A randomized controlled trial of self-management for people with epilepsy and a history of negative health events (SMART) targeting rural and underserved people with epilepsy: a methodologic report

Abstract Background Many people living with epilepsy (PLWE) reside in rural communities, and epilepsy self-management may help address some of the gaps in epilepsy care for these communities. A prior randomized control trial of a remotely delivered, Web-based group format 12-week self-management pro...

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Autores principales:	Gena R. Ghearing, Farren Briggs, Kristin Cassidy, Michael Privitera, Carol Blixen, Martha Sajatovic
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Epilepsy Seizure Self-management Rural Hospitalizations Emergency room Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/1f3d74d15b6c4c058cd175cbd16c0e51
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spelling	oai:doaj.org-article:1f3d74d15b6c4c058cd175cbd16c0e512021-11-21T12:31:18ZA randomized controlled trial of self-management for people with epilepsy and a history of negative health events (SMART) targeting rural and underserved people with epilepsy: a methodologic report10.1186/s13063-021-05762-z1745-6215https://doaj.org/article/1f3d74d15b6c4c058cd175cbd16c0e512021-11-01T00:00:00Zhttps://doi.org/10.1186/s13063-021-05762-zhttps://doaj.org/toc/1745-6215Abstract Background Many people living with epilepsy (PLWE) reside in rural communities, and epilepsy self-management may help address some of the gaps in epilepsy care for these communities. A prior randomized control trial of a remotely delivered, Web-based group format 12-week self-management program (SMART) conducted in Northeast Ohio, a primarily urban and suburban community, demonstrated improved outcomes in negative health events such as depression symptoms and quality of life. However, there is a paucity of research addressing the needs of PLWE in rural settings. Methods The present study leverages collaboration between investigators from 2 mid-western US states (Ohio and Iowa) to replicate testing of the SMART intervention and prioritize delivery to PLWE in rural and semi-rural communities. In phase 1, investigators will refine the SMART program using input from community stakeholders. A Community Advisory Board will then be convened to help identify barriers to trial implementation and strategies to overcome barriers. In phase 2, the investigators will conduct a 6-month prospective randomized control trial of the SMART program compared to 6-month waitlist controls, with the primary outcome being changes in negative health events defined as seizure, self-harm attempt, emergency department visit, or hospitalization. Additional outcomes of interest include quality of life and physical and mental health functioning. The study will also assess process measures of program adopters and system end-users to inform future outreach, education, and self-management strategies for PLWE. Discussion The method of this study employs lived experience of PLWE and those who provide care for PLWE in rural and underserved populations to refine a remotely delivered Web-based self-management program, to improve recruitment and retention, and to deliver the intervention. Pragmatic outcomes important to PLWE, payers, and policymakers will be assessed. This study will provide valuable insights on implementing future successful self-management programs. Trial registration ClinicalTrials.gov NCT04705441 . Registered on January 12, 2021Gena R. GhearingFarren BriggsKristin CassidyMichael PriviteraCarol BlixenMartha SajatovicBMCarticleEpilepsySeizureSelf-managementRuralHospitalizationsEmergency roomMedicine (General)R5-920ENTrials, Vol 22, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Epilepsy Seizure Self-management Rural Hospitalizations Emergency room Medicine (General) R5-920
spellingShingle	Epilepsy Seizure Self-management Rural Hospitalizations Emergency room Medicine (General) R5-920 Gena R. Ghearing Farren Briggs Kristin Cassidy Michael Privitera Carol Blixen Martha Sajatovic A randomized controlled trial of self-management for people with epilepsy and a history of negative health events (SMART) targeting rural and underserved people with epilepsy: a methodologic report
description	Abstract Background Many people living with epilepsy (PLWE) reside in rural communities, and epilepsy self-management may help address some of the gaps in epilepsy care for these communities. A prior randomized control trial of a remotely delivered, Web-based group format 12-week self-management program (SMART) conducted in Northeast Ohio, a primarily urban and suburban community, demonstrated improved outcomes in negative health events such as depression symptoms and quality of life. However, there is a paucity of research addressing the needs of PLWE in rural settings. Methods The present study leverages collaboration between investigators from 2 mid-western US states (Ohio and Iowa) to replicate testing of the SMART intervention and prioritize delivery to PLWE in rural and semi-rural communities. In phase 1, investigators will refine the SMART program using input from community stakeholders. A Community Advisory Board will then be convened to help identify barriers to trial implementation and strategies to overcome barriers. In phase 2, the investigators will conduct a 6-month prospective randomized control trial of the SMART program compared to 6-month waitlist controls, with the primary outcome being changes in negative health events defined as seizure, self-harm attempt, emergency department visit, or hospitalization. Additional outcomes of interest include quality of life and physical and mental health functioning. The study will also assess process measures of program adopters and system end-users to inform future outreach, education, and self-management strategies for PLWE. Discussion The method of this study employs lived experience of PLWE and those who provide care for PLWE in rural and underserved populations to refine a remotely delivered Web-based self-management program, to improve recruitment and retention, and to deliver the intervention. Pragmatic outcomes important to PLWE, payers, and policymakers will be assessed. This study will provide valuable insights on implementing future successful self-management programs. Trial registration ClinicalTrials.gov NCT04705441 . Registered on January 12, 2021
format	article
author	Gena R. Ghearing Farren Briggs Kristin Cassidy Michael Privitera Carol Blixen Martha Sajatovic
author_facet	Gena R. Ghearing Farren Briggs Kristin Cassidy Michael Privitera Carol Blixen Martha Sajatovic
author_sort	Gena R. Ghearing
title	A randomized controlled trial of self-management for people with epilepsy and a history of negative health events (SMART) targeting rural and underserved people with epilepsy: a methodologic report
title_short	A randomized controlled trial of self-management for people with epilepsy and a history of negative health events (SMART) targeting rural and underserved people with epilepsy: a methodologic report
title_full	A randomized controlled trial of self-management for people with epilepsy and a history of negative health events (SMART) targeting rural and underserved people with epilepsy: a methodologic report
title_fullStr	A randomized controlled trial of self-management for people with epilepsy and a history of negative health events (SMART) targeting rural and underserved people with epilepsy: a methodologic report
title_full_unstemmed	A randomized controlled trial of self-management for people with epilepsy and a history of negative health events (SMART) targeting rural and underserved people with epilepsy: a methodologic report
title_sort	randomized controlled trial of self-management for people with epilepsy and a history of negative health events (smart) targeting rural and underserved people with epilepsy: a methodologic report
publisher	BMC
publishDate	2021
url	https://doaj.org/article/1f3d74d15b6c4c058cd175cbd16c0e51
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A randomized controlled trial of self-management for people with epilepsy and a history of negative health events (SMART) targeting rural and underserved people with epilepsy: a methodologic report

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