Abstracts

Rationale: People with epilepsy (PWE) can exercise epilepsy self-management (ESM) to improve seizure control, medication adherence, and lifestyle factors. The CDC’s Managing Epilepsy Well (MEW) 2.0 initiative is designed to increase the evidence-base for the existing evidence-based ESM programs (MEW-EBPs) including: PACES, UPLIFT, HOBSCOTCH and MINDSET. The recent upsurge of telemedicine and distance consults underscore the importance of accommodating patient needs at distance. Web-based applications have the potential to combine the tailored approach of face-to-face clinical interventions with the scalability of public health interventions and patients appreciate the accessible and convenience afforded by web-based applications. In response, MEW-EBPs have moved to online implementation and dissemination. Responsive, mobile, web-based interventions for PWE self-management assessment, action plan development, and linkage to evidence-based MEW-EBPs may enhance reach, and impact on self-management behavior and improve access to MEW-EBPs and social service programs. Management Information Decision Support Epilepsy Tool (MINDSET) 2.0, will be developed as an Internet accessible, responsive cross-platform version of MINDSET, an ESM decision support program with demonstrated usability, feasibility, and effectiveness with inclusion of decision-support algorithms to provide tailored recommendations on appropriate MEW programs (UPLIFT, HOBSCOTCH, and PACES) and prioritized social determinants for PWE.

Methods: A phased development comprised: 1) content analysis to upgrade functional specifications of the original MINDSET program and back-end database informed from RCT field data; 2) literature review to determine inclusion / exclusion criteria for enrolling PWE into MEW-EBPs and triaging for social support services; 3) expert panel design review; 4) user manual and design document development; and 5) software upgrades to responsive cross-platform Internet-accessible website.

Results: MINDSET 2.0 algorithms provide decision support to determine readiness to use MEW-EBPs (UPLIFT, HOBSCOTCH, and PACES) based on existing validated scales including the Neurological Disorders Depression Inventory in Epilepsy (NDDI-E) as an indicator of UPLIFT eligibility and the QoLIE-31 cognitive scale as an indicator of eligibility for HOBSCOTCH. PACES is a general epilepsy self-management program suitable for all patients with epilepsy and particularly those challenged in self-management. MINDSET 2.0 provides a social determinant inventory adapted from Health Leads as a cue to HCPs and has been upgraded from its original Adobe AIR technology to common cross-platform web-based standards of HTML, CSS, and JavaScript on a Cordova framework for access from smart phone, tablet, and desk-top devices.

Conclusions: MINDSET 2.0 enhancements are consistent with the MEW 2.0 initiative for a next generation of self-management evidence-based programs. The MINDSET 2.0 redesign accommodates in-person and distance self-management screening and action planning with the added features to assist HCP decision making on recommended MEW self-management programs and prioritization of social determinants.

Funding: Please list any funding that was received in support of this abstract.: CDC SIP 19-003.