Abstract TP469: The Goal Attainment Measure (GAM-S) for Secondary Stroke Risk Factors Management: Pilot Test and Psychometric Analysis

Abstract

Background and Purpose: Stroke is strongest predictor of a subsequent stroke. Risk factor self-management (SM) prevents many strokes. In SM context, goal setting has been used as outcome measure to assess improvements of physical function. However, there is a dearth of psychometrically valid instruments to measure goal attainment through SM of risk factors. We pilot GAM-S with patients and providers and test scale for usability, content validity and internal consistency. Methods: Ten registered nurse dyads and 44 patients were recruited from Veterans Administration Medical Center. In a pre-experimental pre/post design, nurses delivered one-on-one education and set goals with patients. Nurses in primary care phoned patients 2-weeks post-discharge and evaluated goal attainment with GAM-S. Content validity was evaluated based on experts’ rating. Patients and providers rated GAM-S on ease of use, understandability, credibility and motivational appeal. Results: Participants: patients, N=44, 95% male, 36-81 yrs, mean age 67: providers, N=20, and experts, N=7. Forty-two patients (95%) completed GAM-S. Most experts (71%) specified that each scale item is essential, indicating content validity. GAM-S usability was analyzed descriptively. Detailed results will be presented. GAM-S providers’ usability was scored high: mean score 3.7 (SD 0.24), on 4 points scale. Coefficient of variation (SD/mean) was 6%. Cronbach's alpha for 42 respondents based on 4 items was 0.962 indicating strong internal consistency. Conclusion: We established acceptable ratings for GAM-S for use in clinic setting and demonstrated content validity and internal consistency. These findings suggest future efficacy of GAM-S to determine its impact on patient goal setting behavior.