Abstracts

Rationale: Rationale HOBSCOTCH (HOme Based Self-Management and COgnitive Training CHanges Lives) is a telehealth deliverable neurobehavioral cognitive intervention which improves quality of life (QoL) and cognition in people with epilepsy. Delivery of the program is possible in clinical and community settings by trained multilevel providers certified as Cognitive Coaches. A common hurdle for community-based organizations (CBOs) in the delivery of ESM is consistent staffing to meet program demand, and the often high turnover of staff which results in the need to halt program delivery abruptly until a new coach is trained. This project examined the hybrid partnering of Coaches at a CBO (Epilepsy Foundation of Eastern Pennsylvania (EFEPA)) with the centralized HOBSCOTCH Institute (HI) Coaching team to improve patient access to HOBSCOTCH; and examined QoL as a marker of fidelity, and patient satisfaction.


Methods: Methods Program referrals (n=96) were collected by EFEPA staff; participants self-referred or were clinician referred. HOBSCOTCH delivery was completed by EFEPA coaches and to limit wait times to 8 weeks or less, overflow participants were referred to the HI program coordinator and subsequently assigned a HI HUB Coach. Digital pre and post program surveys were provided to participants. Included in analyses are data from adults with epilepsy and cognitive dysfunction (n=39) who enrolled in the HOBSCOTCH program with EFEPA and returned both pre and post intervention surveys. Demographic data and pre-HOBSCOTCH QOLIE-10 were collected before program start and post-HOBSCOTCH QOLIE-10 and a satisfaction survey collected at the end. Data were analyzed in SAS 9.3, the R programming language, and Microsoft Excel.


Results: Results In total 72 enrollees (75%) received HOBSCOTCH from EFEPA Coaches and 24 enrollees (25%) by an HI Coach. Since initiating HOBSCOTCH at EFEPA, 6 staff trained as Coaches but only 3 remained active in program delivery due to transitions. Aggregate analyses (EFEPA Coached + HI HUB Coached) revealed a statistically significant improvement in QOLIE-10 scores post intervention (Figure 1; p < .0001). Participants reported high level of program satisfaction (Figure 2), with 87.2% reporting “strongly/mostly agree” that they will continue to use the skills and strategies they learned, 76.9% “strongly/mostly agree” they are better able to manage memory problems after HOBSCOTCH, and 87.2% “strongly/mostly agree” they learned tools and strategies useful for day-to-day life; 94.9% reported the program beneficial.