Social and Behavioral Sciences Commons^™

Promoting Music Therapy Referrals For Neurodivergent Children, Benjamin M. Glickman

Family Medicine Clerkship Student Projects

Music therapy is perhaps an underutilized, underfunded, and undervalued part of the tool kit available to physicians, parents and children with ASD and other developmental disabilities within Clinton County. There are opportunities to increase referrals for music therapy for children receiving care at the CVPH Family Medicine Center and within the county.

Community Resilience In Vermont After The 2023 Flooding Event, Alex Poniz

Family Medicine Clerkship Student Projects

Between July 10th-11th 2023 Vermont experienced catastrophic flooding after receiving prolonged heavy rainfall of up to 9” over 48 hrs. Damage from the 2023 event rivals the historic destruction of Hurricane Irene in 2011 and is exceeded only by the Great Vermont Flood of 1927, an event predating modern flood controls. We collected oral histories from Vermonters to better understand their lived experience of the flood and its impacts, and identifed common themes related to community and individual resilience.

Is There An App For That? Introducing Self-Guided Therapy-Based Mental Health Apps In A Primary Care Setting, Althea Jem Darbin Tapales

Family Medicine Clerkship Student Projects

The prevalence of mental health disorders in Vermont continues to be an economic burden, especially in Addison County. The Addison County, VT Community Health Improvement Plan 2022-2025 identified “Access to Mental Health Services” as the top priority with a general concern regarding the affordability and demand of such services, and shortage of providers in the general community. Consequently, the shortage of mental health services along with the coronavirus pandemic resulted in a mental illness epidemic which led to an accelerated growth of self-guided therapy-based mental health apps. Most apps are affordable, accessible, and prioritize patient privacy which overcomes barriers to …

Implementing Sbirt In A Critical Access Emergency Department, Warren P. Mcdermott, Mary Val Palumbo Dr.

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

Purpose: Universal screening and brief intervention with referral to treatment (SBIRT) has become best practice for emergency departments (EDs) over the last two decades. Given the prevalence of alcohol use and the subsequent health impacts of drinking, EDs are well positioned to be on the front line of screening for risky drinking. The available literature is clear in its consensus that universal screening for alcohol use in the ED is critical to identifying people at high risk for drinking and improving health outcomes.

Aims: This project aimed to implement an SBIRT process in a critical access ED. To achieve this …

Addressing Post –Covid-19 Pandemic Depression, Aria Elahi

Family Medicine Clerkship Student Projects

This community project explores the impact of the COVID-19 pandemic on mental health, particularly focusing on depression, and introduces an intervention in the form of a pamphlet distributed at Newtown Primary Care. The pamphlet addresses individuals experiencing worsened depression due to the pandemic, regardless of COVID-19 infection status, and includes the PHQ-2 and PHQ-9 screening questionnaires for self-assessment. Insights from interviews with Newtown Primary Care were instrumental in designing the pamphlet.

Results reveal that the pandemic has substantially affected patients' mental health, increasing the need for resources. Patients diagnosed with pre-existing depression experienced worsening symptoms due increased stressors due to …

Implementation Lgbtq+ Health Education Through Case-Based Learning, Bradley A. Blansky

Family Medicine Clerkship Student Projects

Primary care graduate medical education programs often do not provide adequate training regarding the healthcare needs of the LGBTQ+ population. The purpose of this community project was to develop a case-based teaching session to help provide family medicine residents a basic understanding of LGBTQ+ healthcare. This didactic session was found to be an engaging and effective method of teaching physicians about LGBTQ+ health. Additional work is needed to further train physicians and other healthcare professionals about the challenges faced by marginalized populations in our healthcare system.

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 …

Tackling Access To A Healthier Life, Edom Alemayehu Girma

Family Medicine Clerkship Student Projects

Obesity is a known risk factor for complications during childhood and later in adult life. While numerous factors play a role in the prevalence of obesity, this project focused on better intervention for obesity management in the family medicine clinic located in Plattsburgh, NY. Interviews and literature searches were conducted to determine possible strategies to better assist patients in attaining their sustainable weight loss goals and an overall healthier lifestyle.

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.

Together We Learn: Collaborating With Medical Students To Build An Online Anti-Racism Guide, Gary S. Atwood, Kate E. Bright

University Libraries Faculty and Staff Publications

In the summer of 2020, students from the medical school’s Social Justice Coalition asked if the library could support their project to build a digital collection of anti-racism resources. Specifically, they asked if the library could host the collection and purchase relevant materials when possible. The project presented interesting policy and technical issues related to LibGuides, the platform we eventually selected. It also provided educational opportunities for the medical students, staff, and the library. After six months of hard work, we launched the collection, titled “Together We Learn: Resources for Our Journeys in Justice & Inclusion” in December 2020.

While, …

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.

Learning Empowerment & Advocacy Together: A School-Based Youth Empowerment Program, Sheridan Finnie

Family Medicine Clerkship Student Projects

LEAT is a virtual skills building leadership group for female identifying high school age students grades 9-12. Program objectives are to empower youth to develop their sense of self esteem, identity and to develop leadership skills to be active leaders in their community. Due to the impact of COVID-19 on youth, opportunities to build community and engage in skill building activities are lacking and this group aims to fill that gap.

The Use Of Technology For Mental Wellbeing In The Era Of Covid-19, Adam Fakhri

Family Medicine Clerkship Student Projects

Prevalence of mental health issues has increased during the time of COVID-19. There are many contributing factors to consider, the main one reported has been social isolation due to quarantine precautions. Members of the community have spent extended periods of time at home and away from their loved ones during this pandemic. Many patients have reported many life events occurring including deaths in the family without the ability to even mourn with their family members. This has taken a toll on the community, especially in Vergennes where this small tight knit community that has relied on its tight social bonds …

Tailored Sexual Orientation And Gender Identity (Sogi) Education: Assessing Network Needs Through A Survey Of Knowledge And Attitudes, Luke M. Higgins

Family Medicine Clerkship Student Projects

No abstract provided.

Barriers And Facilitators To Use Of A Clinical Evidence Technology In The Management Of Skin Problems In Primary Care: Insights From Mixed Methods, Marianne D. Burke Ph.D., Liliane Savard Dpt, Alan Rubin Md, Benjamin Littenberg Md

University Libraries Faculty and Staff Publications

Objective: Few studies have examined the impact of a single clinical evidence technology (CET) on provider practice or patient outcomes from the provider’s perspective. A previous cluster-randomized controlled trial with patient-reported data tested the effectiveness of a CET (i.e., VisualDx) in improving skin problem outcomes but found no significant effect. The objectives of this follow-up study were to identify barriers and facilitators to the use of the CET from the perspective of primary care providers (PCPs) and to identify reasons why the CET did not affect outcomes in the trial.

Methods: Using a convergent mixed methods design, PCPs completed a …

Narrative Medicine: Perspectives On Opioid Maintenance, Noorin Damji

Family Medicine Clerkship Student Projects

People who experience opioid addiction often feel marginalized by healthcare workers, or stigmatized by the medical system. Additionally, there are not enough medical providers to meet the needs of people who struggle with opioid addiction. These factors create barriers that prevent the medical establishment from effectively meeting the needs of people who experience addiction. This project compiles rich perspectives of patients on opioid maintenance treatment to share with medical students and providers to foster greater empathy for these patients, and positive attitudes toward managing substance use disorder among future medical providers.

Creating A Standardized Workflow For Providers At South Burlington Family Practice, South Burlington Vt For Documenting And Diagnosing Attention-Deficit/Hyperactivity Disorder In Pediatric Patients Aged 0-17, Racquel Sales De Castro

Family Medicine Clerkship Student Projects

An initiative of the Vermont Child Health Improvement Program (VCHIP) is to improve the attention-deficit/hyperactivity disorder (ADD/ADHD) pediatric diagnostic process in both family medicine and pediatric practices in the state of Vermont. This project specifically on improving this process at South Burlington Family Practice in South Burlington Vermont but is generalizable to all practices caring for pediatric and adolescent patients. For this project emphasis was placed on creating a standardized workflow that is followed by all providers in the practice, creating educational material for caregivers who present with a behavioral concern for their child or adolescent, and establishing an efficient …

Screening And Monitoring Social Determinants Of Health For Migrant Workers In Vermont, Richard Brach

Family Medicine Clerkship Student Projects

No abstract provided.

Onecare Vermont Aco Quality Metric Evaluation, Alexander Braun

Family Medicine Clerkship Student Projects

This project explores OneCare Vermont ACO quality metrics and how they can be used to improve patient care and reimbursement in a Vermont family medicine practice. Perspectives of physicians within the practice and others familiar with OneCare Vermont operations are shared. Several metrics were identified as areas for improvement within the practice by comparing ACO metrics with patient data.

Barriers And Facilitators To Use Of A Clinical Evidence Technology For Management Of Skin Problems In Primary Care: Insights From Mixed Methods, Marianne Burke Phd, Alan Rubin Md, Liliane Savard Dpt, Benjamin Littenberg Md

Larner College of Medicine Faculty Publications

Background: A previous cluster-randomized controlled trial tested the effectiveness of a clinical evidence technology (CET), VisualDx, for skin problems seen by Primary Care Providers (PCPs). Based on patient report, there was no effect on time to problem resolution or return appointments.

Objective: To explain, from the provider perspective, why the CET did not make a difference in the clinical trial and to identify barriers and facilitators to use.

Methods: Mixed methods study design. Providers from both arms completed a survey about their use of VisualDx and information-seeking during and after the trial. Active arm providers participated in interviews to explore …

What's In Your Cup? Increasing Transparency And Confidence In Alcohol Use Screening And Brief Intervention, Dylan C. Koundakjian

Family Medicine Clerkship Student Projects

19% of Vermonters report drinking alcohol at levels which puts their health at risk, but many healthcare providers do not feel confident in addressing their patients' usage. This can stem from lack of experience with alcohol use, worries about stigma, and time constraints. However, data has shown that even 5-15 minute interventional conversations can significantly reduce a patient's risky drinking. This project aims to provide real-world, practical advice for having conversations around alcohol, and provides a conversion chart converting popular alcoholic beverages into standard drink equivalents.

Evaluation Of Patient-Centered Tool For Measuring Opioid Addiction Recovery, Laura A. Till

Family Medicine Clerkship Student Projects

Vermont has expanded access to medication assisted treatment (MAT) since the onset of the opiate epidemic. This has included the use of family medicine clinicians as waivered prescribers of buprenorphine. In the absence of clear expectations or knowledge of discontinuation and detox, patients and providers must now reframe the traditional understanding of addiction recovery success as simply abstinence, maintenance medication detox, and survivorship. A 20-question, interactive “POWERS Form” has been developed by Stowe’s MAT team as part of routine counseling and clinical visits. Tracking score changes with patients allows reflection on the broader life changes during recovery process. This activity …

Out-Of-Pocket Cost For Individuals Being Treated For Opioid Dependence In Rutland County, Vermont, Christopher T. Veal

Family Medicine Clerkship Student Projects

Each day more than 140 Americans die from drug overdoses, 91 specifically due to opioids. In Vermont, more than 50 people die each year from opioid poisoning. With insurance coverage being a critical component of Opioid Dependence Recovery, many people seeking treatment are unaware of the financial barriers to recovery- namely the out-of-pocket costs associated with treatment. This study sought to provide insight on the financial impact of Opioid Dependence Treatment on the patient, and provide financial assistance information to the Rutland County community.

From Passive To Active: A New Model For Library Orientation, Nancy A. Bianchi, Gary S. Atwood

University Libraries Faculty and Staff Publications

Objectives This poster shares the experience of academic librarians turning a traditional, passive library orientation at a Graduate Medical Education Fair for new residents into an active learning activity.

Methods Every summer, new residents enter postgraduate medical training programs at the medical center. In an effort to introduce the library early in their clinical careers, liaison librarians have participated at a Graduate Medical Education fair since 2012. In the past, the library’s orientation activity consisted of a table full of paper handouts, staffed by overzealous librarians. Feedback from the residents, however, revealed that they politely collected the paperwork but frequently …

The Aging Lgbtq Population, John P. Corbett

Family Medicine Clerkship Student Projects

Although being LGBTQ is more accepted than it was in previous times, there are still barriers that exist which keep some LGBTQ people from accessing quality healthcare. In the middle-age and older LGBTQ population, there are further issues that arise. Health care providers should be aware of some of these issues so that they can be addressed during an office visit if necessary.

Intimate Partner Violence In Immigrant/Refugee Populations, Lisa H. Wang

Family Medicine Clerkship Student Projects

Intimate partner violence (IPV) is the most common type of violence affecting women. Globally, Central Africa and South Asia have some of the highest rates of IPV. In Vermont, the majority of refugees are from these regions. Individual, interpersonal, and especially cultural values play critical roles in the definition/appraisal and decision to seek help in these women. This study examines ways to mitigate challenges that healthcare professionals have in identifying women who need help and barriers preventing these women from seeking help.

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.

Engaging Students And Faculty In The Evaluation Of A Usmle Review Product: Implications For Library Collection Development, Alice Stokes, Jeanene Light

University Libraries Faculty and Staff Publications

Introduction: Study materials for USMLE exams are some of the most commonly requested materials at Dana Medical Library. In Fall 2015, the Dana Medical Library received several student requests for online USMLE preparation materials. Librarians arranged for a trial of a new USMLE test preparation software available for library licensing. Librarians designed a plan for soliciting student and faculty feedback to inform the purchasing decision.

Methods: The Dana Medical Library ran a 4-week trial of the USMLE preparation software. Students and faculty were notified of the product trial through meetings, e-mail, signs in the library and social media. Trial participants …

An Interprofessional End Of Life Simulation Using A Movie/Discussion Format, Mary Val Palumbo, Christina S. Melvin, Nancy P. Lemieux, Deborah A. O'Rourke, Jean Beatson, Patricia A. Prelock, Kelly A. Melekis, Mary Alice Favro, Vicki Hart

College of Nursing and Health Sciences Faculty Publications

An Interprofessional End of Life Simulation Using a Movie/Discussion Format

Sigma Theta Tau International Nursing Research Congress

Cape Town, South Africa

July 25, 2016

Mary Val Palumbo, DNP, MSN, BS, APRN, GNP-BC¹ Christina S. Melvin, MS, BS, PHCNS, BC, CHPN¹ Nancy P. LeMieux, MSN, BSEd, RN¹ Deborah A. O'Rouke, PhD, MA, MClSc, BSc, PT² Jean Beatson, EdD, MS, RN³ Patricia A. Prelock, PhD, MA, BS, CCC-SLP, BCS-CL⁴ Kelly A. Melekis, PhD, MSW, LMSW⁵ Mary Alice Favro, MA, BS, CCC-SLP⁶ Vicki Hart, PhD⁷ (1)Department of Nursing, University of Vermont, Burlington, VT (2)Dept. …

Evaluation Of Screen Time In Children, Mohammad Mertaban

Family Medicine Clerkship Student Projects

An evaluation of screen time and media use in children. This project looks to education healthcare practitioners about the effects of current media practices in the United States on children. A presentation was given to healthcare practitioners at a family medicine practice and a brochure was created to distribute to families in the waiting room. Practitioners reported an increase in knowledge regarding the subject of screen time in children, an increase in their comfort level in in discussing these effects with patients, and increase in their ability to effectively communicate the media guidelines of the American Academy of Pediatrics.