Medicine and Health Sciences Commons^™

Diabetic Foot Wound Care, Richard Q. Vuong

Family Medicine Clerkship Student Projects

Diabetic foot wound care educational pamphlet developed during the family medicine rotation for 3rd-year medical students. This project was developed in Brookfield, CT.

The Role Of Food Insecurity With Hunger And Physical Activity Level On Binge Drinking Among Vermont High School Students, Joe Stacy, Codi Williams, Zyakkiriah Rhoden, Han Naung Tun

Master of Public Health Culminating Projects

Objective: To determine the association of hunger, physical activity, Black Indigenous People Of Color (BIPOC) status , and BMI percentile on binge drinking among Vermont high schoolers.

Methods: A cross-sectional study was conducted on Vermont high school students aged between 12 to 18 years (n=18,540) using data obtained from the 2019 Youth Risk Behavior Survey of the Vermont Department of Health. Multiple logistic regression models were utilized to investigate the correlation between binge drinking status and hunger status, physically active status, BIPOC status, and Body Mass Index percentile.

Results: Binge drinkers had significantly higher levels of hunger …

Increasing Patient Education On Proper Antibiotic Stewardship, Arif S. Ahsan

Family Medicine Clerkship Student Projects

Antibiotic resistance is a growing public health issue in the United States. Coinciding with this, patients often inappropriately self-treat infections using antibiotics. Locally, this causes complications in treating patients in an outpatient setting, and nationally, this causes an increased economic burden on the United States healthcare system. A handout was developed for distribution at pharmacies in order to better educate patients on proper antibiotic stewardship, based on information that providers believed to be most important for patients to know.

Improving Knowledge Of Contraceptive Options In Teenage Male Populations, Anthony Quach

Family Medicine Clerkship Student Projects

Despite a plethora of contraception available on the market, nearly 50% of pregnancies in Vermont are unintended. Currently, most educational initiatives aimed at improving contraceptive usage are targeted towards individuals with uteruses, and not their partners with penises. Both qualitative and quantitative data suggest that there are significant gaps in this latter population’s knowledge about contraception for various reasons like limited contraceptive education within formal sexual education in schools, lack of parental and/or physician discussions about contraception, and various complex social and cultural factors. This intervention aims to bridge the knowledge gap in this population by using an educational pamphlet. …

Evaluating The Indirect Effects Of A Community-Based Child Obesity Prevention Program On Adult Health Behaviors, Emily K. Rocheleau

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Community-based intervention (CBI) programs aim to change individuals’ behaviors to reduce the risk of chronic disease, often by addressing factors that contribute to obesity. To provide information for improving interventions, program evaluation is needed. In Franklin and Grand Isle Counties, childhood extreme obesity decreased where a child-targeted, obesity prevention focused CBI was implemented. It has been shown that these programs can have an indirect effect on parent health/body mass index (BMI), but it is unclear if indirect effects of such programs have an impact on adult BMI and related health behaviors. The purpose of this project was to determine …

Return To Play Following Covid-19, Tyler Landman

Family Medicine Clerkship Student Projects

Covid-19 infections among adolescents have led to significant decreases in physical activity and fitness. Many adolescents have been subject to return to play clearance before being able to get back to their sport. Protocols are not only a moving target but are also different from school to school, and county to county. Many patients are not involved in the decision making process of when they get to play again, and furthermore end up being out of sport longer than they need to due to the ordering of unnecessary tests, and long wait times for them. The aim of this study …

Integrating Community Into Middle School Sexual Education, Sierra Miller, Margaret Aitken

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Problem Statement: Most middle school sexual education does not include parents or community members. Evidence shows family and community attitudes towards sex and sexuality are significant factors in adolescent risky sexual and health practices.

Background: Comprehensive sex education (CSE) reduces risky sexual practices and negative health outcomes. National and local organizations have identified CSE as a public health goal. CSE works best when culturally relevant and the community is involved.

Methods: Interviews with the health educator identified community needs. Resources were created in line with the current curriculum focusing on sex education, its importance, and how to talk about …

Lifestyle Changes In Covid-19 Pandemic And Impact On Modifiable Stroke Risk Factors, Kelly J. Chan

Family Medicine Clerkship Student Projects

Stroke is one of the leading causes of mortality and disability in the USA. Underlying conditions such as hypertension, diabetes and cardiovascular disease predispose an individual to increased risk of stroke. In addition, the Covid-19 pandemic presents many challenges to these patients in terms of active health management and maintenance. A screening tool was developed to assess patient patterns of lifestyle behavioral changes measured by modifiable risk factors for stroke (medical condition management, diet, exercise, and smoking habits).

Perceived Addictiveness Of Marijuana, Tobacco And Alcohol Use In Vermont Youth And Young Adults: Associations Between Addiction Perceptions, Sociodemographics, And Substance Use, Julia C. West

Graduate College Dissertations and Theses

Dual and poly-tobacco and substance use are increasingly prevalent in youth and young adults. Current substance use prevention media efforts target addiction perceptions in young people; however, little is known about the perceived addictiveness of multiple substances among young people. The goal of the current study is to examine youth and young adults perceive addictiveness across several substances and the associations between addiction perceptions and substance use. Data were collected in Spring and Summer 2019 (Waves 1 and 2) as part of PACE Vermont, an online cohort study of Vermonters aged 12–25. Latent class analyses grouped participants by responses to …

The State Of Sleep: What Keeps Vermont Up At Night?, Magalie Carey

Family Medicine Clerkship Student Projects

No abstract provided.

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 …

Community Health Interventions To Reduce The Burden Of Radon-Related Lung Cancer, Benjamin Weaver

Family Medicine Clerkship Student Projects

Exposure to radon is the second leading cause of lung cancer in the United States. One in seven homes in Vermont has elevated levels of radon, but most patients are unaware of radon as a risk factor for lung cancer or that radon testing and mitigation services are available to them. To promote increased testing and mitigation of radon we screened patients presenting to a Family Medicine practice in Vermont about whether they had had these services done in their home. We also developed a patient education resource for providers to give to patients who had more questions about radon …

Understanding The Profiles Of Adolescents Engaged In Intentional Self-Poisoning With Suicidal Intent And The Role Of Primary Care In Early Intervention In Vermont, Rachael Comeau

Graduate College Dissertations and Theses

Suicide prevention is a top public health priority in Vermont. It is a complex issue, requiring a multi-faceted response from many different public and private stakeholders. Because intentional self-poisoning with suicidal intent is rarely lethal, it presents a particularly good opportunity for secondary interventions in the primary care setting. Extensive research has been done on intentional self-poisoning with suicidal intent and its relationship to subsequent risk of death by suicide, but gaps exist in research utilizing poison center data in the primary care setting. This dissertation employs an explanatory sequential mixed method research design to (a) develop a profile of …

Updating Evidence-Based Patient Education Resources For Sleep: Sleep Hygiene And Benzodiazepine Discontinuation, Carolyn Geraci, Madeline Fritz

Family Medicine Clerkship Student Projects

There is a major need for patient education around the topics of sleep hygiene and benzodiazepine sleep aid discontinuation in the family medicine clinic setting. Current patient-focused educational materials need updating and are not comprehensive enough. We therefore created new handouts and smartphrases which integrate into the electronic medical record system with the goal of educating patients on these topics.

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 …

Exercise And Physical Therapy In The Elderly, William Holden

Family Medicine Clerkship Student Projects

There are many current barriers to participating in exercise and physical therapy in the elderly. Using reputable online resources, we created a handout containing a list of exercises that can be completed safely at home without equipment. It was designed for elderly individuals, as inactivity tends to increase with age and this population is particularly vulnerable to the deleterious effects of inactivity. The strength and flexibility exercises primarily target the back, hips and core, common problem areas in the elderly. The handout will contain links to further resources for more in-depth physical therapy exercises and will be tailored for administration …

Measuring The Impact Of Rise Vt: Evaluating Community-Based Obesity Prevention Initiatives With A Standardized Intensity Score, Brianna K. Johnson Bsn, Rn, Ocn, Dnpc

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background. Obesity is a leading cause of morbidity and mortality in the US. Rise VT is a multilevel community-based initiative to reduce obesity. The Community Programs and Policies Intensity Score (CPPI) is a standardized metric to evaluate multisector efforts over time, which has correlated with reductions in childhood obesity.

Purpose. The purpose of this project was to quantify the impact of Rise VT using the CPPI score. A secondary aim was to assess the feasibility of using the CPPI score for ongoing program planning and evaluation statewide.

Methods. Interviews with program managers were conducted to gather data related to …

Screening For Palliative Care Services In An Assisted Living Facility, Maria Delia Crosby

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Palliative care services remain under-utilized, even as evidence suggests that early palliative care leads to positive health outcomes, reduced ED visits, and substantial cost savings. Barriers include a lack of knowledge of palliative care services in the community, and under-utilization of validated assessment tools, including a symptom checklist. Aims of this project: 1. To determine whether the integration of validated community-based palliative care screening tool in an assisted living setting will identify older adults with unmet palliative care needs. 2. To determine if tool implementation could lead to a referral for palliative care consultation.

Methods: A screening tool developed …

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 …

Promoting Physical Activity In School-Aged Children During The Covid-19 Pandemic, Abigail H. Belser

Family Medicine Clerkship Student Projects

Due to the COVID-19 pandemic, children and adolescents are engaging in less physical activity and are increasing their sedentary behavior. These changes can lead to long-lasting negative lifestyle behaviors, which increases risk of health complications.

To ensure safety during the pandemic, guidelines have created restrictions on physical education and sports, which are both primary physical activity outlets for children and adolescents. Children and adolescents have to find alternate ways and resources to meet the recommended 60 minutes of physical activity daily.

An informational pamphlet was created to educate parents and children of current physical activity recommendations, with resources and ideas …

The Use Of Mindful Breathing As Part Of The Healthcare Intake Process, Deena Chanowitz, Lauren Struck

Family Medicine Clerkship Student Projects

Most Americans visit the doctor’s office for an acute or chronic condition or for preventative care. No matter what the reason, a visit to the doctor’s office can be stressful for a patient. Our study was designed to determine whether a patient’s experience of the visit can be improved using a mindful breathing exercise. We developed a system for teaching a two minute breathing exercise, with a brief questionnaire to evaluate how the patient feels before and after the intervention. We presented our study design to practitioners in primary care offices in VT and CT who were receptive to the …

Improving Health Literacy Among Latino Migrant Dairy Farmworkers, Dayna A. Stimson

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background/Purpose: Latino migrant farmworkers are a marginalized and medically underserved population in Vermont and nationally. They experience significant health disparities and barriers to healthcare access compared to others living in rural areas. Barriers include limited knowledge regarding available services and low general and health literacy. These barriers lead to poorer health outcomes. The purpose of this evidence-based project was to enhance health literacy and follow-up care for migrant farmworkers by improving health literacy in a community health outreach setting.

Methods: In northwestern Vermont, 33 outpatient migrant farmworkers were recruited following health screening visit and referred for follow-up. AHRQ …

To Juul Or Not To Juul: What We Know About The Health Effects Of Vaping, Chad Serels

Family Medicine Clerkship Student Projects

E-cigarette use, also known as Vaping, has garnered national attention over recent years due to its rapidly rising popularity. While some claim it is the healthier alternative to cigarette smoking we need to reduce the 480,000 deaths in the US from smoking-related diseases each year, others warn that its popularity among teens has the potential to undo years of progress combating nicotine addiction and is just another attempt by the tobacco industry to lure a new generation of customers. Given this ongoing public conversation, it is up to health care providers to stay informed on the health effects of vaping …

An Educational Module For Adolescents On Cannabis Following Its Legalization, Anna Lidofsky

Family Medicine Clerkship Student Projects

Recreational use of cannabis has been recently legalized in Vermont. One year prior to its legalization, 42% of high school students in Washington County reported at least one-time use of cannabis. An educational module for adolescents was developed to address the increasing potency of cannabis and health risks associated with its use.

Quality Improvement: Cervical Cancer Screening Rates Within Hudson Headwaters Health Network, Dylon K. Gookin

Family Medicine Clerkship Student Projects

Nearly 8 out of every 100,000 people are diagnosed with cervical cancer each year. However, powerful screening tools exist that enable us to detect and manage cervical changes before they develop into cervical cancer. In spite of this, cervical cancer screening rates remain low for many providers. This public health project sought to identify and address a cause for low cervical cancer screening rates within the Hudson Headwaters Health Network. A literature review determined that education and mailed invitation letters were proven methods for improving cervical cancer screening rates. Following a review of the local population demographics, West Mountain Health …

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.

Ace’S Contextualization For Healthcare Workers, Nektarios Konstantinopoulos

Family Medicine Clerkship Student Projects

There is a well-established causative relationship between Adverse Childhood Experiences (ACE’s) and pathology. Despite strong supporting evidence, some healthcare workers are unaware of how deep this relationship is. I conducted an educational session surrounding ACEs targeting healthcare workers in an attempt to contextualize the relationship between ACE’s and consequent disease.

Physical Activity And Fall Prevention In Older Adults, An Educational Intervention, Caleb Daniel Knight

Family Medicine Clerkship Student Projects

Falls in adults over 65 years of age constitute a significant health burden in our country, and this age group is growing rapidly. Falls are addressed with a multifactorial approach, addressing comorbidities, medications, and the physical environment, however, an effective point of intervention accessible by most older adults is physical activity. A brief educational presentation about the morbidity and mortality associated with falls, and the protective effects of physical activity, was provided to Meadowbrook Healthcare subacute nursing home residents in Plattsburgh, NY. Questions were encouraged and answered afterwards, and copies of the presentation were left for the residents to review …

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.

Implementation Of Family Planning And Contraception For Female Inmates In Vermont, Callan Janowiec Fnp

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background and Objective(s): Unplanned pregnancies are disproportionately high among female inmates, and incarceration provides a unique opportunity for care may be otherwise difficult to obtain, including reproductive health and family planning services, specifically the provision of contraception. It is known that women are 14 times more likely to initiate contraception if education and services are provided within the prison (Clarke et al., 2006b). Despite decades of research identifying the unmet need, very few prisons around the country provide any sort of sexual health or family planning care to prisoners (Braithwaite, Treadwell, & Arriola, 2008).

Methods: This project involves the creation …