Abstracts

Rationale: Project UPLIFT is an evidence-based epilepsy self-management program that prevents and treats depression through an 8-week, distance delivered, group-based intervention. Since 2012, the program has been disseminated by training community-based providers in delivering UPLIFT to expand access to people with epilepsy (PWE). Limited research has described the adoption, implementation, and maintenance of practice-based delivery of self-management programs, like UPLIFT. We sought to gain a better understanding of this process from trained program adopters.

Methods: Program records were reviewed to describe the number and geographic distribution of trainees. An online survey with closed- and open-ended questions was distributed to collect information about reasons for being trained and experiences implementing the program. Many of the questions were derived from the RE-AIM framework that assesses reach, efficacy, adoption, implementation, and maintenance. For closed-ended responses, frequencies and cross-tabs were calculated. Open-ended responses were reviewed and grouped by theme.

Results: Over 150 people from 35 different states and the District of Columbia have received training in delivering UPLIFT. Of the people who received training, 137 were emailed the survey (41 complete; 30% response rate). Organization types included respondents from clinical (39%, n = 16), educational/research (17%, n = 7), and Epilepsy Foundation affiliates/chapters (12%, n = 5), among others. The most frequently endorsed reason to get trained in UPLIFT included an interest in supporting PWE (73%, n = 30). The majority of respondents thought that delivering UPLIFT was very important (49%, n = 20) or important (32%, n = 13). Of the respondents, 61% (n = 25) had implemented UPLIFT. Of those who had not implemented UPLIFT, 50% (n = 8) planned on implementing it at some point. The estimated number of PWE who have participated in UPLIFT through those who had implemented is over 425 people. People were recruited into the program through a variety of ways, including word-of-mouth (73%, n = 16) and organizational listservs (68%, n = 15). Recruitment was also a challenge many faced in delivering the program (72%, n = 18). In open-ended responses, funding was a key theme that would facilitate continued implementation, but 48% (n = 12) responded that did not have access to resources and/or funding to help continue offering UPLIFT. Despite challenges, respondents agreed (46%, n = 11) or strongly agreed (33%, n = 8) that UPLIFT was effective in addressing mental health problems among program participants, and 76% (n = 19) plan to offer another UPLIFT group in the future.

Conclusions: UPLIFT has been disseminated widely in the U.S. and has reached PWE. Implementation surveys increased understanding of program adoption and impact from our dissemination trainees. Continued refinement of implementation support, such as developing a sustained referral system and providing innovative funding mechanisms may further enhance adoption, implementation, and maintenance.

Funding: Please list any funding that was received in support of this abstract.: This work is funded and supported by the CDC’s Special Interest Projects through the Prevention Research Centers (Grant Number U48DP006377).