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Who Decides? Self-Selected versus Assigned Goals for Weight Loss in a Veteran Population

AuYoung M, Damschroder LJ, Hughes ME, Youles B, Holleman R, Richardson CR. Who Decides? Self-Selected versus Assigned Goals for Weight Loss in a Veteran Population. Paper presented at: Society of Behavioral Medicine Annual Meeting and Scientific Sessions; 2016 Mar 31; Washington, DC.


Abstract Body Goal setting has been associated with greater likelihood of successful outcomes for behavioral changes such as weight loss. However, there are many characteristics of goals that also influence outcomes, including goal specificity, proximity, and acquisition. The literature indicates that greater success is associated with more specific, measurable goals that are also more proximal. Within health behavior, there is a trend towards the use of patient-centered goals (rather than assigned goals) based on Self-Determination Theory. However, there are no known studies that link the goal acquisition with outcomes. This secondary analysis will assess the impact of goal type on patient outcomes within a Veteran population. In a pragmatic trial, eligible Veterans were randomly selected into one of three study arms: in-person diabetes prevention program (DPP), online DPP, and a usual care weight management program. One main program difference was whether health-related goals were determined by the patients themselves or assigned to them. Otherwise, all three arms were designed to help patients achieve weight loss through changes in physical activity (PA) and diet. This sample includes patients who completed questionnaires at 12-months post-intervention. Patient weights were provided through clinical data sources. The majority of patients reported setting their own goals for weight loss (64%), PA (64%), and/or diet (40%) rather than having goals set by a provider or program or by using a collaborative process of goal setting. Participants who set their own goals lost 11.07 lbs more weight compared to participants who had goals set for them (p = 0.014) and 4.45 lbs more weight than those who collaboratively set goals (p = 0.04). Goal type was not associated with diet or PA outcomes, however. For weight loss, these results provide support for programs that are moving increasingly toward more patient-centered care which includes encouraging patients to set their own goals.

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