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.

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.

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.

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.

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 …

Assessment And Awareness Of Mental Health Conditions Among Refugees In Vermont, Sandi Caus

Family Medicine Clerkship Student Projects

Refugees experience profound hardship in their home-country, displaced country and throughout the period of re-settlement. Experiences like direct or indirect exposure to traumatic events, torture, sexual abuse and stigmatized refugee identity post-resttlement are major risk factors for the development of mental health coniditions inlcuding PTSD, depression and psychosis. Despite major risk factors for the development of mental health conditions, culturally-specific mental health stigma persists as a major barrier to addressing mental health among refugees. This project emphasizes techniques and self-education that can be utilized to improve mentah health screening and identification among refugee patients in Vermont.

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 …

Harm Reduction In The Emergency Department, Alexa J. Golden

Family Medicine Clerkship Student Projects

The number of overdose deaths in Vermont has been trending up over the past several years. A majority of these fatalities involved synthetic opioid fentanyl. The Emergency Department (ED) at Central Vermont Medical Center delivers medication assisted treatment (MAT) through the Rapid Access to MAT (RAM) program. This program has connected many people in the region to treatment for opiate use disorder. However it was identified that we lacked connection to harm reduction services for those not interested in MAT. Harm reduction education was provided for recovery coaches and ED nursing staff. Harm reduction kits containing life-saving supplies such as …

Narrative Medicine: Perspectives On Opioid Maintenance, Noorin Damji

Family Medicine Clerkship Student Projects

People who experience opioid addiction often feel marginalized by healthcare workers, or stigmatized by the medical system. Additionally, there are not enough medical providers to meet the needs of people who struggle with opioid addiction. These factors create barriers that prevent the medical establishment from effectively meeting the needs of people who experience addiction. This project compiles rich perspectives of patients on opioid maintenance treatment to share with medical students and providers to foster greater empathy for these patients, and positive attitudes toward managing substance use disorder among future medical providers.

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.

Screening And Monitoring Social Determinants Of Health For Migrant Workers In Vermont, Richard Brach

Family Medicine Clerkship Student Projects

No abstract provided.

Medication-Assisted Treatment In The Hudson Headwaters Health Network, Jordan Munger

Family Medicine Clerkship Student Projects

Background: Opioid use results in over 45,000 overdose deaths annually in the US, with rural areas disproportionately affected. While medication-assisted treatment (MAT) for opioid use disorder (OUD) is an effective intervention available through outpatient primary care, less than 25% of patients with OUD are currently in treatment. This study explored factors associated with patient retention in an MAT program offered by Hudson Headwaters, a Federally Qualified Health Center that serves a vast and mostly rural region of Northeastern New York.

Methods: We included a total of 354 patients diagnosed with OUD who had at least two appointments for MAT between …

Promoting Physical Activity In School-Aged Children During The Covid-19 Pandemic, Abigail H. Belser

Family Medicine Clerkship Student Projects

Due to the COVID-19 pandemic, children and adolescents are engaging in less physical activity and are increasing their sedentary behavior. These changes can lead to long-lasting negative lifestyle behaviors, which increases risk of health complications.

To ensure safety during the pandemic, guidelines have created restrictions on physical education and sports, which are both primary physical activity outlets for children and adolescents. Children and adolescents have to find alternate ways and resources to meet the recommended 60 minutes of physical activity daily.

An informational pamphlet was created to educate parents and children of current physical activity recommendations, with resources and ideas …

Hhhn Clinicians' Beliefs, Barriers, And Motivations Surrounding Mat, Casandra Nowicki

Family Medicine Clerkship Student Projects

Medication-assisted treatment (MAT) consists of using medications that act on the same receptors as opioids to treat opioid use disorder (OUD). MAT providers require formal training and a DEA waiver in order to prescribe certain medications. Providers were asked to complete a survey about the beliefs, barriers, and motivations surrounding MAT to provide valuable insight into what the future of MAT might look like at a specific nonprofit network of community health centers in upstate New York.

Coping Skills For Daily Life: Cost-Effective Strategies To Prevent And Address Mental Health Disorders, Shae Ian Rowlandson

Family Medicine Clerkship Student Projects

Mental health disorders, along with their associated cost and negative outcomes, have continued to persist in Vermont and have become one of the largest, growing challenges to public health in the United States. Unfortunately, Vermont does not appear to have enough resources or providers to optimally address it. Concurrently, coping strategies of minimal cost that have the potential to prevent or address mental health disorders may often be underutilized or misconstrued by the population. A pamphlet providing information on evidenced, cost-effective coping strategies was designed and distributed to providers and patients to enable patients with the skills to help themselves …