Personal Goal Attainment Research Articles

Effect of Paliperidone Palmitate 3-Month Formulation on Goal Attainment and Disability After 52 Weeks' Treatment in Patients with Clinically Stable Schizophrenia.

PurposeThis pragmatic clinical study aimed to assess goal attainment among patients with schizophrenia treated with paliperidone palmitate 3-monthly (PP3M) and its relation to their level of disability, and whether patients achieved symptomatic remission at the study endpoint.Patients and MethodsGoal attainment was assessed as a secondary endpoint using Goal Attainment Scaling (GAS) within a 52-week, prospective, single-arm, non-randomized, open-label, international, multicenter study evaluating the impact of transitioning stable patients with schizophrenia from paliperidone palmitate 1-monthly (PP1M) to PP3M. Additional exploratory analyses were performed to investigate the relationship between disability and functioning as measured by the World Health Organization Disability Assessment Schedule (WHODAS), Version 2.0, symptomatic remission, and goal attainment.ResultsOverall, 305 patients were enrolled, of whom 281 (92.1%) provided GAS data at baseline. Of these, 160 achieved symptomatic remission at the last observation carried forward (LOCF) endpoint. The most common category of goals was “self” related, of which work-related was most frequent. Two-thirds of patients (67.7%) achieved at least one goal at the LOCF endpoint. Goal achievement was positively associated with lower baseline symptoms and symptomatic remission at LOCF endpoint, and with lower WHODAS scores at baseline and LOCF endpoint and greater WHODAS score improvements from baseline. Age, duration of disease, and duration of PP1M treatment before the switch did not impact goal setting and goal attainment. The proportion of patients with remunerated work status increased by 11.3% at LOCF endpoint.ConclusionThe results of this secondary endpoint analysis indicate that continued treatment of patients with schizophrenia with PP3M following stabilization with PP1M may facilitate attainment of patients’ personal goals and reduce disability, especially, but not exclusively, in patients with symptomatic remission achieved at LOCF.

Group education program for hypertension control.

Hypertension continues to be a health crisis, with multiple approaches attempting to define best practices for management. The objective of our hypertension group education program is to improve patient health outcomes through engaging a multidisciplinary health professional team. A 6-hour group curriculum was created with a focus on nutrition, lifestyle, and medication approaches to hypertension management, while incorporating personally identified behavior change goals and barriers. Outcomes were tracked pre-program, at program completion, and 6 and 12months post-program completion. Program participants demonstrated immediate and sustained improvements in blood pressure readings and attainment of personal behavior change goals. Group hypertension education classes are an effective way to care for patients. Additional healthcare resources should be dedicated to creating and evaluating educational delivery models that are sustainable and provide results over time, including financial implications to the health system.

The Relationship between Terminology Preferences, Empowerment and Internalised Stigma in Mental Health

People with a mental illness may be exposed to stigma which, when internalised, negatively influences self-esteem, personal goal attainment and quality of life. However, people who are empowered may actively challenge stigma by engaging in meaningful opportunities, furthering their self-worth as they achieve control within their lives. People who are empowered through active treatment participation are more likely to reach recovery goals and experience the benefits of evidence-based practices. Hence, empowerment can be viewed as essential to the recovery and well-being of people with a mental illness. Participants in this quantitative study (N = 173) were diagnosed with a mental illness and were recruited via convenience sampling from mental health support groups in Australia. Internalised stigma was less common and empowerment more prevalent in this study than was found in previous studies. However high internalised stigma and low empowerment were present. The terms ‘individual’ and ‘person with lived experience’ which have been identified as the preferred terms in a previous study were highlighted as both empowering and recovery focussed.

LEADERSHIP ROLES TOWARDS COACHING CULTURE: A REVIEW OF 1ST LINE MANAGERS AT HIGHER EDUCATIONAL INSTITUTION

Coaching in the workplace often involves helping people to manage transitions in terms of personal development, goal attainment or role changes within organizations, this including leadership roles. Based on Global Leadership Forecast 2018, more than 1 000 chief level (C-level) executives worldwide identified the issues they expect to command their attention in 2019 whereby the top challenges is on developing the ‘next gen’ leaders. It is clearly indicated that top talent and effective leaders will be needed to address the myriad current challenges and to position their organization for future success. This paper contributes to the literature on leadership roles towards coaching culture and exploring the issues associated with its acceptance by higher education institution. The aim of this paper is to review the leadership roles towards coaching culture in the scope of 1st line managers at higher education institution. The aim of this paper is to investigate the benefits gained by organizations specifically higher education institution by implementing leadership roles in their coaching culture.

Terminology Preferences in Mental Health

People with a mental illness may be exposed to stigma which, when internalised, negatively influences self-esteem, personal goal attainment and quality of life. Avoiding the use of stigmatising language and using terminology that does not exclude the positive characteristics of the individual may play an important role in challenging stigma. This study involved a mixed method approach to identify the terminology preferences of people with a mental illness in Australia. N = 173 participants were recruited via convenience sampling. The humanistic terms ‘individual’ and ‘person with lived experience’ were identified as the preferred terms. Qualitatively there was a wide variation in how the terms made the respondents think or feel, with only one of the terms – ‘survivor,’ having solely negative themes. When contrasting the two most commonly used clinical terms, ‘client’ was significantly preferred to ‘patient’. The term ‘consumer’ was one of the least preferred terms. This suggests that the use of this term, which is in regular use in Australia, should be reconsidered.

Application of Marte Meo\xae counselling with people with behavioural variant frontotemporal dementia and their primary carers (AMEO-FTD) \u2013 a non-randomized mixed-method feasibility study

BackgroundOne of the core symptoms of behavioural variant frontotemporal dementia (bvFTD) is the early loss of social cognitive abilities, which has a deteriorating impact on everyday interaction and the quality of dyadic relationships. Marte Meo® (MM) counselling is a video-based intervention that aims to maintain or improve the quality of dyadic relationships. This non-randomized mixed-method study aimed to evaluate the feasibility of the intervention in practice with primary carers of persons with bvFTD as well as the feasibility of a future confirmatory trial.MethodsA pilot effect study with a quasi-experimental, one-group, pre-post design and double pre-measurement was conducted. Data were collected at three time points (t0, t1 after 2 weeks, and t2 after 6 weeks) using videography and several measurement instruments. Between t1 and t2, each primary carer received five MM counselling sessions. The outcomes included positive and negative affect, behavioural and psychological symptoms in dementia (BPSD), the interpersonal abilities of the person with dementia, the sensitivity and distress of the primary carers due to BPSD, the manageability of BPSD, the personal goal attainment by means of MM counselling, and the quality of the dyadic relationships. The pilot process evaluation focused on the primary carers’ and the interventionist’s perceived benefits and perceptions of the intervention process using questionnaires and interviews.ResultsFive dyads were enrolled. Regarding the feasibility of the intervention, MM counselling seems to be appropriate and useful for the target group. Although the recruitment of persons with reliable bvFTD diagnoses was very time consuming and complex, the intervention was well accepted by the dyads, and regarding goal attainment, all carers benefited as much or even more than they expected. The study also showed that the benefits of MM counselling depend on whether the primary carer has accepted his/her relative’s dementia. Regarding the feasibility of a future confirmatory trial, certain outcomes, particularly positive affect, distress due to BPSD, and the quality of the dyadic relationship, seem to be appropriate for describing possible effects.ConclusionOverall, the intervention seems feasible for this target group. A future confirmatory trial should be planned as a multicentre pilot trial with an extension option.Trial registrationDRKS00014377. Registered retrospectively on April 11, 2018.

Life Crafting as a Way to Find Purpose and Meaning in Life.

Having a purpose in life is one of the most fundamental human needs. However, for most people, finding their purpose in life is not obvious. Modern life has a way of distracting people from their true goals and many people find it hard to define their purpose in life. Especially at younger ages, people are searching for meaning in life, but this has been found to be unrelated to actually finding meaning. Oftentimes, people experience pressure to have a “perfect” life and show the world how well they are doing, instead of following up on their deep-felt values and passions. Consequently, people may need a more structured way of finding meaning, e.g., via an intervention. In this paper, we discuss evidence-based ways of finding purpose, via a process that we call “life crafting.” This process fits within positive psychology and the salutogenesis framework – an approach focusing on factors that support human health and well-being, instead of factors that cause disease. This process ideally starts with an intervention that entails a combination of reflecting on one’s values, passions and goals, best possible self, goal attainment plans, and other positive psychology intervention techniques. Important elements of such an intervention are: (1) discovering values and passion, (2) reflecting on current and desired competencies and habits, (3) reflecting on present and future social life, (4) reflecting on a possible future career, (5) writing about the ideal future, (6) writing down specific goal attainment and “if-then” plans, and (7) making public commitments to the goals set. Prior research has shown that personal goal setting and goal attainment plans help people gain a direction or a sense of purpose in life. Research findings from the field of positive psychology, such as salutogenesis, implementation intentions, value congruence, broaden-and-build, and goal-setting literature, can help in building a comprehensive evidence-based life-crafting intervention. This intervention can aid individuals to find a purpose in life, while at the same time ensuring that they make concrete plans to work toward this purpose. The idea is that life crafting enables individuals to take control of their life in order to optimize performance and happiness.

A booklet self-help intervention to reduce depressive symptoms among people living with HIV in Botswana: study protocol for a randomized controlled trial

BackgroundThe treatment of mental health issues among people living with HIV (PLH) in Botswana is yet to be addressed. A recent study revealed that depressive symptoms are highly prevalent in a sample of PLH in Botswana. Based on empirical findings of a study that investigated intervention targets for PLH in Botswana, a self-help program with coaching in booklet format in the Setswana and English languages was developed, composed of cognitive behavioral techniques, coping skills interventions, and goal adjustment training. We will investigate the program for effectiveness in the treatment of depressive symptoms among PLH. Additionally, we will investigate treatment moderators and mediators. This paper describes the study protocol.Methods/designA randomized controlled trial will be conducted to compare the booklet self-help program with coaching with an attention-only control condition, by including pre-test, post-test, and follow-up assessments. We aim to enroll 200 participants with mild to moderate depressive symptoms into the study. The self-help program contains the following main components: activation, relaxation, changing maladaptive cognitions, and the attainment of new personal goals. This content is covered over six lessons to be completed in a maximum of 8 weeks. It uses a combination of psycho-education, assignments, and exercises. The participants will work on the program 1–2 h every week for 6 weeks (maximum 8 weeks). Coaches will offer support and motivate the participants. For both groups, depressive symptoms and possible mediators will be measured three times during the intervention, and at pre-test, post-test, and follow-up.DiscussionIf the intervention is found to effectively treat depressive symptoms, it will be implemented and thus help improve the psychological health of PLH in Botswana.Trial registrationNetherlands Trial Register, NTR7428. Registered on 23 August 2018.

Meaningful Learner Information for MOOC Instructors Examined Through a Contextualized Evaluation Framework

Improving STEM MOOC evaluation requires an understanding of the current state of STEM MOOC evaluation, as perceived by all stakeholders. To this end, we investigated what kinds of information STEM MOOC instructors currently use to evaluate their courses and what kinds of information they feel would be valuable for that purpose. We conducted semi-structured interviews with 14 faculty members from a variety of fields and research institutions who had taught STEM MOOCs on edX, Coursera, or Udacity. Four major themes emerged related to instructors' desires: (1) to informally assess learners as an instructor might in a traditional classroom, (2) to assess learners’ attainment of personal learning goals, (3) to obtain in-depth qualitative feedback from learners, and (4) to access more detailed learner analytics regarding the use of course materials. These four themes contribute to a broader sentiment expressed by the instructors that they have access to a wide variety of quantitative data for use in evaluation, but are largely missing the qualitative information that plays a significant role in traditional evaluation. Finally, we provide our recommendations for MOOC evaluation criteria, based on these findings.

A stepped wedge cluster randomised trial of a cognitive remediation intervention in alcohol and other drug (AOD) residential treatment services

BackgroundExecutive functioning impairment is common in substance use disorder and is a major risk factor for poor treatment outcomes, including treatment drop-out and relapse. Cognitive remediation interventions seek to improve executive functioning and offer a promising approach to increase the efficacy of alcohol and other drug (AOD) treatments and improve long-term therapeutic outcomes. This protocol describes a study funded by the NSW Agency for Clinical Innovation that assesses the effectiveness of delivering a six-week group-based intervention of cognitive remediation in an ecologically valid sample of people attending residential AOD treatment services. We primarily aim to investigate whether cognitive remediation will be effective in improving executive functioning and treatment retention rates. We will also evaluate if cognitive remediation may reduce long-term AOD use and rates of health service utilisation, as well as improve personal goal attainment, quality of life, and client satisfaction with treatment. In addition, the study will involve an economic analysis of the cost of delivering cognitive remediation.Methods/designThe study uses a stepped wedge cluster randomised design, where randomisation will occur at the cluster level. Participants will be recruited from ten residential AOD treatment services provided by the non-government sector. The intervention will be delivered in 12 one-hour group-based sessions over a period of six weeks. All participants who are expected to receive treatment for the duration of the six-week intervention will be asked to participate in the study. The clusters of participants who are randomly assigned to the treatment condition will complete cognitive remediation in addition to treatment as usual (TAU). Primary and secondary outcome assessments will be conducted at pre-cognitive remediation/TAU phase, post-cognitive remediation/TAU phase, two-month follow-up, four-month follow-up, six-month follow-up, and eight-month follow-up intervals.DiscussionThis study will provide comprehensive data on the effect of delivering a cognitive remediation intervention within residential AOD treatment services. If shown to be effective, cognitive remediation may be incorporated as an adjunctive intervention in current treatment programs.Trial registrationAustralian and New Zealand Clinical Trials Register (ANZCTR): ACTRN12618001190291. Prospectively registered 17th July 2018.

High-Impact Community Clinical Experiences to Promote Health and Enhance Well-Being of Older Adults.

Given the complex needs of the aging population, nurse educators must prepare future registered nurses to help older adults remain safe and healthy in their homes. This article describes partnerships between a school of nursing and low-income senior housing providers to develop new, high-impact community-based learning experiences. Baccalaureate nursing students conducted home visits in low-income senior housing communities and engaged in a research study to quantify activities conducted by students and the impact the home visits had on client personal health goal attainment.

Students’ Perspectives on Concepts, Factors, and Models Related to the Attainment of Achievement

This study aimed to explore concepts, factors affecting, and achievement models, from the perspective of tertiary students in Yogyakarta. Respondents (N = 533) were students of a private university in Yogyakarta. Data was collected through an open-ended questionnaire for all respondents, and in-depth interviews with 23 of these. Data were analyzed using content analysis techniques for responses to the answers provided. The results show that the concept of achievement, according to the perspective of the students, is differentiated between into definitions of achievement, and the criteria of what may to be considered to be achievements. The definition of achievement, according to the students, is something which is unique to this finding, with the emergence of non-academic achievement and excellence in competition with others. The criteria discovered, for a person to be considered to be an achiever, include compliance with goals (both personal and social) and the presence of the element of development. The presence of the suitability of social goals, is another unique thing found in this study. Factors which influence achievement include ‘input’ (personal capacities), and ‘process’ (the learning process)’. The external conditions which emerged in this finding took the form of other unique matters, found in the local culture. The dynamics of reaching achievement begin with ‘input’ (cognitive capacity, personal skills, motivation), and external conditions (which give rise to academic learning behaviors with the support of self-efficacy), for future learning achievements which are more optimal, with the attainment of personal and social goals.

The implementation and evaluation of health professions students as health coaches within a diabetes self-management education program

Background and purposeThe purpose of this article is to describe how health professions students were trained and incorporated as health coaches into a group diabetes self-management education (DSME) program in an underserved, urban federally qualified health center. Educational activity and settingNursing, pharmacy, and physical therapy students from three local colleges were provided health coach training and then integrated into the DSME program with faculty assistance. The students connected with the assigned participants both in person and via weekly telephone calls over a three-month time period, applying concepts learned and providing patient-centered support. FindingsStudents noted self-reported improvement in their own perceived knowledge, skills, and attitudes related to health coaching from both qualitative (weekly and end of experience reflections) and quantitative (pre- and post-survey) measures. Participants were also engaged in assessing the program directly via survey responses and indirectly via attainment of personal health-related behavior change goals based on American Association of Diabetes Educators Seven Self-Care Behaviors. SummaryWith appropriate training and support from faculty, health professions students were successfully incorporated into an existing DSME program in the role of health coach, gaining knowledge, skills, and attitudes needed to help patients make behavior change.

Recreational athletes’ running motivations as predictors of their use of online fitness community features

ABSTRACTFitness wearables and apps provide users with quantified information about their exercise behaviour. Users often access this information on online fitness communities (OFCs) such as RunKeeper or Strava. These OFCs do not only provide feedback on the user’s performance but also offer social features. To date, little is known about the extent to which the different features in OFCs answer to users’ motivations to exercise. This study addresses this question, by examining (1) whether there are differences in motivations for running between OFC users and non-users and (2) whether the use of particular features is driven by particular running motivations. A survey study was conducted among 717 runners, of which 57% used an OFC to support running activities. Results demonstrate that OFC users are more achievement-oriented than non-OFC users, especially regarding the attainment of personal goals. OFC users with physical motivations (e.g. weight loss) use self-regulatory features more frequently, while runners with social motivations more often use features that afford them to share activities on social media. Achievement-oriented runners appreciate features that allow them to track their progress and interact with other OFC users. No relation was found between the use of OFC features and psychological motivations for running.

The Role of Working Alliance in Attainment of Personal Goals and Improvement in Quality of Life During Psychiatric Rehabilitation.

A key aspect of psychiatric rehabilitation is supporting individuals with serious mental illness in reaching personal goals. This study aimed to investigate whether various aspects of the working alliance predict successful goal attainment and whether goal attainment improves subjective quality of life, independent of the rehabilitation approach used. Secondary analyses were conducted of data from a Dutch randomized clinical trial on goal attainment by individuals supported with the Boston University approach to psychiatric rehabilitation (N=80) or a generic approach (N=76). Working alliance was measured with the Working Alliance Inventory (WAI) from the practitioner's perspective. Rehabilitation practitioners had backgrounds in social work, nursing, or vocational rehabilitation. Multiple logistic regression and multiple regression analyses explored effects of working alliance on goal attainment and of goal attainment on subjective quality of life at 24 months. Analyses were controlled for client- and process-related predictors, baseline quality of life, and rehabilitation approach. The WAI goal subscale predicted goal attainment at 24 months. No effect was found for the bond or task subscale. Goal attainment significantly predicted quality of life at 24 months. These effects were independent of the rehabilitation approach used. A good bond between client and practitioner is not enough to attain successful rehabilitation outcomes. Findings suggest that it is important to discuss clients' wishes and ambitions and form an agreement on goals. Attaining rehabilitation goals directly influenced the subjective quality of life of individuals with serious mental illness, which underscores the importance of investing in these forms of client support.

307 - An Occupational Therapy Program for Patients Undergoing Bone Marrow Transplant: An Action Plan for Empowerment

The purpose of this poster is to propose a comprehensive, occupation-based program for patients undergoing bone marrow transplantation (BMT) highlighting intrinsic motivation to facilitate engagement with activities of daily living and personal goal attainment to ease transition to community-based skills and engagement. Research has highlighted gaps in supportive care provided in oncology settings in the areas of psychosocial and emotional well-being (Burg et al., 2015; Sleight & Duker, 2016). These unmet needs contribute to functional limitations significantly reducing occupational performance, decreased role retention and decreased quality of life (Somerfield, Curbow, Wingard, Baker, & Fogarty, 1996). The scope of occupational therapy provides the unique ability to help patients cope with the psychological, physical, and emotional side effects of cancer. By educating and empowering patients to set functional goals and begin to self-manage symptoms, occupational therapists have the potential to drastically improve quality of life (Ferrell et al.,1992). Our program includes pre-transplant patient evaluation, education of baseline ADL/IADL function, and assistance with the development of patient-centered goals. Throughout the patient's hospital stay, occupational therapy interventions will include: motivational interviewing, fatigue management, lifestyle redesign, routine building, practical application of coping and/or stress management strategies, safety awareness, executive cognitive training, and instruction to adapt/improve ADL engagement for a successful transition into home and community-based activities following the transplant. Patients will use a Goal Attainment Scale and self competency ratings to track progress and measure program effectiveness.

Relationship Between Psychiatric-Service Consumers' and Providers' Goal Concordance and Consumers' Personal Goal Attainment.

This study tested concordance between consumers' and providers' reports of personal goal setting and its relationship to self-reported goal attainment. Data are from the Israeli Psychiatric Rehabilitation Patient Reported Outcome Measurement project. Consumers (N=2,885) and the providers who were most knowledgeable about their care indicated two domains from a list of ten in which consumers had set goals during the previous year. Consumers reported on goal attainment in each domain. A total of 2,345 consumers (82%) reported a personal goal. Overall, consumer-provider concordance reached 54%. Concordance was greatest in the employment (76%), housing (71%), and intimate relationship (52%) domains and lowest in family relationships (23%) and finances (15%). For most domains, concordance was less than 50%. On average, 75% of consumers reported having achieved their goals. Consumer-provider concordance was associated with goal attainment (p<.001). These findings emphasize the importance of agreed-upon goals and call for conceptualizing goal setting as an interpersonal process central to recovery.

Mobile Health Physical Activity Intervention Preferences in Cancer Survivors: A Qualitative Study.

BackgroundCancer survivors are at an elevated risk for several negative health outcomes, but physical activity (PA) can decrease those risks. Unfortunately, adherence to PA recommendations among survivors is low. Fitness mobile apps have been shown to facilitate the adoption of PA in the general population, but there are limited apps specifically designed for cancer survivors. This population has unique needs and barriers to PA, and most existing PA apps do not address these issues. Moreover, incorporating user preferences has been identified as an important priority for technology-based PA interventions, but at present there is limited literature that serves to establish these preferences in cancer survivors. This is especially problematic given the high cost of app development and because the majority of downloaded apps fail to engage users over the long term.ObjectiveThe aim of this study was to take a qualitative approach to provide practical insight regarding this population’s preferences for the features and messages of an app to increase PA.MethodsA total of 35 cancer survivors each attended 2 focus groups; a moderator presented slide shows on potential app features and messages and asked open-ended questions to elicit participant preferences. All sessions were audio recorded and transcribed verbatim. Three reviewers independently conducted thematic content analysis on all transcripts, then organized and consolidated findings to identify salient themes.ResultsParticipants (mean age 63.7, SD 10.8, years) were mostly female (24/35, 69%) and mostly white (25/35, 71%). Participants generally had access to technology and were receptive to engaging with an app to increase PA. Themes identified included preferences for (1) a casual, concise, and positive tone, (2) tools for personal goal attainment, (3) a prescription for PA, and (4) an experience that is tailored to the user. Participants reported wanting extensive background data collection with low data entry burden and to have a trustworthy source translate their personal data into individualized PA recommendations. They expressed a desire for app functions that could facilitate goal achievement and articulated a preference for a more private social experience. Finally, results indicated that PA goals might be best established in the context of personally held priorities and values.ConclusionsMany of the desired features identified are compatible with both empirically supported methods of behavior change and the relative strengths of an app as a delivery vehicle for behavioral intervention. Participating cancer survivors’ preferences contrasted with many current standard practices for mobile app development, including value-based rather than numeric goals, private socialization in small groups rather than sharing with broader social networks, and interpretation of PA data rather than merely providing numerical data. Taken together, these insights may help increase the acceptability of theory-based mHealth PA interventions in cancer survivors.

What’s So Great About Self-Control? Examining the Importance of Effortful Self-Control and Temptation in Predicting Real-Life Depletion and Goal Attainment

Self-control is typically viewed as a key ingredient responsible for effective self-regulation and personal goal attainment. This study used experience sampling, daily diary, and prospective data collection to investigate the immediate and semester-long consequences of effortful self-control and temptations on depletion and goal attainment. Results showed that goal attainment was influenced by experiences of temptations rather than by actively resisting or controlling those temptations. This study also found that simply experiencing temptations led people to feel depleted. Depletion in turn mediated the link between temptations and goal attainment, such that people who experienced increased temptations felt more depleted and thus less likely to achieve their goals. Critically, results of Bayesian analyses strongly indicate that effortful self-control was consistently unrelated to goal attainment throughout all analyses.

Self-regulated learning strategies predict learner behavior and goal attainment in Massive Open Online Courses

Individuals with strong self-regulated learning (SRL) skills, characterized by the ability to plan, manage and control their learning process, can learn faster and outperform those with weaker SRL skills. SRL is critical in learning environments that provide low levels of support and guidance, as is commonly the case in Massive Open Online Courses (MOOCs). Learners can be trained to engage in SRL and actively supported with prompts and activities. However, effective implementation of learner support systems in MOOCs requires an understanding of which SRL strategies are most effective and how these strategies manifest in online behavior. Moreover, identifying learner characteristics that are predictive of weaker SRL skills can advance efforts to provide targeted support without obtrusive survey instruments. We investigated SRL in a sample of 4,831 learners across six MOOCs based on individual records of overall course achievement, interactions with course content, and survey responses. We found that goal setting and strategic planning predicted attainment of personal course goals, while help seeking was associated with lower goal attainment. Learners with stronger SRL skills were more likely to revisit previously studied course materials, especially course assessments. Several learner characteristics, including demographics and motivation, predicted learners’ SRL skills. We discuss implications for theory and the development of learning environments that provide adaptive support.