Medicine and Health Sciences Commons^™

Age Well: Home Health Care Shortages In Northwestern Vt During The Covid-19 Pandemic, Jeremy Altman, Matthew Breseman, Edom Alemayehu Girma, Alexander M. Kubacki, Louisa Moore, Amanda Nattress, Noah Sorkow, Kristen Wright

Public Health Projects, 2008-present

As of February 2021, there have been over 26.6 million cases and over 450,000 deaths in the United States due to COVID-19. Since the outbreak, a critical focus in the healthcare system has shifted towards protection of healthcare providers as well as vulnerable patients such as the elderly. The growing shortages of providers has resulted in a growing need for home health care (HHC). Beyond HHC addressing this workforce gap, evidence has shown a reduction in emergency department (ED) visits, hospital admissions and a 14- million-dollar savings in healthcare cost. While the role of HHC has been crucial for the …

Assessment Of Snap Utilization And Accessibility In Vermont, Amanda Galenkamp, Mohamad K. Hamze, Elie Kaadi, Elise A. Prehoda, W. Evan Shaw, Nicole A. Walch, Shari J. Zaslow, Paula Tracy

Public Health Projects, 2008-present

Food insecurity exemplifies one of the many public health crises that the COVID19 pandemic both exposed and amplified. In 2019 an estimated 10.5% of households (13.7 million households) were food insecure as determined by the US Department of Agriculture (USDA) including 5.3 million children. In 2020 this number increased to 15.6% of households, including 17.0 million children as projected by Feeding America. Food insecurity in children, especially in infancy, is associated with the development of obesity and hyperlipidemia, highlighting the necessity of federal and state food assistance programs.

We believe that increased funding for SNAP incentive programs and wireless EBT …

Perceptions Of Mask Use During The Covid-19 Pandemic, David Bachoy, Clara Berard, Nicholas D. Brunette, Sadie M. Casale, Tonya Conley, Krystal Gopaul, Tyler Landman, Rhys Niedecker

Public Health Projects, 2008-present

The CDC recommends covering of the face and nose during the COVID-19 pandemic as a primary mitigation strategy for viral transmission. Masks minimize the number of viral particles emitted by the wearer; mask use serves to reduce the effects on population transmission.

Mask wearing behaviors have been shown to vary across different groups like gender identity, however, differences between people with and without lung disease have yet to be explored.

Goal: Examine perceptions, attitudes, and behaviors related to mask use during the COVID-19 pandemic of those with and without lung disease nationally.

Motivators For Convalescent Plasma Donors During The Covid-19 Pandemic, Betsy Assoumou, Natalie J. Bales, Amy K. Chang, Hannah K. Cook, Kiana Heredia, Colby J. Fischer

Public Health Projects, 2008-present

This study will seek to explore the motivators for convalescent plasma donors during the COVID-19 pandemic.

In 2020, the global pandemic caused by SARS-CoV-2 increased donations of transfusion products, particularly convalescent plasma from COVID-19 survivors that is used to provide passive antibody immunity to those infected. Convalescent plasma therapy has been identified as one of the only therapies for COVID-19 beyond supportive care.

Much of the current research focuses on the current motivators of whole blood and plasma donations, commonly citing altruistic motivations, knowing someone who has previously donated, and social media influence as common motivators for donations.

It is …

Health Benefits Are Associated With Employment Status For People With Intellectual Disabilities, Rachel Bombardier, Mialovena C. Exume, Jeremy Frank, Timothy W. Greenfield, Kaela Mohardt, Nathan Schweitzer, Devan Spence

Public Health Projects, 2008-present

Recent studies demonstrate that people with developmental disabilities are at increased risk for preventable illnesses. In our study, we examined several variables suspected to be major contributing factors, with emphasis on job security and employment. The development of sheltered workshops was initially an attempt to promote employment opportunities for people with intellectual and developmental disabilities (IDD), though at subminimum wages.

We explored whether these workshops allow for adequate community and healthcare engagement that is necessary for overall health and wellbeing. We designed a study that allowed us to statistically compare health-related data among states that eliminated sheltered workshops with those …

Assessing Cancer Prevention Knowledge During Covid-19 Pandemic, Robert Anthony Adamian, Lily Deng, Nicholas W. Krant, Trevor Ar Mcdonald, Natalie Qin, Ally Sarkis, Althea Jem Darbin Tapales

Public Health Projects, 2008-present

In response to the COVID-19 pandemic, adjustments in the provision of health care resources have caused a significant decrease in cancer screenings. These missed screenings may have considerable impacts on patients, health care practitioners and health systems.

In addition to the importance of resuming timely screening, studies have shown that a large portion of cancer deaths stemming from breast, skin, and colorectal cancer are preventable by risk factor modification at the patient level.

Many people remain uncertain of how best to prevent cancers, despite general awareness of concerns.

Raising awareness can empower patients to reduce their risk factors for developing …

No Fall Too Small: Assessing Barriers To Fall Prevention Programs, Christina Cobb, Arley Donovan, Heather G. Giguere, Arjune Singh Nibber, Brian L. Shaw Ii, Aathman Swaminathan, Ryan Warner

Public Health Projects, 2008-present

In Vermont, 1/3 of adults 45 years or older fell in the year 2018, statistically above the national average, which has not changed since 2012. Of those who fell, 34% experienced an injury after their fall.

Evidence-based interventions and fall prevention programs effectively reduce falls, and these programs aimed at reducing falls appear to reduce fractures. In fact, it has been shown that exercise intervention reduces fall risk by 30%.

Our review of the literature highlighted that there are numerous barriers to accessing fall prevention programs, including loss of independence, transportation, cost, and lack of interest. With this in mind, …

Initial Assessment Of A Suicide Prevention Resource For Vermont Primary Care, Sam Afshari, Eliot Binkerd-Dale, Zain Chaudry, Varun Gupta, Morgan Howlett, Colleen Mccarthy, Benjamin N. Price, Rebecca B. Rawlings

Public Health Projects, 2008-present

Suicide is the second leading cause of death for Vermonters ages 10-44. Studies have shown that of those who die from suicide 45% have seen their primary care provider in the month prior to their death and only 20% saw a mental health provider.

To help strengthen suicide risk screening in primary care, a group of Larner College of Medicine students partnered with Chittenden Accountable Community for Health to curate a suicide prevention informational resource to be used in Vermont's primary care practices to promote universal suicide screening.

We then surveyed users of the tool to assess its utility and …

Vermont School Districts Meal Service Response To Covid-19, Stephen Brand, Will D. Buick, John E. Fernan, Gina Jin, Rebecca Lapides, Jennifer Lor, Paul Mccleary, Timothy L. Long

Public Health Projects, 2008-present

The COVID-19 pandemic has posed many challenges worldwide, including lack of food access and security. Food insecurity in Vermont has increased from 18% to 24% since the outbreak of the pandemic.

Food insecurity among families with school-aged children puts children at risk for developmental delays, poor social functioning, and poor academic performance.

The goal of this project is to identify the challenges that the COVID-19 pandemic has posed for meal distribution services in school districts across Vermont, recognize the adaptations that were made by schools to address these challenges, and determine which adaptations had positive effects to encourage widespread implementation …

Bridging The Gap: Improving The Relationship Between Social Service Organizations And Healthcare Providers, Gabriela Bosmenier Cruz, Linda L. Cui, Liberty J. Dupuis, Ian Guertin, S. Halsey, Ying K. Loo, Finlay Pilcher, Joaquin Reategui

Public Health Projects, 2008-present

In Vermont, a significant social determinant of health is rurality. Barriers to healthcare services include distance to providers, lack of integration with social services, and failure to recognize community needs.

Integration and robust collaboration between healthcare and social services can likely improve outcomes for individuals who have high utilization of both categories of services.

Understanding relationships between healthcare and social services may provide an important framework for translating interventional research to rural communities to improve health equity.

Project Goal: To understand barriers affecting collaboration between social service providers and community health providers in order to promote research-based improvements in health …

Addressing The Needs Of Sara Holbrook Community Center Caregivers, Stephen J. Foley, Shubhankar Joshi, Ankrish Milne, Izabella Ostrowski, William Robinson, John A. Steinharter Ms, Rachel A. Wayne, Alayna M. Westcom

Public Health Projects, 2008-present

Previous research: parental stress can negatively impact behavioral and cognitive development of children.

Each year, over 4,000 people use SHCC resources: preschool, after school care, teen programs, food shelf, ESL services, etc.

SHCC supports families at the center itself, but many families still experience difficulties at home that contribute to caregiver stress.

The purpose of this study: understand the needs of the caregivers of students who attend SHCC and propose actionable solutions to address the top identified needs.

Attitudes Toward Informational Health Videos Among People With Intellectual Disabilities, Sydney M. Cardozo, Julie P. Connor, Jake Ermolovich, Tyler A. Harkness Bs, Anneliese Lapides, Jack F. Mangan, Nicole Obongo, Maxwell T. Tulimieri

Public Health Projects, 2008-present

An intellectual disability (ID) can be defined as a limit to a person's ability to learn and function in daily life when compared to an expected level. Due to these differences, a person with ID can face more challenges in daily life, including those that impact their health.

Special Olympics Vermont (SOVT) is an organization that hosts athletic events and competitions for people with an ID. We worked with them to formulate a plan for providing educational resources for people with an ID.

We created educational videos with corresponding one-page pamphlets containing material and imagery that was relatable to the …

Naturopathic Medicine In Vermont's Healthcare System: A Thematic Analysis, Trevor D. Coles, Tayler Drake, Rose Eiduson, Daniel J. Fried, Max C. Hoddwells, Simran Kalsi M.S., Mahima R. Poreddy, Clifford A. Reilly

Public Health Projects, 2008-present

Naturopathic Medicine is a system of health care that utilizes education, natural medicines, and natural therapies to support and stimulate a patient's intrinsic self-healing processes and prevents, diagnoses, and treats human health conditions, injuries, and pain.

There are 5 accredited schools of naturopathic medicine in the US and 2 in Canada. Naturopathic physicians were recognized as primary care providers (PCP) in 2009. There are 355 NDs licensed in VT, and 88 NDs with a VT address. 81% participate in Medicaid.

OBJECTIVE: To explore the role of naturopathic physicians in Vermont's healthcare system

Analyzing The Outcomes Of A Comprehensive Pain Management Program, Alia Johnson, Joshua Kohan, Cole Lutz, Patrick Mcclurg, Grace Merritt, Warrick Sahene, Katie Tang

Public Health Projects, 2008-present

An integrative and comprehensive approach to pain management seeks to advance patient outcomes with respect to quality of life, pain management, mindfulness, and physical function. This biopsychosocial approach is an evidence-based medicine modality that has been executed to be cost-effective and targeted to meet individual patient values. Participants can enroll in integrative pain intervention modalities to treat their chronic ailments; examples include Acceptance and Commitment Therapy, PT, OT, nutrition, reiki, hypnosis and yoga. In a systematic evaluation of integrative health projects, Turk et al. concluded interdisciplinary programs yielded better outcomes than traditional pain treatments.

This project tested the hypothesis that …

Improving The Accessibility And Efficacy Of The Uvmmc Chna To Populations Experiencing Homelessness, Rachel Carpenter, Jamie A. Cyr, William Kim, Megala Loganathan, Weida Ma, Dinukie-Chantal Perera, Sean Taylor, William J. Yakubik Iii

Public Health Projects, 2008-present

Under provisions in the Affordable Care Act, tax-exempt hospitals are required to conduct a triennial Community Health Needs Assessment (CHNA) to identify and prioritize the health needs of the community served. UVMMC is preparing to conduct the 2022 CHNA and is exploring best outreach approaches to marginalized or historically underrepresented populations within Chittenden and Grand Isle counties.

Research Question: What actions can be taken to effectively understand the diversity of needs in the homeless population of Chittenden County?

Hypothesis: The current CHNA incompletely captures how health barriers are disproportionately experienced by the homeless population in Chittenden County.

Goals: Identify best …

Addressing Food Insecurity Within New American Communities In Vermont, Lorena Ayoub, Carl W. Brasch, Aria Elahi, Justin L. Esteban, Juwairiyyah Fatima, Brianna J. Spano, Sean Wang, Erik J. Zhang

Public Health Projects, 2008-present

Food insecurity is defined as not having safe, nutritious, or culturally appropriate foods available, or having limited ability to acquire these foods/uncertainty as to when one can acquire these foods.

Reasons for food insecurity can be multifactorial such as language barriers, unfamiliar foods, and limited information about food environments.As a result, many turn to processed and energy- dense foods, contributing to the development of chronic diseases.

Food banks and local food shelves provide supplemental food assistance to residents and communities in need. However, with diverse New American populations living within the same community, it is challenging to determine which foods …

The Importance Of Continued Compliance With Completing Advance Directives In An Outpatient Setting, Maegan R. Neilson

Family Medicine Clerkship Student Projects

Despite continued efforts with conversation, guidelines, and even law, studies still show that the compliance with completing advance directives amongst a global patient population remains around 3 in 100. Those in compliance are more often chronically ill, over 65, or in an acute or terminal care setting. The COVID-19 pandemic is evidence that anything can happen and that helping patients adhere to medical wishes should be a top priority for primary care providers and their patients of all ages and health. Because previous studies have proven to be effective in increasing AD compliance when highlighted, this project aims to reignite …

Community Attitudes Towards Covid-19 Vaccination, John P. O'Keefe

Family Medicine Clerkship Student Projects

Vaccination is a very valuable tool in combating the public health crisis of COVID-19 and will be essential in reducing transmission rates and deaths due to the pandemic. Public willingness to receive the vaccination in large polls has stayed well below the ~95% of the population needed to achieve herd immunity against the virus. Here were survey Vermonters to determine their attitudes towards receiving the vaccine and what sources of information patients use to inform themselves about the different vaccines available.

Inclusive Local And Online Resources To Stay Active During The Covid-19 Pandemic, Collin B. Montgomery

Family Medicine Clerkship Student Projects

The COVID-19 pandemic has interrupted daily life in an innumerable amount of ways. Through gym closures and overcrowded, unsafe public spaces, maintaining exercise routines and reaching physical activity recommendations is increasingly difficult for many people. As a result of this, there has been an increasing emphasis on at home exercise and routines people can do at home. However, many of these resources are not inclusive of populations such as the elderly, people with disabilities, and the otherwise deconditioned as the exercises can be too strenuous or require specific equipment. The goal of this project was to compile a list of …

Transgender Healthcare Resources For Clinicians In Vermont, Jeanie Lin

Family Medicine Clerkship Student Projects

Transgender individuals face disproportionate levels of discrimination in healthcare settings and have worse health than their cisgender peers. One major barrier to healthcare reported by transgender individuals is a lack of providers who are sufficiently knowledgeable on the topic. The 2011 National Transgender Discrimination Survey found that half of respondents reported having to teach their providers about their own healthcare. To address this problem in Vermont, transgender healthcare resources were compiled into a single document to be distributed to primary care practices around Vermont.

Follow-Up With New Sga Prescriptions In Burlington, Vt, Obhijit D. Hazarika

Family Medicine Clerkship Student Projects

No abstract provided.

Improving The Therapeutic Environment In The Crisis Stabilization Unit At Glens Falls Hospital, Emma Hall

Family Medicine Clerkship Student Projects

The Crisis Stabilization Unit (CSU) at Glens Falls Hospital provides a separate, safe space within the Emergency Department for adults and children struggling with mental health crises to stabilize before discharge or admission to an inpatient psychiatric unit. An increase in mental health crises over the past 10+ years plus a shortage of nearby inpatient beds, especially for adolescents and children, has led to longer stays in the CSU. Longer stays in a place not built for therapeutic intervention but rather for crisis stabilization may lead to increased agitation, prolonged stays or prolonged time to stabilize a patient, and potentially …

Health Care Delivery To The Homeless Population In The Greater Danbury Community: A Needs Assessment, Ariella Yazdani

Family Medicine Clerkship Student Projects

• The Greater Danbury Region has substantial health resources; two hospitals, community health centers and health clinics. Residents who lack health insurance struggle to access the full continuum of care, especially outpatient and preventative care. Although a vast majority of people in Danbury have health insurance, it is unclear if individuals living with homelessness are amongst this insured population and have equitable access to healthcare. Two transitional housing programs in Danbury were identified and interviewed directly. A qualitative assessment of healthcare delivery to members of these programs was then performed.

Improving Communication In Patient Visits Requiring Medical Interpreters, Daniel J. Moroney

Family Medicine Clerkship Student Projects

Handout for effectively using medical interpreting services.

Screening For Food Insecurity In New Milford, Ct, Liana K. Mathias

Family Medicine Clerkship Student Projects

Food insecurity is defined as a lack of consistent access to enough food for an active, healthy life. Litchfield county, home to New Milford, CT, suffered severe economic changes over the Covid-19 pandemic. The number of food insecure households, represented by those requesting food from local food pantries, skyrocketed. This study demonstrates the importance of screening for food insecurity in primary care. A 3-part screen is implemented in a primary care setting to better assess those at risk and connect them to resources and local food services.

Exercise As A Tool For Treating Anxiety And Depression, Lizzi Hahn

Family Medicine Clerkship Student Projects

In addition to its important role in the maintenance of physical health, exercise has been shown to have numerous benefits for mental health. Recent studies indicate that even brief engagement in physical activity can make a positive impact on the treatment of pre-existing anxiety and depression - as well as the prevention of future symptoms. Despite this relationship between exercise and emotional wellness, regular activity in the United States is still exceedingly low, and exercise remains an underused tool by healthcare providers in the treatment of their patients’ anxiety and depression. The goal of this project was to assess patient …

It's A Walk In The Park: The Health Benefits Of Exercising In Nature And A Beginner's Guide To Hiking In Connecticut, Elena Dansky

Family Medicine Clerkship Student Projects

No abstract provided.

Resources To Decrease Social Isolation In The Elderly, Alexandra Novelli

Family Medicine Clerkship Student Projects

Social isolation has significant negative impacts on both the physical and mental health of the elderly. Older Vermonters face additional barriers to social engagement including living in a rural environment, lack of access to transportation, and financial barriers. The aim of this project was to provide information about opportunities for social engagement for older individuals by distributing a pamphlet at Colchester Family Practice in Colchester, VT.

Motivation For Mat, Jacob Bernknopf

Family Medicine Clerkship Student Projects

The goal of this project was to discover a commonality in why patients begin the MAT program. This will hopefully make it easier for future providers to help future patients articulate why they need to make the change in their life. This can be especially beneficial in patients dealing with concurrent stimulant or alcohol use.

Dry Eye: Patient Education, Mark Oet

Family Medicine Clerkship Student Projects

Recent literature has shown increased incidence of dry eye and eye strain symptomatology during the COVID-19 pandemic, coinciding with an increase in screen time for almost all populations. This project aims to address this observation at a community level by creating a patient-friendly education pamphlet for Newtown Primary Care about dry eye and digital ocular strain based on American Academy of Ophthalmology guidelines.