Addressing implementation challenges in the delivery of an epilepsy self-management program in community settings.
Abstract number :
2.075
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2025
Submission ID :
21
Source :
www.aesnet.org
Presentation date :
12/7/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: MARTHA SAJATOVIC, MD – Case Western Reserve University
Peggy Beem Jelly, BA – Epilepsy Association of Western and Central Pennsylvania
Kathy Schrag, BS – Epilepsy Alliance of Ohio
Patricia Varanese, BA – Epilepsy Association
Kelley Needham, BA – Epilepsy Association
Jessica Black, BS – Case Western Reserve University
Clara Adeniyi, MA – Case Western Reserve University
Richard Barigye, BS – Case Western Reserve University
Nicole Fiorelli, MA – Case Western Reserve University
Carrie Rogers, BS – Case Western Reserve University
Farren Briggs, PhD – University of Miami
Rationale: Epilepsy self-management (ESM), the overall approach of reducing seizures and optimizing health for people with epilepsy (PWE). “Self-management for people with epilepsy and a history of negative health events” (SMART) is an evidence-based, remotely delivered ESM. This report describes approaches that can address challenges in implementation of SMART in community settings, longer-term aggregate outcomes data and new information to inform potential additional ways to engage hard-to-reach PWE.
Methods: SMART was implemented by 3 regional, epilepsy-focused social services agencies. Early implementation challenges included ensuring fidelity to the intervention, optimizing engagement in performance evaluation by PWE who participated in the SMART program, measuring SMART outcomes and identifying additional resource needs that may impede PWE being able to engage with the SMART program and expanding buy-in beyond the core agencies. The SMART curriculum is delivered by Nurse Educators (NEs) and Peer Educators (PEs), who are PWE trained on the program. Pre/Post SMART outcomes evaluated included past 30-day seizure frequency, depression as measured with the 9-item Patient Health Questionnaire (PHQ-9), epilepsy-related quality of life measured with the 10-item Quality of Life in Epilepsy (QOLIE-10) and anxiety measured with the 7-item Generalized Anxiety Disorder (GAD-7) scale.
Results: Thus far, there have been 8 NEs and 14 PEs trained in the SMART program. NEs have a mean age of 63.6 (SD 9.1) years, all female and white. PEs have a mean age of 44.3 (SD 15.8) years, n=10 (71.4% female), n =10 (71.4%) White, and n=4 (28.6%) Black. PEs have had epilepsy a mean of 18.2 (SD 11.1) years. The average number of SMART group sessions attended (out of a maximum of 8) was 5.7 (SD 2.2). Mean values for past 30-day seizure frequency, PHQ-9, GAD-7 and QOLIE-10 for PWE that provided pre/post SMART data were 1.9 (SD 5.9) vs 1.8 (SD 4.6) p=0.26, 8.0 (SD 5.4) vs 7.3 (SD 5.0) p=0.026, 7.6 (SD 5.7) vs 7.5(SD 5.7) p=0.580 and 2.8 (SD 0.9) vs 2.6 (SD 0.9) p < 0.007 respectively. Compared to PWE who attended at least 1 SMART session, individuals who attended no SMART sessions were more likely to be non-White (P=.003), have less than a high school education (P=.027) and less likely to have any mental health diagnosis (P=.048).
Conclusions: This implementation initiative demonstrates that epilepsy-focused social services agencies can readily provide SMART to PWE and their families. Positive evaluation outcomes and agency experience could help other social services agencies consider adopting evidence-based programs to support their clients with epilepsy.
Funding: This work was supported the Centers for Disease Control & Prevention (CDC) project 6NU58D9006968-01-01.
Health Services (Delivery of Care, Access to Care, Health Care Models)