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.

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.

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 …

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 …

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 …

Are Wolves Welcome? Hunters' Attitudes Towards Wolves In Vermont, Usa, Nelson Grima, John Brainard, Brendan Fisher

Rubenstein School of Environment and Natural Resources Faculty Publications

Published by Cambridge University Press on behalf of Fauna & Flora International. The forests of the north-east USA were once home to the Wolf Canis lupus, a species that played an important role in the ecology of this region. However, wolves were eradicated from the region more than a century ago, altering the species composition of the landscape and driving cascading changes in this ecosystem. Outdoor recreation is a major component of the economy of this region, and outdoor recreationists, including the hunting community, have a strong influence over decision-making related to policies on natural resources. Given their powerful position, …

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 …

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

Family Medicine Clerkship Student Projects

No abstract provided.

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 …

Payment For Ecosystem Services: Incentives To Support Environmental Quality & Farming In Vermont, Stephen Posner, Taylor Ricketts, Eric Roy

Reports and Policy Briefs

Environmental quality is an ongoing concern in the Lake Champlain Basin. Vermont farmers are in a unique position to manage land in a way that maintains and improves environmental quality. A payment for ecosystem services (PES) program for Vermont would both support the economic vi- ability of Vermont farms and incentivize farmers to improve water quality and soil health. How- ever, conceptual and practical implementation challenges remain.

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 …

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.

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.

Intimate Partner Violence: Updated Screening Tool And Approach To Screen Positive Patients, Michael J. Hall

Family Medicine Clerkship Student Projects

Intimate partner violence screening is recommended in all women of child-bearing age. Ensuring validated screening tool utilization and employing strategies to identify risk while providing non-judgmental support is critical to identifying patients and optimizing appropriate resource referral.

The Association Of Hormonal Contraception With Depression, Pamela Derickson

Family Medicine Clerkship Student Projects

Hormonal contraceptives are widely used by women during their reproductive years. Currently, over 100 million women worldwide use the pill, and 82% of sexually active women in the USA will use oral contraceptive pills at some time during their reproductive years (Carrol, 2017). Oral contraceptive use, especially among adolescents, is associated with subsequent use of antidepressants and a first diagnosis of depression, suggesting depression may be a potential adverse effect of hormonal contraceptive use (Skovlund, 2016). This project focused on educating health care providers at the Community Health Center of Burlington, VT (CHCB) about the association of depression and oral …

Perinatal Depression: Breaking Barriers To Treatment, Florence Lambert-Fliszar

Family Medicine Clerkship Student Projects

Depression in the perinatal period is a common medical issue in Vermont, affecting about 10% of women. Multiple and severe consequences of depression during this time are seen for both mothers and babies, including lower breastfeeding rates, fewer healthcare visits for the child, and psychopathology in the child later on. The goal of this project is to identify and address some of the barriers we currently face in identifying and treating women for depression. Major barriers women encounter in seeking help involve poor recognition of symptoms facing increasing stress of motherhood, stigma, as well as neglecting to attend to mental …

Out-Of-Pocket Cost For Individuals Being Treated For Opioid Dependence In Rutland County, Vermont, Christopher T. Veal

Family Medicine Clerkship Student Projects

Each day more than 140 Americans die from drug overdoses, 91 specifically due to opioids. In Vermont, more than 50 people die each year from opioid poisoning. With insurance coverage being a critical component of Opioid Dependence Recovery, many people seeking treatment are unaware of the financial barriers to recovery- namely the out-of-pocket costs associated with treatment. This study sought to provide insight on the financial impact of Opioid Dependence Treatment on the patient, and provide financial assistance information to the Rutland County community.

Smoking Prevention Program For Adolescents: A Hands-On Approach, Sean Closs

Family Medicine Clerkship Student Projects

This project is an initial pilot idea for hands-on experiences to reinforce smoking prevention in adolescents. The proposed idea is to have students specifically those identified 'at-risk', being given opportunities to interact with pathology specimens on-site at the hospital, introduce spirometry, and real-world panel discussions. The resources of the hospital provide a unique opportunity for promotion of this public health goal.

Indirect Approach To Intimate Partner Violence, Jasmine Y. Robinson

Family Medicine Clerkship Student Projects

Discussing Intimate Partner Violence can be difficult, and has many barriers. An indirect approach to speaking with patients about domestic violence, whether is is sexual, physical, emotional or financial can be achieve with patient's trust in a physician if they withhold judgement.

Intimate Partner Violence In Immigrant/Refugee Populations, Lisa H. Wang

Family Medicine Clerkship Student Projects

Intimate partner violence (IPV) is the most common type of violence affecting women. Globally, Central Africa and South Asia have some of the highest rates of IPV. In Vermont, the majority of refugees are from these regions. Individual, interpersonal, and especially cultural values play critical roles in the definition/appraisal and decision to seek help in these women. This study examines ways to mitigate challenges that healthcare professionals have in identifying women who need help and barriers preventing these women from seeking help.

Hidden Adolescent Risks: Provider Education On Non-Suicidal Self-Injury, Bailey Fay

Family Medicine Clerkship Student Projects

Non-suicidal self-injury (NSSI) has been shown to be a strong risk factor for suicidal ideation and suicide attempt. One study has shown over 50% of people engaging in NSSI have at least one suicide attempt in their lifetime. The 2015 Vermont Youth Risk Behavior Survey found 17% of high school students reported non-suicidal self-injury at least once in the past year. This reflects roughly one in four females and one in ten males. Furthermore, these numbers have increased significantly since 2013. In an effort to promote awareness of NSSI in the primary care setting, a handout was created for providers …

Increasing Advance Directive Knowledge Among Healthcare Professionals, Laura K. Donnelly

Family Medicine Clerkship Student Projects

Advance Directives (ADs) have been shown to be associated with increased patient satisfaction with end-of-life care, decreased in-hospital deaths, and decreased end-of-life costs in high-cost regions. Nationally, prevalence of ADs has increased over the last 20 years, but the majority of patients still have not completed an AD. A significant obstacle to completion is lack of awareness. A presentation to increase knowledge regarding ADs among primary care staff was created to address this.

Psychotherapy: Skills And Resilience Through Self-Knowledge, Gilana Finogenov

Family Medicine Clerkship Student Projects

At least 20% of all primary care visits are related to mental health. A limited number of patients are being referred to therapy, even though therapy is shown to be as effective as medication for disorders like depression and anxiety. A pamphlet was designed to explain what psychotherapy is to patients and to describe several common therapy modalities.

Creating A Welcoming Clinical Environment For Lgbt Patients, Samy S. Ramadan

Family Medicine Clerkship Student Projects

The aim of this project was to develop a welcoming clinical environment for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients at Northern Counties Health Care (NCHC) and to serve as a model for community health centers across the nation that want to provide their LGBT communities with patient centered care that is affordable, compassionate and accessible. This was achieved by revising non-discrimination policies and new patient forms to be more inclusive of sexual orientations and gender identities, incorporating LGBT health learning modules into yearly provider and staff mandatories, and adding LGBT inclusive material into all waiting and exam rooms. The …