Medicine and Health Sciences Commons^™

Oral Health Intervention: A Multifaceted Approach To Improve Oral Health Care During Pregnancy, Tabitha Ford, Gregory Frechette, Sruthi Sakamori, Caleb Seufert, I-Hsiang Shu, Patrick Silveira, Wendy Davis, Kristin Fontaine

Public Health Projects, 2008-present

Introduction:

Early Childhood Caries (ECC) is the most common chronic disease of childhood

Mothers’ oral health status is a strong predictor of the oral health status of their children

2009:

Vermont spends $2.7 million treating children ages 0-5 with Early Childhood Caries

2012:

Vermont lifts the $495 Medicaid cap on reimbursement for a woman’s dental care during pregnancy and up to 60 days after delivery

American College of Obstetrics and Gynecology (ACOG) Guidelines on prenatal dental care are published

2013:

74% of surveyed Vermont providers treating pregnant women are unaware of the Medicaid change

82% of these providers are not …

Vermont Restaurant Owner & Manager Perspectives On Creating Heart-Healthy Kids Meals, Elisabeth Lucas, Mary K. Lopiccolo, Lauren Haggerty, Apoorva Trivedi, Alex Jacobson, Daniel Trigg, Taylor Sommer, Carolyn Payne, Tina Zuk, Paula Tracy

Public Health Projects, 2008-present

Introduction: The prevalence of sugar sweetened beverages and fried foods combined with a lack of healthy children’s menu options has contributed to the obesity epidemic among young Americans. Recent legislation in New York City and San Francisco instituted strict nutritional requirements on children’s menu items.

We performed a cross-sectional study that focused on independently owned restaurants with printed children’s menus in Vermont. We investigated the nutritional content of children’s menu items, restaurant owner and manager perspectives on customer ordering habits, and barriers that restaurants would face if they made children’s menu items healthier.

Vermont Adolescent Perception Of Barriers To Smoking And Cessation, Kathryn Anderson, Aniruddha Bhattacharyya, Nicholas Kovacs, Nicole Mendelson, Gayathri Prabhakar, Andre Robinson, Rebecca Ryan, David Kaminsky

Public Health Projects, 2008-present

Introduction: Despite a decline in youth smoking rates over the past decade, thirteen percent of Vermont high school students still smoke (Vermont Youth Risk Behavior Survey, YRBS, 2013). Smoking and nicotine exposure at an early age can have detrimental effects on brain development and lead to long term, sustained tobacco use (Arrazola et. al 2015). It was our goal to characterize the barriers to cessation for these adolescents. Some important factors suggested by the literature include living with someone who smokes (50% of VT teen smokers report a parent or guardian who smokes) and having a close friend who smokes …

The Digital Age: Reminder And Confirmation Preference In Blood Donation, Michael Chung, Catherin Hayes, Peter Hyson, Y-Lan Khuong, Saurabh Patel, Brett Powers, Emily Ryan, Ryan Schmoldt, Jan Carney, Mark Fung

Public Health Projects, 2008-present

Introduction:

It is widely accepted that individuals are more likely to comply and follow through with responsibilities when reminded and asked to confirm their commitments. With the American Red Cross’ access to fast and affordable communication and this notion in mind, there is potential to develop new recruitment strategies and better methods of ensuring blood donation commitments.

In particular, understanding modes of communication with the donor population can have significant implications: avoiding loss of follow up, improving donor experience, and ensuring appropriate use of resources and staff; therefore, the American Red Cross is interested in understanding demographic differences among those …

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 …

Accessing Reliable Health Information On The Internet, Nathaniel Sugiyama ,Ms3

Family Medicine Clerkship Student Projects

In a low socioeconomic farming town at a rural family medicine clinic in upstate NY, I wanted to find a way to help reduce barriers to healthcare and help patients take an active role in their health using free internet resources. My idea was to help connect patients with reliable health information without needing to travel to the clinic, understanding that some patients may be limited in their ability to travel, take time off from work or afford the copays/expenses associated with seeing their providers. As such, I chose to investigate access to the internet, the ways in which users …

Evaluation Of Geo-Social Networking Application Use Among Young Adults, Caleb Seufert

Family Medicine Clerkship Student Projects

Background: Since 2009 geosocial networking applications (GNAs) have rapidly emerged as a new technological platform for users to communicate, date, and meet for sex. Popular GNAs include Tinder, Grindr, Bumble, Plenty of Fish, and many more. GNA’s are unique to traditional dating websites in that they allow users to connect with each other based on geographic proximity of their mobile phones. Given the pervasiveness of technology usage among young adults, it is important to understand the potential risks and benefits that GNA-facilitated communication poses on sexual health, emotional well-being, and safety. Popular GNA’s, like Tinder, estimate the majority of …

Improving Community Health With Affordable Internet Access, Joshua Jeremy Pothen

Family Medicine Clerkship Student Projects

Internet access is associated with increases in health information seeking and benefits in health statuses. However, many individuals of low socioeconomic status (SES) lack Internet access, thereby creating significant disadvantages from a health perspective. In this project, we describe a potential project for providing affordable Internet access to a neighborhood of Newport, VT containing many SES individuals. This network includes a splash page that provides regular health event promotion and health information dissemination to everyone connecting the network. We then discuss how to determine the impacts of the Internet on multiple aspects of health within the community.

Transportation As A Barrier To Access To Care In Bangor And The Surrounding Penobscot County Area, David A. Leon, David A. Leon

Family Medicine Clerkship Student Projects

The focus of this project was to assess issue with transportation as a potential barrier to accessing health care in Bangor, Maine. This pilot project involved interviews with community members and providers, as well as evaluated the needs in terms of transportation for accessing primary care. Research regarding this need was conducted through anonymous patient surveys, conducted by the author, and was used to guide the recommendations for future interventions that would address transportation issues in Bangor and the Penobscot County area.

Integrating Care: The Primary Care Provider’S Role In Age-Related Macular Degeneration In Eastern Maine, Homer Chiang, Steven Coffin

Family Medicine Clerkship Student Projects

Objectives: To assess general patient knowledge of age-related macular degeneration (AMD), including risk factors, early signs, treatment options, and low-vision resources. We also aimed to assess primary care provider practice patterns including early detection, timely referral to ophthalmology, and management after diagnosis of AMD.

Methods: A 20-point patient questionnaire was distributed to all adult patients at check-in by front office staff at the Center for Family Medicine office in Bangor, ME. Additionally, a looping waiting room slideshow and informational exam room flyer were created for patient education. A 10-point online questionnaire was distributed to residents and faculty at the Center …

Introducing Opiate Addicts To The Hub And Spoke Treatment System In Vermont, Richard T. Carrick

Family Medicine Clerkship Student Projects

Opiate abuse and addiction is an epidemic in the state of Vermont. Brandon Medical Center has recently become involved in Vermont's "Hub and Spoke" system of medically assisted opiate addiction treatment. This project involved the development of a pamphlet for safe, low-threshold transmission of information regarding opiate addiction and entrance into this system for patient's who may be suffering from this disease.

Screening For Domestic Violence Against Women: A Public Health Crisis In Maine, Clare Park

Family Medicine Clerkship Student Projects

The role of healthcare providers in stopping domestic violence against women, a public health crisis, through promoting a culture of universal screening and community education.