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Replication of an evidence-based epilepsy self-management program in Georgia (USA): The HOBSCOTCH trial

Epilepsy Behav. 2025 Nov 23;174:110805. doi: 10.1016/j.yebeh.2025.110805. Online ahead of print.

ABSTRACT

BACKGROUND: The efficacy of Managing Epilepsy Well Network (MEWN) self-management programs is well-established. The purpose of this study was to replicate the HOBSCOTCH program to evaluate program implementation and assess effectiveness on patient cognition, quality of life and self-management behaviors.

METHODS: Participants from clinical and community settings were recruited and randomized to intervention vs waitlist control. Program outcomes assessing quality of life, cognition, treatment adherence, depressive symptoms, and self-management behavior were measured at baseline and 3 months. Program staff provided survey data guided by the RE-AIM model regarding program delivery and acceptability, appropriateness, and feasibility. Data were analyzed using descriptive statistics, linear regression, and qualitative methods.

RESULTS: This predominantly female (69 %) and White (64 %) sample (N = 61) with active epilepsy (66 % had a seizure in the past year) also had a higher portion of Black (32 %) participants. Analyses yielded significant differences in cognition, quality of life and self-management behaviors between the two groups at follow-up. Staff indicated the packaged intervention, remote delivery, trained coaches and investment of leaders/clinical staff as intervention benefits. Implementation barriers included difficulty contacting participants and mental health concerns. Program appropriateness and feasibility ratings were high; 98 % reported that they very much or moderately enjoyed working with their coach and would recommend the program to others.

CONCLUSION: HOBSCOTCH was effective in increasing cognition and quality of life in people with epilepsy in this replication study. A novel finding highlighted changes in the frequency of participants’ self-management behaviors. These findings have implications for healthcare systems incorporating evidence-based self-management programs for their patients.

PMID:41285072 | DOI:10.1016/j.yebeh.2025.110805

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