Types of Epilepsy Curricula and Their Effectiveness: A Global Scoping Review Protocol of School-Based Educational Interventions

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From 1990 to 2021, childhood idiopathic epilepsy cases increased by 26.34%. Despite treatment advancements, stigma, fear, and misconceptions, especially in schools, hinder the inclusion of learners with epilepsy. School-based educational interventions have emerged as a vital strategy to raise awareness and reduce stigma. This scoping review aims to identify and map the types of epilepsy-related curricula in primary and secondary schools and special education settings worldwide, evaluating their effectiveness. Using the Joanna Briggs Institute (JBI) methodology, a comprehensive search strategy will be implemented across electronic databases and grey literature sources. Eligible studies will include various research designs focusing on educational interventions for learners, educators, or school communities. Study selection and data extraction will be performed independently by two reviewers, with a third reviewer resolving any disagreements. The findings will be synthesized through thematic analysis. The review is expected to reveal significant variation in the design and evaluation of epilepsy curricula, with many lacking standardized implementations. It aims to inform the development of relevant and scalable education strategies, ultimately supporting inclusive, equitable, and stigma-free learning environments for students with epilepsy." } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/14-936/v1", "name": "Types of Epilepsy Curricula and Their Effectiveness: A Global Scoping..." } } ] } Home Browse Types of Epilepsy Curricula and Their Effectiveness: A Global Scoping... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Makhado TG, Munyadziwa M, Makhado L and Cooley-Strickland M. Types of Epilepsy Curricula and Their Effectiveness: A Global Scoping Review Protocol of School-Based Educational Interventions [version 1; peer review: awaiting peer review] . F1000Research 2025, 14 :936 ( https://doi.org/10.12688/f1000research.169377.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Types of Epilepsy Curricula and Their Effectiveness: A Global Scoping Review Protocol of School-Based Educational Interventions [version 1; peer review: awaiting peer review] Thendo Gertie Makhado https://orcid.org/0000-0001-5673-1644 1 , Muimeleli Munyadziwa 2 , Lufuno Makhado https://orcid.org/0000-0003-1689-9308 3 , Michele Cooley-Strickland https://orcid.org/0000-0003-2071-3270 4,5 Thendo Gertie Makhado https://orcid.org/0000-0001-5673-1644 1 , Muimeleli Munyadziwa 2 , Lufuno Makhado https://orcid.org/0000-0003-1689-9308 3 , Michele Cooley-Strickland https://orcid.org/0000-0003-2071-3270 4,5 PUBLISHED 18 Sep 2025 Author details Author details 1 Advanced Nursing Sciences, University of Venda, Thohoyandou, Limpopo, 0950, South Africa 2 Public Health, University of Venda, Thohoyandou, Limpopo, 0950, South Africa 3 Public Health, University of Venda, Thohoyandou, Limpopo, 0950, South Africa 4 University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA 5 Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA Thendo Gertie Makhado Roles: Conceptualization, Formal Analysis, Investigation, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Muimeleli Munyadziwa Roles: Formal Analysis, Investigation, Methodology, Writing – Original Draft Preparation Lufuno Makhado Roles: Methodology, Supervision, Writing – Review & Editing Michele Cooley-Strickland Roles: Formal Analysis, Supervision, Writing – Original Draft Preparation OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW Abstract Epilepsy affects approximately 70 million people globally, with nearly 80% living in low- and middle-income countries. From 1990 to 2021, childhood idiopathic epilepsy cases increased by 26.34%. Despite treatment advancements, stigma, fear, and misconceptions, especially in schools, hinder the inclusion of learners with epilepsy. School-based educational interventions have emerged as a vital strategy to raise awareness and reduce stigma. This scoping review aims to identify and map the types of epilepsy-related curricula in primary and secondary schools and special education settings worldwide, evaluating their effectiveness. Using the Joanna Briggs Institute (JBI) methodology, a comprehensive search strategy will be implemented across electronic databases and grey literature sources. Eligible studies will include various research designs focusing on educational interventions for learners, educators, or school communities. Study selection and data extraction will be performed independently by two reviewers, with a third reviewer resolving any disagreements. The findings will be synthesized through thematic analysis. The review is expected to reveal significant variation in the design and evaluation of epilepsy curricula, with many lacking standardized implementations. It aims to inform the development of relevant and scalable education strategies, ultimately supporting inclusive, equitable, and stigma-free learning environments for students with epilepsy. READ ALL READ LESS Keywords curricula, educational interventions, effectiveness, epilepsy Corresponding Author(s) Thendo Gertie Makhado ( [email protected] ) Close Corresponding author: Thendo Gertie Makhado Competing interests: No competing interests were disclosed. Grant information: The funding for this study was provided by the University Staff Doctorate Programme (USDP) as part of the Epilepsy Research Project under the Junior Research Fellow. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 Makhado TG et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Makhado TG, Munyadziwa M, Makhado L and Cooley-Strickland M. Types of Epilepsy Curricula and Their Effectiveness: A Global Scoping Review Protocol of School-Based Educational Interventions [version 1; peer review: awaiting peer review] . F1000Research 2025, 14 :936 ( https://doi.org/10.12688/f1000research.169377.1 ) First published: 18 Sep 2025, 14 :936 ( https://doi.org/10.12688/f1000research.169377.1 ) Latest published: 18 Sep 2025, 14 :936 ( https://doi.org/10.12688/f1000research.169377.1 ) 1. Introduction Epilepsy, a neurological condition affecting approximately 70 million people worldwide, is characterized by recurrent seizures that manifest in various forms, from brief blank stares to convulsive movements and sudden falls. 1 The diverse etiologies of epilepsy include genetic predispositions, structural brain abnormalities, infections, and traumatic brain injuries, though many cases remain idiopathic. 2 Global estimates of childhood idiopathic epilepsy cases have increased 26.34% from 1990 to 2021. 3 Diagnosis typically involves neurological examinations, electroencephalography, and neuroimaging. 4 , 5 Effective management requires a multifaceted approach, including pharmacological interventions, lifestyle modifications, and, in some cases, surgical interventions or neurostimulation therapies. 6 , 7 Epilepsy is marked by a continuous likelihood of experiencing epileptic seizures and associated neurological, intellectual, emotional, and societal repercussions. 8 , 9 Psychiatric, cognitive, and social comorbidities frequently accompany epilepsy, significantly impacting an individual’s well-being and quality of life. 10 – 12 For example, idiopathic childhood epilepsy, which affects approximately 1.23 million children aged 0 to 14 globally, is a neurological condition increasingly linked to a range of adverse outcomes, including depression, intellectual disability, and an elevated risk of suicide. 3 The prevalence of epilepsy among school-aged children highlights the critical need for targeted educational interventions. 13 , 14 School-based epilepsy education programs aim to enhance awareness and understanding, reduce stigma and misconceptions, as well as equip individuals with the knowledge to provide appropriate first aid and support. Given the high rate of epilepsy among children, particularly in the first decade of life, addressing knowledge gaps and misconceptions within the educational environment is imperative. 15 Fostering a supportive and inclusive school environment can promote academic achievement, social integration, and overall well-being. 16 School-based educational interventions are crucial for increasing awareness, reducing stigma, and improving epilepsy management among learners and educators. 13 , 15 , 17 Effective epilepsy curricula require a thorough understanding of the target audience, educational objectives, and available resources. Curricula should be tailored to the learners’ age group, developmental stage, and cultural context, incorporating interactive teaching methods, visual aids, and real-life scenarios to enhance engagement and knowledge retention. Therefore, a comprehensive scoping review is essential to evaluate the effectiveness of existing school-based educational interventions for epilepsy, identify best practices, and inform the development of targeted and impactful curricula. The aim of the scoping review The purpose of this scoping review is to synthesize the effectiveness of existing epilepsy educational curricula interventions in improving knowledge, shaping attitudes, and influencing outcomes among learners and educators. Objectives of the review The specific objectives of this scoping review are to: • Identify and describe the types of epilepsy curricula or educational interventions implemented in primary, secondary school and special education settings globally. • Map the components of these curricula, including delivery methods, target audiences, duration, and content focus. • Summarize the available evidence on the outcomes and effectiveness of these interventions in terms of: − Increased epilepsy awareness and knowledge − Reduction in epilepsy-related stigma − Improvements in seizure response preparedness − Inclusion and psychosocial support for students with epilepsy • Identify gaps in the literature to guide future research, policy development, and curriculum design. Scoping review question This scoping review question supports the broader aim of identifying gaps in the literature, understanding existing practices, and informing the future development of contextually relevant epilepsy education interventions, particularly within the rural under-resourced settings. This question is structured according to the PCC (Population–Concept–Context) framework, as recommended for scoping reviews (see Table 1 ). Table 1. PCC framework breakdown. Component Description Population Learners and educators involved in or targeted by epilepsy education programs Concept Epilepsy-related education or awareness curricula, including formal, informal, or health-promoting interventions delivered within primary, secondary schools, and special education setting Context School settings globally, encompassing primary, secondary school, and special education setting globally The overarching question that will guide this scoping review is: “What types of epilepsy-related curricula have been implemented in Primary, secondary school, and special education settings globally, and what evidence exists regarding their effectiveness on knowledge, attitudes, and outcomes among learners and educators?” Sub-questions To complement the main review question, the following sub-questions will be explored: • What are the pedagogical and delivery approaches used in these Epilepsy curricula? • What roles do stakeholders play in the implementation of Epilepsy curricula? • What outcomes or indicators are used to measure the effectiveness of the Epilepsy curricula? • How culturally or regionally adaptable are these programs? 2. Research design and methods 2.1 Study design This scoping review proposes to explore and map the various types of epilepsy educational curricula that have been implemented in primary, secondary schools and special education settings worldwide. It further proposes to assess the extent to which these educational interventions have been effective in enhancing knowledge, shaping attitudes, and influencing outcomes among learners and educators. Given the broad nature of this topic and the diversity of sources and intervention types expected the Joanna Briggs Institute (JBI) methodology for scoping reviews will be followed. 18 Scoping reviews are particularly suitable for examining emerging or under-researched topics, where the goal is to map the breadth and nature of evidence rather than assess the effectiveness or quality of interventions through meta-analysis. 19 2.2 Search strategy This scoping review will adopt the three-step search strategy as recommended by the JBI to ensure a comprehensive and systematic identification of all relevant literature. 18 , 20 , 21 This approach helps to maximize coverage across various data sources, minimize bias, and improve the reproducibility of the review process. Step 1: Initial search The first step involves conducting a limited preliminary search of two key databases, PubMed and ERIC to identify common keywords, index terms, and Medical Subject Headings (MeSH) relevant to epilepsy education in school settings. This step allows for the refinement of the main search strategy by examining how key concepts such as “epilepsy,” “school curriculum,” and “inclusive education” are described in the literature. This step is crucial because a poorly designed search strategy can lead to the omission of critical studies. 22 By identifying variations in terminology, the initial search informs the construction of a more sensitive and precise search string for the next phase. Step 2: Full search In the second phase, the optimized search strategy developed from Step 1 will be systematically applied to a broader range of databases and sources to ensure comprehensive literature retrieval. These will include: • Electronic databases PubMed/MEDLINE, Scopus, ERIC, Web of Science, and Google Scholar (limited to the first 100 results for feasibility) • Institutional and organizational repositories WHO Global Health Library, UNESCO Library • Grey literature sources Government curriculum documents, NGO epilepsy training manuals, dissertations/thesis and unpublished project reports. Inclusion of grey literature is critical in this review, as many school-based epilepsy education programs are initiated by health or education ministries, non-governmental organizations, or local institutions that may not publish findings in peer-reviewed journals. Excluding grey literature could introduce publication bias and overlook effective grassroots or community-led initiatives. 23 The full search will include no restrictions on publication date or geographical region, ensuring that the global scope of epilepsy curriculum initiatives is captured. This is essential for mapping trends over time and drawing comparisons between high- and low-resource settings. Step 3: Supplementary search The third step involves manual searching of reference lists from all included full-text studies to identify additional articles that may not have been captured in the electronic database search. This technique, known as citation chaining, increases the sensitivity of the review and is commonly recommended in scoping review methodology. 24 Although studies published in all years and regions will be considered, language will be restricted to English due to resource limitations related to translation. This limitation will be transparently acknowledged in the final review. The following keywords and subject headings will guide the search strategy: • “epilepsy education” • “epilepsy curriculum” • “school-based intervention” • “inclusive education” • “life skills education” • “stigma reduction” Boolean operators (AND, OR) and truncation symbols (e.g., educat*, interven*) will be used to enhance the sensitivity and specificity of searches. The exact syntax will be customized for each database based on its controlled vocabulary and interface requirements. 2.3 Selection of sources All search results will be imported into a reference manager such as EndNote for deduplication. After that, the de-duplicated records will be exported into Covidence, an online review management software, to streamline the screening and selection process. Covidence is the best software to use because it improves efficiency in duplicate removal and screening, Blinded review to reduce bias, audit trails for transparency and reproducibility, and team collaboration during full-text screening and data extraction. Three reviewers will independently screen the titles and abstracts using Covidence software blinded screening function. Full texts of potentially relevant studies will then be retrieved and screened against the inclusion criteria. Any disagreements between reviewers will be resolved through discussion or by involving a Fourth reviewer where necessary. The study selection process will be documented and reported using a PRISMA-ScR flow diagram, 24 , 25 automatically generated and customizable within Covidence. Inclusion criteria (PCC framework) The inclusion criteria of this review will be based on the PCC frame as shown in Table 2 . Table 2. Inclusion criteria using PCC framework. Element Inclusion criteria Population School-aged learners, teachers, curriculum advisors, school health personnel, and parents involved in epilepsy-related educational interventions. Concept Any structured educational intervention or curriculum related to epilepsy, delivered within a school setting. This includes standalone epilepsy modules or content integrated into broader subjects such as health, life skills, or inclusive education. Context Primary and secondary school settings globally, across both low- and high-resource environments. All types of studies will be eligible for inclusion, including qualitative, quantitative, mixed-methods, experimental, and comparison designs. Grey literature (e.g., NGO reports and education department documents) will also be included, recognizing its importance in capturing local innovations and policy-driven interventions. 23 2.4 Data extraction A structured data extraction template will be developed in Excel and piloted on a sample of 3–5 articles to ensure consistency. The following variables will be extracted from each included source: • Author(s), publication year, and country • Study design and methodology • Educational setting (e.g., primary, secondary schools and special education setting) • Target population (learners and teachers) • Description of the curriculum or intervention (content, duration, format and delivery methods) • Theoretical framework (if reported) • Evaluation methods used (qualitative/quantitative/mixed/multimethod) • Reported outcomes (e.g., increase in knowledge, stigma and discrimination reduction, misconceptions and attitude change) • Implementation barriers or enabling factors • Recommendations for curriculum development, guidelines and policies. Data will be presented using descriptive summaries, frequency tables, and thematic narrative synthesis, allowing the review to illustrate patterns across contexts, populations, and intervention types. 2.5 Timeline A tentative timeline has been developed to guide the systematic execution of the scoping review: Table 3. Scoping review timeline. Task Timeframe Protocol registration & initial search August 2025 Full database search & screening September - October 2025 Data extraction & synthesis November- December 2025 Writing & submission of full review January 2025 This timeline ensures that all review stages are planned efficiently, while allowing for iterative adjustments as needed based on reviewer feedback or search complexity. Following a structured timeline also promotes methodological transparency and aligns with best practices in scoping review conduct. 21 3. Expected results This review anticipates identifying a range of epilepsy educational approaches used to address epilepsy awareness in primary, secondary schools and special education settings. Furthermore, it is expected that the findings will highlight a lack of availability of standardized or comprehensive epilepsy education curricula, especially in low-resource or rural settings, and may reveal that many programs lack formal evaluation. Ultimately, this review anticipates generating a synthesized evidence base that can inform the development of a culturally and regionally relevant and scalable epilepsy education curriculum. It may also reveal best practices and transferable models for broader adaptation. Ethical considerations As the review is based solely on secondary analysis of publicly available literature, it does not involve human participants and therefore does not require ethical clearance. However, the findings will directly inform the design of a future ethics-approved pilot intervention to be conducted globally. 4. Conclusion This scoping review will offer a comprehensive overview of the types and outcomes of primary, secondary schools and special education setting epilepsy curricula globally. By mapping existing practices and highlighting gaps in implementation and evaluation, the review will provide an essential foundation for future intervention design, policy advocacy, and inclusive education reform, particularly in under-resourced educational settings. Author statement on generative AI use We confirm that generative AI tools, including Grammarly, were used solely for paraphrasing, grammar correction, and language refinement purposes. The content, ideas, analysis, and conclusions presented in the manuscript are entirely my own and those of my co-authors. Data availability Underlying data No data associated with this article. Extended data OSF: Types of Epilepsy Curricula and Their Effectiveness: A Global Scoping Review Protocol of School-Based Educational Interventions, https://doi.org/10.17605/OSF.IO/Y7ZRN . 26 The project contains the following extended data: 1. PRISMA ScR Protocol Checklist Data are available under the terms of the Creative Commons Zero “No rights reserved” data waiver (CC0 1.0 Public domain dedication). Acknowledgments We wish to express our gratitude to the University of Venda for granting approval for our research project. Additionally, We wish to convey our appreciation to the University Staff Doctorate Programme ( USDP ) for their generous financial support for the Epilepsy Research Project, of which our study is an essential component. References 1. Ghosh S, Sinha JK, Ghosh SK, et al. : A Comprehensive Review of Emerging Trends and Innovative sTherapies in Epilepsy Management. Brain Sci. 2023; 13 (9). PubMed Abstract | Publisher Full Text | Free Full Text 2. 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Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 18 Sep 2025 ADD YOUR COMMENT Comment Author details Author details 1 Advanced Nursing Sciences, University of Venda, Thohoyandou, Limpopo, 0950, South Africa 2 Public Health, University of Venda, Thohoyandou, Limpopo, 0950, South Africa 3 Public Health, University of Venda, Thohoyandou, Limpopo, 0950, South Africa 4 University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA 5 Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA Thendo Gertie Makhado Roles: Conceptualization, Formal Analysis, Investigation, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Muimeleli Munyadziwa Roles: Formal Analysis, Investigation, Methodology, Writing – Original Draft Preparation Lufuno Makhado Roles: Methodology, Supervision, Writing – Review & Editing Michele Cooley-Strickland Roles: Formal Analysis, Supervision, Writing – Original Draft Preparation Competing interests No competing interests were disclosed. Grant information The funding for this study was provided by the University Staff Doctorate Programme (USDP) as part of the Epilepsy Research Project under the Junior Research Fellow. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (1) version 1 Published: 18 Sep 2025, 14:936 https://doi.org/10.12688/f1000research.169377.1 Copyright © 2025 Makhado TG et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. 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