WED-065 - Translation of Evidence-based Epilepsy Self-management Programs into Healthcare Systems: Implementation of HOBSCOTCH and Project UPLIFT

Brief Abstract Summary: Discover how two evidence-based epilepsy self-management programs, HOBSCOTCH and Project UPLIFT, were successfully integrated into two healthcare systems in Atlanta, GA. This presentation will detail the multi-step implementation process, including clinical collaboration, workflow adaptation, and interventionist training. Preliminary data reveals significant patient-reported improvements in quality of life and program satisfaction. Gain insight on the lessons we learned on building sustained clinical engagement, managing program capacity, and creating sustainable models for implementing self-management programs in real-world settings. This presentation offers key insights for anyone interested in bridging the gap between research and practice in chronic disease management.

Detailed abstract description:

Background:
Capacity building programs address the implementation science-to-practice gap in epilepsy self-management (eSM) for adults. The Managing Epilepsy Well (MEW) Network’s research highlights healthcare system barriers to adopting evidence-based eSM programs. HOBSCOTCH, a one-on-one coaching program for people with epilepsy (PWE) and Project UPLIFT, a group-based program, have both shown effectiveness in improving cognition and reducing depressive symptoms in PWE, respectively. The Building Capacity grant enabled translation of both programs into the Emory Clinic and Grady Memorial Hospital.

Purpose:
This project aimed to build organizational capacity to deliver two evidence-based eSM programs by training interventionists and embedding program delivery into existing epilepsy care.

Methods:
Program implementation consists of a multi-step approach: 1) collaboration with neurologists and clinical and implementation staff; 2) development and adaptations of workflows for recruitment and referrals; 3) trainings for Cognitive Coaches for HOBSCOTCH and facilitators for UPLIFT, including a peer facilitator with epilepsy; 4) technical assistance for program staff provided by program developers through monthly meetings, and 5) participant surveys.

Results:
Implementation involves building a collaborative network to streamline recruitment. One experienced coach consistently delivered HOBSCOTCH, while four individuals were trained as Cognitive Coaches and UPLIFT facilitators, and one peer facilitator created a flexible pool of interventionists to support steady enrollment. Contracting external facilitators helped meet referral demand but raised concerns about cost, coordination, and technology. Since October 2023, 272 patients have been referred (28 participants completed HOBSCOTCH; 25 completed UPLIFT). Currently, 27 participants are active in HOBSCOTCH and 143 in UPLIFT. Preliminary evaluations showed a 16.7% improvement in quality of life scores for HOBSCOTCH (86.4% of completers) and 18.4% for UPLIFT (96% of completers). Of completed participants, 59.1% found HOBSCOTCH to be very or extremely helpful, and 92% found UPLIFT provided them with the help that they wanted.

Discussion:
Program implementation reveals that evidence-based eSM programs can be integrated into healthcare systems. Lessons learned include the importance of sustained clinical engagement, building a pool of interventionists, and iterative evaluation for program sustainability. Tracking participant progress and analyzing participant surveys provided insights into program effectiveness and satisfaction. Recruitment tracking revealed a significant imbalance between referrals and program capacity, indicating an area for improvement. A formal evaluation will inform healthcare systems seeking to implement chronic disease self-management programs in a real-world setting.