Abstracts

Rationale: People with Epilepsy (PWE) face many challenges beyond seizures, including co-morbidities, unemployment, financial difficulties, and transportation. Non-traditional health care providers, including Community Health Workers (CHW) offer untapped potential to aid in these non-medical needs to improve the quality of life for PWE. CHWs can support PWE with disease management, education, access to community resources, insurance, transportation, and managing isolation and stigma. Additionally, integrating a CHW onto the care team can alleviate burden from providers, allowing them to focus on direct patient care. The purpose of this project is to understand the perceptions and readiness of PWE to include a CHW on their epilepsy care team.

Methods: A digital survey was developed and implemented at the Dartmouth Hitchcock Epilepsy Center to evaluate patient and caregiver perceptions and readiness for CHW integration onto an epilepsy center care team. Potential survey participants were identified by the CHW via the EMR. Participants (n=21) (PWE 100%, female 61.9%; White 95.6%; not Hispanic or Latino 95.25%) accessed and completed the survey via QR code on their smartphone. The survey included questions such as participants’ familiarity with a CHW role, if they’d previously received care from a CHW, if participants would be willing to receive help from a CHW, andparticipants’ interest in a CHW addressing their identified needs (Figure1), participants’ confidence in a CHW, and whether or not they believed a CHW could improve their health and well-being.

Results: Survey participants’ baseline knowledge of CHWs was divided (42.8% with prior knowledge and 42.8% without, 14.2% not sure). About 7 out of 10 (66.6%) of patient respondents indicated they had not received care from a CHW (19% said yes, 14.2% were unsure). 42.9% of respondents reported they had previously received this assistance from their physician; 33.3% reported another member of the care team (CHW (14.2%), nurse (14.2%), social worker (4.76%), and 19% reported not having receiving this kind of assistance. 71% of respondents believed a CHW could connect them with local resources in their communities (4.7% disagreed, 19% were unsure). 76% of participants reported being willing to receive epilepsy education from a CHW (9.52% said no, 14.2% were unsure). 42.8% of respondents indicated feeling confident in a CHW’s ability to address their needs (52.3% neutral, 4.76% disagreed). 61.9% of respondents agreed that working with a CHW would improve their health and well-being (38.1% neutral).

Conclusions: CHWs fill the gaps in the social and health care systems. In this cohort of patients at a Level 4 epilepsy center, patient readiness to include a CHW on the care team was high and the perception a CHW could assist in improving health and in offering links to community supports to improve their quality of life both trended positive. Integrating a CHW onto epilepsy care teams provides patients with improved access to community resources and allows providers to focus their time on medical decision making and care.

Funding: Centers for Disease Control and Prevention