University of Vermont Community Tobacco Use and Attitudes Survey

Introduction: Smoking remains an important public health issue in U.S. Colleges. 17.3% of U.S. smokers are 18-24 years old. 28% of U.S. college students began smoking at age 19 or older. Currently 1,104 U.S. Colleges have adopted Tobacco-Free policies.https://scholarworks.uvm.edu/comphp_gallery/1216/thumbnail.jp

UVM Tobacco Use and Attitudes After Implementation of a Tobacco-Free Policy

Introduction: Widespread public health initiatives have led to falling smoking rates. Currently, 1,620 U.S. colleges have adopted smoke-free policies. In August 2015, the University of Vermont (UVM) adopted a tobacco-free policy that bans all forms of tobacco use on university property. The purpose of this study was to compare tobacco use and attitudes before and after policy implementation.https://scholarworks.uvm.edu/comphp_gallery/1230/thumbnail.jp

Willingness To Donate Blood During the Summer

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 of 292 surveys were received. Survey respondents across multiple demographic groups cited similar barriers to summer donation, namely “Too busy” (27.5 %) and “Traveling is a time for me to relax.” (30.6 %). Of the respondents who travel in the summer, very few reported donating while traveling (3.4 %). Summer donation rates between summertime travelers (36.5 %) and non-travelers (36.4 %) were essentially equivalent. The most preferred methods of scheduling appointments were via ARC website (45.6 %) and phone (28.4%). Willingness to use the ARC app was highest among respondents ages of 18 to 34 (45-55%) and lowest among ages 55 and older (13-15%). Of respondents with no prior knowledge of summer seasonal shortages (22 %), 2/3rds indicated newfound motivation to donate.Conclusion. Regardless of travel, increasing awareness of summer shortages may increase summer donations. Use of donor websites and smartphone apps may be instrumented as part of recruitment efforts.https://scholarworks.uvm.edu/comphp_gallery/1239/thumbnail.jp

Opioid Overdose Deaths in Vermont: Effectiveness of Buprenorphine Provider Density on Mortality Rates

Background Since 2017, there has been an increase in the frequency of mortality related to opioids in Vermont. Buprenorphine is a great alternative to traditional opioids because of its efficacy in treating opioid use disorder (OUD), however, it is underutilized by providers due to needing a specific waiver to prescribe it. This project looks at two different angles: is the number of Buprenorphine providers associated with the number opioid related deaths per county?; and does a rural setting in Vermont affect mortality rates due to a possible lack of Buprenorphine providers? Methods The incidence of overdose deaths per county to the number of buprenorphine providers per county were compared, as listed on the Vermont Department of Health website. Tukey HSD and Bonferroni statistical tests were run to measure a linear association between deaths per county and city town code (CTC). Grand Isle County was excluded from the analysis due to no deaths. Results Counties with medium provider densities had higher numbers of overdose deaths compared to counties with higher and lower provider densities. Some limitations in the study included the lack of diversity and the inability to synchronize the Vermont mortality data registry from 2017-2019 to the date buprenorphine providers received their x-waiver. Conclusion Further research is needed to investigate if there needs to be a reevaluation of the hub and spoke program as well as the impact of other factors, such as age and cities, have any effect on the opioid related death rates in Vermont

Life\u27s Simple 7 and Health Care Utilization among the Framingham Generation III Cohort

Abstract Objective: To evaluate associations of cardiovascular health status with utilization of healthcare services. Methods: Our study included 3,786 participants from the Framingham Third Generation Cohort (enrollment: May 2008 – February 2011). LS7 0-14 point summary scores were categorized as “suboptimal” (score of 0-7) and “optimal” (score of 8-14). Participants were stratified into two utilization groups. Those with 0-1 utilizations were compared to those with 2 or more visits ( Super Users”). Logistic regression was used to estimate associations of the two LS7 categories with the odds of Super User utilization (models adjusted for age, sex, race, and education). Results: Compared to those with “suboptimal” LS7 scores, participants with “optimal” LS7 scores had a 40.5% lower odds (95% confidence interval: 28-51%) of being a “Super User” of health care services (p\u3c0.005). Conclusions: In a younger population, higher LS7 cardiovascular health metric scores were associated with lower utilization of costly health care services. Public Health Implications: These results may have implications for primary care physicians and other health professionals to help identify patients at risk for over-utilization of higher-cost health care services

Double Red Blood Cell Donation Eligibility and Interest

Introduction: The process of double RBC donation by apheresis (DRBC), which facilitates the donation of two units of red blood cells (RBC) in a single donation session, was estimated to account for approximately 4% of blood donations in 2005, and is believed to be growing at a rate of 40% per year. Blood shortages in this country could be corrected by converting as few as 10% of current single unit whole blood donors to DRBC donors. Advantages of DRBC donation may include reduction in donor-related exposures in recipients, improved cost-effectiveness of the donation process, and improved convenience for donors. The safety profile of DRBC has been found to be equal to, and in some cases better than that of single unit whole blood donation, especially in young donors (/o). DRBC donors have been shown to restore 92% of RBC volume in 4 weeks without iron supplementation, and to have no significant differences in hemoglobin, serum iron, or ferritin when compared with single unit whole blood donors six months after donation. Our study seeks to quantify the number of current single unit whole blood donors who are both eligible for and interested in DRBC donation.https://scholarworks.uvm.edu/comphp_gallery/1031/thumbnail.jp

Factors Identified by Lapsed Donors that Might Influence Donor Return

Introduction: The Burlington Chapter of the American Red Cross estimates that 8,000 donors a year become lapsed, or fail to return for further donation. To better target this population and retain current donors, it is essential to identify reasons for lapsed donation. Several studies have been conducted on the barriers to retaining blood donors, revealing these common factors: past physical reactions, convenience, previous deferrals, lack of awareness, medical reasons, time, satisfaction with the experience, too impersonal, and personal benefit. While many studies have identified reasons for lapsed donation, the majority have not used free text as their data source, have been conducted in a wide range of geographic locations not specific to Vermont residents, and have focused on reasons for discontinuing donations, rather than positive factors. Using free text limits the question bias and eliminates constraints that predefined answers enforce. In 2007, Balderama et alconducted a study identifying common motivations for donating blood, which included an unanalyzed free text portion. We used this free text to answer the question, “What factors identified by lapsed donors might influence donor return?”https://scholarworks.uvm.edu/comphp_gallery/1047/thumbnail.jp

Should 16-Year-Olds Be Allowed to Donate Blood? A Vermont Perspective

Introduction: Supplying adequate blood for transfusions is an ongoing challenge for blood collection agencies. One potential source of increased Whole Blood (WB) supply is among 16-17 year-olds, whose donation rates are still quite low. In 2010, donors aged 16-18 years-old provided 14% of all WB collected by the American Red Cross. Young donors may represent an opportunity to establish a committed, long-term blood donation base as they are more likely to return after first donation and donate at a higher yield rate than older donors. However, younger donors also have higher rates of adverse events during donation. Currently, 38 states allow 16 year-olds to donate blood with parental consent but Vermont is not among them. Our study examines the public’s comfort with 16 year-olds donating blood. As blood donation is a voluntary system, ascertaining the perspective of the general population regarding this issue could contribute to a policy debate surrounding the minimum age of donation.https://scholarworks.uvm.edu/comphp_gallery/1065/thumbnail.jp

The Effects of Text Message Reminder on Blood Donor Show Rate

Introduction: Declining blood collection endangers the blood supply at a time when the health care system is requiring an increasingly greater amount of blood products. Blood donation centers are challenged to recruit and develop first-time donors into reliable repeat donors, thereby ensuring a sufficient blood supply. Communication strategies such as e-mail reminders have been shown to be an effective communications tool to promote blood collection. Alternatively, Text Messaging has been shown effective in primary care and preventative medicine. Text messaging improved patient compliance with a schedule of vaccine dosing, as well as improving patient attendance at outpatient clinics. Additionally, text messaging reminders have been shown to be as effective as phone reminders in increasing patient attendance at outpatient appointments. Finally, text messaging has been shown to be useful for managing self-care such as smoking cessation, monitoring asthmatic symptoms, and diabetes control. We investigated whether offering the use a text message reminder to donors would increase attendance at donation events, demonstrating that text messaging can be an effective tool in maintaining a pool of blood donors.https://scholarworks.uvm.edu/comphp_gallery/1008/thumbnail.jp