Medicine and Health Sciences Commons^™

Evaluating & Improving Adolescent Mental Health Accessibility In Vt, Kaitlyn A. Surwilo

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

Background: Rates of anxiety among adolescents are increasing. Providers at a rural Vermont clinic identified the need for an evidence-based process to use when adolescents screen positive for anxiety. Reports from providers regarding the challenges of referring to mental health providers called the accessibility of care into question.

Purpose: The purposes of this quality improvement project are to create an evidence-based toolkit for adolescent anxiety and assess the accessibility of mental health care in Vermont.

Methods: A literature review identified mindfulness and exercise as effective tools for managing anxiety. An anxiety toolkit was designed for adolescents aged 11-18 …

Knowledge Of Guidelines On Pediatric Patients In Foster Care, Katharine A. Stones

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

Purpose: The American Academy of Pediatrics (AAP) identifies children living in foster care (CFC) as a special health care needs population due to a high prevalence of health conditions. To address these disparities, the AAP released guidelines regarding the timeliness of medical assessments for CFC. Lack of recognition of the guidelines further widens health disparities experienced by this population. This project’s purpose was to 1.) Improve pediatric providers’ and nurses’ knowledge of AAP guidelines by at least 50% and 2.) Initiate acknowledgment by participants that CFC represent a special health care needs population.

Methods: Following conduction of qualitative interviews and …

Benign Vs. Malignant: Improving Prevention And Detection Of Cancerous Vs. Non-Cancerous Skin Lesions Through Inclusive Patient Education, Simran Kalsi, Sam Afshari

Family Medicine Clerkship Student Projects

Vermont consistently has one of the highest annual rates of melanoma in the United States. This is likely due to a range of factors including population demographics (predominantly white, aging population), active outdoor lifestyles, intense seasonal bursts of sun exposure, and inadequate Winter sun protection. The COVID-19 pandemic and its associated shutdowns have caused significant delays in healthcare delivery, further exacerbating the incidence and severity of melanoma. Primary care providers are therefore an increasingly essential first line of defense in detecting suspicious skin lesions and expediting treatment of skin cancer, but patients should be aware of when to seek evaluation. …

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.

Improving Dental Health Screening In The Primary Care Setting, Kali Amoah

Family Medicine Clerkship Student Projects

Oral health is an important part of systemic health that is often overlooked by patients due to various barriers to dental care. Dental caries is a public health crisis and one of the most common chronic diseases globally. Poor oral health and the resulting inflammation caused by oral bacteria is associated with cardiovascular disease, pregnancy complications, poor glycemic control in diabetes mellitus, and many more conditions. The goal of this project is to increase dental health screening in the primary care setting and to provide a list of affordable dental clinics in Vermont that take Medicaid/ Medicare and offer sliding …

Improving Identification Of Dermatological Conditions In Skin Of Color, Sam Afshari B.S., Simran Kalsi M.S.

Family Medicine Clerkship Student Projects

Vermont primary care practitioners are less likely to have experience diagnosing dark skin tones given that the state population is 94.2% white. Only 4.5% of images in general medicine textbooks and 4-19% of images in dermatology textbooks depicted darker skin. Black patients are significantly less likely to see a dermatologist, which highlights the importance of diagnosis at the primary care office.

Effects Of Gender, Physical Activity, Weight Status, And Mental Health Symptomatology On Primary Care Utilization, John W. Carew, Jaime Cotton, Hannah Shoshan, Alex Gevirtz, Thomas Delaney, Donna O'Malley

Master of Public Health Culminating Projects

Objectives. To determine the association between weight status, gender, physical activity, and mental health symptomatology on utilizing primary care in the last year.

Methods. We used data from the 2019 Vermont Behavioral Risk Factor Surveillance System. We used multivariate logistic regression and X² tests of association to assess factors associated with primary care utilization.

Results. Gender and obese or overweight status are significantly associated with one’s likelihood of utilizing healthcare in the past year. For those with 1-13 bad mental health days, the odds of having utilized healthcare in the past year are 1.65 times greater among women than …

Primary Care And The Housing Insecure In Central Vermont, Hunter Goldsmith

Family Medicine Clerkship Student Projects

In this project, I performed a literature review of the research regarding the benefits of primary care on population health. I also looked at healthcare utilization and interviewed community members. I then surveyed individuals suffering from housing insecurity to determine if they were connected to primary care homes and if not the reasons they have not been able to be connected. Finally, I attempted to link interested individuals with local primary care offices to establish care.

Approach To Providing Culturally Sensitive Gynecologic And Obstetric Care For Somali Women, Izabella Ostrowski

Family Medicine Clerkship Student Projects

Many refugees have fled Somalia over the past 30 years due to political instability and civil war. Since 1980, over 8,000 refugees have settled in Vermont, with about 9% of refugees being from Somalia. Community Health Centers of Burlington (CHCB) provides prenatal and primary care to many Somali women in the community. There are known gynecologic and obstetric health disparities for Somali women, such as significantly lower completion rates of mammography and pap smears than non-Somali patients. Research has shown that an understanding of cultural health beliefs and values are crucial for creating tailored prevention programs for refugee women. This …

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.