Medicine and Health Sciences Commons^™

Increasing Patient Awareness And Education Surrounding Prescription Weight Loss Medications, Anirudh A. Hirve

Family Medicine Clerkship Student Projects

Obesity is a growing problem in the United States. While it remains important for clinicians to emphasize health supportive behaviors including dietary modification and exercise when counseling patients, the advent of new weight loss medications has created a need for patient education materials regarding these interventions for a growing number of patients who request them at primary care visits. This project created a smart phrase in the electronic medical record summarizing weight loss medications currently available on the market to transform patient counseling and enable better shared decision making between patients and providers.

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.

Using Clinical Workflow Assessment Frameworks For Process Improvement Of Patient-Provider Communication In A Primary Care Office, Madeline Morris

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

The purpose of this project was to assess the current workflow for addressing the needs of patients between face-to-face healthcare visits at a primary care clinic in Northern New England. The assessment served as a framework to inform recommendations for process improvement interventions. Workflow was mapped using Lean’s value stream map (VSM) tool. Observational data and retrospective chart review were performed to collect information on time to complete tasks, equipment used, and personnel involved in each patient request. Key patterns in workflow variation, guided by theoretical frameworks of system constraints, were identified. Finally, a team brainstorming session was organized with …

Improving Communication Between Community Care Settings And Primary Care, Kristin Morgan

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

Background

In older patients with more complex and chronic health concerns, consistency and continuity of care is essential. Patients often live in assisted living residences or independently with support from programs such as Support and Services at Home (SASH), so nurses are available to address concerns and assist with certain aspects of care. Effective inter-professional communication is essential, but communication of assessments and coordinating care with participants’ primary care providers is complex.

Purpose

Improve efficiency and clarity of care-related communication for patient and care team by developing a system that standardizes and streamlines workflow and addresses current concerns.

Methods

At …

Aging And Exercising Gracefully, Karena P. Nguyen

Family Medicine Clerkship Student Projects

Exercise and physical therapy are concerns among patients experiencing menopause and patients who near the age of menopause. Newtown Primary Care serves a population, whose census indicates an aging population. An interdisciplinary pamphlet on weight-bearing exercises and community resources for the peri- and postmenopausal population was developed with input from physical therapists and doctors.

Surgical And Non-Surgical Gender Euphoria Options For Bottom Dysphoria, Hunter Myers, Neeki Parsa

Family Medicine Clerkship Student Projects

No abstract provided.

Improving Access To Gender-Affirming Care: A Welcome Packet, Kelsey J. Rumley

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

BACKGROUND: Transgender and gender diverse (TGD) individuals face unique challenges in accessing healthcare such as stigma, bias, fear of rejection, limited access to providers, and lack of information on where to seek care. There is evidence that creating an inclusive clinic atmosphere improves access and leads to a more positive healthcare experience

AIMS: The global aim of this project is to improve access to gender-affirming care for students at a New England university. Specific aims were to assess stakeholder needs for content inclusion and develop a new patient welcome packet based on the needs assessment.

METHODS: The Plan Do Study …

Implementing A Patient Resource Guide On Intimate Partner Violence (Ipv) At A Connecticut Primary Care Practice, Mahima R. Poreddy

Family Medicine Clerkship Student Projects

Intimate partner violence is an ongoing public health crisis in the United States. According to the Connecticut Coalition Against Domestic Violence, nearly 39,000 victims were served in 2021, which was a 5% increase from the year prior. As intimate partner violence continues to affect numerous lives in Connecticut and across the nation, the risks of seeking assistance in these situations prevent those experiencing domestic violence from accessing support services. The cost of intimate partner violence can range from an increase in health care utilization to restricted access to safe housing. The Ridgefield Primary Care practice does not currently have educational …

Screening For Areca (Betel) Nut & Quid Use, Gabriela Sarriera Valentin Ms

Family Medicine Clerkship Student Projects

Standardized screening tools for patients who use betel quit and areca nut products do not currently exist. Given the increased risk of oral and oropharynx cancer development in this patient population, increasing awareness of this practice could result in decreased morbidity and mortality. The purpose of this project is to (1) increase provider awareness of this cultural practice and its associated health consequences, (2) to develop a screening tool, and (3) to propose suggested follow-up when concerning lesions are identified.

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.

Addressing Exercise And Physical Therapy In Older Patients In Colchester, Vt, Adam Morehead

Family Medicine Clerkship Student Projects

Participation in physical activities remains low among much of the older adult population, particularly during the winter months. Many individuals who are active during warmer times of the year become more sedentary during the winter, and this physical inactivity can contribute to declining health. This project sought to develop a simple brochure outlining several simple exercises that can be performed safely at home without equipment to be distributed to patients at wellness visits to encourage indoor exercise.

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 …

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.

Nutritional Habits: Encouraging Simplicity And Consistency, Alim Esemenli

Family Medicine Clerkship Student Projects

Nutrition plays a crucial role in development of diseases that are the leading causes of morbidity and mortality in the Unites States. However, due to reasons such as time limitations, lack of clear guidelines, and what seems like a sense of hopelessness felt by providers and patients alike upon lack of results, discussions around nutrition may lack in frequency, consistency, and/or adequacy of duration, Research shows that flexibility of mindset, as well as achievability and sustainability of nutritional goals, play a key role in achieving success in weight This project proposes a three-page document that can potentially help primary care …

Dental Basics For The Pcp, Tierra Lynch

Family Medicine Clerkship Student Projects

Oral health is a key component of overall systemic health. However, dental care remains a severely under met need in healthcare today, especially in rural settings. Thus, the primary care physician may find herself presented with a variety dental pathology and may feel underprepared for this challenge.

The purpose of this project is to develop concise, evidence based resources regarding the identification, stabilization, and management of common dental pathologies for the primary care physician. Additionally, a database of local resources for patients including basic oral care and local dental clinics for those without insurance will be compiled. This project will …

Preventive Healthcare Education In Primary Care, Anna B. Chamby

Family Medicine Clerkship Student Projects

Primary and secondary prevention are vitally important mainstays of primary care. Every well visit at Newtown Primary Care involved some discussion of preventive health screening and services and relied on patient recall or EHR document search for last screening/intervention dates. We aimed to find ways to make use of wait times for in-office visits that could also potentially improve efficiency during patient encounters and help educate patients about preventive health measures.

Improving Primary Care Access For The Housing Insecure In Washington County, Kristina J. Valentine

Family Medicine Clerkship Student Projects

For this project I went to two local hotels in Washington Co that were providing shelter for people experiencing homelessness during the COVID-19 pandemic. I would survey them on their barriers to primary care and tried to connect them to local providers. I then tracked how many individuals were able to have an appointment with a provider.

First Contact: Headache Management In Primary Care, Sydney Chatfield

Family Medicine Clerkship Student Projects

Primary headaches are one of the most common and debilitating disorders experienced worldwide. Many people are unaware of the everyday triggers and continue to take over the counter medication with little to no relief. Primary care providers are often the first or only people patients will address the issue with, but are faced with time constraints and lack of resources. I created an educational pamphlet on common triggers and solutions for patients to begin to think about root causes of their headaches and implement lifestyle changes.

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.

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.

Autism Resources For Primary Care Patients And Families, Keara M. Lynn

Family Medicine Clerkship Student Projects

At this time in Vermont, there are not enough resources to care for children with autism spectrum disorder. This problem has been exacerbated by the COVID19 pandemic and children are waiting months to years to access needed services. The goal of this project was to create a brochure for patients and families that has information about autism resources in the Northern Vermont community.