Goal setting in diabetes self-management: Taking the baby steps to success

Abstract

Objective To evaluate the usefulness of a diabetes self-management guide and a brief counseling intervention in helping patients set and achieve their behavioral goals. Methods We conducted a quasi-experimental study using a one group pretest posttest design to assess the effectiveness of a goal setting intervention along with a self-management guide. English- and Spanish-speaking patients with diabetes had one in-person session and two telephone follow-up calls with a non-clinical provider over a 12–16-week period. At each call and at the end of the study, we assessed success in achieving behavioral goals and problem solving toward those goals. Satisfaction with the self-management guide was assessed at the end of the study. Results We enrolled 250 patients across three sites and 229 patients completed the study. Most patients chose to set goals in diet and exercise domains. 93% of patients achieved at least one behavioral goal during the study and 73% achieved at least two behavioral goals. Many patients exhibited problem solving behavior to achieve their goals. We found no significant differences in reported achievement of behavior goals by literacy or language. Patients were very satisfied with the guide. Conclusions A brief goal setting intervention along with a diabetes self-management guide helped patients set and achieve healthy behavioral goals. Practice implications Non-clinical providers can successfully help a diverse range of patients with diabetes set and achieve behavioral goals.

Effect of a Self-Management Support Program on Diabetic Foot Care Behaviors

“…Previous study similarly reported that individual education sessions combined with an explanatory booklet were effective in improving the patients' diabetic foot care knowledge and behaviors within a period of 6 months (Vatankhah et al, 2009). Furthermore, the use of counseling related action plans and discussion of the subjects' difficulties in performing DFCB was instrumental in strengthening their problem solving skills, allowing them to overcome barriers in achieving the behaviors they wanted to implement (DeWalt et al, 2009).…”

“…These goals and action plans also provided clear guidance for the subjects as to what activities needed to be undertaken and how the desired goals were to be achieved. Additionally, the manner in which the goals were set allowed the subjects to set the most achievable goal first and once that goal was achieved that served to strengthen the subject's self-confidence, which in turn provided encouragement for them to successfully achieve further goals (Bodenheimer and Handley, 2009;DeWalt et al, 2009).…”

“…Detailed explanations of the goals, action plans and the goal achievement levels recorded in the current study have already been published in a separate article (Kurniawan et al, 2011). DeWalt et al (2009) reported that the use of a goal setting and action planning strategy combined with education sessions and brief counseling were effective in improving the patients' self-confidence to manage their diabetes foot care behavior. The use of the goal setting and action planning strategy was also reported to be effective in encouraging patients to adopt healthier behaviors (Bodenheimer and Handley, 2009;Handley et al, 2006;DeWalt et al, 2009;Cullen et al, 2001).…”

“…A Self-Management (SM) support program is one of the most effective strategies in improving health-related behaviors in chronically ill patients (Bodenheimer and Handley, 2009;Bodenheimer et al, 2002;DeWalt et al, 2009;Fan and Sidani, 2009;Handley et al, 2006). SM support programs include collaboration between patients and health care providers to ensure that patients actively adopt specific behaviors to prevent the adverse effects of chronic diseases (Bourbeau, 2008).…”

Supporting implementation of evidence-based behavioral interventions: the role of data liquidity in facilitating translational behavioral medicine

“…health can benefit [3]. Examples of translational behavioral interventions that span these blocks have been presented elsewhere, such as the application of basic scientific understanding of diabetes and its management (T1) to develop behavioral interventions for diabetes self-management (T2) [4] and the cultural tailoring of these same interventions to most effectively reach identified populations in need (T3) [5].…”