Abstracts

Rationale: Few epilepsy centers currently employ CHWs and their valuable skillset remains underutilized. In other chronic conditions, studies of CHW activities have documented positive effects on health outcomes. CHWs can serve as non-clinical intermediaries between patients, care teams, and community resources, helping with patient’s social determinants of health (SDOH) needs outside of routine clinic visits. The current state of knowledge and preparedness of epilepsy centers to integrate a CHW is unknown.

Methods: An online survey of clinical providers (n= 65) at registered NAEC epilepsy centers across New England (MA, NH, VT, ME, CT, RI, NY) aimed to assess prior knowledge of and experience with CHWs [recruitment, training, supervision]. Survey content validity was obtained by an expert panel of epilepsy center clinical providers and community health educators responsible for developing training and facilitating placement of CHWs. Epilepsy center leaders were contacted via email with survey link and subsequent snowball sampling was utilized to obtain multidisciplinary input. 60% of participants reported that >50% of their practice was dedicated to caring for persons with epilepsy (PWE).

Results: About half of respondents were aware of the role a CHW could play on a medical team and services they provide. Half denied having familiarity with scientific evidence supporting the role of CHW in chronic disease. 38% reported receiving information about CHWs through a colleague and 20% through a hospital meeting. Less than 3% attended a professional conference session regarding CHWs. In our cohort of 65 clinical providers, 25% (n = 16) had a CHW employed at their epilepsy center. These providers felt there were staff with knowledge and support at their medical center to recruit CHWs for the epilepsy clinic. Of epilepsy centers with CHWs, only 14% indicated that their CHW had completed Epilepsy and Self-Management Training, and none had general CHW certification training or state accreditation. < 50% felt there was a sufficient system in place to track CHW referrals and adequately monitor CHW’s ability to address patient needs. Of those without prior CHW experience, only 40% of respondents felt that their epilepsy center team had the knowledge base to construct a CHW job description and recruit a CHW. >80% were unaware of any state-based training programs for CHW or CHW specific Epilepsy and Self-management Training. Only 13% felt there was an effective system that could be used to track patient referrals to a CHW and their ability to meet patient needs.

Conclusions: Within the New England region, few clinicians have firsthand experience with an integrated CHW. Clinicians are unaware of scientific evidence showing positive effects of CHW health outcomes. Knowledge of CHW recruitment, training and supervision is low. This regional assessment highlights a need to provide directed education and guidance for epilepsy center teams to increase readiness for integrating CHW in the care of PWE.

Funding: CDC- U48DP006381-02-01 SIP20-006