Abstracts

Rationale: The efficacy of epilepsy self-management programs warrants evaluation related to translation to different settings to support increased access. HOBSCOTCH, a self-management program for people with epilepsy (PWE) who report cognitive difficulties, has been shown to improve quality of life (QOL) and cognition among PWE. The program includes sessions with certified Cognitive Coaches who engage in patient education, develop skills for self-monitoring, provide problem-solving therapy, and support developing memory strategies. Guided by an implementation science framework, RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), this evaluation explored experiences of implementing HOBSCOTCH in a new setting to support future dissemination.


Methods: We evaluated HOBSCOTCH implementation at one clinical trial site that delivered the program for the first time and conducted a randomized, waitlist-controlled trial (RCT). RCT data included surveys about demographics and epilepsy history of PWE, session completion, and satisfaction. An implementation staff survey assessed organizational readiness, recruitment, implementation, and effectiveness. Additional questions assessed attitudes toward the program and implementation outcomes. Implementation staff interviews asked questions aligned with the RE-AIM framework. We analyzed quantitative data with descriptive statistics and qualitative data with descriptive thematic analysis.


Results: The implementation site recruited a diverse population into the clinical trial with about 35% identifying as Black (18 of 52). Most (71.2%) completed eight sessions with a coach. HOBSCOTCH participants rated the tools and strategies provided by coaches as very or extremely useful (n = 32, 78%). Implementors strongly agreed (3 of 3) that “[their] organization finds HOBSCOTCH to be effective,” but indicated more variability on recruiting participants and organizational support. Implementors indicated positive implementation outcomes (Figure 1). Descriptive themes from interviews (n = 3) aligned with the survey responses. Marketing the program as a free resource to help with memory made participation in the program attractive. Yet, contacting potential participants was challenging. Implementors thought the program was effective, especially for addressing QOL. Implementors identified mental health support as a focal area where additional attention might improve outcomes for PWE.

Conclusions: Implementing HOBSCOTCH in a new location contributed to reaching a diverse population that reflected satisfaction with the program. Program implementors reported positive experiences and identified opportunities for refining implementation. Two specific recommendations resulted from this implementation evaluation: 1) address mental health needs of participants and 2) connect recruitment with onsite staff members to reduce difficulties reaching people. The successful implementation of HOBSCOTCH indicates the program is transferrable and provides opportunities to enhance QOL among PWE.

Funding: Centers for Disease Control and Prevention U48 DP006377-04-00