Abstracts

Rationale: Epilepsy self-management (ESM) helps people with epilepsy (PWE) control their seizure frequency, increase their self-confidence, and better cope with their disease.  Despite advances in the field, web-based interventions for ESM are still limited. Web-based applications have the potential to combine the tailored approach of face-to-face clinical interventions with the scalability of public health interventions. Management Information Decision Support Epilepsy Tool (MINDSET 2.0) can be used by patients online, remotely or in a clinical setting and facilitates healthcare providers in assisting patients to periodically assess, maintain, and/or improve their epilepsy self-management.  The purpose of this study is to describe the usability and feasibility testing of MINDSET 2.0 in Arizona and Texas.

Methods: MINDSET 2.0 was redesigned as an internet accessible, responsive cross-platform version of MINDSET, an ESM decision support program, with inclusion of decision-support algorithms to provide tailored recommendations on appropriate MEW programs (UPLIFT, HOBSCOTCH, and PACES) and prioritized social determinants for PWE. A usability study was conducted with a sample of patients (n=6) in three neurology clinics in Arizona and Texas. Patients entered self-management data into MINDSET 2.0, the program compared responses to benchmarks, and identified areas for improvement. An action plan was developed that summarizes the patient’s self-management status and the goals and strategies they selected for improvement. A usability rating scale and exit interview were used to collect quantitative and qualitative usability data after they completed MINDSET 2.0. The feasibility study was conducted with a sample of patients (n=8) at five neurology clinics in TX and AZ during one regular clinic visit. Patients completed MINDSET 2.0 before their scheduled clinic visit and discussed their action plan with their healthcare provider. A feasibility rating scale and exit interview were used to collect feasibility data after each visit.

Results: Patients in the usability study (n=6; AZ=2, TX=4) were 19-70 years old, female (50%), White (100%), Hispanic (100%), and a mean age of diagnosis of 9.83±6.79 years). All (100%) reported seizures in the last 12 months with 50% reporting >1 seizure per month. Most had no insurance (50%) or were on Medicaid (16.67%). Patients rated the time taken to use MINDSET 2.0 as just right (83.33%) and all patients (100%) rated MINDSET 2.0 as helpful, easy to use, credible, and understandable. All (100%) perceived MINDSET 2.0 as having a positive impact on thinking about and managing their epilepsy and understood the action plan. These results supported the feasibility testing of the tool. The findings from the feasibility study will be reported at the meeting.

Conclusions: Positive usability findings suggest that MINDSET 2.0 enhancements are consistent with the CDC-MEW initiative for a next generation of online accessible 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 HCPs decision making on recommended MEW programs.

Funding: CDC SIP 19-003