Combating Diabetes in Chittenden County: A Healthcare Provider Referral Campaign to Increase Patient Participation in the Vermont Diabetes Prevention Program

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 does not definitely progress to type 2 diabetes if interventions are made, including healthier eating and physical activity to promote modest weight loss. The CDC has developed evidence-based curricula for lifestyle intervention in prediabetics with intensive individual counseling and motivational support on effective diet, exercise, and behavior modification. One of these curricula is currently run through the CDC-led National YMCA Diabetes Prevention Program (YDPP). Participation in this program reduces the risk of developing type 2 diabetes by 58% across all ethnic groups and sexes overall and by 71% in individuals over age 60. The Vermont YDPP had 325 participants in 2016, with only 21% (n=70) of those referrals to the program coming from healthcare providers. Healthcare providers have a unique role in the community of being the voices of health promotion. With the correct provider awareness of the YDPP and patient identification, awareness, and education, an increase in the percentage of YDPP-referring healthcare providers can increase the overall YDPP participation in Chittenden county. As of 2016, 60,038 people in Chittenden county have prediabetes, but only 8,026 are diagnosed, and an additional 52,012 people could be diagnosed with prediabetes by their healthcare professional and referred to the YDPP. This campaign intends to serve as a pilot project to create provider and patient awareness of the YDPP, identify patients with prediabetes, and ensure providers screen and refer prediabetic patients to the YDPP. Through exam room posters, panel query management, electronic medical record reprogramming, and targeted patient intervention, this study aims to increase YDPP patient participation via healthcare provider referral and refine the model for adaptation and implementation in other healthcare centers throughout Chittenden County.https://scholarworks.uvm.edu/fmclerk/1301/thumbnail.jp

Tailoring Supports to Youth in Schools: One Approach to Identifying Needs and Targeting Intervention

Youth experiences intersect along their race, gender, language and socioeconomic status, schools must consider the intersectionality in order to improve outcomes. The current study sought to understand if, and to what extent, different clusters of youth in one large urban high school perceive their psychosocial behaviors as well as social and interpersonal skills. Cross-sectional survey data from 1,164 high school youth were collected using four valid scales: Internalizing Behaviors, Externalizing Behaviors, Peer Relationships, and Social Skills. The analytic strategy was twofold. Cluster analysis was used to form homogeneous clusters of the 1,147 complete responses based on a combination of race/ethnicity, socioeconomic status, English language learner status, and gender. Next, a multivariate analysis of variance (MANCOVA) was used to compare cluster profiles on the aforementioned measures. The cluster analysis revealed a 5-factor solution. Findings of the MANCOVA showed that the clusters differed significantly on the set of psychosocial behaviors, social skills, and peer relationships variables (p\u3c0.05, η2= 0.08), with significant univariate differences (p \u3c 0.05) emerging on all four variables. Results point to cluster analysis as an emerging way to identify needs and tailor supports to youth in schools. Youth with identified needs could receive more specialized Tier II and III interventions aligned with their intersecting cultural and personal experiences, in addition to universal interventions to meet school wide priorities

Public Awareness of Medical Imaging as a Source of Ionizing Radiation Exposure

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 conducted using SPSS. Results. The three age groups of respondents had different knowledge levels about ionizing radiation (p Conclusions/Recommendations. 1. A standard oral presentation for pre-imaging patient-provider communication, along with a written handout, be developed; 2. A section of the electronic medical record (also accessible through the patient portal) containing IR exposure be created for patients and physicians to track individuals\u27 information.https://scholarworks.uvm.edu/comphp_gallery/1249/thumbnail.jp