Abstracts

Rationale: Goals are important for achieving health behaviors, yet there are few descriptions of people with epilepsy's (PWE) self-management (SM) goals in context of their epilepsy self-efficacy. Previous research suggests that self-efficacy for medications has an indirect effect on SM mainly through goals. The PAUSE to Learn your Epilepsy (PAUSE) SM education program is tailored to the specific goals and needs of a given PWE. Methods: The PAUSE project at the University of Illinois at Chicago (UIC) is one of the seven Managing Epilepsy Well network collaborating centers in the USA. It is designed to evaluate the effectiveness of a digital approach to personalized epilepsy SM education using the Epilepsy Foundation's website, epilepsy.com, to improve the lives of adult PWE from underserved populations. Among other measures, PWE completed goal sheets at enrollment in which they are asked to generate three SM goal areas for improvement. These goals were described and analyzed using content analysis and assigned themes. PWE were also asked to list three ways they could improve their SM and completed the Epilepsy Self-Efficacy Scale. The PAUSE study is ongoing, but preliminary results of goal setting suggest important gaps to address. Results: PWE (N = 25) ranged in age from 18-56 years (M = 34.07, SD = 11.49), were majority female (64%), represented a diverse range of racial backgrounds (64% Black or African American), with 56% reporting a high school education or less. The most common goals listed by PWE were grouped into 3 major components: 1) independent living (n = 14) - driving (n = 9) and work or volunteer (n=5); 2) well-being (n = 10) ?" mood (n=5) and energy level (n=5), and 3) seizure control (n =6). All but one person were able to identify an area for improvement related to their epilepsy SM and treatment. However, when asked to generate potential ways to improve their epilepsy SM in the next year, 44% of all PWE surveyed could not list a single idea, explicitly responding, "Not sure," and nothing else. On the Epilepsy Self-Efficacy Scale, PWE who generated one or more ideas for improving their epilepsy SM had a mean score of 253.4 whereas those PWE generating no ideas for improving their epilepsy SM had a mean score of 239.6. Conclusions: PWE's most commonly reported goals related to independent living and wellness over improvement in seizure control. Clinically, there is great overlap between these areas with seizure control and well-being affecting independent living abilities. It is difficult to address one area without improving the others. While those PWE who can think of at least one way to improve their epilepsy had a higher mean self-efficacy score than those unable to generate an improvement idea, the sample is too small to determine if this is a significant difference between these groups at this time. The relationship(s) between goals and their correlates and how PWE prioritize their goals has significance for designing and evaluating interventions for PWE. A limitation of this analysis is its cross-sectional design. Future directions include longitudinal follow-up of goals and their behavioral outcomes with additional PWE. Funding: PAUSE is a project supported by the Univ. of Illinois Prevention Research Center and the Centers for Disease Control and Prevention's Managing Epilepsy Well (MEW) Network. The project is administered by the Institute for Health Research and Policy of the University of Illinois at Chicago, under CDC cooperative agreement no. U48-DP005010.