Medicine and Health Sciences Commons^™

Biopsychosocial Case Report, David F. Lo, Gaurav Kumar, Don D. Shamilov

Rowan-Virtua Research Day

Ms. R, a 32-year-old Hispanic female, suffers from severe anxiety exacerbated by a car accident and past struggles with depression and substance use. Evaluation reveals hypothyroidism, mild anemia, and GAD as the primary diagnosis. Factors contributing to her condition include genetic predispositions, medical issues, and social stressors. Treatment involves pharmacotherapy, psychotherapy, and monitoring her physiological health. Research on wearable data for GAD severity offers potential insights for her treatment. A holistic approach, considering biological, psychological, and social factors, guides her tailored treatment plan for overall well-being.

The Correlation Of Consistent Exercise With Depressive Symptoms, John Gericke, Tara Pellegrino, Robert Steer

Rowan-Virtua Research Day

Background: Depression is a major health issue that affects an estimated 350 million people worldwide. Typically, depression is associated with individuals who follow a poor diet and are physically inactive. Exercise is one form of treatment for depression and has been shown to reduce the risk of depression and protect against the onset of depression. The PHQ-9 Depression Score is a tool used to screen individuals for depression on a scale from 0-27. The goal of this study is to identify a relationship between consistent exercise and depression symptoms.

Methods: An original Qualtrics survey was created to be distributed with …

A Review Of Risk Factors, Adverse Outcomes, And Counseling Strategies Among Pregnant Individuals With Eating Disorders, Alexandra Fontaine, Emily Meale

Rowan-Virtua Research Day

Background: Eating disorders (EDs) among women of childbearing age have become more prevalent on the global level. Identifying at-risk populations of women having EDs before, during, or after pregnancy is essential for clinicians to improve treatment and decrease the likelihood of negative maternal and/or fetal outcomes. Purpose: The purpose is to determine risk factors for women who have EDs throughout pregnancy, to identify negative pregnancy outcomes of women suffering from EDs, and to explore treatment and counseling options through the postpartum period. Methods: This literature review mainly utilizes sources from PubMed and the National Institute of Health databases. An expansive …

Health Impacts Of Remote Work, Tin Nhan Nguyen

Family Medicine Clerkship Student Projects

Remote work has increased in frequency in the past few years with a notable rise in Connecticut. While working from home has certain benefits, it can also increase the risk of certain physical and mental health issues. An educational pamphlet on the health impacts of remote work with suggestions to reduce negative effects was developed and distributed to community members.

A Helping Hand Out Of The River: Refugee Perspectives For Provider Engagement, Brian L. Isakson, Elizabeth R. Stein, Alexandra Olson, Destiny Waggoner, Jill Holtz, Sara Ali, Suha Amer, Martin Ndayisenga

Journal of Patient-Centered Research and Reviews

Purpose: A growing number of refugee groups are seeking care within the U.S. health care system for medical, psychological, and social needs. Research is limited in understanding refugee-specific conceptualizations of helping relationships and provider characteristics that improve interactions in health systems. This study aimed to identify provider characteristics that facilitate engagement and helpfulness in a refugee-specific population from refugee participant voices to inform future practices of health care clinics.

Methods: Semi-structured interviews with refugee participants were conducted to assess 1) experiences moving on from difficult experiences, 2) engagement with the health system, and 3) provider characteristics that facilitated engagement and …

Primary Care In Southern Illinois And Western Kentucky, Matthew J. Crabtree

Honors College Theses

There is a major physician shortage occurring across the United States as of 2023 and it is expected to get worse over the next five to ten years. A significant portion of the shortage is predicted to consist of primary care physicians in rural areas. Data on factors that affect primary care visits like rurality, household income, health insurance coverage, non-communicable disease, and primary care physician prevalence were analyzed from the regions of Southern Illinois and Western Kentucky. Health coverage was found to be average to above average in the two regions. However, almost all counties included in the study …

Improving Depression Screening Protocol And Subsequent Sbirt Referrals, Mclaine S. Rich

Family Medicine Clerkship Student Projects

As a federally qualified health center, Lamoille Health Family Medicine receives annual data evaluating their performance in a number of categories. They exceeded expectations in screening eligible patients for depression, yet did not see the same success in referrals following a positive screening. After discussing with nursing and physician staff it became clear that there were discrepancies regarding office workflow/specific responsibilities. Moreover, some physicians expressed that they were unsure exactly how to handle positive screening results. This flowsheet developed will alleviate confusion in who is responsible for each step of screening, and uses evidence based guidelines for when to refer …

New Americans Accessing Mental Health Services, Alexander M. Kubacki

Family Medicine Clerkship Student Projects

No abstract provided.

Suicide Screening At Tchc, William J. Yakubik Iii

Family Medicine Clerkship Student Projects

Vermont is currently battling with a mental health epidemic and one of the consequences of mental illness is suicide and self-harm. According to the Vermont Department of Health Vermont’s suicide rate is higher than the national average and suicide is the 8th leading cause of death in the state. Every part of medicine especially primary care is struggling with providing adequate resources for the demand needed to provide quality mental health care. Thomas Chittenden Health Center (TCHC) is no stranger to these demands and is working on ways to ensure each patient has access to the care they need. The …

Improving Mental Health Access In A Rural Setting Via Telehealth, Timothy W. Greenfield

Family Medicine Clerkship Student Projects

There are several barriers patients face when accessing mental healthcare in rural areas including: lack of internet, lack of resources, and stigma.

Local options are limited, and patients face barriers such as access to transportation.

These factors position telehealth as a unique, tangible solution for patients in the community.

Community Services For Patient Referral Document, Jett Choquette

Family Medicine Clerkship Student Projects

Patients have a need for referral to a variety of services that directly relate to their health and wellbeing that are not generally included in the traditional referral system of healthcare networks. These services include (but are not limited to) social work support, pandemic support, elderly services, LQBTQ+ services, intimate partner violence services, functional medicine, and substance use disorder and mental health support and treatment. Because these services are not part of the traditional healthcare referral system, healthcare providers may not have an up-to-date list of organizations and programs in the community that could provide these needed services. This is …

Creating A Screening Tool To Prevent Intimate Partner Violence (Ipv), Ankrish B. Milne

Family Medicine Clerkship Student Projects

No abstract provided.

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

Family Medicine Clerkship Student Projects

No abstract provided.

Cbt In Primary Care, Brianna J. Spano

Family Medicine Clerkship Student Projects

This is a community improvement project designed to address the growing need for and shortage of mental health care in Vermont. The project focuses on creating a brief training tool and guide for primary care physicians to be able to incorporate cognitive behavioral therapy in their practice.

Promoting Community Health During The Covid-19 Pandemic, Erik J. Zhang

Family Medicine Clerkship Student Projects

The COVID-19 pandemic has affected aspects of health and community beyond the acute phase of COVID-19 infection, including chronic health conditions, mental health, substance use, food insecurity, access to healthcare, and housing insecurity. Further, existing disparities in these factors and other social determinants of health such as socioeconomic status, education, neighborhood, and physical environment have been exacerbated by the response to the COVID- 19 pandemic. Community members face negative health impacts as a result of the COVID-19 pandemic and response. They should be made aware of community resources for immediate and long-term solutions to the difficulties they experience.

Mental Health Outcomes At A Student-Run Free Clinic, Jessica-Sophie Horoschak, Riya Tandra, Sahil Parikh, Shayna Peterzell, Roma Padalkar, Tara Pellegrino

Rowan-Virtua Research Day

In this project we aim to:

1. Assess the outcomes of screening, management, and diagnosis for patients at the Rowan Community Health Center (RCHC).

2. Compare the outcomes of screening, management, and diagnosis between different groups (gender, race, income, insurance status) using validated surveys.

3. There is a need for accessible and affordable primary care in the South Jersey area, which the RCHC is hoping to meet.

Hypothesis:

The quality of mental health care available to patients at the RCHC is comparable to that at other insured practices.

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.

Community Resources Addressing Peripartum Depression, Tiffany L. Lao

Family Medicine Clerkship Student Projects

Peripartum mood disorders affect a large proportion of new mothers as well as their families, partners, and support systems. This project aims to provide patients with information about peripartum mood disorders as part of their initial prenatal packet. Also included are a list of local community resources specifically addressing peripartum mood disorders for patients seeking additional support outside of their primary care office.

Setting Expectations For Mental Healthcare Referral, Emily Bennett

Family Medicine Clerkship Student Projects

Patients are referred to mental health care by their primary care providers, but there is often a misunderstanding of what that process looks like. This project aimed to understand the referral process and create improvements that will help patients stay engaged to improve their mental wellbeing.

Strengthening Mental Health Diagnostic Detection In Integrated Primary Care, Julia Brechbiel

Theses and Dissertations

Primary care behavioral health (PCBH) is crucial for providing mental health treatment to underserved, minority, and uninsured populations. There is a lack of knowledge about accurate mental health diagnoses at PCBH. Underdetection of mental health symptoms has the potential to worsen racial and socioeconomic disparities. Using an expert review process, I developed an abbreviated diagnostic clinical interview (ADCI) for integrated primary care. Next, patients (N = 82) completed the interview after attending PCBH appointments. According to the interview, 63.4% of participants met criteria for a diagnosis, while 64.7% received a diagnosis from their provider. A large portion of patients …

Mental Health Technology During The Era Of Covid-19, Michael Tabet

Family Medicine Clerkship Student Projects

Mental health symptoms - especially those of depression and anxiety - have become more prevalent during the COVID pandemic. As seen in previous years, direct and indirect costs of depression can be staggering. Apps exist on smart devices that are based in evidence-based practices that can be therapeutic for mental health issues such as depression, anxiety, and insomnia. A simple handout with some suggested popular mental health apps and accompanying descriptions was created to be used in the CVPH Family Medicine clinic to increase awareness of these apps among patients suffering from depression, anxiety, and insomnia.

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.

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

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 …

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.

Assessing Barriers To Mental Health Resources, Young Bo Sim

Family Medicine Clerkship Student Projects

This project was done to assess patients' barriers to mental health services in Newtown Primary Care. The project focused on identifying and developing questionnaires to assess if there were any perceived barriers and what those barriers were.

Phq-9, But In Spanish, Jose Calderon

Family Medicine Clerkship Student Projects

Spanish speaking patients are often missed for depression. A common issue is lack of awareness of the Spanish version of the PHQ-9

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.

Integrating Primary Care Into Community Mental Health Centres In Texas, Usa: Results Of A Case Study Investigation, Rebecca Wells, Ellen D Breckenridge, Sasha Ajaz, Aman Narayan, Daniel Brossart, James H Zahniser, Jolene Rasmussen

Journal Articles

INTRODUCTION: Despite evidence that people with serious mental illness benefit from receiving primary care within mental health care settings, there is little research on this type of integration. The objective of this study was to characterize how providers and patients experienced implementation of primary care into specialty mental health services.

METHODS: During site visits, study team members interviewed staff and conducted focus groups with patients at 10 United States community mental health centres then beginning to integrate primary into their practices. One year later, follow up phone interviews with key centre staff informants validated and updated findings. Data analysis included …

Patient Education On The Association Of Hormonal Contraception With Depression, Julia E. Hannigan

Family Medicine Clerkship Student Projects

Hormonal contraceptive agents are widely used by women during their reproductive years. In recent years, research has been released linking hormonal contraception with the initiation of antidepressant medication and a first diagnosis of depression. More research is still warranted in order to further elucidate the relationship between hormonal contraception and depression, but current evidence prompts the necessity for shared decision making between clinicians and women considering treatment with hormonal contraceptive agents. The goal of this project is to give providers easily accessible patient educational materials in the form of epic smart phrases to aid in informed decision making.