Public Health Commons^™

Older Adults’ Experience In Owning A Guide Dog, Jeffrey Kou, Yvonne Lam, Patricia Lyons, Susan Nguyen

Student Research Posters

Low vision is an age-related condition that affects many older adults, and may create challenges in everyday activities in older adults. Guide dogs have been shown to be an effective assistive device that can help older adults within their community. Despite vast research on dog companionship, there is limited research on the facilitators and barriers of owning a guide dog among older adults with low vision. The purpose of this qualitative phenomenological study is to explore the facilitators and barriers of owning a guide dog as experienced by older adults with low vision participating in Guide Dogs for the Blind …

Reaching Local Community With The Message Of Developmental Milestones And Early Identification Of Autism, Hope M. Duncanson

Poster Presentations

This poster presents project activities for a pilot program for effectively distributing Learn the Signs, Act Early materials to a small study group in a community in Maine.

Asthma In Vermont Dairy Farmers, Wyll T. Everett, Victoria Lauren Close, Rebecca Merriam-Stelfox, Sravana Paladugu, Jacob B. Reibel, Ruby L. Russell, Rebecca Ryan, David Kaminsky

Public Health Projects, 2008-present

Introduction. Although 5.4% of the Vermont population participates in agriculture as an occupation, little data exists on the prevalence of asthma in Vermont dairy farmers, due to inadequate sample sizes. Previous studies have shown dairy farmers are at risk of respiratory illness due to unique exposures intrinsic to their occupation. We conducted a study to assess the prevalence of asthma in dairy farmers in Vermont, to understand rates among this population and potential occupational risks.

Methods. We distributed a paper survey modeled after previously-validated surveys, such as the BRFSS, to farmers at Vermont Farmer Bureau meetings, farmers markets, …

Willingness To Donate Blood During The Summer, Christopher Bernard, Taylor Brown, Ramya Ghantasala, Obhijit Hazarika, Nicole Leonard, Cori Polonski, Zachary Wunrow, Michelle Heleba, Jan Carney, Mark K. Fung

Public Health Projects, 2008-present

Introduction. Each year donation rates fall in the summer months straining blood banks’ capacities to meet local demands. In hopes of identifying factors to increase summer donations, our study investigated donor reported barriers which influence summer donations habits.

Methods. An anonymous 16 question survey investigating various donation factors was administered across multiple American Red Cross (ARC) donation centers in Vermont. Questions addressed donor demographics, frequency of blood donation, preference in appointment making modalities including smartphone app use, summer travel habits, willingness to donate during vacation, and factors that deter donors from donating on vacation.

Results. A total …

Vermont Healthy Kids' Meals: Parents' Perspectives, Ashley C. Hodges, Geordie C. Lonza, Lindsay S. Howe, Omkar Betageri, Ryan Erik Landvater, Sean Closs, Tina Zuk, Paula Tracy

Public Health Projects, 2008-present

Introduction. Childhood obesity has increased for decades. Options on kids’ menus in restaurants typically involve unhealthy choices such as fries, chicken fingers, and grilled cheese, with soda as the drink. When healthy options are the default choice, children are more likely to eat them. Though initially skeptical of modifications, restaurants will enact changes to maintain customer satisfaction and profits, and there is no significant difference in price of healthier kids’ meals.

Methods. 187 paper and electronic surveys were administered throughout Vermont to explore attitudes towards availability, cost, and importance of healthy kids’ meals, as well as income, education, and children …

Effects Of Art From The Heart On Nurse Satisfaction And Patient Well-Being, Kassandra J. Gibbs, Eric C. King, Nicholas S. Loschiavo, Unchan Pyon, Jasmine Y. Robinson, Luke Soelch, Brianna F. Waller, Rebecca Schwarz, Buffy F. Dekmar, Sarah Mccarthy

Public Health Projects, 2008-present

Introduction. Art programs have been shown to positively affect unit culture, quality of care, and nursing practices. Art interventions improve well-being, reduce stress, and enhance nurse-patient communication. Art from the Heart (AFTH) is an art program that provides art supplies, visual art, and patient "About Me" pages to patients, families and employees at University of Vermont Medical Center (UVMMC).

Objective. Assess the efficacy of AFTH through nursing staff perceptions, understanding, and attitudes toward the program.

Methods. Structured interviews were conducted on Baird 4, an adult inpatient ward, at UVMMC. A 19-question survey using Likert scales and short …

Gaps In Adolescent Tobacco Prevention And Counseling In Vermont, Dexter C. Allen, Morgan Hadley, Margaret Klepack, Amber J. Meservey, Lynn Sipsey, Greg Whitcher, Mushtaba Yuridullah, Jill Sudhoff-Guerin, Jill Jemison, Jan Carney

Public Health Projects, 2008-present

Introduction. Tobacco use remains the leading cause of preventable death in Vermont. While the Vermont Blueprint for Health includes compensation for adult tobacco counseling, it includes no specific mention of pediatric populations. Research questions: To what extent are tobacco assessment and cessation efforts occurring in the primary care setting with pediatric patients? What factors influence their practices?

Methods. A 12-question electronic survey, modeled on an American Academy of Pediatrics survey, was distributed to primary care providers throughout Vermont; through the UVM departments of pediatrics, family medicine, the Vermont Medical Society and the Vermont Area Health Education Center. We …

Assessing The Awareness Of Lead Hazards In The Greater Burlington Area, Tessa R. Barclay, Laura Taylor Director, Steven Everse, Bailey Fay, Aaron M. Gelinne, Eliot S. Jia, Julia Mcginty, Sunit K. Misra, Lauren Pyatt

Public Health Projects, 2008-present

Introduction. Lead is a heavy metal found in and around homes built before 1978, comprising more than 80% of the housing stock in Chittenden County, Vermont. Lead exposure during infancy and childhood can have deleterious effects on development. Our study assessed baseline community understanding of potential household lead hazards in Chittenden County, Vermont.

Methods.. 123 paper, 10-question surveys were randomly administered to Chittenden County, VT residents to assess recognition of lead toxicology symptoms and awareness of lead safety programs. Scores were treated as continuous variables, demographically grouped, and analyzed using non-parametric statistical analysis (Mann-Whitney & Kruskal-Wallis). Individual questions …

Stress Identification And Management In Cots Family Shelter Residents, Kristen J. Bartlett, James Duguay, Sebastian A. Franco, Marie Kenney, Callie Linehan, Alexander W. Marchese, Rebecca Robbins, Brian J. Rosen, Rebecca Mills, Anne Brena, Jan Carney

Public Health Projects, 2008-present

Introduction. Previous studies have demonstrated that the homeless population experience higher stress levels than the general population. The goal of our study was to identify potential sources of stress for families staying with COTS, the largest service provider for the homeless and those at risk of becoming homeless in Vermont, and also to gauge potential interest in evidence-based stress-reduction strategies.

Methods. Interviews were conducted with seven adult representatives of seven different families (of fourteen eligible) currently residing at the family shelters managed by COTS, in fall 2016. Questions included a mix of short answer items and open ended …

Nutrition Education In Vermont Public Schools, Garyn Worrall, Allison Greene, Suven Cooper, Francis G. Gause Iv, Patrick Saunders, Daniel Lambert, Rebekah Misir, Alison Howe, Katy Davis

Public Health Projects, 2008-present

Introduction. Despite positive changes, childhood obesity and food insecurity remain prevalent across the country. Vermont is not immune to these issues. We set out to: research the level of nutrition education Vermont elementary schools provide their students, understand teacher perceptions of these programs, and recommend ways to fill identified gaps.

Methods. Our study is a cross-sectional survey of Vermont educators around nutrition education. The survey consisted of 17 questions, used LimeSurvey, and included demographic and nutrition education questions. The survey was distributed statewide through newsletters and list-servers.

Results. 64 responses met inclusion criteria. Vermont elementary school (K-6) …

The Effects Of Poetry In Elderly Populations With Memory Impairment, Michael Burton, Katherine Clifford, John P. Corbett, Midori Eckenstein, Jenna Conway Jorgensen, Stephanie S. Kulaga, Hyunsoo Joshua No, Nathaniel White, Judith Christensen

Public Health Projects, 2008-present

Introduction. A small body of research on therapeutic use of poetry in individuals with memory impairment demonstrates benefits similar to that of more widely studied music interventions. This project aims to assess the effects of participation in a poetry group on the residents of a memory care floor within the Converse Home, an assisted living facility in Burlington, Vermont.

Methods.. We evaluated the effects of twelve group poetry sessions on residents' well-being in several domains. Each session included a reading and writing portion, which were evaluated separately to assess differences in measures of communication, interest, and enjoyment. These …

Patient Perspectives On Medication Assisted Therapy In Vermont, Ashley D. Adkins, Holly Bachilas, Florence Dibiase, Michael J. Marallo, John Paul Nsubuga, Lloyd Patashnick, Curran Uppaluri, Elizabeth Cote, Charles Maclean

Public Health Projects, 2008-present

Introduction. Medication-Assisted Therapy (MAT) for opioid addiction has dramatically increased in Vermont, supported by a novel statewide system that integrates specialty treatment centers ("Hubs") with primary care office-based opioid therapy ("Spokes"). In 2010, Vermont had the highest per capita buprenorphine use in the US. Previous studies of patient perspectives of MAT have identified social barriers, rigid program rules, and concerns about withdrawal and relapse as common causes of treatment failure. Our goal was to elicit patient perspectives on barriers and enablers of successful MAT to further inform system refinement.

Methods. An interview guide was developed based on previous …

Diagnostic Medical Errors: Patient's Perspectives On A Pervasive Problem, Cody J. Couperus, Sree Sahithi Kolli, Sergio Andres Munoz, Quinn Self, Russell R. Reeves, Erica Worswick, Sterling A. York, Allen B. Repp

Public Health Projects, 2008-present

Introduction. The Institute of Medicine defines diagnostic error as the failure to establish an accurate or timely explanation for the patient's health problem(s), or effectively communicate the explanation to the patient. To our knowledge, no studies exist characterizing diagnostic error from patient perspectives using this definition.

Objective. We sought to characterize diagnostic errors experienced by patients and describe patient perspectives on causes, impacts, and prevention strategies.

Methods. We screened 77 adult inpatients at University of Vermont Medical Center and conducted 27 structured interviews with patients who experienced diagnostic error in the past five years. We performed qualitative …

Public Health Outcomes As A Measure Of Efficacy Of Syringe Exchange Programs, Andrew Corse, Katelyn Donaldson, Andrew Gallagher, Anita Li, Morgan R. Pratt, Benjamin F. Smith, Amelia V. Tajik, Peter Jacobsen, T. Vezina, Jerry Larrabee

Public Health Projects, 2008-present

Introduction. A syringe exchange is a public health intervention that offers nonjudgmental services to intravenous drug users (IVDU), providing clean syringes in exchange for used syringes. While prior studies demonstrated that syringe exchanges can reduce transmission of HIV, hepatitis C, and other blood-borne pathogens, other measures of health improvements have been less studied.

Methods. 91 members of Vermont CARES syringe exchange program were surveyed on their healthcare practices. New members were defined asprogram.

Results. Long-term members tended to have a primary care provider (PCP). Lack of insurance and fear of judgment were commonly cited reasons for not …

Prenatal Lead Exposure Risk Assessment By Vermont Maternity Care Providers, Amy M. Berkman, Brendon Kinsley, Margaret S. Johnston, Rose Kristine Leu, Niketu P. Patel, Maia Sakradse, George Zhang, Wendy Davis, Matthew Bradstreet

Public Health Projects, 2008-present

Introduction. One percent of women of childbearing age in the U.S. have blood lead levels ≥ 5 ug/dL, which are associated with maternal hypertension during pregnancy, neural tube and cardiac defects in infants, low birth weight, prematurity, and spontaneous abortion. It is unknown whether obstetrics providers in Vermont are screening their pregnant patients for lead levels and educating them on lead exposure risks.

Objective. To gain an understanding of current lead screening practices in Vermont and issue recommendations for disseminating lead screening information.

Methods. We developed and e-mailed a survey to practicing OB/GYN physicians, maternity care focused …

Public Awareness Of Medical Imaging As A Source Of Ionizing Radiation Exposure, Tim Fields, Michael J. Hall, Arjun Janardhan, Lawrence J. Leung, Samantha Magier, Allison B. Robbins, Katie C. Warther, Razelle Hoffman-Contois, William Irwin, Jan Carney

Public Health Projects, 2008-present

Background. Biological effects of exposure to ionizing radiation (IR) are well known. Literature suggests most patients and physicians lack proficient understanding of risks associated with ionizing radiation. Our study goals were to: assess the extent to which productive, informed conversations regarding ionizing radiation are occurring between patients and providers; characterize public awareness of medical imaging procedures as sources of IR exposure; and investigate best practices in patientprovider communications.

Methods. We developed and administered a 17-question survey to 303 adults at five locations across Chittenden County, Vermont, over a 6-week period in fall 2016. Descriptive and statistical analyses were …

Understanding Refugees' Perspectives On Health Care, Khaled H. Al Tawil, Nathan L. Centybear, Julia Lane Cowenhoven, Emily Kinn, Joseph J. Lahey, Jayne Manigrasso, Chantal Mendes, Martha Friedman, Shaden Eldakar-Hein

Public Health Projects, 2008-present

Introduction. Burlington, Vermont accepts refugees from around the world. These individuals face unique barriers to accessing healthcare due to language, culture and finances. Research suggests that cultural beliefs about healthcare can affect ability or willingness to seek medical care. Gaining a better understanding of refugee perspectives of the healthcare system may offer insight into how to rectify this issue.

Objectives. The goal of this study was to learn about refugee perspectives of the healthcare system and assess their use of services.

Methods. We surveyed a convenience sample of 24 refugees to learn more about thoughts and practices surrounding …

Analysis Of Care Coordination For Children With Special Health Care Needs: A Parent's Perspective, Kristen M. Dalton, Desiree N. Dibella, Alan Lee, Althea L. Morrison, Adam Michael Schlauch, Marc J. Vecchio, Paige M. Wood, Lisa Maynes, Heather Link

Public Health Projects, 2008-present

Introduction. Care coordination involves organizing patient care activities and sharing information among all of the participants concerned with a patient's care to achieve improved outcomes, a recent national focus. Compared to the national average, a higher percentage of Vermont children are cared for in an office that meets medical home criteria. However, there is limited research on medical home and care coordination for children with special health care needs (CSHCN) in the state of Vermont.

Objectives. The goal of this study was to assess family perceptions, knowledge, and attitudes about how well care coordination is working for Vermont …

Exploration Of The Use Of Sensory Diets In Occupational Therapy, Allison Hunt, Morganne Peterson, Emily White

Student Research Posters

The purpose of this study was to fill the gap in literature and further examine the use of sensory diets in the field of occupational therapy. This study investigated the use of sensory diets among California occupational therapy practitioners. A mixed-methods design was used to collect data through a SurveyMonkey survey. The survey was sent out to members of the Occupational Therapy Association of California (OTAC) and received 98 respondents within one month. Participants worked among various clinical settings and implemented sensory diets with various client populations. Practitioners reported using terms such as “sensory strategies,” “sensory tools,” and “sensory supports” …

Influenza Vaccination In School-Aged Children, Isabella Jao, Chloe Mcfadin, Nica Nuguid, Dan Recinto, Kaitlin Van Ryn

Student Research Posters

Should schools in the United States require children between the ages of six months to 17 years to have flu vaccination shots? Influenza is a serious disease that can lead to hospitalization and sometimes even death. According to the Center of Disease Control (CDC), every flu season varies, and an influenza infection can affect people differently. Millions of people get the flu every year, hundreds of thousands of people are hospitalized, and thousands or tens of thousands of people die from flu-related causes every year. Everyone is at risk for influenza, but the highest risk lies within children who are …

Nutrition And Exercise Resources For Clinton County, Paige M. Wood

Family Medicine Clerkship Student Projects

The obesity epidemic is a nation wide problem that has increased prevalence in Clinton County, NY when compared to the surrounding areas. Obesity leads to many co-morbid health conditions and is associated with a large increase in health care spending costs. This brochure tackles the limited resources, such as limited number of fitness centers, lack of nutrition education and an overall lower socioeconomic status, that is present in the Clinton County area. This brochure offers help in these areas through free phone applications which cover nutrition education, healthy shopping guidance, at home exercise routines, motivation, habit trackers and mindfulness exercises.

Education On Tick Bites, Tick Borne Disease, And Prevention In Middlebury, Vt, Florence Dibiase

Family Medicine Clerkship Student Projects

Tick borne disease and tick encounters are continuing to increase significantly in Vermont, and represent a significant portion of primary and urgent care visits. In order to spread awareness and educate both providers and patients as to the incidence, symptoms, treatment, and prevention of tick borne diseases, an informational guide was made. This guide includes information for providers including up to date statistics, a tick identification and life cycle guide, and a chart explaining symptoms, lab findings, diagnosis, and treatment of the diseases found in Vermont. It also includes a patient education handout with a cut out identification card. This …

Immunization Safety: Addressing Parental Safety Concerns, Andrew Gallagher

Family Medicine Clerkship Student Projects

Since 1998, when a fraudulent research paper alleged a connection between the MMR vaccine and autism, increasing numbers of parents are refusing routine childhood vaccinations. Recent research has shown parents’ top vaccine-related concerns included the number of vaccines during the first 2 years of life, administration of too many vaccines in a single doctor visit, and a possible link between vaccines and autism. More than 10% of parents of young children refuse or delay vaccinations, with most believing that delaying vaccine doses is safer than providing them in accordance with the Centers for Disease Control and Prevention’s recommended vaccination.

Increasing Advance Directive Knowledge Among Healthcare Professionals, Laura K. Donnelly

Family Medicine Clerkship Student Projects

Advance Directives (ADs) have been shown to be associated with increased patient satisfaction with end-of-life care, decreased in-hospital deaths, and decreased end-of-life costs in high-cost regions. Nationally, prevalence of ADs has increased over the last 20 years, but the majority of patients still have not completed an AD. A significant obstacle to completion is lack of awareness. A presentation to increase knowledge regarding ADs among primary care staff was created to address this.

Combating Diabetes In Chittenden County: A Healthcare Provider Referral Campaign To Increase Patient Participation In The Vermont Diabetes Prevention Program, Samantha Magier

Family Medicine Clerkship Student Projects

As of 2016, diabetes affects more than 29 million people in the United States and is the 7th leading cause of death nationwide. In Vermont, 1/10 people are diagnosed with either diabetes or prediabetes, with 6% of Vermonters affected by prediabetes and 5% of Chittenden Country affected by prediabetes. The public health burden of this chronic disease is immense: diabetes costs Vermont an estimated $543 million each year and is the leading cause of kidney failure, lower limb amputations, and adult-onset blindness. Prediabetes occurs when blood sugar is higher than normal but not at the diagnostic threshold of diabetes. Prediabetes …

Addiction Recovery Support: Connecting Primary Care Providers And Community Resources, Amber J. Meservey

Family Medicine Clerkship Student Projects

Addiction to drugs and alcohol is a pervasive problem throughout Vermont and the U.S., and only a fraction of those needing help receive it. The vast majority of admissions to substance abuse treatment programs do not come from healthcare providers, who report a lack of preparedness in managing addiction screening and referrals. Recognizing that Family Medicine Providers are likely to be caring for many patients struggling with substance abuse, this project aims to improve provider familiarity with local resources. In particular, this project focuses on promoting long-term retention in self-help group programs, as these have been demonstrated to be the …

Vermont Food Insecurity: Implementing Screening Tools And Interventional Assistance At Thomas Chittenden Health Center, Quinn Self

Family Medicine Clerkship Student Projects

Hunger Free Vermont estimates that over 11% of Vermonters experience Food insecurity defined as a lack or access to adequate nutritious food due to lack of money or other resources. Food insecurity has been linked with numerous health problems including obesity, depression, poor school performance, heart disease, anemia and increased number of hospitalizations. Despite the adverse health outcomes associated with food insecurity, primary care providers don't usually screen for it. There are short validate tools to screen with high sensitivity and specificity for food insecurity. The goal of this project was to generate a screening poster for waiting rooms and …

Adolescent Sex Education, Carolyn Payne

Family Medicine Clerkship Student Projects

This project identified a significant need for adolescent sex education and curriculum development in Vermont and the United States. A comprehensive sex education presentation was developed, reviewed by experts in the field, and piloted at The Boys and Girls Club of Burlington. Subjective results were positive and future strategies to teach students, evaluate effectiveness, and expand impact were developed.

Barriers To Affordable Prescriptions In Rural Vermont, Niketu P. Patel

Family Medicine Clerkship Student Projects

This project aimed at understanding why people in Rutland County, Vermont struggle with buying medications for their health. The project implemented and proposed several methods to help the population of Rutland area better adapt to the growing cost of prescriptions via $4 medication lists, rebates, samples, etc.