SMAs And Goal Setting
How many times have you set a healthcare goal and failed to meet it? Yeah, me neither.
Changing behaviors around our health is incredibly difficult. Whether it is losing weight, exercising more, monitoring our blood glucose levels, or taking our prescriptions regularly, we all struggle to meet our goals. Part of this is because we are often doing it on our own. Part of it is because it seems to get in the way of our everyday lives. Part of it is forgetfulness.
We all have things that get in our way. Our physicians can try to help us, but when we only have 15 minutes with them we tend not to talk about our lives. We focus on how our bodies feel, what our immediate issues are, and what we need until the next time we meet.
Shared medical appointments change all that.
Typically, health-related goals actually conflict with people’s central life goals. However, research suggests that when patients participate in the decision making process, they are more likely to adopt the agreed upon behavior. Because shared medical appointments offer a more holistic care option, patients don’t have to feel like their life is separate from their health. They have the opportunity to discuss their barriers to behavior change and get feedback from other patients in addition to the healthcare team.
Goal setting is weaved throughout all shared medical appointments. Some organizations even train their behaviorists on motivational techniques for goal setting. In standard one-on-one appointments, one study found that diet and physical activity counseling, which often includes goal setting, occurred less than 50% of the time (Bodenheimer & Handley, 2009) despite its correlation to many chronic conditions being managed by patients. Because shared medical appointment teams have at least one member trained in goal setting, there is an opportunity to improve this statistic.
Collaborative goal setting occurs when the provider and the patient agree on a health-related goal together. There are two types of goals, specific and general. Specific goals are called action plans, which are smaller steps that will move the patient towards a larger, more general goal. The workplace goal setting research of the 1970s and 1980s found that workers who were given long-term goals did not perform as well as those given both short and long-term, and this research has carried through to healthcare goal setting.
Two of the most important factors in facilitating goal achievement are:
- The belief that achieving a goal is important.
- The confidence in one’s ability to achieve said goal (also known as self-efficacy).
Shared medical appointments have been shown to increase patient self-efficacy. The stronger a patient’s perceived self-efficacy:
- The higher the goals they will set for themselves
- The firmer their commitment will be to the goal
- The more likely they are to act on a goal
- The more likely they are to develop tactics to reach a goal
To sum it up – having a SMA facilitator trained in goal setting could help your patients be healthier people. And what’s better than that?