NHPHA would like to recognize the hard work that the students, advisors, and organizations put into these research projects. The New Hampshire public health community is grateful for their contributions to the field and excited to see where they go next.

Click here to see the Top 3 Undergraduate Posters.


Top 3 Graduate Posters

Bryan Patriquin
Advisor Name: Karla Armenti
Co-Author’s Name(s): Martha McGowan-Lee FNP-BC, COHN-S
School Name: University of New Hampshire
Degree Program: MPH
Project Title: Evaluating Healthcare Personnel During a Pandemic Using the Burnout and Occupational Well-Being Survey (BOWS)

Background and Objectives: Burnout trends increasing among nurses have contributed to national shortages of healthcare personnel (HCP) in the US. Burnout is an occupational phenomenon resulting from chronic unmanaged job stress presenting as feelings of exhaustion, decreased worker efficiency, and reduced self-care practices. Objectives include assessing HCP to identify trends of burnout and positive occupational well-being.
Methods: A framework of evidence-based domains and subdomains was developed using the Total Worker Health® model of worker-well-being, various burnout inventories, and utilizing the health belief model. This framework guided the construction of the Burnout and Occupational Well Being Survey (BOWS), including domains: compassion fatigue, presenteeism, and personal wellness. The BOWS utilizes a 6-point agreement scale and reverse scoring method to produce scores for each subdomain, domain, and a cumulative score, referred to as the BOWS score. BOWS Scores classification uses three categories: positive occupational well-being, burnout trends, and burnout. The BOWS was distributed to all registered nurses and licensed nursing assistants throughout the hospital system.
Results: 199 (34.01%) of the 585 nurses invited to participate responded, and 196 nurses (33.5%) consented to participate. The mean BOWS score (2.94,n=196) indicated positive occupational well-being of nursing staff. Mean compassion fatigue and personal wellness showed burnout trends (CF:3.03;PW:3.1,n=196). Univariate analyses conducted between departments indicated the highest burnout rate among emergency medicine nurses (3.64,n=13) and burnout trends in the intensive care unit (3.17,n=10) and medical-surgical nursing staff (3.18,n=40). Regression analyses revealed that participant BOWS, compassion fatigue, and personal wellness scores statistically significantly predicted participants' perceived experience of burnout (F(3,192)=130.466, p<0.001, R2=0.671, n=196).
Conclusions: The first step of addressing HCP burnout is conducting the assessment. Assessment finds that HCP are not experiencing burnout hospital-wide. Multiple departments exhibiting burnout trends were identified. Healthcare organizations recognize burnout's detrimental impact and want to support HCP however possible, including developing targeted interventions.

Hannah Wunderlich
Advisor Name: Ashley Hall
Co-Author’s Name(s): Ashley Hall
School Name: University of New Hampshire
Degree Program: MPH
Project Title: Using the Ecological Model to Understand Influences of Ever Use of Electronic Nicotine Delivery Systems in a Massachusetts High School

In December of 2018, U.S. Surgeon General Jerome Adams declared electronic nicotine delivery systems (ENDS) use among youth an epidemic. Nicotine is the extremely addictive substance in most ENDS products. Since the young adult brain is not fully developed until at least 25 years old, nicotine has negative consequences on the developing brain including memory, the ability to learn, depression or mood disorders, and more.
For this qualitative research analysis, data was collected by the Massachusetts Tobacco Cessation and Prevention Program (MTCP) epidemiologists from the 2017 Youth Risk Behavior Survey (YRBS). According to the YRBS, in 2017 41.4% of Massachusetts high school students ever used ENDS. In the same year, the rate of ever ENDS use at Lynnfield High School was the lowest in Northeast, MA, at only 29.6% of all high school students.
This project was adapted for high school-aged youth from a study published in the Journal of American College Health titled “Using the Ecological Model to understand influences on college student vaping.” The study by Cheney et al. used the Ecological Model to consider the social and environmental influences on ENDS use among college-aged students. The Ecological Model considers the individual and their relationship with people, organizations, and the community. A brief survey was created based on the themes from the Ecological Model with the goal of understanding what level of influence has the most impact on a student’s decision to ever use ENDS.
From the 98 students who took the survey, only 9 students (9.2%) reported ever use of ENDS. Of all students surveyed, the intrapersonal and interpersonal levels had the most impact on ENDS use.
The information gathered should be used to better inform health communication messages to prevent high school students from ever using ENDS and incorporate messages of self-image and reactions of individuals within their social network.


Christian Seasholtz
Advisor Name: Karla Armenti
School Name: University of New Hampshire
Degree Program: MPH
Project Title: Winnipesaukee Public Health Network COVID-19 Vaccine Education and Empowerment Campaign

Purpose: Vaccination hesitancy within New Hampshire’s Winnipesaukee Public Health Network risks prolonging the SARS-CoV-2 public health emergency. Without a locally driven vaccination messaging effort, the Partnership for Public Health (PPH) identified a need for direct education to community members influenced by vaccine misinformation.
Partners: Partnership for Public Health (PPH) a 501 ©3 is one of 13 Regional Public Health Networks. The PPH is responsible for leading health initiatives and maintaining population health in 16 towns and cities within New Hampshire lakes region. The PPH facilitates community outreach, connecting with a broad range of area organizations, healthcare providers, and businesses to engage in health initiatives and dialogues.
Description: This tailored media campaign relied on its local connects to address the underlining cause of vaccine hesitancy, misinformation. Vaccine hesitancy can be viewed as a continuum, outlined by the WHO’s SAGE Working Group on Vaccine Hesitancy, which offers opportunities to persuade someone towards vaccine acceptance. The media campaign focused on:

• Bright and inviting infographics with a single statement targeting false vaccine narratives.
• Creating a QR for each infographic with more vaccine facts on PPH’s website.
• Web page delivered text and multimedia content including, videos of local health, and community testimonials.

Impact: By creating a customizable template styled media campaign, local organizations can adjust information to meet their specific needs. An infographic template model allows agencies to update their messaging and refrain from using outside or generic looking media.
Lessons learned: Authenticity matters when creating infographics, especially in a time of growing government distrust. Additionally, national health agencies may wish to invest in templated infographics so any community health leader may produce specialized messaging with well researched facts.


MPH (Graduate) Poster Submissions

Felicia Brackett
Advisor Name: Karla Armenti
School Name: University of New Hampshire
Degree Program: MPH
Project Title: Recovery Friendly Workplace: Industry Coding and Engagement Analysis
Purpose: Identify engagement levels across industry type to provide insight on ways to perform better outreach, marketing and tailor recruitment strategies to specific industries and demographics.
Partners: Utilizing data the Recovery Friendly Workplace Team has compiled I was able to run a variety of qualitative and quantitative analysis projects to identify gaps in recruitment, outreach, and engagement on an industry specific level.
Description: This project is an analysis of the program participant data from the Recovery Friendly Workplace (RFW) Initiative. This analysis will provide understanding for levels of engagement across industry type. This will allow the Initiative to develop industry specific marketing and outreach processes and be aware of the greatest need based on industry type. The analysis will include the use of the North American Industry Coding System (NAICS) to help define businesses in the data set. This project will provide in depth analysis and recommendations on ways to increase engagement across industry type.
Impact: The data and conclusions gathered from this analysis project will help improve outreach and engagement to more businesses to create workplace environments free of stigma around substance use. Increased New Hampshire business engagement in the RFW Initiative will lead to engagement and education on a state level. Increased engagement will lead to a resilient and supported work force through education, resources, and advocacy.



Innocent Musonera
Advisor Name: Karla Armenti
School Name: University of New Hampshire
Degree Program: MPH
Project Title: Biomonitoring NH Study looking at human exposures to VOCs and PAHs in the Berlin area
Purpose: The population in Berlin, NH scores high on many SVI metrics and lives in area known to have high levels of environmental contaminants. The objective of this study was to recruit a representative population, conduct a survey, collect and test clinical samples to evaluate human exposures to VOCs and PAHs in the Berlin area.
Partners: The Biomonitoring NH program is located in the chemistry lab Section within NH Public Health Laboratories under the Division of Public Health Services/DHHS. The program began in 2014 and receives grant from CDC state Biomonitoring cooperative agreement to assess human exposure to environmental chemicals.
Description: As part of my field study, I was involved in the process of this study project. I conducted toxicity data review for risk analysis to identify chemicals to be tested in the study. Criteria used to determine chemicals to be tested included source of contamination, health effects, EPA prioritization, and capacity for NHPHL to test for chemicals. I also developed research summary forms to provide toxicological profiles for chemicals to be tested. To get the community engaged in the study I developed a community engagement plan.
Impact: Criteria used for risk analysis to identify chemicals to be tested in the Berlin study can be used for future similar studies in different cities/towns of NH. Community engagement plan will help Biomonitoring NH program to move forward with the study project. Lessons learned: I learned that toxicity data review is crucial to a biomonitoring study and can impact heath outcomes. I learned that it is essential to incorporate community engagement plan in the design of a biomonitoring study. Most importantly, I observed how the biomonitoring NH program can have substantial impacts on environmental concerns.



Isabelle Margerit
Advisor Name: Karla Armenti
School Name: University of New Hampshire
Degree Program: MPH
Project Title: Medicare For All Pregnancies: establishing the thought base for a national plan for mothers and babies.
Background: Un-insurance, under-insurance and insurance churn in Maternal and Child Health populations play a central role in the maternal mortality and severe morbidity crises faced by the United States. Primary Maternity Care has put forward a Medicare For All Pregnancies policy proposal. Medicare for All Pregnancies is an episode-based Medicare-for-All proposal to achieve universal coverage for all services related to maternal and infant care during pregnancy, birth, and the first year.
Objectives: The purpose of this project is three-fold: (1) building the thought base for the policy proposal in order to support its framing to different constituencies; (2) raising awareness about the proposal through the convening of a roundtable of policy and academic stakeholders involved in Maternal and Child Health; (3) coalition-building through stakeholder engagement. The project will help beta-test the policy proposal and make it ready for further advocacy and formulation.
Methods: Stakeholder feedback is collected through town hall meetings and other forms of stakeholder engagement, then used to better frame and beta-test the policy proposal. We produced advocacy materials that range from one-pagers and factsheets to submissions in the commentary section of thematic issues of academic journals.
Results: Stakeholder needs are diverse. Maternal and Child Health advocates are interested in the concrete impact of the policy on outcomes in a few key areas (mental health, midwifery-led care, underfunded populations and care settings). Academic and policy stakeholders care about modeling, implementation models, economy-wide effects and using the proposed episode-based policy as a pilot for general Medicare For All plans.
Discussion: Both the magnitude of the impact on outcomes and stakeholder support for the proposal depend on implementation models for the policy.
Conclusion: We recommend the creation of a commission examining various implementation models, and organizing a policy roundtable of thought leaders and key stakeholders that reflects stakeholder diversity

 Click here to return to the Top 3 Graduate Posters.


Top 3 Undergraduate Posters

Mikaela MacKinnon
Advisor Name: Sarah Philips
School Name: Rivier University
Degree Program: BS or BA
Project Title: New Hampshire Lung Cancer Screening

Lung cancer is the nation’s leading cause of cancer deaths. New Hampshire currently faces a significant rate of lung cancer cases with a rate of new lung cancer cases at 64.0 age-adjusted lung cancer incidence rate per 100,000 which is much higher of a rate than the national average at 58.7 age-adjusted lung cancer incidence rate per 100,000. The 5-year survival rate for Lung Cancer in New Hampshire is improving due to lung cancer screening measures and tobacco cessation efforts. Assuring that physicians and communities are aware of how to screen for lung cancer, which people are in the eligible category, and what exposures are harmful can assist with reducing the rate of new cases. This study aims to determine the rate of diagnoses within New Hampshire and the measures being taken for prevention and screening.
To test prevention and screening methods an immersive internship has been taking place with evaluation of response measures by Exeter Hospital and their lung cancer screening program in relation to the National and New Hampshire made efforts. The results show that facilities offering lung cancer screening and tobacco cessation are having a lower number of lung cancer cases at late stages making treatment and survival rates better for that of the state of New Hampshire.
Results of lung cancer screening suggest the potential for diagnosing lung cancer at an earlier stage and potentially even assisting with prevention of developing lung cancer.


Annaliese Volckaert
Advisor Name: Lisa Purvis
School Name: Colby-Sawyer College
Degree Program: BS or BA
Project Title: Gun Violence in Chicago

Purpose: Gun violence has increasingly become a point of concern in the United States. Chicago has the highest number of homicides due to firearm per year out of all U.S. states. The purpose of this project is to outline an intervention plan in order to lower the rates of gun violence. Project Description: For my senior capstone project at Colby-Sawyer College I have created an intervention program in order to lower gun violence rates amongst adolescents, aged 12 to 24, in the Southside and Westside of Chicago. For this, I have created a poster that outlines a hospital-based intervention program and advocates for greater research in order to better tackle gun violence and determine the effectiveness of different programs and policies. This intervention is based on existing effective programs and hopes to fill a gap in Chicago’s current gun violence intervention plan. This poster includes a logic model, work plan, and evaluation plan for the proposed intervention.
Lessons learned: Gun violence prevention is an under-researched field in comparison to other causes of deaths with similar mortality rates. It is a public health issue that has many barriers due to the politics of gun ownership. The preventions that have worked so far emphasize the importance of engaging the community and help address the issues that lead to gun violence, like poverty. Through this project, I have learned the basic steps needed to set up an intervention program.


Elizabeth Morse
Advisor Name: Bailee Ethridge
School Name: George Washington University
Degree Program: BS or BA
Project Title: Descriptive Epidemiology of COVID-19 in New Hampshire Correctional Facilities, [4/3/2020 to 3/19/2021]

Correctional facilities face many challenges in preventing the spread of COVID-19. These facilities are at a higher risk of outbreaks due to close contacts, confined spaces, and the potential for new arrivals and staff members to introduce the virus to the setting. The objective of this study was to describe the epidemiology of COVID-19 in New Hampshire correctional facilities in order to enhance planning and response strategies. The study population included New Hampshire correctional facility residents and staff (n=5,297 total including n=3,677 residents and n=1,620 staff) from 15 facilities (10 county jails, 4 state prisons, and 1 federal prison) and included all cases reported between April 3, 2020 and March 19, 2021. Data were collected from case reports stored in the New Hampshire Electronic Disease Surveillance System (NHEDSS). A total of 1,038 COVID-19 cases were identified, including 765 residents (21% of residents infected) and 273 staff (17% of staff infected). Among all cases, 1,000 (96%) were associated with facility outbreaks. Across all facilities, the mean age of resident and staff cases was 41. A total of 5 hospitalizations (0.5%) and 4 deaths (0.4%) were reported. During the study time frame, a total of 14 outbreaks were documented across 11 facilities, with several facilities having experienced multiple outbreaks. The average size and duration of outbreak was 71 cases, lasting 56 days. Of the outbreak associated cases there was an average attack rate of 19% overall, 25% for residents, and 15% for staff. Like other congregate settings, correctional facilities have been impacted significantly by COVID-19. It is important for COVID-19 cases to be identified quickly and for preventative measures to be consistently applied as they are critical to protecting the health of residents and staff of correctional facilities alike.



BS/BA (Undergradute) Poster Submissions

Jessica DiCicco
Advisor Name: Suzanne Gaulocher
School Name: Plymouth State University
Degree Program: BS or BA
Project Title: Improving Patient Communication
Purpose: This project is in fulfillment of an internship placement with Speare Memorial Hospital. The purpose of this internship is to assess and evaluate current patient communications protocols for effectiveness and identify recommendations for quality improvement, specifically with telehealth in care and transitions.
Partners: This public health internship is in partnership between Speare Memorial Hospital (SMH) and Plymouth State University (PSU). Partners include: Michelle L. McEwen, Kris Hering, Melissa Howard, Beth Simpson, Kim Johnstone, Debra Thompson, Dr. Vercin Ephrem, Maureen Booth, Dr. Joe Ebner, Anna Hansen with SMH.
Description: This project was designed to address areas of communication within the hospital between its patients and providers. Its purpose is to improve Speare Memorial hospital’s performance with inpatient communication and the telehealth system. The project will help improve, evaluate, develop, and implement comprehensive provider/team communication with patients. The specific aim is to develop new communication tools, daily checklists, and improve effective communication in team meetings.
Impact: This project aims too find new strategies for providers to deliver effective, sensitive, and comprehensive communication with patients. It is the hope of partners that findings from this evaluation will improve overall communication in the hospital to be more operative.
Lessons Learned: This internship provided an opportunity for an Allied Health student to gain transferable skills, such as: research methods, building professional networks, and author assessment evaluation reports from start to finish. Added skills include exercising critical thinking and intrapersonal skills by working in a professional setting.


Steven Moody
Advisor Name:
Lisa Purvis 
School Name: Colby-Sawyer College 
Degree Program: BS or BA
Project Title: The Opioid Epidemic and Middle-Aged Adult Manual Labor in New Bedford, Massachusetts
Background: The opioid crisis has manifested itself mainly in the United States.1 Within the U.S., Massachusetts has been hit particularly hard.1 In Massachusetts, the city of New Bedford was ranked in the top 5 cities in the state for the most opioid overdose fatalities from 2012 to 2016, also, during this time, the number of these deaths had more than doubled.2 Manual labor has been shown to increase opioid rates in certain regions.3 One of the leading manual labor occupations in Massachusetts that has been associated opioid overdose fatalities is fishing.4 New Bedford’s economy is based around fishing.2 The total cost of the opioid epidemic since 2001 is over 1 trillion dollars.5 
Objective: The objective of my project is to reduce the burden of the opioid epidemic on middle-aged manual laborers in New Bedford, Massachusetts. Specifically, we will seek to decrease the opioid-related fatalities and misuse within this population, increase employment in the unemployed portion of this demographic, and improve the opioid prescribing practices of local prescribers to limit high-risk and unnecessary prescriptions. 
Methods: The core components of this project that make up our methods are as follows: establishing the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model in local hospitals, establishing employment-based interventions in collaboration with local businesses, and building an educational program for the community and local opioid prescribers 
Status: My project has not yet been initiated; my first steps would be to establish my partnerships, secure my funding and materials, hire and train staff, and begin developing and implementing the community outreach campaign to raise awareness of the issue and the program to address it. 



Student Name: Emily St. Louis
Advisor Name: Sarah Philips
Co-Author’s Name(s): Ashley Iannaco, RD, LD; Donna Proulx, PhD, RN, CCRN-CSC; Judi O'Hara, Ed.D., RN, CAGS, CNE; Karyn Heavner, PhD, MSPH
School Name: Rivier University
Degree Program: BS or BA
Project Title: Reach for the Stars Intervention
The Reach for the Stars intervention was conducted in 2017 with funding from Hannaford supermarket, in collaboration with the nursing and public health departments at Rivier University. Purpose: The purpose of the intervention was to provide nutrition education to individuals who had elevated levels of blood glucose or cholesterol. Methods: Individuals who visited the Nashua Soup Kitchen and Shelter (NSKS) were screened by Rivier nursing students for HbA1C, random glucose, and cholesterol. If they had elevated blood levels, they were invited to sign up for transportation to Hannaford supermarket where they met with a dietician for an educational session on nutrition and reading food labels. After the intervention, participants were given $25 to purchase food with the help of the dietician. Participants completed surveys before and after the nutrition education session. Results: We observed a significant increase in the proportion of respondents who knew that eating foods high in sugar is related to the start of diabetes between the pre- and post- survey time points (72.4% vs. 93.1%, p=0.03). In addition, a greater proportion of respondents were able to correctly identify the food label indicating an unhealthy sugar choice, however this difference was not statistically significant (47.6% vs. 71.4%, p=.302). Based on the sample of people who volunteered for the screening, we also observed that about 45% of participants had HbA1C levels >6.5%, indicating risk of type 2 diabetes. We observed no significant differences in mean HbA1C levels between men and women (p=0.46), however females did have significantly higher total cholesterol levels compared to men (169 vs 192, p=0.02).
Conclusion: This intervention allowed us to identify a population that may be at risk for diabetes or heart disease because of their limited choices in food from the soup kitchen.


Madelyn Turell
Advisor Name: Suzanne Gaulocher
Co-Author’s Name(s): Suzanne Gaulocher, Madelyn Turell, Maegan Castriotta, Kadirah Abdul-Jabbar, Mashayla Simpson, Zachary Swanson, Lumei Abatangelo, Grace McKeon, Abigail Johnson, Michael Van Aken, Emma Veazie, Sally Cederberg
School Name: Plymouth State University
Degree Program: BS or BA
Project Title: Binge Drinking Among Plymouth State University Students
Purpose: Binge drinking among college students is common and poses a huge threat to their health. Qualitative data were collected from Plymouth State University (PSU) students in order to identify what influencing factors foster binge drinking behaviors. Findings from this community-based study will be used to inform interventions and apply for future funding.
Partners: PSU student researchers partnered with the Communities for Alcohol and Drug-Free Youth (CADY), a non-profit organization that aims to create and apply prevention programs that reduce alcohol, tobacco, and substance use among youth and communities while promoting a healthy environment. Funding from this research was from the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.
Description: In Fall 2019, the Phase I initiative launched binge drinking surveys that were used to create interview questions for Phase II. The focus of the Phase II research was to collect data through focus groups and key informant interviews to more deeply explore themes generated from Phase I (N=46 participants). In Phase II, qualitative data were collected and coded using Constant Comparative Analysis and data mined for themes.
Impact: ​We have already seen some impact from the 2019 Phase I findings yet recognize the need for a deeper look at the themes to better inform interventions to the target population. Study findings will be used by policy and decision-makers at CADY and Plymouth State University to modify alcohol drinking behaviors, reduce risk, and apply effective interventions.
Lessons Learned: The student co-investigators learned how to collect and evaluate qualitative data in a formal research process while collaborating with community partners. They also learned the clear impact binge drinking has on PSU students and what the research’s role is in a positive outcome.