Poster Day 2021: Abstracts: Outreach & Narrative Review

Elizabeth Clark Lanier, OMS-II 

Rural Americans are more likely to have increased essential needs and more substantial barriers to healthcare. Rural populations have increased rates of poverty and food insecurity. Similarly, more rural residents are without health insurance and, therefore, experience higher rates of chronic health problems such as diabetes, high blood pressure, and obesity. In Houston County, AL, specifically, 18.23% of residents are below the poverty line, 10.51% lack health insurance, and 16.5% are considered food insecure. Resources that address these difficulties can increase the quality of life in those who are affected by these social determinants of health.

The purpose of this project was to engage with vulnerable members of the Wiregrass community and promote the use of community resources within the rural primary care setting.

This objective was approached initially by creating a survey which assessed for specific essential needs within the community, such as mental health, domestic violence, substance use dependence, food insecurity, ability to afford medications, and lack of transportation access. A variety of resources were created and assembled, including brochures encompassing local community resources for each specific need. A plan was then implemented at the Ashford Clinic in Ashford, Alabama utilizing the surveys and resources to provide information to those patients who screened positively for these essential needs. Data was collected anonymously for 45 days via the screening surveys.

This project was successfully implemented, and results will be analyzed from data collection by final submission.

Keana-Kelley D. Swanner and Katelyn Johnson

Mental, neurological, and substance-use disorders represent a vast global burden of disease. There is a relationship between diet, stress, and mental health which is often poorly understood by medical practitioners. Understanding the role of diet and mental health could prove to provide a substantial benefit to providing adequate and appropriate care to their patients and for their own personal wellbeing.

The purpose of this review is to educate and provide tools for future medical practitioners and other community members to understand the role that diet plays within depression, PTSD, and brain function that plays a role in mood and behavior.

We reviewed literature that describes the relationship between diet, stress, obesity, and psychiatric disorders related to stress. We also providing a wellness event to the medical school community to shed light on the topic and provide information and resources to future medical practitioners.

Understanding the relationship between diet, stress and mood and behavior could have important implications for practitioners to provide adequate medical care for their patients as well as improve the quality of healthcare that they provide for their patients by reducing their personal burnout and stress. Even small changes may present with possibly significant effects on disease burden of mental and neurological diseases by food and nutrient-based approaches.

Katherine Ellen Whalen, OMS-I; Erica M. Román, MD; Tim Mayhall, M.Div., BCC; Amith Skandhan, MD; Kierstin Kennedy, MD; Ellen Eaton, MD; and George Marty Solomon, MD

The COVID-19 pandemic has immortalized as the biggest challenge in healthcare worldwide. Its consequences on population health have intensified as we battle yet another pandemic, that of vaccine misinformation. The State of Alabama ranks lowest in the country in vaccination against COVID-19. In order to take a proactive approach towards this twofold battle, we reached out to local churches in order to understand the causes of vaccine hesitation in Alabama.

Multiple faith-based organizations across the State of Alabama were surveyed on the reasons for vaccine hesitancy against the COVID-19. Based on these results, we prepared a discussion amongst experts in the field of Infectious Disease and Pulmonary Medicine to the faith based leaders in order to provide them with the proper information pertaining COVID-19 and vaccinations in their community. Policy changes were also encouraged by inviting the legislatures of the Health Policy committee of the state to this discussion.

The survey results showed a predominant concern regarding vaccine safety. Other reported apprehensions included uncertainty about the vaccine’s side effects and the need to be vaccinated. Less common reasons were the vaccine’s novelty, mistrust of the government, mistrust of vaccines in general, and just not wanting to get the vaccine.

In order to succeed in the fight against COVID-19 and vaccine misinformation, we must understand the concerns of the community. Social media can be used as a catapult in order to educate community leaders with the proper information so that this can resonate within the community.

Alexis OConnell, OMS-IV, Leah Grcevich OMS-IV, Justin Hovey, MD, Robin Fischer, DNP, MEd, NP-C

In Alabama, 69.0% of adults are overweight (BMI >/= 25) and 32.2% of adults are obese. Obesity in the rural southeast is a multifaceted epidemic consisting of socioeconomic, educational, and food access barriers.

The “ACT NOW: ACOM CommuniTy NutritiOn and Wellness” study was created to identify the current health behaviors and anthropometric measurements of the rural population of Ashford, AL. Additionally, we aimed to measure the effect and satisfaction of an educational program teaching community members about whole food, plant-predominant nutrition, and behavior modification.

Utilizing multiple learning theories to adult education as a model, a pilot study was conducted by first- and second-year Medical Students at Alabama College of Osteopathic Medicine to determine the feasibility and impact of a community-based lifestyle intervention program. In the process of developing and delivering this program, the medical students gained valuable tools in curriculum design and patient education that will benefit the future physicians in their careers in academia or clinical practice. This program design can be adapted to meet the cultural and educational demographics of other communities while maintaining the evidence-based educational model aligned with osteopathic principles and practices that proved successful in the pilot study.

Widespread adaptation of this model, or adaptation of a virtual curriculum, can improve accessibility and ease for other medical schools to establish lifestyle intervention programs in their local communities to improve population health.

Ashley Lefebvre

Rapid eye movement sleep behavior disorder (RBD) is a parasomnia characterized by a loss of physiologic REM sleep atonia and subsequent reenactment of dreams. RBD is commonly seen in conjunction with Parkinson disease (PD) and associated with an increased risk of sleep-related injury (SRI) in this population.

Risk factors reported to be associated with the development of RBD in PD include male sex, advanced age, smoking, heavy alcohol use, and use of antidepressant medication. RBD in PD is thought to be caused by alpha-synuclein neurodegeneration in areas of the pontine and medullary brainstem responsible for producing atonia during REM sleep. These alterations disrupt the circadian rhythm and sleep-wake cycle leading to REM sleep without atonia (RSWA) presenting clinically as dream reenactment behaviors.

The standard for diagnosis of RBD in PD is polysomnography (PSG) displaying rapid eye movement sleep without muscle atonia (RWSA). Prognostic implications for developing RBD in patients with PD include more severe PD and decreased quality of life (QOL). Treatment of RBD in PD includes pharmacotherapy with either clonazepam or melatonin and modification of the sleeping environment to prevent SRI. Further large prospective randomized clinical trials are needed to determine the safety and efficacy of these medications in the treatment of RBD in PD.

Awais Farooq, Dr. Ellie Razzouk, Dr. Skandhan, Dr. Kulkarni

EMR implementation is a stark process improvement that has a cascading effect on the ability of healthcare modalities to render care varying from outpatient clinical facilities to large scale health systems. These can create significant interdepartmental challenges that can be exacerbated by the need of new adaptations, notably, during the COVID-19 pandemic.

We aim to correlate process plans to implement Epic in a middle size healthcare system such as Southeast Health, which was in the process of transitioning from multiple EMR systems into one, and how these efforts were chronologically affected with the ongoing COVID pandemic. Retrospective analysis and interviews with key department personnel will be utilized to help illustrate the burden COVID-19 may have had in Epic implementation chronologically since the onset of the pandemic.

Southeast Health was able to meet its “Go Live” date with many interdepartmental coordination and planning. This additionally was notable, as it was coming off, at the time, the highest COVID surge in terms of case load (Figure 1).

Through interdisciplinary teamwork, and significant amounts of planning with adaptive parts, Southeast Health was able to consolidate significant independent systems into one. There were hardships at the onset, but overall system implementation was able to match its scheduled onset in setting of a surging pandemic. Communicating with multiple stakeholders help improve adherence and utilization in order to achieve improved system integration.