Abstract

Objective

We know little about how goal setting is actually delivered in routine practice. The National Health Service Diabetes Prevention Programme (NHS-DPP) is a behavioural intervention aiming to prevent progression to Type 2 diabetes in those at risk. It has been delivered across England by four commercial providers. This study aimed to establish whether goal setting in the NHS-DPP was delivered in line with the current evidence base. Design: Observational study and document review. One-hundred-and-eighteen NHS-DPP sessions with 419 people were observed at eight sites (two sites per provider). Main outcome measures: Multiple characteristics of goal setting were reliably coded from each providers’ programme plans (intended goal setting) and from audio-recorded NHS-DPP sessions (actual goal setting). Results: Providers intended to deliver goal setting in 88.3% of sessions, though goal setting was delivered in only 52.5% of sessions. During delivery, the observed goals set across providers were generally specific (62.5%), set privately (53.1%), with goal difficulty rarely mentioned (3.1%). Conclusions: Goal setting in the NHS-DPP is being under-delivered, and not in line with the evidence base for promoting behavioural change. Goal setting in national behaviour change programmes should be optimised and training provided specifically for goal setting.

摘要

客观的

我们对如何在日常实践中实际实现目标设定知之甚少。国家卫生服务糖尿病预防计划 (NHS-DPP) 是一项行为干预措施，旨在防止高危人群发展为 2 型糖尿病。它已由四家商业供应商在英格兰各地交付。本研究旨在确定 NHS-DPP 中的目标设定是否符合当前的证据基础。设计：观察性研究和文件审查。在 8 个站点（每个提供者两个站点）观察到 419 人的 18 个 NHS-DPP 会议。主要观察指标：从每个提供者的计划计划（预期目标设定）和录音 NHS-DPP 会话（实际目标设定）中可靠地编码了目标设定的多个特征。结果：提供者打算在 88.3% 的会话中提供目标设置，但目标设置仅在 52.5% 的会话中提供。在交付期间，观察到的跨提供商设定的目标通常是具体的（62.5%），私人设定的（53.1%），很少提及目标难度（3.1%）。结论： NHS-DPP 的目标设定未完成，与促进行为改变的证据基础不符。应优化国家行为改变计划中的目标设定，并专门针对目标设定提供培训。