Medicine and Health Sciences Commons^™

Promoting Safe Sex Practices And Sexually Transmitted Infection Prevention In The Adolescent Population In Ridgefield, Ct, Gina Jin

Family Medicine Clerkship Student Projects

Adolescents are a uniquely at-risk population for the spread of preventable sexually-transmitted infections. Direct lifetime medical costs of sexually transmitted infections (per CDC) is nearly $16 billion in the United States. Nearly half (46%) of all new STIs in the country occur among young people (ages 15-24). Because of this, effective STI prevention in the adolescent population is important and should be further investigated.

Increasing Access Of Outpatient Therapeutic Services For Adolescents With Persistent Symptoms After Sport-Related Traumatic Brain Injury, Natalie J. Bales

Family Medicine Clerkship Student Projects

Persistent symptoms lasting at least 21 days after initial traumatic brain injury occur in about 15-20% of adolescents. Initial assessment of concussions can be done using the SCAT5 and a wide variety of other standardized assessment tools. However, there are striking gaps in standard clinical procedure for follow-up care for athletes who have persistent symptoms. Furthermore, there are many issues with accessibility to therapeutic services including long wait times that prevent timely referral to those services. This pilot intervention was implemented at the University of Vermont to address those issues by providing a hotline resource for families to use and …

Adolescent Substance Use: Standardizing Screening Methods In Clinical Practice, Bryan D. Shin

Family Medicine Clerkship Student Projects

Adolescent substance use is a highly pervasive issue that strongly correlates with increasing depression and anxiety rates. Standardized screening tools for substance use, such as the CRAFFT or the Screening to Brief Intervention Tool, are freely available but not widely utilized for every patient encounter in clinical practice. This project aimed to improve standardization of substance use screening at a primary care clinic located in Castleton, Vermont through implementation of the CRAFFT tool as an automatically-loaded form in each adolescent encounter note. The goal was to improve substance use detection rates by facilitating efficient incorporation of standardized screening into the …

Characterizing The Relationship Between Binge Drinking And Condom Use Among Vermont High School Students, Danielle G. Allen, Michael Schwartz, Steph Tack, Robert O'Conner, Madaline Schmidt, Kelsey Gleason

Master of Public Health Culminating Projects

Objectives. To determine if there is a relationship between binge drinking and risky sexual behavior in Vermont high schoolers.

Methods. We used data from the 2019 Vermont Youth Risk Behavior Survey, a survey administered every other year in high schools across Vermont asking students questions about various habits and behaviors. We used binary logistic regression to determine the association between binge drinking in the past 30 days and condom usage at last sexual intercourse.

Results. Binge drinking within the past 30 days was found to have increased odds of students not using a condom during intercourse (OR=0.782) when adjusting …

Adolescent Suicide Prevention Via Parental Education, Junelle Shepard, Mary Val Palumbo

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

Purpose. Up to 24% of children from the ages of 12 to 17 have reported suicidal ideation, with 7-11% reporting at least one suicide attempt in the past 12 months (Hetrick, 2017). In a study by Jones et al (2019) over 50% of parents were unaware their child was exhibiting suicidal ideation. This project aims to increase community awareness of suicidal ideation and teach community members how to talk with adolescents about this sensitive topic.

Methods. Five online training sessions were offered in Fall 2021, with each session lasting 90 minutes. Using Smith et al.’s Suicide Knowledge and Skills Questionnaire, …

Adolescent Anticipatory Guidance, Anna M. Corbalan

Family Medicine Clerkship Student Projects

This project focuses on creating an educational resource specifically for adolescents and young adults regarding the anticipatory guidance for this age group. Although adolescence is generally a healthy time for most, many health or social problems will start or peak during this time. Therefore, it is a crucial time to incorporate preventive guidance and increase health literacy to avoid unhealthy chronic behaviors in adulthood.

Suicide And Non-Suicidal Self-Injury Among Vermont High School Students: An Analysis Of Associated Health-Behavior Variables, Douglas Michael Lebo, Catherine Markesich, Ida Sargent, Mika Smith, Mariana Wingood, Heidi Hales

Master of Public Health Culminating Projects

Objectives: To determine the prevalence of suicidal ideation (SI) and non-suicidal self-injury (NSSI) among Vermont high schoolers and examine their relationship with health-behavior and demographic variables.

Methods: We used responses to the 2019 Centers for Disease Control and Prevention Youth Risk Behavior Surveillance survey from Vermont high schoolers (n = 18 613) to perform bivariate logistic regression analyses of variables thought to predict SI and NSSI.

Results: In 2019, 14.8% of Vermont high schoolers reported SI in the past year, and 18.9% reported NSSI. Lower grade level, LGBT identity, self-perception as over- or underweight, being bullied, alcohol use, smoking, and …

Improving Health Care Transition Planning In Pediatric Primary Care, Angela M. Brisson

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

Background: For adolescents and young adults (AYAs), health care transition (HCT) is the purposeful and planned process of moving from pediatric, adult-supervised care to adult-oriented care. The use of evidence-based guidelines and interventions can ensure AYAs receive the services necessary to transition successfully.

Purpose: This project aimed to improve a pediatric office’s ability to educate AYAs and parents/caregivers on the practice’s approach to HCT and HCT planning (HCTP) by using Got Transition’s Six Core Elements of Health Care Transition™ 3.0 model to guide the development and dissemination of a Transition and Care Policy/Guide (TCP/G). The adoption of a TCP/G is …

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 …

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 …

The Association Between Relationships With Approachable Adults At School And Non-Suicidal Self-Harm In Vermont High School Youth Identifying As Transgender: A Cross-Sectional Study, Gabe Clarke, Bidur Dahal Ms, Mallory James, Robin Katrick, Casey Rogers Dc, Abby Beerman

Master of Public Health Culminating Projects

Objectives. To explore the association between non-suicidal self-harm (also known as non-suicidal self-injury (NSSI)) in adolescents in Vermont identifying as transgender and relationships with approachable adults at school.

Methods. Responses of self-reported self-harm in adolescents identifying as transgender and the ability to confide in an approachable adult or teacher at school were obtained from the 2019 Youth Risk Behavior Survey (YRBS) (n=18,613). Analysis was conducted using a binary logistic regression at a 95% confidence interval (CI) for the odds ratio (OR) and a best selection process.

Results. Students who identify as transgender and had self-harmed in the past 12 months …

How To Have The “Vape Talk” With Adolescent Patients, Helen Gandler

Family Medicine Clerkship Student Projects

Recent years have shown a dramatic increase in the popularity of electronic vapor products, which include e-cigarettes, vapes, vape pens, e-cigars, e-hookahs, hookah pens, and mods. While emerging data shows that adolescents are becoming more aware of the dangers posed by these products, more than 3.6 million US youth still use e-cigarettes. As of February 18, 2020, a total of 2,807 hospitalized e-cigarette, or vaping, product use-associated lung injury (EVALI) cases or deaths in the United States have been reported to CDC.

This project had two goals: to create a tool to help facilitate discussions between providers and their adolescent …

Electronic Vapor Product Usage And Its Relationship To Suicidality In Vermont Youth, John Paul Grogan, Bonnica Zuckerman, Frezette Ackah, Melissa Ackley, Margaret Cameron, Kelsey Gleason

Master of Public Health Culminating Projects

Objective: To examine the association between the use of electronic vapor products (e-cigarettes) and suicidal ideation.

Methods: This study explored the association between e-cigarettes usage and suicidal ideation among 16,733 Vermont high school respondents of the 2017 Youth Risk Behavior Survey (YRBS). Bivariate logistic regression was used to predict the odds of suicidal ideation with current electronic vapor product (EVP) use as the main predictor while controlling for current cigarette, alcohol, and marijuana use, age, gender, sexual orientation, and a history of bullying or sexual violence.

Results: The odds of suicidal ideation are 5.86% lower for students using EVPs than …

Adolescent And Young Adult Medicine: Supporting An Often Forgotten Population, Isabelle Mason

Family Medicine Clerkship Student Projects

The actions and lifestyle choices adolescents and young adults make have profound effects on their future health and well-being. Unfortunately, these patients are often scarce among family practice lineups, making it difficult for physicians to provide impactful preventative care. This project looks at how to help reach these oft-forgotten patients.

Association Between Sexual Assault And Sexual Minority As Risk Factors For Suicidality Among Vermont Youth, Katherine Mariani, Heidi Gortakowski, Thomas Delaney

Master of Public Health Culminating Projects

Purpose: Sexual assault and sexual minority are known risk factors for suicidality in adolescents. This study identifies the association between sexual assault and sexual orientation in order to better predict and direct resources to teens at high-risk for suicide.

Methods: This is a cross-sectional study utilizing the Vermont Youth Risk Behavior Survey data from 2015. Logistic regression was used to correlate risk based on sexual assault and sexual orientation.

Results: 34.9% who were sexually assaulted attempted suicide compared to 4.0% of students who were not assaulted. 21.3% of LGB or unsure students attempted compared to 3.9% of straight youth. …

Rutland City Public School At Risk Youth Mentorship, Michael J. Marallo

Family Medicine Clerkship Student Projects

This after school program’s purpose is to address the unique challenges of Rutland, VT Middle/High School students with multiple psychosocial risk factors (as determined by comparison to the ACE questionnaire) through mentorship, health and life skills education, and by guiding the development of positive coping skills. Activities will allow for self-expression outside of the classroom in a safe environment. Focus will be placed on assisting paraeducators and teachers with meeting goals that are appropriate for each individual student.

Mindfulness As An Effective Strategy For Anxiety Relief In Adolescent Patients, Desiree N. Dibella

Family Medicine Clerkship Student Projects

Anxiety disorders affect 6.8 million adults over the age of 18 in the United States, and anxiety disorders are the most common mental health illness in children.

Risk Factors for anxiety disorders in young adults include the following: -Shyness, or behavioral inhibition, in childhood -Being of the female sex -Having few economic resources -Exposure to stressful life events in childhood -Anxiety disorders in close biological relatives -Parental history of mental disorders -Elevated afternoon cortisol levels in the saliva Teens and young adults increasingly suffer from anxiety disorders with the CDC reporting the rate of anxiety disorders among 3 to 17 …

The Facts - Your Choice: Std Risk Information For The Adolescent Patient, J C. Gwilliam

Family Medicine Clerkship Student Projects

Sexual health education is one of the factors that has led to a dramatic drop in adolescent pregnancy since the 1990s. Paradoxically, though, rates of sexually transmitted-infections (STI) in the adolescent population during that period soared. The educational deficit appears to be a lack of understanding of both short- and long-term health risks that STIs pose, and conflation of contraceptive effectiveness with STI prevention. This project sought to develop an inexpensive, office-based education product that would aid practitioner-adolescent patient discussion and facilitate follow-up in the family medicine setting.

Correlates Of Adherence To An Adolescent Weight Management Program: A Secondary Data Analysis, Meredith Walker Hanson

Graduate College Dissertations and Theses

The aim of this study was to determine the relationship between HRQOL and

adherence to an adolescent weight management program and identify variables predictive of increased adherence which are critical to motivating engagement in weight

management. This study was a non-experimental, retrospective secondary analysis from

aggregate data collected as part of the REWARD Teens program, a weight management

program for overweight and obese adolescents. Data from 37 subjects were included in

this study. Subject adherence to the program was the primary outcome variable. There

was no significant relationship between baseline adolescent or parent-proxy sub-scale or total HRQOL scores with program …

Adolescent Prescription Drug Abuse: An Overview Of Current Data, Tavis Cowan Md

Family Medicine Scholarly Works

Prescription drug abuse among adolescents is a growing and increasingly lethal problem. Recent survey studies show a concerning increase in abuse and poor awareness among users, parents, and medical providers. Access to prescription drugs of abuse is often through relatives’ supply of medications. Categories of abused drugs include opiates, stimulants, and benzodiazepines. Methamphetamine is a special case as prescription-only pseudoephedrine can drastically change patterns of abuse. Awareness programs are emerging for youths, parents, community members, and medical providers; but data on effectiveness of these interventions is not yet available.