Goal-setting as a behaviour change technique in diabetes self-management: a systematic review of intervention studies

Abstract

Background: Diabetes self-management requires patients to engage in a range of complex behaviours. Self-management is often sub-optimal, leading to illness complications or mortality. Intervention programmes have been developed to improve diabetes self-management. Goal-setting is a widely used component of behaviour change interventions in diabetes. However, the effects of goal-setting on diabetes outcomes remain inconclusive. This study aims to identify which goal-setting behaviour change techniques (BCTs) are effective in improving outcomes in diabetes patients. Methods: Five databases were searched in 2015 to identify intervention studies, targeting diabetic control, which incorporated goal setting as a core component. Identified papers were double-screened for inclusion. Intervention content of included studies was coded for goal setting techniques using the BCT Taxonomy v1. An analysis was conducted to see which goal-setting BCTs are most frequently used and effective in improving behavioural, clinical, and health outcomes. Findings: Database searches identified 16040 citations. Title/ abstract screening with an inter-rater reliability of k= 0.75 led to 49 studies being screened at full text for inclusion. There was significant heterogeneity in intervention approaches in the identified studies. Improvements in diabetes-related self-efficacy, dietary intake, physical activity, and A1c were observed in some but not all studies. Effectiveness on patient outcomes was analysed per BCT and varied across techniques. Discussion: The BCT Taxonomy v1 identifies nine goal-setting and planning BCTs. Using this taxonomy in this review allowed the identification of effective goal-setting BCTs. More systematic research is needed to determine the conditions and specific behaviours for which goal-setting BCTs are most effective.