A case study in science-to-service application of epilepsy self-management.

Autor: Sajatovic M; Department of Psychiatry and of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA. Electronic address: martha.sajatovic@uhhospitals.org., Beem Jelley P; Epilepsy Association of Western and Central Pennsylvania, Pittsburgh, PA, USA., Schrag K; Epilepsy Alliance Ohio, Cincinnati, OH, USA., Varanese P; Epilepsy Association, Cleveland, OH, USA., Needham K; Epilepsy Association, Cleveland, OH, USA., Black J; Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA., Adeniyi C; Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA., Barigye R; Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA., Yala J; Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA., Ghearing GR; University of Iowa, Iowa City, IA, USA., Glasgow RE; University of Colorado Anschutz Medical Campus, Denver, CO, USA., Briggs F; Department of Public Health Sciences, Division of Epidemiology, Miller School of Medicine, University of Miami, Miami, FLA, USA.
Jazyk: angličtina
Zdroj: Epilepsy & behavior : E&B [Epilepsy Behav] 2024 Oct; Vol. 159, pp. 109945. Date of Electronic Publication: 2024 Aug 08.
DOI: 10.1016/j.yebeh.2024.109945
Abstrakt: Aims: Epilepsy self-management (ESM), the overall approach of reducing seizures and optimizing whole-health, is a targeted approach to improve population health for people with epilepsy (PWE). "Self-management for people with epilepsy and a history of negative health events" (SMART) is an 8-session group-format, remotely delivered ESM. This report describes the evolution of SMART development, testing and scale-up, taking advantage of ESM team expertise, community relationships and infrastructure established by social service agencies that deliver support to PWE.
Methods: This is a case-study dissemination and implementation (D&I) science-to-service model using the RE-AIM framework approach (Reach, Effectiveness, Adoption, Implementation, and Maintenance) focused on 5 dimensions of individual- and setting-level outcomes important to program adoption, impact and sustainability. Performance evaluations include participation representativeness, ESM attendance and acceptability as well as change in relevant health outcomes.
Results: SMART D & I is implemented via a collaboration of 3 unique regional, epilepsy-focused nonprofit social service organizations and a university team that developed SMART. The ongoing collaboration is expanding SMART delivery to PWE across 13 U.S. states. Thus far, we have trained 17 Nurse and Peer Educators (NEs and PEs). PEs (N = 10) have a mean age 51.1 (SD 10.4) years and a mean age of epilepsy diagnosis of 29.4 (SD 19.3). Of 128 participants offered SMART, and who provided age data (N = 86) mean age was 37.7 years (SD 14.4). Of participants who provided data on gender and race (N = 89), 65 were women (73.9 %), 18 African-American (20.2 %). Mean age of epilepsy diagnosis was 19.4 years (SD 16.6) and 59 (52.2 %) of PWE reported having seizures in the last 30 days pre-SMART sessions. Among those with attendance data (N = 103), mean number of SMART groups attended was 5.7 (SD 2.3). Mean values for past 30-day seizure frequency, 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Inventory (GAD-7) and 10-item Quality of Life in Epilepsy Scale (QOLIE-10) for PWE that provided both pre and post SMART data were 7.6 (SD 15.8) vs 2.8 (SD 3.4) p = 0.3, 7.63 (SD 6.6) vs 6.3 (SD 5.7) p = 0.95, 6.6 (SD 5.7) vs 6.67(SD 5.3) p = 0.47 and 2.8 (SD 0.8) vs 2.7 (SD 1.0) p = 0.07 respectively.
Conclusions: Implementing ESM using a RE-AIM/Iterative RE-AIM framework links intervention developers and community partners. While PWE have substantial barriers to health, including frequent seizures, they are able engage in the SMART program. Although a major limitation to patient-level evaluation is challenges in collecting post-SMART follow-up data, preliminary findings suggest a trend for improved quality of life.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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