crisis stabilization units – including the project site – evaluate treatment efficacy via assessments including the Level of Care Utilization System (LOCUS). The LOCUS is totaled into a composite score, expected to decrease at treatment completion. The project site has not consistently seen LOCUS scores decrease at completion. The project’s purpose was to improve use of a clinical assessment tool to reflect treatment and progress for patients utilizing crisis stabilization programs. A secondary aim was to increase incidence (75%) of …

Adolescent Suicide Prevention Via Parental Education, Junelle Shepard, Mary Val Palumbo

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

Purpose. Up to 24% of children from the ages of 12 to 17 have reported suicidal ideation, with 7-11% reporting at least one suicide attempt in the past 12 months (Hetrick, 2017). In a study by Jones et al (2019) over 50% of parents were unaware their child was exhibiting suicidal ideation. This project aims to increase community awareness of suicidal ideation and teach community members how to talk with adolescents about this sensitive topic.

Methods. Five online training sessions were offered in Fall 2021, with each session lasting 90 minutes. Using Smith et al.’s Suicide Knowledge and Skills Questionnaire, …

Story Slam Rx: Is Connection To Personal Stories In Medicine An Antidote To Burnout, Francis Mtuke, Andrea Green

Larner College of Medicine Fourth Year Advanced Integration Teaching/Scholarly Projects

With the increasing demands of the contemporary healthcare system, providers are spending less time with colleagues in a team environment or engaged in direct patient care. This has been identified as a key factor in physician dissatisfaction and burn out.1 The Story Slam event aims to reconnect providers and trainees with their sense of meaning by focusing attention on their stories. Under the conceptual umbrella of “narrative medicine,” there is growing recognition that the stories that run beneath the medical encounter can provide important insights and represent a pathway to greater well-being for providers.2,3 Our study has a two-fold approach. …

Medical Repatriation In Vermont: The Current Landscape And Recommendations, Olivia Dominque, Kelly Knight, Aathmika Krishnan, Kassondra Little, Clara Maxim, Sofia Toro Alvarez, Patti Smith Urie, Mark Pasanen Md, Charles Maclean Md

UVM AHEC

Background: Medical repatriation is the practice of returning patients to their country of origin when they have major medical problems_. Forced repatriation, or “medical deportation”, disproportionately affects undocumented individuals. This project aimed to assess the prevalence of medical repatriation in Vermont, identity factors that lead to it, and recommendations to prevent it.

Methods: Interviews were conducted with ten stakeholders including physicians, lawmakers, and advocates for undocumented patients. Team members then analyzed interview transcripts for major themes.

Results: This study did not uncover any occurrences of forced repatriation. Qualitative themes included: lack of awareness about medical repatriation, inability to track …

Nature Is The Best Medicine, Nathan Schweitzer

Family Medicine Clerkship Student Projects

This project examined the cost of mental health diagnosis on the health care system and how interactions with green space and nature increase mental health wellbeing. A Vermont state government program to increase access to state parks through primary care providers offices is highlighted. Interviews were conducted with a community psychologist discussing interaction with nature and its effects on mental health. The second interview was with a member of the volunteer board for the Governors council on fitness discussing the origins of the state park program.

Increasing Mental Health Resource Access During The Covid-19 Pandemic, Valerie Braddick

Family Medicine Clerkship Student Projects

No abstract provided.

Improving Access To Medication Assisted Treatment For Opioid Use Disorder In A Rural Emergency Department, Warren Grunvald

Family Medicine Clerkship Student Projects

Opioid Use Disorder (OUD) is a growing epidemic throughout the United States and Maine has not been sparred by this. As the Emergency Department is a frequent location for people with OUD to interact with physicians it has been targeted as an opportunity to initiate Medication-Assisted Treatment (MAT) with Suboxone. This project details an effort to streamline this process and improve outcomes for patients interested in MAT.

Improving access to medication assisted treatment for opioid use disorder in a rural Emergency Department

Improving Access To Medication Assisted Treatment For Opioid Use Disorder In A Rural Emergency Department, Warren Grunvald

Family Medicine Clerkship Student Projects

Opioid Use Disorder (OUD) is a growing epidemic throughout the United States and Maine has not been sparred by this. As the Emergency Department is a frequent location for people with OUD to interact with physicians it has been targeted as an opportunity to initiate Medication-Assisted Treatment (MAT) with Suboxone. This project details an effort to streamline this process and improve outcomes for patients interested in MAT.

Increasing Healthcare Delivery To The Abenaki People Through Health Screenings, Warrick Sahene

Family Medicine Clerkship Student Projects

Utilizing health screenings can increase the number of Abenaki individuals identified with comorbidities related to diabetes and hypertension. Education and resources for health maintenance are also provided to this patient population through physician counseling.

Ipv: Why Don’T We Screen For Those Committing Acts Of Violence?, Hannah K. Cook

Family Medicine Clerkship Student Projects

State of the evidence for screening for IPV in men or those who are committing acts of violence.

Lifestyle Modifications To Support Mental Health, Alexa W. Rosenthall

Family Medicine Clerkship Student Projects

No abstract provided.

More Than A Meal : A Resource For Communities Striving For Food Sovereignty Through The Charitable Food System, Kaitlin J. Robertson

Food Systems Master's Project Reports

The 2020 pandemic and economic crisis showcased the fragility of the American food system. In the months of quarantine and lockdowns, a growing number of Americans searched for ways to feed themselves and their families. Community-based and volunteer-supported feeding programs worked to bridge the divide between the hungry and their next meal. In many cases, these programs rely on an unpaid workforce and donations – of time, food, and facilities. With limited resources, volunteer-led programs often lack centralized training options; this guidebook seeks to fill that void. This project is a streamlined, introductory-level guide for volunteers and community members working …

Emulating Agricultural Disease Management: Comparing Risk Preferences Between Industry Professionals And Online Participants Using Experimental Gaming Simulations And Paired Lottery Choice Surveys, Eric M. Clark, Scott C. Merrill, Luke Trinity, Gabriela Bucini, Nicholas Cheney, Ollin Langle-Chimal, Trisha Shrum, Christopher Koliba, Asim Zia, Julia M. Smith

College of Agriculture and Life Sciences Faculty Publications

Mitigating the spread of disease is crucial for the well-being of agricultural production systems. Implementing biosecurity disease prevention measures can be expensive, so producers must balance the costs of biosecurity investments with the expected benefits of reducing the risk of infections. To investigate the risk associated with this decision making process, we developed an online experimental game that simulates biosecurity investment allocation of a pork production facility during an outbreak. Participants are presented with several scenarios that vary the visibility of the disease status and biosecurity protection implemented at neighboring facilities. Certain rounds allowed participants to spend resources to reduce …

Development And Validation Of The Smoker Self-Stigma Questionnaire (Sssq), Thomas Geist

Graduate College Dissertations and Theses

Though rates of smoking have declined for decades, the tobacco epidemic persists. During this time, denormalization of smoking and the tobacco industry emerged as viable strategies to decrease smoking rates. However, researchers have become increasingly concerned with denormalization strategies’ impact on the stigmatization of smokers, and have questioned their ethics and continued utility. Unfortunately, current research lacks a theoretically and psychometrically sound measure to represent smokers’ experience of stigma and help explore these issues. This study sought to develop and validate such a measure, the Smoker Self-Stigma Questionnaire (SSSQ). Initial items for the SSSQ were developed to cover three domains …

Understanding The Profiles Of Adolescents Engaged In Intentional Self-Poisoning With Suicidal Intent And The Role Of Primary Care In Early Intervention In Vermont, Rachael Comeau

Graduate College Dissertations and Theses

Suicide prevention is a top public health priority in Vermont. It is a complex issue, requiring a multi-faceted response from many different public and private stakeholders. Because intentional self-poisoning with suicidal intent is rarely lethal, it presents a particularly good opportunity for secondary interventions in the primary care setting. Extensive research has been done on intentional self-poisoning with suicidal intent and its relationship to subsequent risk of death by suicide, but gaps exist in research utilizing poison center data in the primary care setting. This dissertation employs an explanatory sequential mixed method research design to (a) develop a profile of …

Quantifying Language Changes Surrounding Mental Health On Twitter, Anne Marie Stupinski

Graduate College Dissertations and Theses

Mental health challenges are thought to afflict around 10% of the global population each year, with many going untreated due to stigma and limited access to services. Here, we explore trends in words and phrases related to mental health through a collection of 1- , 2-, and 3-grams parsed from a data stream of roughly 10% of all English tweets since 2012. We examine temporal dynamics of mental health language, finding that the popularity of the phrase ‘mental health’ increased by nearly two orders of magnitude between 2012 and 2018. We observe that mentions of ‘mental health’ spike annually and …

Health Screening For Individuals Diagnosed With Mental Illness Within A Housing-First Organization, Jennifer J. Chamberlin

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

Background: Individuals with serious mental illness are a high-risk population that need improved access to physical health care. Many have negative experiences with the healthcare system and need support in accessing it. A housing-first organization in Vermont offers wrap-around services to these individuals but does not have a standardized way to assess for client healthcare needs or to communicate with primary care provider offices.

Purpose: The project aimed to: 1. Identify the current processes used to assess client health needs; 2. Change organizational workflow to include comprehensive and standardized health protocols. 3. Instruct staff to increase knowledge to identify and …

Preliminary Analysis Of Vermont's Ems Naloxone Leave-Behind Program, Samantha J. Bissonette

Larner College of Medicine Fourth Year Advanced Integration Teaching/Scholarly Projects

Background: Naloxone is well known to effectively reverse the effects of unintentional opiate overdose and reduce mortality from opiate overdose (12, 18). Despite activation of emergency medical services (EMS) after an overdose, many patients choose against transport to a hospital for further treatment and initiation of support services. These patients were previously left on scene without any additional support or services, despite encountering emergency medical personnel. To supplement the state's naloxone distribution efforts, Vermont initiated an EMS protocol allowing all levels of providers to provide naloxone leave-behind kits to patients and/or their family or friends when a patient is identified …

Climate Impacts Associated With Reduced Diet Diversity In Children Across Nineteen Countries, Meredith T. Niles, Benjamin F. Emery, Serge Wiltshire, Molly E. Brown, Brendan Fisher, Taylor H. Ricketts

College of Agriculture and Life Sciences Faculty Publications

It is widely anticipated that climate change will negatively affect both food security and diet diversity. Diet diversity is especially critical for children as it correlates with macro and micronutrient intake important for child development. Despite these anticipated links, little empirical evidence has demonstrated a relationship between diet diversity and climate change, especially across large datasets spanning multiple global regions and with more recent climate data. Here we use survey data from 19 countries and more than 107 000 children, coupled with 30 years of precipitation and temperature data, to explore the relationship of climate to child diet diversity while …

Improving The Therapeutic Environment In The Crisis Stabilization Unit At Glens Falls Hospital, Emma Hall

Family Medicine Clerkship Student Projects

The Crisis Stabilization Unit (CSU) at Glens Falls Hospital provides a separate, safe space within the Emergency Department for adults and children struggling with mental health crises to stabilize before discharge or admission to an inpatient psychiatric unit. An increase in mental health crises over the past 10+ years plus a shortage of nearby inpatient beds, especially for adolescents and children, has led to longer stays in the CSU. Longer stays in a place not built for therapeutic intervention but rather for crisis stabilization may lead to increased agitation, prolonged stays or prolonged time to stabilize a patient, and potentially …

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.

Improving Access To Meditation And Mindfulness For The Management Of Anxiety, Stress, And Other Chronic Diseases, Alex Cohen, Jesse Naumann

Family Medicine Clerkship Student Projects

Chronic diseases can have an enormous burden on not only an individual’s quality of life, but their economic output as well. The challenge is that many patients with a chronic disease are not fully treated despite many different medications and doctor’s appointments. Mindfulness is an extremely beneficial tool that can be used as an adjunctive treatment for different chronic health diseases including anxiety, depression, insomnia, chronic pain, and many others. An enormous barrier is that many patients are unsure about what mindfulness truly is, and where one can go about accessing mindfulness resources. Our goal was to create a quick …

Combating Seasonal Affective Disorder In Vermont, Prasanna Kumar

Family Medicine Clerkship Student Projects

Seasonal Affective Disorder (SAD) is a cyclical pattern of depression-like symptoms that occur during the winter months. In Vermont, SAD is estimated to affect up to 10% of individuals. An informational flyer was developed that explained the symptoms of SAD, what the treatment options are, and then linked individuals with local resources for wellness activities in Chittenden County using QR codes in order to prevent SAD. The flyer was distributed at the Community Health Care Centers of Burlington South End office. The flyer was met with enthusiasm and will be given out to patients at the end of this season …

Updating Evidence-Based Patient Education Resources For Sleep: Sleep Hygiene And Benzodiazepine Discontinuation, Carolyn Geraci, Madeline Fritz

Family Medicine Clerkship Student Projects

There is a major need for patient education around the topics of sleep hygiene and benzodiazepine sleep aid discontinuation in the family medicine clinic setting. Current patient-focused educational materials need updating and are not comprehensive enough. We therefore created new handouts and smartphrases which integrate into the electronic medical record system with the goal of educating patients on these topics.