Email updates

Keep up to date with the latest news and content from BMC Medical Informatics and Decision Making and BioMed Central.

Open Access Research article

Measuring the quality of Patients’ goals and action plans: development and validation of a novel tool

Cayla R Teal3, Paul Haidet4, Ajay S Balasubramanyam1, Elisa Rodriguez1 and Aanand D Naik12*

Author Affiliations

1 Houston VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA

2 Department of Medicine, Section of Health Services Research, Baylor College of Medicine, MEDVAMC HSR&D Center of Excellence, 2002 Holcombe Blvd. (152), Houston, TX, 77030, USA

3 Department of Medicine, Section of General Medicine, and the Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, TX, USA

4 The Office of Medical Education and the Departments of Medicine and Humanities, The Pennsylvania State University College of Medicine, Hershey, PA, USA

For all author emails, please log on.

BMC Medical Informatics and Decision Making 2012, 12:152  doi:10.1186/1472-6947-12-152

Published: 27 December 2012

Abstract

Background

The purpose of this study is to develop and test reliability, validity, and utility of the Goal-Setting Evaluation Tool for Diabetes (GET-D). The effectiveness of diabetes self-management is predicated on goal-setting and action planning strategies. Evaluation of self-management interventions is hampered by the absence of tools to assess quality of goals and action plans. To address this gap, we developed the GET-D, a criteria-based, observer rating scale that measures the quality of patients’ diabetes goals and action plans.

Methods

We conducted 3-stage development of GET-D, including identification of criteria for observer ratings of goals and action plans, rater training and pilot testing; and then performed psychometric testing of the GET-D.

Results

Trained raters could effectively rate the quality of patient-generated goals and action plans using the GET-D. Ratings performed by trained evaluators demonstrated good raw agreement (94.4%) and inter-rater reliability (Kappa = 0.66). Scores on the GET-D correlated well with measures theoretically associated with goal-setting, including patient activation (r=.252, P<.05), diabetes specific self-efficacy (r=.376, P<.001) and inverse relationship with depression (r= −.376, P<.01). Significant between group differences (P<.01) in GET-D scores between goal-setting intervention (mean = 7.33, standard deviation = 4.4) and education groups (mean = 4.93, standard deviation = 3.9) confirmed construct validity of the GET-D.

Conclusions

The GET-D can reliably and validly rate the quality of goals and action plans. It holds promise as a measure of intervention fidelity for clinical interventions that promote diabetes self-management behaviors to improve clinical outcomes.

Trial registration

Clinicaltrials.gov Identifier: NCT00481286

Keywords:
Goal-setting; Diabetes; Self-management; Goals; Action plans; Measurement