Building capacity for implementing evidence-based epilepsy self-management supports in health care settings

Description

This NOFO aims to develop health care system (e.g, neurology/epilepsy center clinics) capacity to deliver evidence-based epilepsy self-management supports (e.g., evidence-based epilepsy self-management programs) through health care settings. The NOFO includes an additional component for the delivery of expert technical assistance and training in health care system change, chronic care collaboratives, and/or clinical quality improvement to enhance outcomes. About 3.4 million people in the U.S. have active epilepsy.(1) Compared with adults without epilepsy, adults with active epilepsy report more comorbidity, worse psychological health, more cognitive impairment, limitations in social activities, and worse health-related quality of life.(2,3) At least 56% of them have had at least one seizure in the past year, indicating suboptimal seizure control.(4) Self-management (e.g., what individuals and families do on a daily basis to feel better and pursue the life they desire) and self-management support (e.g., actions taken by others to support individual self-management), are critical strategies aligned with CDC’s National Center for Chronic Disease Prevention and Health Promotion priorities aimed at ensuring that “communities support and clinics refer patients to programs that improve management of chronic conditions.”(5,6) As one type of self-management support, epilepsy self-management programs have been shown to be effective in improving select health and quality of life outcomes, including reduced seizure frequency, but these programs remain underutilized in community and clinical settings.(7-10) Integrating delivery of evidence-based epilepsy self-management supports in health care settings may reduce barriers to widespread program adoption.(11) This NOFO supplements previous CDC funding opportunity announcements DP16-1602 and DP21-2101 aimed at building social service agency capacity for delivering self-management supports through community-based organizations.(9) To address gaps in effectively reaching people with epilepsy with self-management supports, this NOFO is designed to build health care system capacity to deliver evidence-based self-management supports (e.g., evidence-based epilepsy self-management programs) through health care settings (e.g., epilepsy center clinics). The NOFO includes an additional component for the delivery of expert technical assistance and training in health care system change strategies (e.g., chronic care model learning collaboratives, quality improvement) to enhance outcomes.(12) Key outcomes include effective intervention implementation in health care settings; increased patient referrals; increased patient participation in interventions; patients’ improvements in health and quality of life outcomes; and decreased health care utilization. This announcement is only for non-research activities supported by CDC. References: Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy — United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66:821–825. doi: 10.15585/mmwr.mm6631a1 Kadima NT, Kobau R, Zack MM, Helmers S. Comorbidity in Adults with Epilepsy — United States, 2010. MMWR Morb Mortal Wkly Rep. 2013;62(43):849–853. Kobau R, Cui W, Kadima N et al. Tracking psychosocial health in adults with epilepsy—Estimates from the 2010 National Health Interview Survey. Epilepsy Behav 2014;41:66-73. Tian N, Boring M, Kobau R, Zack M, Croft J. Active Epilepsy and Seizure Control in Adults — United States, 2013 and 2015. MMWR Morb Mortal Wkly Rep. 2018;67(15):437–442. doi: 10.15585/mmwr.mm6715a1. Brady TJ, Anderson LA, Kobau R. Chronic disease self-management support: public health perspectives. Front Public Health. 2015;2:234. Published 2015 Apr 27. doi:10.3389/fpubh.2014.00234 CDC. How we prevent chronic diseases and promote health. https://www.cdc.gov/chronicdisease/center/nccdphp/how.htm#community. [accessed 2/3/22] Sajatovic M, Jobst BC, Shegog R. et al. The Managing Epilepsy Well Network: Advancing Epilepsy Self-management. Am J Prev Med 2017;52(3S3):S241-S245. Thompson NJ, McGee RE, Garcia-Williams A, Selwa LM, Stoll SC, Johnson EK, Fraser RT. The impact of a depression self-management intervention on seizure activity. Epilepsy Behav. 2020; 103(Pt A):106504. Helmers SL, Kobau R, Sajatovic M, et al. Self-management in epilepsy: Why and how you should incorporate self-management in your practice. Epilepsy Behav. 2016. doi: 10.1016/j.yebeh.2016.11.015 Lewinski A, Shapiro A, Gierisch JM et al. Barriers and facilitators to implementation of epilepsy self-management programs: A systematic review using qualitative evidence synthesis methods. Syst Rev 2020. doi: 10.1186/s13643-020-01322-9. Ozuna J, Kelly P, Towne A, Hixson J. Self-management in epilepsy care: Untapped opportunities. Fed Prac. 2018;35(Suppl 3):S10-S16. CDC Div. of Heart Disease & Stroke Prevention. A guide to facilitating health systems change. https://www.cdc.gov/dhdsp/programs/spha/docs/guide_facilitating_hs_change.pdf. [accessed 2/3/22]

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