Medicine and Health Sciences Commons^™

Staff And Provider Education On Diabetic Foot Exams And Foot Care Using The Ophelia Process, Shasta Pickens

Doctoral Projects

Diabetes mellitus continues to grow in global prevalence and consumes an increasing amount of healthcare resources. Persons that live in disadvantaged groups have a higher prevalence due to a lack of understanding and access to care. Diabetes is one of the leading causes of chronic disease and limb loss worldwide. Diabetes foot care is essential, as diabetes can be dangerous to patients’ feet.

The purpose of this doctoral project was to increase diabetic foot care education and foot exams for staff and providers in a federally qualified health center (FQHC). Many people in this rural community do not understand the …

Transportation To Little Rivers Health Clinic In Wells River, Vermont, Anupama Balasubramanian

Family Medicine Clerkship Student Projects

Transportation to healthcare appointments is one of the biggest challenges that rural patients face. Currently, there are no resources available to patients at Little Rivers Health Care that can help them with transportation-related knowledge. This project aims to create a guide that improves patients' understanding of the options they have available in getting to their appointments.

Assisting Rural Mat Patients Through Peer Social Support, Anthony Plochocki

Family Medicine Clerkship Student Projects

Throughout the COVID19 Pandemic, there has been a spike in opioid relapse and opioid overdose related death. This problem, though multifactorial, can be attributed to lack of social outlets for MAT patients. Now that different social support groups are reopening, there is a greater emphasis placed on groups for patients suffering with alcoholism rather than those suffering from opioid addiction. This project hopes to plant the seeds for group therapy for MAT patients, giving them a social outlet with the hopeful outcome assisting patients with forming non-user networks.

Ambulance Service Coverage In Rural Coventry, Vermont, Katelynn Briere

Family Medicine Clerkship Student Projects

Ambulance service coverage is made difficult by the rural landscape of many Vermont towns. Discrepancies in quality and cost of ambulance service providers can make it difficult for town administrators to decide which service would be best for their town. This decision is even more important in towns like Coventry, Vermont where there is no in-town ambulance service. Providing town administrators with informative documents is one way to assist them in the decision making process.

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 Housing-Insecurity Screening In A Rural Primary Care Setting, Heather G. Giguere

Family Medicine Clerkship Student Projects

Housing-insecurity and homelessness have a direct impact on individual health, and are well established causes of premature morbidity and mortality (6). Screening for housing-insecurity leads to earlier identification, and more extensive engagement of services, which can help to mitigate the individual and public health ramifications of these social determinants of health (8). The aim of this project was to improve the screening process for housing-insecurity within an rural primary care setting.

Barriers To Head And Neck Cancer Treatment In Rural Populations, Amy K. Chang

Family Medicine Clerkship Student Projects

Head and Neck cancer (HNC) patients have unique outcomes and resource needs. They often experience debilitating speech, nutrition, respiratory, and psychological problems, requiring a multidisciplinary team. Additionally, they also require more support in terms of alcohol and tobacco support, whether that be an addiction medicine specialist or a support group. The coordination of these specialists is difficult in a rural setting with limited resources. Furthermore, HNC is more prevalent in developing countries and rural populations due to use of known etiological factors like tobacco and alcohol. The combination of high prevalence and low resources in rural populations may lead to …

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

Physician Burnout Among West Virginia Primary Care Providers, Kevin S. Mccann, Adam Baus, Joanna Bailey, Laura Boone, Jennifer Boyd, Martha Cook-Carter, Dan Doyle

Marshall Journal of Medicine

Introduction

Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.

Methods

Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.

Results

Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP …

Patient Recommendations For Providers To Avoid Stigmatizing Weight In Rural-Based Women With Low Income, Declan Watson, Katherine Hughes, Emma Robinson, Jacqueline Billette, Andrea E. Bombak

Journal of Patient-Centered Research and Reviews

Purpose: Weight stigma has become widespread within health care and disproportionately affects women, who are under greater appearance-based scrutiny than men. It is also well established that rural-based individuals with low incomes suffer greater health disparities compared with urban, higher-income counterparts, yet studies examining recommendations for nonstigmatizing health care among higher-weight women from low-income rural settings are lacking. This study examined the experiences and recommendations of higher-weight, low-income, rural women, with the aim of improving health care for similar populations.

Methods: In-depth, semi-structured interviews were conducted in a rural region of the Midwestern United States to explore participants’ recommendations for …

The Preventative Healthcare Shortage: A Look At The Vt And Ct Community Perspectives And Medical Student Interest, Michael J. Lawler

Family Medicine Clerkship Student Projects

We adapted and modified a previously generated survey to better understand the motivations and barriers of medical students to enter primary care. The survey was dispersed to all medical students at LCOM as well as third and fourth year medical students at Ross University and American University of the Caribbean (AUC). We analyzed preliminary data from 100 respondents. Notable barriers identified included cost of medical school, stigma associated with primary care, and inadequate time spent with patients. Recommendations for possible intervention were discussed.

Preventative Health Care Shortage, Jenna A. Elkhoury

Family Medicine Clerkship Student Projects

The primary care shortage is major problem that impacts people in rural and often low income communities. Our project seeks to address the primary care workforce shortage affecting the Vermont and Connecticut communities by better understanding current medical school student perspectives on primary care as a career of interest. Attractors and deterrents of primary care were highlighted through a survey distributed to all medical students at the Larner College of Medicine at the University of Vermont.

Patient Education On Sweetened Beverages: An Interactive And Module-Based Approach, Matt Tsai

Family Medicine Clerkship Student Projects

As sugary beverages continue to contribute to negative health outcomes, there remains a need for efficient, effective patient education in this area. A custom, interactive and reflective web-based module on sugary beverages for adult participants (n=42) was introduced at a rural Vermont outpatient clinic. Built-in quizzes evaluated learning through a pre and post-intervention design. On average, participants improved significantly from a pre-module mean score of 3.00 to a post-module score of 4.33 (p<0.0001). Additionally, participants' average rating of the module's effectiveness was 8.3 out of 10. A module-based approach may be one efficacious solution to improve patient education on sugary beverage consumption.

The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell

DNP Projects

BACKGROUND: Lack of access to healthcare is a nationwide issue that affects underserved, minority, and rural populations. School-Based Health Centers (SBHCs) is one way to help increase access to care for students, staff, and family members.

PURPOSE: The purpose of this project was to provide preliminary data on the impact of a SBHC in a rural Kentucky community on access to care and school attendance.

METHODS: A univariate descriptive analysis was conducted to evaluate the perceived impact of the SBHC on access to care and demographic factors. Data was analyzed using Pearson’s Product Moment Correlation, two-sample t-tests, and The Wilcoxon …

Diabetic Eating At The Dollar Store, Lee Hiromoto

Family Medicine Clerkship Student Projects

Ideas on following a diabetic diet using ingredients from a dollar store.

Ambulance Response Times In A Rural Vt Town: Is There A Role For Fema’S “Ready” Training In Hinesburg, Vt?, Kyna Silvana Donohue

Family Medicine Clerkship Student Projects

The purpose of this project was to examine the ambulance response times in a rural town in Vermont. The goal was to determine if there is a role for FEMA's "Until Help Arrives" campaign to increase bystander ability to provide immediate and life-saving medical care.

Gender Nonconforming Children: Education For Rural Vermont Families, Zachary Silberman

Family Medicine Clerkship Student Projects

Trans and Gender Nonconforming children and adolescents make up an increasing percentage of today's youth. Many of their families, parents, and healthcare providers lack information on how to address the topic. Additionally, the lack of research in the field, and the ever changing definitions, can make it difficult to navigate and, as a result, there are several persistent myths and misconceptions. This project seeks to address these myths, the terminology as currently used, and local community resources from a patient and family perspective, specifically targeted at rural Vermont.

Using Online Behavioral Health Modules To Expand Care In Rural New York State, Matthew Sommers

Family Medicine Clerkship Student Projects

There are substantial barriers to receiving behavioral health in rural areas such as Upstate New York. Online modules are an evidence-supported option that could exist within a primary care focused stepped-care model, expand access, and increase efficiency of existing resources.

Barriers To Colorectal Cancer Screening Within A Rural Community In Ohio, Kristina Knoll

DNP Projects

Purpose: The purpose of this study was to perform a needs assessment within the primary care practice of ProMedica Family Medicine in Fostoria, OH. The needs assessment will specifically identify intentions and behaviors, attitudes and beliefs, subjective norms about behavioral control, and healthcare provider or healthcare system barriers related to colorectal cancer screening.

Methods: This was a cross-sectional study using a survey among a convenience sample of patients who were 50 - 75 years of age and were not currently up-to-date with their colorectal cancer screening. In total, 222 patients were screened, 133 patients were determined to not be up-to-date, …

Nutrition And Exercise Resources For Clinton County, Paige M. Wood

Family Medicine Clerkship Student Projects

The obesity epidemic is a nation wide problem that has increased prevalence in Clinton County, NY when compared to the surrounding areas. Obesity leads to many co-morbid health conditions and is associated with a large increase in health care spending costs. This brochure tackles the limited resources, such as limited number of fitness centers, lack of nutrition education and an overall lower socioeconomic status, that is present in the Clinton County area. This brochure offers help in these areas through free phone applications which cover nutrition education, healthy shopping guidance, at home exercise routines, motivation, habit trackers and mindfulness exercises.

Rural Teens And Stress, Morgan R. Pratt

Family Medicine Clerkship Student Projects

Stress is significantly associated with risk taking behavior and increasing depression/anxiety among teens. There is no shortage of stressors experienced within the teenage years.This project's aim is to create a pamphlet that can be available for teens in rural Vermont. It will contain apps for healthy lifestyle, stress, mood, mindfulness as well as local help line numbers for teens in crisis and signs and symptoms of anxiety and depression.

Barriers To Affordable Prescriptions In Rural Vermont, Niketu P. Patel

Family Medicine Clerkship Student Projects

This project aimed at understanding why people in Rutland County, Vermont struggle with buying medications for their health. The project implemented and proposed several methods to help the population of Rutland area better adapt to the growing cost of prescriptions via $4 medication lists, rebates, samples, etc.

Assessing Transportation Hurtles In Lamoille County, Vt, Brian J. Rosen

Family Medicine Clerkship Student Projects

Rural areas are often characterized by low population densities, and large distances between available services and the population they serve. Lack of transportation in these areas makes access to services even more challenging. Access to primary healthcare was listed as the number one concern for patients in 2015 Copley Hospital Service Area (Lamoille County) and lack of suitable transportation was a major reason for this lack of access. The primary purpose of this project was to assess the medical transportation options for patients without appropriate transportation in Lamoille county, and to produce a flyer educating the patients about their options. …

Promoting Awareness Of The Opioid Epidemic In Rural Vermont, Kathleen Olson

Family Medicine Clerkship Student Projects

Vermont is in the middle of an opioid epidemic. Heroin use fatalities are on the rise and the number of people in treatment for opioid use disorder in Rutland County has tripled in recent years. Despite this widespread problem, community members of Rutland County feel that there is reluctance to talk about opioid misuse and lack of awareness. This project aims to bring awareness, provide resources, and encourage people struggling with opioid use disorder to seek treatment.

Velamentous Cord: A Dangerous Case Complicated By A Rural Population, Adam Franks, Md, Carolyn Curtis, Md, Shawndra Barker, Md

Carolyn A. Curtis, MD

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. This area of weakness exposes a threat to the well-being of the fetus through acute hemorrhage and both acute and chronic restriction of nutrition. With advances in technology, resolution capabilities of ultrasounds allow for antenatal diagnosis, when previously this was impossible. With this knowledge, considerations for screening and management of this pathology are essential when dealing with a rural population …

Generational Differences In Practice Site Selection Criteria Amongst Primary Care Physicians., Christopher Duffrin Phd, Mches, Molly Cashion Mph, Doyle M. Cummings Pharmd, Lauren Whetstone Phd, Jonathon Firnhaber Md, Gary Levine Md, Ricky Watson Md, Msph, Aaron Lambert Md

Marshall Journal of Medicine

ABSTRACT

Background and Objectives: Generational differences are often viewed as shaping the overall attitudes and actions of different age cohorts. It is essential to understand the motivations and generational differences in primary care physicians for efforts to recruit, retain, and educate the future physician workforce. Determining what factors most influence different generations of primary care physicians when choosing a practice site is essential to build our future primary care system. This study examined generational differences in the factors that attracted primary care physicians to their current practice.

Methods: A survey instrument was mailed to all active members of the North …

Transportation Is A Barrier To Healthcare In Central Vermont, Apoorva Trivedi

Family Medicine Clerkship Student Projects

Transportation is a significant barrier to healthcare access in Central Vermont due to a variety of reasons that include low income households, poor access to public transportation, elderly populations, and populations with disabilities. Improving access to transportation is a goal for both the local public transportation authority and the UVMHN-Central Vermont Medical Center in Berlin, VT. The purpose of this project was twofold. The first goal was to find an underutilized transportation resource in the community by heavily researching the area's transportation system and coordinating the distribution of informational sheets regarding this resource with my family medicine clerkship site members. …

Reducing Falls: Merging Research And Community Resources, Alison Mercier

Family Medicine Clerkship Student Projects

1/3 of older adults over the age of 65 fall, 10% of these falls can lead to serious injuries like hip fractures. The average length of life for someone who fractures their hip is 6 months. The risk and reasons for falling are multifactorial and often take a long time to assess. There are a few evidence based recommendations for reducing fall risk, yet a lack of awareness of these recommendations, and community resources to address this need. This project aimed to create a standardized assessment tool based on literature research and available community resources to facilitate fall risk assessment …

Tackling Obesity In Rural Vermont, Abishag Suresh

Family Medicine Clerkship Student Projects

Obesity is a growing epidemic across the United States. It affects rural areas such as those in Vermont deeply. An intervention addressing this problem using a health and exercise brochure was undertaken. Future direction will need to fully address the effectiveness of this intervention and take on other goals.

Promoting Physical Activity Using Walking Poles In Senior Citizens Of Southern Vermont's Deerfield Valley Region, Siyeon A. Seong

Family Medicine Clerkship Student Projects

Walking poles have been shown to be beneficial in increasing physical activity and improving functional outcomes. Walking poles have been recommended during patient encounters using an informational pamphlet at Deerfield Valley Health Center in Wilmington, VT.