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Neuropsychological status of alcohol-dependent patients: increased performance through goal-setting instructions.

AIMS: The effects of goal-setting instructions on neuropsychological performance of alcohol-dependent patients and control subjects were assessed. METHODS: 57 alcohol-dependent patients and 59 carefully age- and education-matched healthy control subjects underwent standard neuropsychological investigation. In addition, the goal-setting paradigm was used to systematically manipulate motivation. Participants were requested to calculate simple mathematical problems repeatedly within phases of a 2-min duration receiving normal or goal setting-instructions (to increase performance in the next phase by 20%). RESULTS: The patients demonstrated deficits in standard neuropsychological tests. Patients under goal-setting instructions demonstrated significantly higher improvement (correct responses: P = 0.016) relative to patients with standard instructions. Control subjects with goal-setting instructions demonstrated tendencies for higher improvement relative to control subjects with normal instructions. However, the differences were not significant. Interaction of group (patients vs. control subjects) and instructions (goal setting vs. normal) remained insignificant (P = 0.489) indicating that the increase through goal setting for the patients was not significantly higher than that for the control subjects. CONCLUSIONS: Despite of neuropsychological deficits in reasoning and psychomotor functioning, alcohol-dependent patients early in recovery are responsive to goal setting and able to increase neuropsychological performance. Therefore, goal-setting strategies might possibly be used in cognitive rehabilitation and therapy of alcohol-dependent patients. As there was no significant interaction in increase between patients and control subjects, our results do not support the hypothesis that the neuropsychological deficits are affected by or even caused by motivational limitations of the alcohol-dependent patients.

Adult↗

Goal setting and health risk reduction.

The effectiveness of client participation in goal selection aimed at health risk reduction was compared with the effectiveness of provider-selected goals and of no goal setting. No difference in goal attainment was found between the two groups with goals. However, analyses of covariance for selected subsamples of individuals at risk revealed a significant difference between goal-setting groups for weight reduction, with the collaborative goal-setting group being more effective. Covariance analyses for other subsamples at risk showed significant differences between the goal-setting groups for current health age and potential for life expectancy increase; the provider goal-setting group proved to be more effective. Paired t tests within groups revealed that the provider goal-setting group made significant change in alcohol intake, seat belt use, and exercise as well as in global measures of current health age, estimated life expectancy, and potential for life expectancy increase. For the collaborative goal-setting group, significant change was found in weight reduction, exercise levels, and the global measures of estimated life expectancy and potential for life expectancy increase. The control group made a significant change in exercise, but not in any of the global measures of risk reduction.

Adult↗

Work-site health promotion: the effects of a goal-setting program on nutrition-related behaviors.

A Goal Attainment Scaling procedure was used to quantify and evaluate change in nutrition-related behaviors of participants in a work-site wellness program. Goal Attainment Scaling is a procedure for quantifying change over time, in five categories varying from "less than expected" success to "more than expected" success. The sample consisted of 60 enlisted military personnel who had indicated, on a screening questionnaire, their desire to improve dietary practices. The subjects were assigned to three groups but remained unaware throughout the study that nutrition was being investigated. The Goal-Setting/Goal Attainment group (GSGA, no. = 19) received a full 8-week health promotion program, based on goal-setting, fitness information, and skill development (12 sessions). The Goal-Setting group (GS, no. = 19) received only the part of the program that focused on setting goals (two sessions). The control group (no. = 22) received no instruction. Results from analysis of variance indicated that GSGA had significantly higher "Change Scores" in nutrition-related behaviors than the control group (p less than .05); "Change Scores" reflect degree of dietary improvement. Frequency data indicate that dietary improvements were sustained for 84% of the GSGA members, 64% of the GS members, and 37% in the control group. These findings suggest goal-setting skills enhance individuals' capabilities for making and maintaining improvements in nutrition-related behaviors.

Adult↗

Awareness of activity limitations, goal setting and rehabilitation outcome in patients with brain injuries.

PRIMARY OBJECTIVE: To examine the relationship between self-awareness, goal setting ability (i.e. ability to set realistic goals) and performance/outcome in a cognitive task and for rehabilitation. RESEARCH DESIGN: Regression analyses were conducted to compare the predictive power of self-awareness and demographic/neuropsychological variables on goal setting ability and performance/outcome. METHODS AND PROCEDURES: Self-awareness of 63 patients with brain injuries was measured by direct clinicians' rating and the difference between patient and staff ratings in a questionnaire. RESULTS: The awareness measures predicted 32% of the variance for goal setting ability in the rehabilitation context but only 4% of the goal setting variance in the cognitive task. Similarly, self-awareness predicted 33% of the variance for rehabilitation outcome but only 5% of the performance in the cognitive task. CONCLUSIONS: Self-awareness seems to be related to goal setting ability and outcome in a long-term rehabilitation process but less in short-term experimental tasks.

Adult↗

[Effect of goal setting on information processing in letter comparison tasks].

In two laboratory experiments (N1 = 84, N2 = 20) the impact of goal setting on information processing (perception) in letter-matching tasks was examined. It was expected that setting difficult goals for reaction times improves performance because identification and especially semantic classification of letters should be speeded up under goal-setting instructions. Three findings can be emphasized. (1) Current models of simultaneous letter matching are incomplete because they do not account for differences in reaction time based on alphabetic variations (lower case vs. upper case letters) within a pair of letters that are largely independent of real letter sizes. (2) In both experiments and for all types of letter pairs (AA, Aa, Ab AB), goal-setting effects are found as expected. In addition, the explanation that these effects are due to a speed-accuracy trade-off can be excluded. (3) Moreover, in some conditions goal-setting effects are also influenced by special features of letter pairs. Specifically, goal-setting effects are especially strong for letter pairs in which the right letter was enlarged and in which alphabetic differences and semantic differences within pairs call for opposite answers (Aa, AB). Based on the overall pattern of results, it is concluded that difficult goals lead to a general facilitation of processes in visual perception and, in addition, to a reduction of stimulus-induced, performance-delaying inhibition processes if linguistic information is processed predominantly in the left hemisphere.

Adult↗

Goal setting as a strategy for dietary and physical activity behavior change: a review of the literature.

OBJECTIVE: Estimate effectiveness of goal setting for nutrition and physical activity behavior change, review the effect of goal-setting characteristics on behavior change, and investigate effectiveness of interventions containing goal setting. DATA SOURCE: For this review, a literature search was conducted for the period January 1977 through December 2003 that included a Current Contents, Biosis Previews, Medline, PubMed, PsycINFO, and ERIC search of databases and a reference list search. Key words were goal, goal setting, nutrition, diet, dietary, physical activity, exercise, behavior change, interventions, and fitness. STUDY INCLUSION AND EXCLUSION CRITERIA: The search identified 144 studies, of which 28 met inclusion criteria for being published in a peer reviewed journal and using goal setting in an intervention to modify dietary or physical activity behaviors. Excluded from this review were those studies that (1) evaluated goal setting cross-sectionally without an intervention; (2) used goal setting for behavioral disorders, to improve academic achievement, or in sports performance; (3) were reviews. DATA EXTRACTION AND SYNTHESIS: The articles were categorized by target audience and secondarily by research focus. Data extracted included outcome measure, research rating, purpose, sample, sample description, assignment, findings, and goal-setting support. RESULTS: Thirteen of the 23 adult studies used a goal-setting effectiveness study design and eight produced positive results supporting goal setting. No adolescent or child studies used this design. The results were inconclusive for the studies investigating goal-setting characteristics (n = 7). Four adult and four child intervention evaluation studies showed positive outcomes. No studies reported power calculations, and only 32% of the studies were rated as fully supporting goal setting. CONCLUSIONS: Goal setting has shown some promise in promoting dietary and physical activity behavior change among adults, but methodological issues still need to be resolved. The literature with adolescents and children is limited, and the authors are not aware of any published studies with this audience investigating the independent effect of goal setting on dietary or physical activity behavior. Although, goal setting is widely used with children and adolescents in nutrition interventions, its effectiveness has yet to be reported.

Diet↗

Does self-regulation require cognitive resources? Evaluation of resource allocation models of goal setting.

The resource allocation model of goal setting (R. Kanfer & P.L. Ackerman, 1989) maintains that self-regulation initiated through goal setting requires attentional resources that could be more productively applied to skill acquisition and complex task performance. The current study questioned this hypothesis because attentional resources had not been directly manipulated or measured in studies supporting the model. Thus, alternative explanations that are based on other complex task goal-setting models cannot be excluded. As a direct test of the resource allocation hypothesis, dual task methodology was used to measure the attentional resource requirements of self-regulation. Even at the limits of human information processing, participants who were assigned difficult, specific goals performed at least as well on the secondary task as did individuals with do-your-best goals. These findings suggest that self-regulation does not necessarily require attentional resources. Implications for theory and practice are discussed.

Adolescent↗

Combined effect of goal setting and self-talk in performance of a soccer-shooting task.

To examine the combined effect of goal setting and self-talk, 41 professional and semiprofessional soccer players from four different teams were tested on a soccer-shooting task. Teams were assigned to one of four conditions: (a) self-talk, (b) goal setting, (c) goal setting plus self-talk, and (d) do your best control. Subjects performed one baseline measurement and three experimental sessions. Analysis showed that performance, compared to the do your best condition, in the combined condition is immediately enhanced, whereas self-talk and goal-setting effects were significant from Session 3. No significant differences in performance were observed among experimental groups, except in Session 2, during which the combined group scored significantly better than the goal-setting group. It seems that, whereas both goal setting and self-talk are effective in enhancing performance, some advantage may be derived from a combined intervention. Findings are discussed in the perspective of past research efforts on goal setting and self-talk.

Achievement↗

Goal setting frequency and the use of behavioral strategies related to diet and physical activity.

Goal setting is an effective way to focus attention on behavior change. Theoretically, frequency of goal setting may indicate the level of commitment to diet and physical activity behavior change. Yet, little is known about the association between goal setting frequency and use of specific diet or physical activity-related strategies. This study examines whether changes in goal setting frequency predict changes in use of behavioral strategies over time, controlling for baseline strategy use, demographics and whether a person was trying to lose weight. Data are from a baseline and 1-year follow-up survey of adults in rural Iowa (n = 385). Overall, goal setting frequency was positively associated with use of the strategies measured, at baseline and overtime. Frequent goal setting that is focused specifically on diet or physical activity was more predictive of using dietary or physical activity strategies, respectively, than goal setting focused on weight loss overall. The study provides empirical support for what has been assumed theoretically, that is, frequent goal setting for weight management is an indicator of use of specific behavioral strategies. Significant challenges remain in regard to maintenance of this activity and attainment of weight loss goals.

Adult↗

The effects of goal setting on rugby performance.

Goal-setting effects on selected performance behaviors of 5 collegiate rugby players were assessed over an entire competitive season using self-generated targets and goal-attainment scaling. Results suggest that goal setting was effective for enhancing task-specific on-field behavior in rugby union.

Adult↗

Staff nurse performance. Effects of goal-setting and performance feedback.

Goal-setting and performance feedback have motivated improved performance in various occupational groups for over 30 years. During the current time of staffing cutbacks and increased patient acuity, the nurse administrator has growing concern for the morale of the nursing staff. In this study, goal-setting and performance feedback, used in conjunction with a performance appraisal session, were successful in improving the performance of staff nurses. The author outlines the implications for head nurse training.

Adult↗

Effects of goal-setting and feedback on memory performance and beliefs among older and younger adults.

This research examined the impact of goal-setting conditions on memory beliefs and performance among older and younger adults. After baseline recall and assessment of beliefs, participants were assigned to goal-setting, goals plus feedback, or control. Then, additional recall trials were followed by repeated memory beliefs assessments. For both younger and older adults, performance, motivation, and self-efficacy were affected positively by goal-setting. The impact of goals plus feedback was mixed and varied as a function of age and dependent measure. Success rates for reaching memory goals, which were low for the older adults, may have been a factor in these results. Adults' self-set recall goals were predicted initially by baseline performance and self-efficacy. On the final trial, goals were predicted by last trial performance, self-efficacy, and control beliefs.

Adolescent↗

Self-regulation of goal setting: turning free fantasies about the future into binding goals.

Fantasy realization theory states that when people contrast their fantasies about a desired future with reflections on present reality, a necessity to act is induced that leads to the activation and use of relevant expectations. Strong goal commitment arises in light of favorable expectations, and weak goal commitment arises in light of unfavorable expectations. To the contrary, when people only fantasize about a desired future or only reflect on present reality, expectancy-independent moderate goal commitment emerges. Four experiments pertaining to various life domains supported these hypotheses. Strength of goal commitment was assessed in cognitive (e.g., making plans), affective (e.g., felt attachment), and behavioral terms (e.g., effort expenditure, quality of performance). Implications for theories on goal setting and goal striving are discussed.

Adolescent↗

A survey of goal-setting methods used in rehabilitation.

OBJECTIVES: This survey provides a description of the goal-setting methods that are currently being used in community and inpatient rehabilitation centers across the United Kingdom. Given current policy, emphasis was placed on finding out how much patient involvement in the goal-setting process exists, concentrating on how such involvement may be facilitated. DESIGN: A postal survey design was used to access a large sample size over a broad geographical area. The questionnaire was piloted at a British Society for Rehabilitation Medicine (BSRM) meeting; subsequently, some response categories were expanded. The questionnaire was approved by the BSRM Research and Clinical Standards committee. Questionnaires were coded to track responses from individuals. The received data were anonymized and analyzed using a statistics package for social science (SPSS) database. Subjects. Members of the BSRM were selected for this survey because this represents one of the most comprehensive listings of rehabilitation services in the United Kingdom. RESULTS: The survey had a 60% response rate. A problem-orientated approach to goal setting was most commonly reported, with rehabilitation teams defining, formulating, and evaluating the goals. Patients were supplied with limited information about goal setting during their rehabilitation admission, although 60% of respondents reported giving patients a copy of their goals. Thirty percent of respondents used goals as a measure of rehabilitation effectiveness. Standardized goal-setting measures were not commonly used. CONCLUSION: These data demonstrate that individual disciplines tend to discuss potential goals with their patients during treatment sessions and then formulate goals on the basis of the discussion. There is scope to develop and refine the approach to goal setting so the patients have more opportunities to engage in the goal-setting process.

Case Management↗

Goal-setting protocol in adherence to exercise by Italian adults.

A goal-setting protocol, based on research in goal setting and performance and personal construct theory, was tested for its effect on adherence to a new exercise program. The Goal-setting group (n = 50) had significantly less dropout (30%) than the control group (n = 50) (74%). The Goal-setting group also had significantly better attendance (p<.0001). Suggestions for increasing confidence in findings through further research and practical implications of using the protocol to improve exercise maintenance across settings were discussed.

Adult↗

Injury rehabilitation: a goal-setting intervention study.

The study examined the effects of a 5-week goal-setting intervention on athletes' rehabilitation adherence, self-efficacy, treatment efficacy, and the psychological response variables: dispirited and reorganization. Participants were matched across six variables and randomly assigned to one of three groups: goal-setting intervention, social support control, and control. The results confirmed some of the hypothesized effects of the goal-setting intervention: (a) athlete self-report of adherence showed the goal-setting group adhered significantly more to the rehabilitation program than the other two groups; (b) the goal-setting intervention resulted in significant group differences for self-efficacy (the goal-setting group having the highest level of self-efficacy); and (c) there was a significant increase across time for reorganization and decrease across time for dispirited (between specific time phases).

Adolescent↗

Patient participation in physical therapy goal setting.

BACKGROUND AND PURPOSE: An important part of treatment planning in physical therapy is effective goal setting. The Guide to Physical Therapist Practice recommends that therapists should identify the patient's goals and objectives during the initial examination in order to maximize outcomes. The purpose of this study was to examine whether therapists seek to involve patients in goal setting and, if so, what methods they use. Therapists' attitudes toward participation and patient satisfaction with the examination were also examined. SUBJECTS AND METHODS: Twenty-two physical therapists audiotaped the initial examination of 73 elderly patients (mean of 76.4 years of age, SD = 7.1, range = 65-94). The audiotaped examinations were then scored using the Participation Method Assessment Instrument (PMAI) to determine the frequency of attempts made by therapists to involve patients in goal setting. Therapists and patients completed surveys following the examinations. RESULTS: Therapists' use of participation methods during examinations ranged from a minimum of 1 to a maximum of 19 out of 21 possible items on the PMAI. The therapists stated that they believed that it is important to include patients in goal-setting activities and that outcomes will be improved if patients participate. Patients also indicated that participation is important to them. DISCUSSION AND CONCLUSION: In most cases, the therapists did not fully take advantage of the potential for patient participation in goal setting. Patient and therapist education is needed regarding methods for patient participation during initial goal-setting activities.

Aged↗

How is goal setting used in interventions for chronic disease prevention and management in sub-Saharan Africa? A systematic review and narrative synthesis.

Non-communicable diseases are increasingly prevalent in sub-Saharan Africa, and goal setting is often used to promote healthy self-management behaviours. In this review, we aimed to synthesise literature around how goal setting is used, for application in future interventions in the region. A systematic search was conducted in six databases and results screened for eligibility. Study characteristics, intervention details, goal setting components, feedback from participants and facilitators were extracted. Data were analysed using narrative synthesis and thematic analysis. The Mixed Methods Appraisal Tool was used to assess study quality. We included 24 publications describing 18 unique interventions. Included studies were of high to moderate methodological quality. Goal setting intervention components were informed by a variety of frameworks and involved a range of tasks. Interventions were often facilitator-led; many were conducted in group settings. Participants reported goal setting as useful for putting self-management into practice but encountered challenges related to language and literacy levels. Adequate detail on goal setting intervention components was not always present. Through this review, we provide a comprehensive picture of the variability of goal setting approaches in chronic disease prevention and management in sub-Saharan Africa and recommend more standardised use and reporting of goal setting intervention components.

Humans↗