While public health concerns like teen e-cigarette use, blood donation recruitment, and ensuring quality senior care existed prior to the pandemic, many have become of greater concern over the past two years. Class of 2025 Larner College of Medicine medical students dug into these and other health and social issues as part of their Public Health Projects course, revealing important findings that will help shape policy and direction for numerous social service agencies in the region.
With support from the United Way of Northwest Vermont, a longtime partner of the college, 16 medical student groups were matched to 16 community projects at the end of the fall 2021 semester. Working with faculty and community mentors, each student group applied practical research methods to identify ways to translate science into public health practice. Through this process, they learned lessons about health policy and advocacy, discovered how Vermont legislators prioritize community health needs, and encountered challenges associated with addressing social determinants of health and the unique health needs of the state’s rural communities.
On June 1, the 16 student groups shared their findings at a Public Health Projects Poster Session and Community Celebration, held in the college’s Hoehl Gallery.
According to course director Jan Carney, M.D., M.P.H., associate dean for public health and health policy, “Vermont’s public health issues are also linked to national Healthy People
priorities, and our students' projects contribute to broader knowledge of community engagement, health advocacy, and scholarship in public health.”
The 2022 collaborating agencies included the American Heart Association; American Red Cross; Champlain Community Services; Give Way to Freedom; Northern New England Clinical & Translational Research Network; Prevent Child Abuse Vermont; Support and Services at Home; UVM Medical Center; UVM Office of Primary Care and AHEC Program; Vermont Cancer Support Network; Vermont CARES; Vermont Department of Health; Vermont Public Health Association; Windham County Seniors' Health Collaborative; Winooski Food Shelf; and Winooski Partnership for Prevention. Some of the 2022 projects are highlighted, below.
Understanding E-Cigarette Use among Undergraduates
While youth and younger teens have been studied more widely, perceptions about e-cigarette use among college undergraduates has not been well examined. Titled “A Survey of College Youth Habits Surrounding Electronic Nicotine Delivery Devices in Vermont” and conducted in collaboration with the Vermont office of the American Heart Association, this project was prompted by data that showed a significant increase in teen e-cigarette use between 2017 and 2019. The group conducted a 38-question survey of students from three Vermont colleges. Of the 326 respondents, 147 reported vaping at some point in their life, with the mean age of vaping initiation at 16.5 ± 2.1 years. A total of 61 percent of respondents reported trying to quit at some point and the survey found that students were more likely to vape at school than at home and purchase devices from physical stores. In conclusion, the group stated that “future research should identify effective strategies to assist youth struggling to quit and reduce underage purchasing in physical stores.”
Increasing Blood Donations from Black Communities
To increase COVID-19 vaccination rates among members of the BIPOC community, vaccine clinics were held at community centers around Vermont – a strategy that led to higher vaccination rates in the Black community. With an aim to diversify their blood pool and assist with the support of sickle-cell patients, the American Red Cross’s (ARC) Burlington office wanted to investigate the role that location accessibility played in Black donors’ rate of donation. The medical student group created an 18-question online survey, which was completed by a total of 512 black ARC blood donors who self-identified as African American and had donated blood at least once since January 1, 2019. A total of 329 of respondents had donated more than three times (repeat donors); 129 had donated less than three times (new donors). While new donors preferred blood drives at community centers and walk-in scheduling and were motivated by the opportunity to give back to the community, repeat donors preferred advance scheduling of appointments.
Substance Use Disorder and Human Trafficking in Vermont
Substance use disorder is one of the leading factors predisposing individuals to become trafficked. Working with the nonprofit organization Give Way to Freedom, this public health project group conducted nine qualitative interviews to explore the relationship between human trafficking and substance use disorder in Vermont specifically. Interviewees were representatives of three professions that interact with victims of trafficking – community services, healthcare, and law enforcement. The group concluded that human trafficking and substance use disorder are closely entwined in Vermont, and to address this public health crisis, national guidelines should be augmented with regional risk factors and accessibility concerns.
Senior Care Challenges in Rural Vermont
As the second most rural state in the country, Vermont frequently faces barriers associated with remote locations, including access to a wide range of services. This project’s goal was to better understand the challenges faced by caregivers of seniors in Windham Country to promote better care outcomes and accessibility to needed services in rural Vermont. The group conducted a one-hour focus group on Zoom with six caregivers, during which participants were asked four open-ended questions. The discussion yielded comments about multiple challenges, among them “finding someone to care for a loved family member,” “the bureaucracy of the medical system,” “transportation and an overall lack of physician accountability” stated the group in their poster. The focus group also highlighted the fact that many of the caregivers underutilized or were not aware of available resources. While admitting the limitations of their small sample, the project group considers their pilot study “a necessary first step to identify a framework for addressing caregiver needs in rural areas.”
In addition to the students, community agency mentors and project faculty, Larner community members who played a role in the success of the Public Health Projects course include Dean Richard L. Page, M.D., the Office of Medical Student Education – and especially Deja Murray, course coordinator – as well as Raj Chawla, M.P.H., faculty technology liaison in the Department of Technology Services, and Thomas Delaney, Ph.D., associate professor of pediatrics and public health faculty member.