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

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.

[1]  Brendan Reilly,et al.  Preferences for self-management support: findings from a survey of diabetes patients in safety-net health systems. , 2008, Patient education and counseling.

[2]  D. Schillinger,et al.  Behavior-change action plans in primary care: a feasibility study of clinicians. , 2006, Journal of the American Board of Family Medicine : JABFM.

[3]  K. Lorig,et al.  Self-management education: History, definition, outcomes, and mechanisms , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[4]  T. Bodenheimer Coordinating care--a perilous journey through the health care system. , 2008, The New England journal of medicine.

[5]  S. Humiston,et al.  Improving vaccine risk/benefit communication with an immunization education package: a pilot study. , 2002, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[6]  Dean Schillinger,et al.  Facilitating behavior change with low-literacy patient education materials. , 2007, American journal of health behavior.

[7]  R. Jackson,et al.  Intervention to increase mammography utilization in a public hospital , 2007, Journal of General Internal Medicine.

[8]  K. Lorig Action planning: a call to action. , 2006, Journal of the American Board of Family Medicine : JABFM.

[9]  A. Rademaker,et al.  Health care provider-directed intervention to increase colorectal cancer screening among veterans: results of a randomized controlled trial. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[10]  M. Handley,et al.  The Action Plan Project: Discussing Behavior Change in the Primary Care Visit , 2005, The Annals of Family Medicine.

[11]  R. Glasgow,et al.  The Frequency and Behavioral Outcomes of Goal Choices in the Self-management of Diabetes , 2005, The Diabetes educator.

[12]  D. Schillinger,et al.  Literacy-appropriate educational materials and brief counseling improve diabetes self-management. , 2009, Patient education and counseling.

[13]  H. Holman,et al.  Helping Patients Adopt Healthier Behaviors , 2007 .

[14]  Dean Schillinger,et al.  Using action plans to help primary care patients adopt healthy behaviors: a descriptive study. , 2006, Journal of the American Board of Family Medicine : JABFM.

[15]  D. Baker,et al.  Development of a brief test to measure functional health literacy. , 1999, Patient education and counseling.

[16]  Dean Schillinger,et al.  Seeing in 3-D: Examining the Reach of Diabetes Self-Management Support Strategies in a Public Health Care System , 2008, Health education & behavior : the official publication of the Society for Public Health Education.

[17]  T. Davis,et al.  Health Literacy and Cancer Communication , 2002, CA: a cancer journal for clinicians.

[18]  Michael A Weiss,et al.  National Standards for Diabetes Self-Management Education , 2000, Diabetes Care.

[19]  Mark V. Williams,et al.  Test of Functional Health Literacy in Adults , 2016 .