Self-Management for People with Epilepsy and a History of Negative Health Events

A program to improve health outcomes.

Smart Study Logo PNG.png



Learn to manage your mental health and improve your health outcomes.



Register an institution or organization in order to offer this important program to patients.

Color Squares_Purple.png

Program Snapshot


Key Components

The SMART intervention is intended to improve health outcomes in people with epilepsy.

  • Trained nurse and peer educator who collaboratively deliver the program during group sessions.

  • The program addresses challenges imposed by stigmatization, stress, and limited social support.

  • Information-sharing in an accessible manner that fosters motivation for active self-management.

  • Guided with a standardized manual and handouts that re-emphasize materials tailored to the needs of participants.


Program Description

SMART is a program for adult individuals with sub-optimally controlled epilepsy.  It involves educational and behavioral interventions intended to enhance epilepsy self-management.

The initial group session is in-person where individuals receive curriculum materials and learn to utilize the Web format (such as Adobe Connect or ZOOM) and a teleconferencing service needed to access the remainder of the group sessions. These sessions are held over an 8 week time period and are co-lead by a trained nurse educator and a trained peer educator. The peer educator is someone with epilepsy and a history of NHEs. Educators use a written curriculum delivered online, and the interactive sessions last 60-90 minutes. Groups are limited to about 6 -12 adult participants.

After the group sessions are done, individuals have 8 telephone maintenance sessions with the nurse educator and the peer educator spaced approximately 2 weeks apart.

SMART is intended for adults with epilepsy, especially those who belong to disadvantaged sub groups, those who are under-insured and veterans with epilepsy. People with epilepsy who belong to disadvantaged sub-groups are more likely to have poor outcomes and often end up using expensive crisis-oriented care, and thus potentially might benefit the most from self-management programs if they can be actively engaged.

To learn more about the program and our partnerships, visit the Epilepsy Association. To hear about the program from a participant & peer educator, click the video below.



  • 8 groups sessions followed by 8 maintenance sessions

  • Session 1 - in-person

  • Session 2-8 - web-sessions

  • Maintenance sessions - phone


Adults with epilepsy, especially those who belong to disadvantaged sub groups, those who are under-insured and veterans with epilepsy.


Each SMART group is led by a nurse educator and a peer educator.

Training Requirements

  • Nurse and Peer educator orientation and training: 2-half day sessions.

  • Debriefing sessions with the Nurse and Peer Educators as needed (expect 2-4 over 1 year).

Resource Requirements

  • Adequate space for the first group session.

  • Laptop set-up to display power-point slides for session leaders and for participants

  • Subscription (usually free) to a video conferencing service (such as Adobe Connect or ZOOM)

  • Toll-free number or teleconference line available for those unable to make in-person sessions.

  • Reimbursement costs of public transportation to in-person sessions for individuals that do not have other resources. Original program costs for this were in the order of $5/per person/session


The cost of SMART varies based upon staffing and number of participants in a group and geographical setting. The following reflect original program costs:

  • Nurse educators are typically paid $50/session including training sessions.

  • Peer educators are typically paid $25-$30/session including training sessions.

Other costs include printing the SMART instructor manual, SMART participant manuals, and session PowerPoint slides.

After the initial training, the time commitment for nurse and peer educators should not exceed 1-3 hours/week.


Program Contact

To learn more about becoming a program adopter or if you wish to participate in the SMART program contact:

Martha Sajatovic




Program Development & Evaluation

SMART is based upon the idea that people learn by observing others, gaining knowledge, skills, and experience, and acquiring the self-confidence to put their new-found knowledge into practice in ways that are practical and self-sustaining.

SMART uses peer support to promote connection, understanding, and acceptance.

Past research experience with the TIME program suggests that the SMART program will also be highly acceptable to participants. The on-line format may help minimize social isolation that some people with epilepsy experience due to driving restrictions or other burden imposed by their epilepsy.

SMART is an adaptation of an evidence-based self-management intervention (TIME) that was developed for individuals with epilepsy and comorbid mental health conditions. SMART was refined based on input from a community advisory board and it is intended to improve self-management and mood and to reduce negative health events (NHEs) such as seizures, hospitalizations, emergency department visits or self-harm attempts.



One of the hidden problems with epilepsy is that no one wants to talk about it and the other problem is the restrictions imposed from the outside. The challenges are different from year to year and the group sessions addressed that. Even though it seemed at the beginning that it was basic information for people who do not know anything about epilepsy, I learned something new something every session. As the sessions went on, people opened up and shared a lot and that was very helpful.

- SMART Participant