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Health-Related Goal Setting and Achievement Among Veterans with High Technology Adoption

JOURNAL OF GENERAL INTERNAL MEDICINE(2021)

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摘要
Background There is increasing recognition of the importance of supporting patients in their health-related goals. Patient-provider discussions and health-related mobile applications (apps) can support patients to pursue health goals; however, their impact on patient goal setting and achievement is not well understood. Objective To examine the relationships between the following: ( 1 ) patient demographics, patient-provider discussions, and health-related goal setting and achievement, and ( 2 ) patient mobile health app use and goal achievement. Design Cross-sectional survey. Participants Veterans who receive Veterans Health Administration (VA) healthcare and are users of VA patient-facing technology. Main Measures Veteran demographics, goal-related behaviors, and goal achievement. Methods Veterans were invited to participate in a telephone survey. VA administrative data were linked to survey data for additional health and demographic information. Logistic regression models were run to identify factors that predict health-related goal setting and achievement. Key Results Among respondents ( n =2552), 75% of patients indicated having set health goals in the preceding 6 months and approximately 42% reported achieving their goal. Men (vs. women) had lower odds of setting goals (OR: 0.71; CI95: 0.53–0.97), as did individuals with worse (vs. better) health (OR: 0.18; CI95: 0.04–0.88). Individuals with advanced education—some college/college degrees, and post-college degrees (vs. no college education)—demonstrated higher odds of setting goals (OR: 1.35; CI95: 1.01–1.79; OR: 1.71; CI95: 1.28–2.28, respectively). Those who reported having discussed their goals with their providers were more likely to set goals (OR: 3.60; CI95: 2.97–4.35). Patient mobile health app use was not statistically associated with goal achievement. Conclusions Efforts to further promote patient-led goal setting should leverage the influence of patient-provider conversations. Use of patient-facing technologies, specifically mobile health apps, may facilitate goal-oriented care, but further work is needed to examine the potential benefits of apps to support patient goals, particularly if providers discuss and endorse use of those apps with patients.
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关键词
goal setting,patient engagement,technology,mobile health apps,Veterans
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