Community Health and Preventive Medicine Commons^™

Addressing The Opioid Crisis In Vermont: Lessons Learned From Primary Care Physicians, Tim Henderson, Molly Markowitz, Adam Petchers, Brittany Rocque, Andrew Sheridan, Nathanial Sugiyama, Lyndsey Wyatt, Elizabeth Cote, Charles Maclean, Jan Carney

Public Health Projects, 2008-present

Background:

Opioid Misuse in Vermont:

The number of Vermonters seeking treatment for opioid abuse is increasing, particularly in Chittenden County.

Emergency department visits and deaths related to opioid misuse continue to increase, both locally and nationally.

Opioid Addiction Treatment:

The Drug Addiction Treatment Act (2000) was passed to allow physicians to prescribe buprenorphine-naloxone for opioid addiction, termed Office-Based Opioid Therapy (OBOT).

OBOT has been shown to be a highly effective treatment for opioid addiction.

The Hub and Spoke model was implemented in Vermont to connect specialty treatment centers with outpatient OBOT providers.

Project Goal: To identify barriers to providing OBOT …

Characterization Of Hypertension Risk Factors At The Committee On Temporary Shelter, Lindsey M. Eastman, J. Curtis Gwilliam, Ethan R. Harlow, Adrienne R. Jarvis, Jacob Korzun, Michael K. Ohkura, Samantha M. Siskind, Brianna L. Spencer, Tim Coleman, Virginia L. Hood

Public Health Projects, 2008-present

Introduction: The health of homeless populations is at risk due to a high prevalence of undiagnosed hypertension (HTN) and cardiovascular disease (CVD). The interaction of housing and socioeconomic status with the risk factors for HTN and CVD remains unclear. Prevention of HTN through a healthy diet, exercise, adequate sleep, and avoidance of tobacco has been well described, but financial limitations and competing priorities for shelter and food make blood pressure (BP) control difficult for this population. By characterizing the risk factors and awareness of hypertension within the homeless population at the Committee on Temporary Shelter Daystation (COTS) in Burlington, Vermont, …

Assessing The Need For A Social Worker At The Chittenden Emergency Food Shelf, Grace Adamson, Moshe Bitterman, Sherilyn Destefano, Susannah Kricker, Richard Mendez, Tyler Wark, Nina Xue, Kelly Saunders, Judith Christensen

Public Health Projects, 2008-present

Introduction: Chittenden Emergency Food Shelf (CEFS)

• Largest direct service emergency food provider in Vermont Serves over 12,000 people/year
• Works to alleviate hunger through grocery services, hot meals, and home delivery
• Offers a culinary job training program

CEFS seeks to understand client need for assistance in accessing/coordinating additional public assistance services and resources. Could CEFS improve its services by staffing a social worker on site?

Project Goal: Collect data from CEFS users to assess current need for in-house social worker to assist with diverse needs beyond emergency food assistance.

Slipping Through The Cracks: Receptivity Of Healthcare Professionals To An Electronic Screening Tool For Human Trafficking, Jennifer Albert, Kenyon Bolton, Gilana Finogenov, Mateen Hakim, Julia Shatten, Abishag Suresh, Soriaya Thura, Stephen Wheat, Edith Klimosky, Ted James

Public Health Projects, 2008-present

Introduction:

Human trafficking is the exploitation of an individual through force or coercion, for labor or services, including commercial sex.

Healthcare providers are uniquely positioned to encounter trafficked people.

Prior research has found a need for increased sensitivity in identifying trafficked persons in healthcare settings, and for provider education about the issue.

Effects Of Art Intervention On Pediatric Anxiety And Pain In The Medical Setting, Ashley L. Deeb, Miles W. Grunvald, David A. Leon, Anton Manyak, Lindsay R. Miller, Kelsey M. Veilleux, Lisa H. Wang, Buffy F. Dekmar, Rebecca Schwarz, Shaden Eldakar-Hein

Public Health Projects, 2008-present

Introduction: Hospitalization and illness can be a painful and stressful time for a child. There may be anxiety over procedures and inpatient stays disrupt normal routines. Previous research found that for pre-school aged children, having parents around, having the help of the hospital staff, and playing an active role in alleviating their fears were the most helpful in reducing anxiety. Another study found that visual creative expressions can be meaningful experiences for young adult cancer survivors. Additionally, there is abundant literature on formal art therapy and its favorable effects on children in the hospital, however, there are fewer studies investigating …

Nutrition In Early Childcare Programs: The Benefits And Barriers, Patrick Cruden, Timothy Flanagan, Emily Forbes-Mobus, Xiaoyu Lu, Alison Mercier, Siyeon A. Seong, Yazen Qumsiyeh, Alison Howe

Public Health Projects, 2008-present

Introduction:

1 in 5 Vermont children experience food insecurity. Inadequate nutrition threatens cognitive, social, and emotional development in the first years of life.

49.1% of Vermont children arrive at kindergarten underprepared. It has been shown that undernourished children have reduced activity levels and withdraw from their environment, removing them from critical learning opportunities and social interactions.

Supporting the provision of healthy food in early childcare programs may help address the issue of food insecurity and promote healthy childhood development.

Currently, there are no existing data on both Vermont childcare providers and parents of these children on their perceptions of the …

Implementing A Fitness And Nutrition Program For Special Olympics Athletes, Andrea Blood, Shannon Brady, Liam Donnelly, Do Young Gwak, Charlotte Hastings, Astia Roper-Batker, Kasra Sarabakhsh, Stephen Shenouda, Justin Graham, Stephen Contompasis

Public Health Projects, 2008-present

Introduction:

Only 17-30% of individuals with ID meet the recommendations for daily exercise

Populations of individuals with ID have higher BMI, lower cardiovascular fitness and lower muscle strength compared to the general population

Individuals with ID also have many dietary challenges necessitating nutritional education and interventions

One study following four athletes with ID, showed that pairing athletes with and without (unified sports) resulted in a positive change in social self-concept for athletes with ID

Given the above, we:

Created a 6-week pilot training and nutrition program for Special Olympics Vermont (SOVT).

Paired athletes with ID with college athletes without ID …

Parental Perceptions Of Oral Health And School-Based Dental Sealant Programs, Laura Donnelly, Peter Evans, Ian Grant, Allicia Imeda, Daniel Kula, Clare Park, Hao Fang Wu, Julie Cole, Kristin Fontaine, Wendy Davis

Public Health Projects, 2008-present

Introduction:

Community Health Needs Assessment (University of Vermont Medical Center, 2013)

Identified oral health in pediatric population as a primary concern

Barriers to dental care cited: access, affordability, education School-Based Sealant Program (SBSP)

Dental sealants are an evidence-based method of cavity prevention

CDC strongly recommends delivery via SBSPs

Few Vermont schools have such a program

Vermont Medicaid State Plan amendment allows dental hygienists to bill without on-site dentist (2015)4

Unique opportunity to pilot an SBSP

Pilot program implemented by the University of Vermont Medical Center Community Health Improvement

Goal: sustainable model able to be replicated in Vermont schools Pilot School …

Living In Recovery:Perceptions Of Health Care And Comorbidities In Rural New England, Theodore Cisu, Elizabeth Doughty, Rahul Gentyala, Kathleen Olson, Kishan Patel, Taylor Wolfgang, Richard Yun, Gary Decarolis, Jill Jemison

Public Health Projects, 2008-present

Introduction:

Alcohol and Drug Abuse: In the USA, abuse of tobacco, alcohol, and illicit drugs is costly, exacting more than $700 billion annually in costs related to crime, lost work productivity, and health care.

9% of Vermont residents and 8% of US residents report alcohol or illicit drug abuse, and 10% of US adults consider themselves to be in recovery from drugs or alcohol.

Health Care and Recovery: Persons with drug addictions are approximately twice as likely to suffer from mood and anxiety disorders compared to the general population.

Aside from mental health disorders, other common comorbidities include dental problems, …

Uvm Tobacco Use And Attitudes After Implementation Of A Tobacco-Free Policy, Christina Cahill, Elizabeth Carson, Eric Day, Melissa Rafferty, Saraga Reddy, Anthony Sassi, Eric Schmidt, Tom Delaney, Burton Wilcke, Jan K. Carney

Public Health Projects, 2008-present

Introduction: Widespread public health initiatives have led to falling smoking rates. Currently, 1,620 U.S. colleges have adopted smoke-free policies. In August 2015, the University of Vermont (UVM) adopted a tobacco-free policy that bans all forms of tobacco use on university property. The purpose of this study was to compare tobacco use and attitudes before and after policy implementation.

Lake Champlain Water Quality: A Study Of Public Awareness, Perceptions, And Behavior, Kelley Collier, Tridu Huynh, Michael Ialeggio, Colby Kearl, Autumn Reilly, Dana Ribaudo, Elaine Wang, Razelle Hoffman-Contois, Andrew Chevrefils, Jan Carney

Public Health Projects, 2008-present

Introduction: Lake Champlain serves as a major source of drinking water and a prime recreational area in Vermont. The Vermont Department of Health actively monitors Lake Champlain water quality, generates informational resources, and issues restrictions and advisories as necessary. Key water quality issues include: blue-green algae blooms (BGAB), combined sewer overflow (CSO), mercury-based fish consumption advisories, and suitability for recreational use. Determining public awareness of Lake Champlain water quality, and how perceptions of Lake Champlain water quality influence behavior, are essential to improving communication with at-risk and underinformed populations.

Naturopathic Physician Attitudes And Practices For Vaccination And Primary Care In The State Of Vermont, David Arsanious, Paul Baresel, Stephanie Brooks, Rachel Carson, Vicenta Hudziak, Stephen Maurer, Kelsey Sullivan, Chris Finley, Sarah Mccarthy, Jan Carney

Public Health Projects, 2008-present

Introduction:

Recent increase in measles cases has sparked vaccination controversy.

Naturopathic physicians (NDs) have been recognized as primary care providers by VT since 2012.

It is not well understood how NDs address vaccination with patients.

Our goal was to determine how Vermont NDs address vaccines and preventative care with their patients.

Facilitators And Barriers To Prescribing Preexposure Prophylaxis (Prep) For The Prevention Of Hiv, Theresa B. Flanagan, Margaret M. Graham, Tihn T. Huynh, Derek L. Luzim, Alexandra K. Miller, David M. Nguyen, Yueyue Shen, Peter Jacobsen, Jerry Larrabee

Public Health Projects, 2008-present

Background:

What is PrEP and who gets it?

PrEP is the use of medication by individuals to prevent HIV contraction, approved in 2012 after demonstrating safety and efficacy in the iPrEx study and Partners PrEP2 trials.

HIV infection risk is 92% lower in patients using PrEP.

Truvada®, a combination of tenofovir and emtricitabine taken orally daily, is the only approved PrEP regimen and is intended to compliment other prevention strategies such as condoms.

HIV negative-individuals at risk for exposure to HIV have been identified as men who have sex with men (MSM), IV drug users, heterosexuals who have unprotected sex …

Harvesting Health: A Community-Based Participatory Evaluation Of The Veggie Rx Program, Natalie Royal, Kristin Brown, Fanny Rodriguez, Bianca Fernandez, Leticia Valle, Elizur Bello

Articles, Abstracts, and Reports

No abstract provided.

Web-Based Media Literacy To Prevent Tobacco Use Among High School Students, Jane S. Phelps-Tschang, Elizabeth Miller, Kristen R. Rice, Brian A. Primack

Journal of Media Literacy Education

Facilitator-led smoking media literacy (SML) programs have improved media literacy and reduced intention to smoke. However, these programs face limitations including high costs and barriers to standardization. We examined the efficacy of a Web-based media literacy program in improving smoking media literacy skills among adolescents. Sixty-six 9th grade students participated in a Web-based SML tobacco education program based on health behavior theory. Pre- and post-test assessments demonstrated statistically significant changes in the primary outcome of total SML as well as each of the individual SML items. However, there were inconsistent changes in other theory-based outcomes including attitudes and normative beliefs.

Medicaid Financing, Sally Coberly

National Health Policy Forum

This publication provides an overview of how the Medicaid program is financed. It explains how the federal and state shares of funding are determined, briefly describes disproportionate share hospital payments and how those are affected by the Patient Protection and Affordable Care Act of 2010, and outlines financing mechanisms states have used to maximize federal Medicaid matching funds.

Medicaid Eligibility And Benefits, Sally Coberly

National Health Policy Forum

This publication provides a brief overview of the Medicaid program. It highlights the range of eligibility and benefits requirements and options and it briefly describes the program's financing structure.

Medicare, Sally Coberly

National Health Policy Forum

This publication provides an overview of the Medicare program including eligibility, covered services, cost-sharing requirements, and program financing.

The Medicare Drug Benefit (Part D), Sally Coberly

National Health Policy Forum

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit for Medicare beneficiaries that began January 1, 2006. This publication provides an overview of the drug benefit.

Promoting Hiv Testing For Gay And Bisexual Men: An Evaluation Of The 2011-2012 Campaign In Toronto And Ottawa, Barry D. Adam, Sandra Gardner, Carol Major, Diana Campbell, Lucia Light, Jason Globerman

Sociology, Anthropology, and Criminology Publications

This paper reports on a social marketing campaign directed toward high-risk men who have sex with men (MSM) in Toronto and Ottawa to: encourage testing for HIV and syphilis; improve knowledge about HIV transmission, seroconversion symptoms, and the HIV window period; and heighten awareness of syphilis transmission and its relationship to facilitating HIV transmission. Evaluation data were collected from a large-scale online pre-and post-campaign survey of sexually active MSM and from laboratory testing data. Men who turned up to be tested also filled out an exit survey. The campaign websites attracted some 15,000 unique visitors, 54% of whom had an …