Abstracts

Rationale: Hispanic people with epilepsy, especially those who speak mainly Spanish, may be at an increased risk of disparities in managing their epilepsy. This may be due to limited communication between the patient and their healthcare provider (HCP) and self-management tools available to them. To help mitigate these challenges we are translating an existing epilepsy self-management decision-support tool (MINDSET 3.1) for use by Spanish speaking Hispanic patients within the clinic encounter (Spanish-MINDSET 4.1). MINDSET highlights the patient’s epilepsy self-management ‘at-risk’ behaviors for discussion with the HCP and for improvement.Methods: The research team met over a series of meetings to revise MINDSET. In Step 1, the MINDSET assessment questions (My Epilepsy) were revised by integrating systematic reviews from eight members of the research team. They include experts in communication technology, behavioral science, public health, and clinical management of epilepsy. In Step 2, a new module (My Goals) for prioritizing at-risk behaviors for improvement was created. This step was informed by results from a completed MINDSET efficacy trial and feasibility study. Step 3 involved streamlining the Action Plan to help the patient to select goals and strategies to overcome self-management barriers. In Step 4, the revised version of MINDSET was programmed for tablets. This step was completed by software programmers under contract with the research team. The final step before developing Spanish MINDSET was to test the revised English MINDSET usability with a sample of patients and their HCPs.Results: The revised script for My Epilepsy includes questions covering seizure frequency and symptoms, medications and medication side effects, and self-management domains related to seizure management, medication management, and lifestyle management. The questions are designed to be clear, relevant, and understandable for the average adult with epilepsy. The new module (My Goals) lists all at-risk items in each self-management domain and prompts the patient to identify one to three items for improvement before their next visit. The revised Action Plan is designed as a social contract between the patient and their provider where the patient selects a behavioral goal from flagged behaviors in each self-management domain, selects behavioral strategies to meet these goals, estimates confidence to perform these behaviors; lists any barriers for achievement, and brainstorms strategies to overcome the barriers. The results of the usability test of the revised version of MINDSET will be reported at the meeting.Conclusions: MINDSET 4.1 enhancements are a marked improvement over previous versions in terms of its focus on prioritization and goal setting for self-management practice. Next steps will be the development and feasibility testing of Spanish-MINDSET.