Authors :
Presenting Author: Robert Ross-Shannon, MS – Dartmouth Health
Edward Camp, BS – Dartmouth Health
Todd MacKenzie, PhD – Dartmouth College
Barbara Jobst, MD – Dartmouth Health
Trina Dawson, BA – Dartmouth Health
Sarah Kaden, BA – Dartmouth Health
Elaine Kiriakopoulos, MD, MPH, MSc – Dartmouth Health
Rationale:
Cognitive impairment is a major contributor to reduced quality of life among individuals with epilepsy. The HOBSCOTCH program is an 8 week one to one telehealth delivered evidence based cognitive-behavioral intervention designed to improve disease self-management, quality of life and cognitive function. Integrating mobile app supports into self-management programs bring potential for enriching understanding of ESM intervention dynamics beyond traditional measurement approaches. This study evaluated the feasibility of using a mobile application to collect daily self-reported data during a fully virtual implementation of the HOBSCOTCH intervention in a nationally recruiting randomized control trial (HOBSCOTCH-3). Methods:
Adults with epilepsy participated in a multi-phase, longitudinal waitlist randomized controlled nationally recruiting HOBSCOTCH study (Figure 1). Data was collected electronically by means of daily logs filled out by participants on the HOBSCOTCH mobile phone app. Participants received daily notifications on their mobile device to fill out logs and had options available to customize when they received the notifications. The HOBSCOTCH mobile app collected daily data on seizure occurrence, medication adherence, memory strategy use, emotional well-being, and app engagement (Figure 1). Generalized additive models (GAMs), beta-binomial regressions, and ordinal models were used to assess within- and between-phase changes and temporal trends. Results:
Participants (n=109) reliably submitted daily self-reports (n=22276 logs included in analysis) supporting the feasibility of continuous mobile data collection. Seizure frequency and medication adherence did not significantly differ across intervention, booster, or follow-up phases, likely due to low baseline variability. However, significant within-phase temporal trends were observed for memory strategy use and well-being ratings, particularly during intervention and booster periods. Engagement with the app peaked during active intervention/booster and saw an overall modest decline within a phase. Significant correlations were identified between seizure reporting and mood, and between memory strategy use and mood, suggesting meaningful clinical associations (Figure 2).
Conclusions:
The HOBSCOTCH mobile application provided a feasible platform for high-resolution monitoring of self-reported outcomes in individuals with epilepsy. Although mean-level changes in clinical outcomes were limited, temporal trends and inter-item relationships revealed nuanced patterns of intervention effects. Mobile platforms offer a promising method for real-time, personalized epilepsy care and evaluation of digital health interventions like HOBSCOTCH. These findings highlight mobile app potential to enrich understanding of intervention dynamics beyond traditional measurement approaches.
Funding:
Centers for Disease Control and Prevention U48 DP006377-01-00.