Bruce Barrett, MD, PhDMindful Climate Action: Qualitative Interviews & Video Production

Human behaviors related to transportation, diet, and energy use drive greenhouse gas emissions which cause global warming and climate change. Substituting active transportation (biking and walking) for automobile transport, and eating more plant-based foods, can support mental and physical health while also reducing carbon footprints. Mindfulness-based trainings have been successful in changing behaviors to enhance mental and physical health, but they have not been tested for impact on environmentally sustainable behaviors.

The proposed MCA project will employ mindfulness-based practices to increase awareness of habitual or “mindless” behaviors that adversely impact both personal health and environmental sustainability.  This will enhance health and stimulate carbon footprint reduction by increasing awareness, compassion, and connection to the environment. Mindfulness-based practices will include personal centering, breath awareness, body scan and awareness of physical sensations, sitting meditation, mindful movement, gentle yoga, emotional state awareness, and empathy and compassion. Instructors will introduce each of these practices in tandem with science education on energy use, carbon footprints, and sustainability.

Brian Arndt, MD and Karina Atwell, MD – Verona EATS Healthy: Employee Meal Kit Program

Meal kits have become increasingly popular over the past few years. However, more than 50% of customers cancel their subscription within the first 6 months likely based on volume, frequency, and or cost. As a direct approach to enhancing UW Health employee wellness, a key aspect of UW Health’s strategic plan, the aim of this feasibility study is to develop an employer-subsidized once weekly meal kit program for UW Health Verona faculty, residents, and staff in partnership with Hy-Vee, the Badger Prairie Needs Network, UW Health’s Culinary Services, UW Health’s Dietetic Internship, and UW Health’s Employee Wellness Program.

Purpose and goals

  1. Feasibility study of an employer-subsidized once weekly meal kit program delivered to UW Health Verona Clinic faculty, residents, and staff
  2. Identify the impact upon employee wellness as it pertains to eating behaviors through participation in the meal kit program and the impact upon changes in nutrition knowledge through participation in the meal kit program.
  3. Further extend the mission of the Department of Family Medicine and Community Health by developing new, and refining current, community relationships.

Thomas Hahn, MD and Emily Ramharter, MDDynaMed Plus: Bringing Back a Point of Care Resource

This grant will provide the funding for a departmental subscription for DynaMed Plus for 1 year. Based on our surveys from the DMP trial, we know there is enthusiasm for DynaMed Plus from the residents. We will conduct a survey after 6-9 months of use of DynaMed Plus to assess for the following: how often people use DynaMed Plus, how DynaMed Plus compares to other resources like UpToDate and Essential Evidence Plus, and how easy it is to access DynaMed Plus from the link that we will set up. This project will help to guide our understanding of which point of care resources provide the greatest value to our faculty and residents.  This will help to guide allocation of departmental resources in the future.

Ronni Hayon, MD – Adolescent Champion Project Implementation

Purpose and goals:

  1. Use an evidence-based approach to remove barriers to change and streamline implementation to improve care delivery to adolescents. The Champion model is a multidisciplinary intervention to address a health center’s environment, policies, practices, and culture in order to become adolescent-centered medical homes
  2. Increase faculty, resident, and staff comfort and confidence in caring for adolescents
  3. Increase clinician and staff knowledge of minor confidentiality and minor consent laws.
  4. MOC IV certification for participating physicians
  5. Ultimately, goals of the program will be to improve the care we provide to adolescent patients, and empower them to establish lifelong healthy behaviors.

Karina Atwell, MD, MPH – UW Department of Family Medicine and Community Health Balint Group Leadership Training and Program Implementation

The Balint group process is an experiential model that has been used in residency teaching, and by practicing physicians, for decades. Balint groups meet regularly to examine the doctor-patient relationship through case discussions, focusing on the emotions of the clinician and patient that arise from the clinical encounter, rather than the medical aspects of the case. Balint groups are a unique way to examine difficult situations in a non-threatening way. As a result of working in a peer group over a period of time, physicians can recognize their habitual patterns of behavior with various types of patients and situations, and they have a safe space to process these experiences. Balint work encourages self-awareness and self-reflection while simultaneously reinforcing that all clinical relationships occur with reciprocal emotional influence, a key principle in Relationship-Centered Care.

We propose a project to implement Balint groups in residency education and faculty development, with the intent to expand opportunities to explore the patient-physician relationship and foster physician wellness for both resident and faculty physicians within the DFMCH. In order to promote continuity within the groups we intend to create separate resident and faculty groups both founded on the same Balint philosophies. This project fills a current gap in our curriculum by directly addressing the importance of the patient-physician relationship in maintaining empathy in clinical encounters. It further provides concrete tools for strengthening communication skills while proactively valuing and empowering provider wellness and resiliency as a means to lessen burnout.

Jared Dubey, DO – OMT for the MD

The philosophies of osteopathic medicine and family medicine are inherently harmonious. Both seek to treat the whole person (body, mind, and spirit) while respecting the self-healing capacity of each individual. Osteopathic theory and practice is based on the core concept that alterations in physical structure      affect physiologic functioning, and vice-versa. By addressing these physical alterations (ie somatic dysfunctions) OMT aims to correct aberrant physiology. MT is indicated in many common primary care clinical scenarios. This elective is designed for allopathic residents who desire an in depth training in osteopathic manipulative diagnosis and treatment.

A modular, non-linear curriculum allows residents to jump in and out, as schedules necessitate. Modules can be completed in any order; with the exception that module 1 is foundational and should be completed first. In person lab time will heavily prioritize hands-on learning, while significant didactic curriculum will be accomplished via readings and online lectures.

Ellen Goldstein, PhD – A Motivation-Based Intervention to Improve Health Risk Coping Among Urban Black Primary Care Patients

Adverse childhood experiences (ACEs) characterized by abuse, neglect and household dysfunction prior to age 18 underlie many of the most pervasive societal problems and are a root cause of the leading causes of morbidity and mortality in the United States. ACEs affect health at each life stage, are cumulative and can detrimentally impact health and social advantage of subsequent generations. The stressful impact of a traumatic event on an individual can have lasting consequences on health by influencing downstream determinants such as health-risk behaviors. Early life stress is an important risk factor for mental health disorders and chronic diseases. Reducing toxic stress burden on the body may be preventive of a multitude of chronic mental and physical health conditions. Research shows that childhood trauma is especially prevalent in low-income, disadvantaged, minority primary care populations, and is associated with high-risk health behaviors. This study addresses an important gap given that Blacks face greater inequities and persistent health disparities associated with poverty, discrimination, maltreatment and higher than average trauma exposures and health risk behaviors to cope with stressors. Urban Blacks are disproportionately exposed to traumatic events and, therefore, are at a greater risk for PTSD than the General Population. Primary care is often the first point of contact for trauma-exposed individuals and can be a gateway for individuals who have both primary care and behavioral health needs.

To our knowledge, this study offers a novel approach that can assist providers with an actionable step to utilize ACE screen results to improve health and to address the root cause of many health and social disparities among African-Americans.  We propose pilot research using a one-group pre-and-posttest design to assess for feasibility, acceptability and preliminary efficacy of a 2-session motivation-based intervention to reduce perceived (psychological) stress and unhealthy behaviors and to improve patient acceptance of behavioral health referrals among medically underserved, African-American primary care patients.  This study incorporates patient-accepted trauma screening tools as eligibility criteria to participate in an intervention that helps to address the common provider question of what to do after identifying a patient who has endorsed ACEs or PTSD symptoms.

Vincent Minichiello, MD – The effect of a novel adapted Mindfulness Based Stress Reduction program on family medicine resident physician burnout, stress, resiliency, and mindful awareness

It is well documented that resident physicians experience a high level of burnout during their training. (1) In May 2016, 42 out of a total of 47 residents in the Madison Residency Program were surveyed internally about their level of burnout using the Maslach Burnout Inventory. Ninety-eight percent of respondents said that they had experienced some degree of burnout during their training. This project needs support – both financial and administrative – to assess and address resident well-being in the Department of Family Medicine and Community Health.

The purpose of the project is to determine the effect of an adapted, resident-specific Mindfulness Based Stress Reduction (MBSR) program on resident physician well-being. The goals of the project are to: 1) assess program efficacy based on quantitative measures of mindful awareness, burnout, perceived stress, and resiliency, 2) document qualitative experiences of the curriculum through confidential resident interviews, 3) provide a foundation from which future research in resident physician wellness through mindfulness education may evolve.