Individual Goal Setting Research Articles

Effectiveness of an Educational Seminar for Older Adults With Hearing Loss

Purpose: Despite the recognized benefits of aural rehabilitation (AR), its adoption has been limited. The purpose of this study was to investigate the effectiveness of group AR through an educational seminar for older adults with hearing loss, “Optimal Hearing,” evaluating the application of various patient-reported outcome measures. Method: Participants were older adults with hearing loss. The seminar covered content such as hearing loss and aging, audiogram interpretation, clear speech, lipreading, and hearing aids. Small group activities for personalized instruction also included: the Client Oriented Scale of Improvement (COSI), Communication Confidence Profile (CCP), and, a study-specific measure, the Optimum Hearing Questionnaire (OHQ). Results: Participants experienced significant improvements in various areas measured by the COSI. The CCP showed significant change in one item (confidence while conversing with friends in a noisy restaurant), while several items on the OHQ indicated significant changes postintervention. Conclusion: The findings suggest the potential clinical utility of these measures in group AR settings and the importance of individualized goal setting. Supplemental Material: https://doi.org/10.23641/asha.26824111

Evaluation of a Nutrition and Exercise Group Intervention for Older Adults with Frailty and Probable Sarcopenia

Abstract Background The prevalence of probable sarcopenia in frail older adults attending a Community Specialist Team (CST) is 52%. Resistance exercise and optimising nutrition are recommended interventions. The aim of this study was to evaluate a nutrition and exercise group for frail older adults with probable sarcopenia. Methods Adults aged ≥65 years, with probable sarcopenia identified through Comprehensive Geriatric Assessment (CGA) by a CST over 18 months were included. At CGA (baseline), sarcopenia infographics and 2 attendances at Dietetic and Physiotherapy group were offered. Group intervention comprised nutrition and exercise information and individualised goal setting. Clinical Frailty Scale (CFS) score, grip strength and 5 Times Sit-to-Stand (5TSS) were measured. Participants' needs and perceived changes in knowledge were evaluated using open questions and Likert Scales. Data was analysed using thematic analysis, descriptive and inferential statistics. Results Intervention was offered to 82 people. Twenty-nine (35%) attended an initial group (18 women, 11 men), with mean age 80.7 years (SD=7). Nine (30%) attended the second group. Participants were significantly less frail (median CFS 4, IQR 4, 6) than non-participants (median CFS 6, IQR 5, 7) (p= 0.002). Male grip strength improved significantly from baseline (mean 22kg, SD=4.21) to first group (mean 27.8kg, SD=4.36) (p=0.007) and to second group (mean 29kg, SD=4.21) (p=0.012). Female grip strength increased non-significantly from baseline (mean 12.6kg, SD=3.38) to first group (mean 14.5kg, SD=5.85), (p=0.127) and to second group (mean 14.83kg, SD=4.21) (p=0.890). Participant’s 5TSS did not change significantly (mean 19.75 sec, SD=6.38 to mean 20.78 sec, SD=7.73) (p=0.782). Nutrition and exercise knowledge improved significantly (p=0.004, p=0.003 respectively). Access to clear information was an identified theme. Conclusion Educational resources and tailored plans within group interventions can improve grip strength and knowledge in older adults living with very mild frailty. Further research is required to design an accessible intervention for more frail cohorts.

Design and methods of the StepByStep randomized trial of a mobile health and social media physical activity intervention among adolescent and young adult survivors of childhood cancer: A report from the Children's Oncology Group

BackgroundInterventions to increase physical activity are needed in adolescent and young adult survivors of childhood cancer who are largely inactive but at lifelong elevated risk of multiple chronic conditions improved by physical activity. The goals of the StepByStep study are to evaluate the effects of a 48-week distance-based, multi-component mobile health and social media behavioral intervention on physical activity, biomarkers of cardiometabolic health, and health-related quality of life. MethodsThis ongoing study is a two-arm, prospective, multi-site randomized controlled trial. 384 childhood cancer survivors age ≥ 15 years and < 21 years who were 3–36 months off therapy and not meeting physical activity guidelines were enrolled. The trial will test the efficacy of a 24-week intensive multi-component physical activity intervention combining a wearable physical activity tracker, social media peer support group, and individualized goal setting followed by a 24-week maintenance phase of the intervention to improve outcomes. The control group receives the wearable physical activity tracker only. ConclusionThere is a growing need for novel, developmentally appropriate interventions to increase physical activity and improve the health trajectory of adolescent and young adult survivors of childhood cancer. If efficacious, this portable and scalable intervention would be a much-needed tool to reduce the morbidity from cancer treatment and improve quality of life among survivors after treatment ends. Clinical trial registrationClinicalTrials.gov Identifier: NCT04089358; COG Identifier: ALTE2031.

Evaluating the feasibility and acceptability of a co-designed physical activity intervention for rural middle schoolers: a pilot study

BackgroundLack of physical activity is a concern for children across diverse backgrounds, particularly affecting those in rural areas who face distinct challenges compared to their urban counterparts. Community-derived interventions are needed that consider the unique context and additional physical activity barriers in under-resourced rural settings. Therefore, a prospective pre-post pilot/feasibility study of Hoosier Sport was conducted over 8-weeks with 6th and 7th grade children in a low-socioeconomic rural middle school setting. The primary objective of the present study was to assess trial- and intervention-related feasibility indicators; and the secondary objective was to collect preliminary assessment data for physical activity levels, fitness, psychological needs satisfaction, and knowledge of physical activity and nutrition among participating youth.MethodsThis prospective 8-week pilot/feasibility study took place in the rural Midwestern United States where twenty-four middle school students participated in a mixed-methods pre-post intervention during physical education classes. The intervention included elements like sport-based youth development, individualized goal setting, physical activity monitoring, pedometer usage, and health education. Data were collected at baseline (T1) and post-intervention (T3), with intermediate measures during the intervention (T2). Qualitative data were integrated through semi-structured interviews. Analytical methods encompassed descriptive statistics, correlations, repeated measures ANOVA, and thematic analysis.ResultsKey findings indicate robust feasibility, with intervention-related scores (FIM, AIM, and IAM) consistently surpassing the “good” threshold and 100% retention and recruitment success. Additionally, participants showed significant physical performance improvement, shifting from the 25th to the 50th percentile in the 6-minute walk test (p < 0.05). Autonomy and competence remained high, reflecting positive perceptions of program practicality. Nutrition knowledge, initially low, significantly improved at post-intervention (p < 0.01), highlighting the efficacy of targeted nutritional education in Hoosier Sport.ConclusionsThis study pioneers a community-engaged model for physical activity intervention in under-resourced rural settings. Positive participant feedback, coupled with improvements in physical fitness and psychosocial factors, highlights the potential of the co-design approach. The findings offer valuable insights and a practical template for future community-based research, signaling the promising impact of such interventions on holistic well-being. This research lays the foundation for subsequent phases of the ORBIT model, emphasizing collaborative, community-driven approaches to address the complex issue of declining physical activity levels among adolescents.

Effect of motivational interviewing on preventive strategies for children receiving full-mouth dental rehabilitation under general anesthesia: A randomized controlled trial.

Motivational interviewing (MI) is an approach to increase parental compliance to follow up and recall of their children. It has proven to be successful in motivating parents to adopt and maintain preventive child oral health behaviors. To assess the effectiveness of motivational interviewing on prevention strategies for parents of children who have received full-mouth dental rehabilitation under general anesthesia (GA). This is a parallel-arm randomized controlled trial. Parents in the treatment arm were randomized and received a combination of motivational interviewing, individualized goal setting, visual aids, and verbal education post-GA. Those in the control arm received the same information by verbal and written education. Both groups were evaluated at 2-week follow-up and 3-month recall. Differences in attendance, oral health knowledge, readiness to change, and parental self-efficacy (PSE) were compared between groups and at return visits. Of 74 parents of children randomly allocated in this study, 22 (61%) and 13 (38%) from the intervention group, and 21 (55%) and 16 (46%) from the control group attended the 2-week, and 3-month follow-up, respectively. The average PSE for participants in the intervention group was significantly higher than that of the control group at the follow-up visit (p = .0050). Readiness to change dietary habits and average PSE for parents in the intervention group were significantly higher than that of the control group after receiving the modified preventive strategy.

Solutions for Independent Goal Setting and Implementation of Primary School Students Fostering the Competence of Learning to Learn

The paper analyzes what personal goals primary school pupils are able to set on their own and how they achieve them in their decision-making process, thereby developing competence in learning to learn. In this work, the reader will be able to get acquainted with the theoretically grounded concept of the development of competence in learning and the possibilities of developing this competence in primary schools. In addition, it provides practical tools for the quality development of students’ learning competence, where students not only set personal goals and plan the steps to achieve them but also reflect on their experiences. An action research study analyzed the content of students’ (N = 50) personal learning diaries, discussing the students’ learning goals and the choices they make to achieve them and reflecting on the efforts made, and results were obtained in the development of the competence to learn. Based on the study findings, it is evident that fourth-grade students exhibit distinct patterns in individual goal setting, action-planning, and reflection processes. The analysis presented in this paper analyzes the general highlights and overarching themes and provides specific instances of goals, activity tasks, and reflections, offering insight into the cognitive processes of fourth-graders and their perceptions regarding the benefits and challenges of learning.

Adolescent Preferences for a Pediatric Primary Care-based Sexually Transmitted Infection and HIV Prevention Intervention

PurposeWe sought to elicit perspectives on HIV and sexually transmitted infection (STI) prevention among adolescents with recent STIs in primary care to optimize acceptability and effectiveness in designing a novel HIV/STI prevention intervention. MethodsWe enrolled 13-19 year-olds with recent gonorrhea, chlamydia, trichomonas, and/or syphilis in a multimethods cross-sectional study at two primary care clinics. Participants completed surveys and interviews. We used an integrated analytic approach deductively coding data using the Integrated Behavioral Model, then inductively coding to identify themes not represented in the Integrated Behavioral Model. ResultsParticipants (n = 35) were 85% cisgender female, 14% cisgender male, 1% transgender female; 25% identified as lesbian, bisexual, or queer. Most (97%) identified as non-Latinx Black. None used condoms consistently, 26% were aware of pre-exposure prophylaxis (PrEP), and 31% were never HIV tested. Five key themes emerged. 1) Mental health was central to HIV prevention behavior uptake and coping with STI diagnosis. 2) Youth desired prevention counseling that allowed decisional autonomy and individualized goal setting. 3) Negative social norms around condoms and absent norms around HIV testing and PrEP limited method uptake. 4) Both confidence and concrete skills were needed to initiate prevention methods. 5) Youth desired education at the time of STI diagnosis to improve subsequent prevention decision making. DiscussionKey intervention design considerations included 1) integrating mental health assessment and referral to services, 2) promoting individualized goal setting, 4) building communication skills, 4) providing navigation and material support for PrEP uptake and HIV testing, and 5) augmenting comprehensive STI and HIV prevention education.

Economic Evaluation of an Enhanced Post-Discharge Home-Based Care Program for Stroke Survivors

ObjectivesTo examine the cost-effectiveness of an enhanced postdischarge home-based care program for stroke survivors compared with usual care. MethodsThis was a trial-based economic evaluation study. One hundred and sixteen patients with ischemic stroke were recruited from neurology units in a Chinese hospital and randomized into intervention (n = 58) or usual care groups (n = 58). The intervention commenced with predischarge planning and transitioned to home follow-up postdischarge. Trained nurse case managers supported by an interdisciplinary team provided comprehensive assessment, individualized goal setting, and skill training to support home-based rehabilitation for intervention group participants. Standard care was provided to usual care group participants. Total cost and quality-adjusted life-years gained at 3-month (T1), 6-month (T2), and 12-month (T3) follow-ups were calculated. The incremental cost-effectiveness ratios between the groups were obtained. ResultsThe intervention group showed a significant increase in utility compared with the usual care group at T1 (P = .003), T2 (P = .007), and T3 (P < .001). The average total QALY gain from baseline for the intervention group was higher than for the usual care group at all time points. The likelihood of being cost-effective ranged from 61.9% to 67.2% from the provider perspective, and from 59.7% to 66.8% from the societal perspective. ConclusionsThe results showed that the intervention program was cost-effective with significantly higher quality-adjusted life-years for stroke survivors when compared with usual care. It provides economic evidence to support the development of home-based stroke rehabilitation program, especially in the low- and middle-income countries.

Shallow Water Crossings: Elevating Indigenous Knowledge Systems Through Adventure Learning

Background: Outdoor Adventure Education (OAE) predominantly centers learning around individual goal setting and experiences and has not traditionally elevated Indigenous Knowledge Systems (IKS). Purpose: This research focuses on understanding how student learning and inquiry is affected through OAE that emphasizes the importance of IKS as a starting point for environmental and experiential data collection. Methodology/Approach: Over the course of two multi-day river trips on Idaho's Salmon River during the summer of 2023, 30 incoming university students encountered an Adventure Learning (AL) educational framework centered around IKS. Students used citizen science methods to collect environmental and experiential data to be shared digitally using GIS applications prior to oncampus learning. Web-based surveys will be sent to assess learning impacts. Results will be analyzed for changes in appreciation and awareness of IKS. Conclusions: We anticipate that the data will demonstrate an appreciation and awareness of other ways of knowing within OAE that decenters a Western epistemic ideal of goal driven knowledge production and elevates IKS as a recognized and respected approach to knowledge production. Implications: Incorporating a hybrid environment for incoming university students to address personal knowledge production in context to IKS will promote various decolonizing projects within higher education through shifting student inquiry.

Effectiveness of a multicomponent intervention to promote physical activity among Japanese remote workers: a pilot open-label randomized controlled trial.

Remote work (ie, teleworking) may adversely affect physical activity (PA) among workers, but no strategies have been effectively implemented to address this issue. We aimed to test whether a multicomponent intervention program could promote the PA of remote workers. This study was an 8-week pilot open-label randomized controlled trial. Fifty-one participants (19 women) aged 23-58years were recruited via an information technology company in Tokyo, Japan, and randomly assigned to the control (n = 26) or intervention (n = 25) group. The intervention group was provided a multicomponent intervention that comprised individual (lecture, print material, goal setting, feedback, and posters), sociocultural (supportive atmosphere and team building), and organizational (encouraging message from an executive) strategies. The control group only received posters. The primary outcome was an 8-week change in objectively measured moderate-to-vigorous PA (MVPA). The secondary outcomes were changes in light PA, moderate PA, vigorous PA, steps, and sedentary time. We also conducted subdomain analyses divided into working and nonworking days. No significant difference was observed in MVPA changes between the 2 groups. However, the intervention group showed significant improvement in light PA by +14.0min/d (95% CI, 1.7-26.2). Subdomain analyses also showed no significant differences in MVPA changes between the 2 groups. However, MVPA in the intervention group significantly increased by +9.4min/d (95% CI, 2.5-16.2) on working days. The present multicomponent intervention was feasible for remote workers, although some revisions are necessary to enhance the effect size.

Strength-Based Therapy: Empowering Athletes' Self-Efficacy and Life Satisfaction

While it is known that focusing on positive attributes and capabilities can enhance psychological resilience, the specific effectiveness of strength-based therapy in improving self-efficacy and life satisfaction among athletes remains unexplored. By emphasizing positive attributes and capabilities, strength-based therapy aims to enhance athletes' psychological resilience and overall well-being, which are crucial in the highly competitive and physically demanding world of sports. Therefore, this study investigates the effectiveness of strength-based therapy in enhancing the self-efficacy and life satisfaction of athletes. The study used a quasi-experimental design with 50 competitive athletes aged 18-35. The methodology included an 8-week intervention focusing on leveraging individual strengths, goal setting, and resilience building. Outcomes were measured using the General Self-Efficacy Scale and the Satisfaction with Life Scale. To examine these differences, an analysis of variance with repeated measures, coupled with Bonferroni’s post-hoc test, was conducted using SPSS-26. Results indicated significant improvements in both self-efficacy and life satisfaction in the experimental group compared to the control group. The study concludes that strength-based therapy positively impacts athletes' psychological well-being, suggesting its potential for broader application in sports therapy.

DESIGN AND IMPLEMENTATION OF THE ACHIEVE HEARING INTERVENTION

Abstract The ACHIEVE trial required the development of a manualized best-practice hearing intervention designed to meet the needs of older adults with mild-moderate hearing loss. The hearing intervention (HI) was developed using an iterative process including input from a diverse professional panel and a feasibility study to confirm that expected outcomes from a best-practices, evidence-based HI would be obtained. The HI involves use of hearing aids and related technologies along with counselling, coaching and education to support self-management of hearing loss. The HI is delivered in four sessions after the completion of a comprehensive hearing evaluation. Individualized goals are developed using the Client Oriented Scale of Improvement (COSI), which guides selection of hearing aids and other technologies to meet prioritized listening needs and assessment of how well those needs are met. The most frequent COSI listening goal categories included: Conversation in Noise (n= 413; 29%), Conversations in Quiet (n= 296; 21%), and TV/Radio at Normal Volume (n= 280; 20%). Three levels of hearing aid technology differing by the number of signal processing approaches included were: Basic (n=223, 20%), Advanced (n=662, 56%), and Premium (n=283, 24%). Additional hearing assistive technologies included streaming devices, TV connectors, and remote microphones were provided. We discuss how the baseline audiological results and individualized goal setting informed delivery of the HI and how the use of manualization allowed us to maintain excellent treatment fidelity throughout the clinical trial.

Use of the 2021 UK Medical Research Council guidance to refine the Women's Wellness with Type 2 Diabetes Programme: a mixed-methods study

BackgroundThe Women's Wellness with Type 2 Diabetes Programme (WWDP) is an online behavioural intervention for midlife women living with type 2 diabetes. The gender-specific intervention fosters self-efficacy, encouraging positive wellbeing behaviours to enhance diabetes and menopause outcomes. In 2016, We co-led a feasibility trial and process evaluation with 70 women aged 45–50 years from the UK and Australia. The intervention comprised an e-book, a website, and nurse consultations. The WWDP seemed to improved diabetes distress, self-efficacy, and menopausal symptoms, but with impactful, costly, diabetes nurse input, compromising feasibility and delivery by the NHS. We report WWDP refinement using the 2021 Medical Research Council (MRC) framework for complex interventions to optimise future implementation. MethodsIntervention refinement was guided by six core MRC elements of context, programme theory, stakeholder engagement, key uncertainties, intervention refinement, and economic considerations. Critical analysis of quantitative and qualitative feasibility data, informed by self-efficacy theory, provided a deeper understanding of how the intervention was used. Eight PPI consultations took place between Sept 1, 2021, and Dec 31, 2022, with three women from diverse cultural and socioeconomic backgrounds and three female diabetes professionals to strengthen the e-book and methods of support for women undertaking the programme. FindingsContext was improved by the feasibility study and the PPI consultations, making the e-book relevant to UK health care. Understanding that self-efficacy was supported through primary use of peer group, and goal setting components supported the existing programme theory. Stakeholder engagement shaped the structure of the online peer support group. The feasibility study revealed uncertainties around goal settings. These uncertainties were addressed by introducing individualised goals focusing on aspects like medication adherence. The nurse support in the intervention was replaced with peer support, which might lead to greater economic feasibility of the programme. An optimised website and individualised goal setting underpin the WWDP. InterpretationThe MRC Framework provides intervention refinement structure, allowing adaptive adjustments based on emerging evidence, feedback, and contextual nuances. Limitations exist. Intervention refinements, including peer support, might affect adherence and unexpected interactions. New components could influence long-term efficacy. FundingTurkish Ministry of National Education.

Children’s Use of Evaluative Devices in Response to the Global TALES Protocol

Introduction: It has been well established that the function of sharing personal narratives is to inform the listener about what the event meant to the narrator, for example, by using a range of evaluative devices. The use of these evaluative devices may reflect a person’s understanding of the differences between one’s own mind and others, by expressing their beliefs, emotions, thoughts, and desires. This paper investigates children’s use of evaluative devices when producing personal narratives in response to the six emotion-based prompts contained in the Global TALES protocol (excited, worried, annoyed, proud, problem situation, something important). It addresses three research questions: (1) What types and proportions of evaluative devices do 10-year-old English-speaking children use in response to the six prompts contained in the Global TALES protocol and are there differences in performance between boys and girls? (2) What are the correlations between the different types of evaluative devices? (3) Does children’s use of evaluative devices differ depending on the type of prompt used? Methods: Eighty-two native English-speaking ten-year-old children from three English-speaking countries (Australia, New Zealand, and the USA) participated. None of the children had been identified with language and/or learning difficulties. Children’s personal narratives were transcribed and analysed for the use of 12 evaluative devices: compulsion, internal emotional states, evaluative words, intensifiers, mental states, causal explanations, hypotheses, objective judgements, subjective judgements, intent, negatives, and repetition. Results: Results showed that children use a high number of evaluative devices, with “intensifiers” and “evaluative words” used most frequently. There were few effects for sex, apart from girls using a wider range of evaluative devices than boys. We found moderate to large correlations between most devices, with factor analysis revealing three factors we labelled “causality,” “hypothesis,” and “judgement.” Although there were significant overall effects for prompt type on the use of evaluative devices, there was no clear pattern when inspecting responses to individual prompts. Conclusion: The results from this study shed light on children’s use of evaluative devices to convey the meaning of their personal narratives in response to six different prompts tapping into different emotions. Moving beyond appraising children’s structural language skills when narrating their personal experiences may enhance the understanding of interpersonal and intrapersonal aspects of theory of mind, which may inform clinical practices, such as individualized goal setting and intervention choices.

Individualized Goal Setting for Pediatric Intensive Care Unit-Based Rehabilitation Using the Canadian Occupational Performance Measure.

The Canadian Occupational Performance Measure (COPM) is a client-centered outcome measure that facilitates the prioritization of individualized interventions. Given the rising emphasis on individualized intervention in pediatric intensive care units (PICUs), this cross-sectional study aimed to explore caregivers' perspectives on their children's functional goals within PICUs. From 1 September 2020 to 26 June 2022, caregivers of 41 children aged 1-18 years completed the COPM within 48 h of PICU admission. The study also explored the clinical variables predicting a high number of occupational performance goals (≥4/5). Out of 190 goals proposed by caregivers, 87 (45.8%) pertained to occupational performance, while 103 (54.2%) were related to personal factors. Among the occupational performance goals, the majority were associated with functional mobility (55; 28.9%), followed by personal care (29; 15.2%) and quiet recreation (3; 1.6%). Among personal goals, physiological factors (68; 35.8%) were most common, followed by physical factors (35; 18.4%). We found caregiver anxiety, measured by the State-Trait Anxiety Inventory-State, to be a significant predictor of the number of occupational performance goals. These findings underscore the importance of caregiver psychological assessment in the PICU to facilitate personalized goal setting and improve rehabilitation outcomes.

Creating Adjusted Scores Targeting mobiLity Empowerment (CASTLE 1): determination of normative mobility scores after lower limb amputation for each year of adulthood

Purpose As United States healthcare transitions from traditional fee-for-service models to value-based care, there is increased need to demonstrate quality care through clinical outcomes. Therefore, the purpose of this study was to create equations to calculate an expected mobility score for lower limb prosthesis users specific to their age, etiology, and amputation level to provide benchmarks to qualify good outcomes. Materials and Methods A retrospective cross-sectional analysis of outcomes collected during clinical care was performed. Individuals were grouped based on amputation level (unilateral above-knee (AKA) or below-knee (BKA)) and etiology (trauma or diabetes/dysvascular (DV)). The mean mobility score (PLUS-M® T-score) for each year of age was calculated. AKAs were further stratified into having a microprocessor knee (MPK) or non-microprocessor (nMPK) for secondary analysis. Results As expected, average prosthetic mobility declined with age. Overall, BKAs had higher PLUS-M T-scores compared to AKAs and trauma etiologies had higher scores compared to DV. For AKAs, those with a MPK had higher T-scores compared to those with a nMPK. Conclusions Results from this study provide average mobility for adult patients across every year of life. This can be leveraged to create a mobility adjustment factor to qualify good outcomes in lower limb prosthetic care. IMPLICATIONS FOR REHABILITATION Normative values of mobility are needed to qualify good outcomes in prosthetic care as healthcare shifts towards value-based care. Understanding where an individual is relative to others with similar characteristics (e.g., age, etiology, gender, amputation level, and device type) can provide clinicians with better benchmarks for individual goal-setting. The ability to generate predicted mobility scores specific to each individual can create a mobility adjustment factor to better qualify good outcomes.

Individual goal-setting in municipal homecare: A participatory appreciative action and reflection study.

There is a need for structural change in municipal homecare to shift power to older persons and to center the individuals in need. To make this change, the individual older persons should have enough self-determination to formulate their own individual homecare goals. Our aim was to explore how stakeholders reason about individual goal-setting in homecare. We theoretically and methodologically used a participatory appreciative action and reflection (PAAR) design. The stakeholders, that is, the older persons, the older persons' relatives, and the multi-professional team, were seen as co-researchers. Data were collected between 2019 and 2020 through in depth-interviews, focus group discussions, and reference groups. The data were analyzed using thematic analysis. We learned from the stakeholders that it was a struggle to sustain the individual's goal to continue life as usual, that is, being an ordinary human being with an ordinary everyday life and maintaining individual roles. The individual wants to improve health, be active, and enjoying life. The individuals were struggling against the homecare organization, which tended to overshadow the individual's goals. The individual's goals fall under several legal jurisdictions and come to be overshadowed by the professionals' dominant goal. The organization is rigid, with finances and resources creating the framework. We learned that older persons receiving homecare must have the same rights as other citizens in society, which is in line with public health goals.

Mapping the evidence on clinical activities and outcome measures of pharmacist‐involved collaborative care models in managing diabetes: A scoping review

AbstractObjectiveThis scoping review aimed to map the extent and range of evidence on the clinical activities performed and types of outcomes evaluated in pharmacist‐involved collaborative care models for diabetes management.MethodsThis scoping review was guided by the five‐stage methodological framework developed by Arksey and O'Malley. Publications in the English language were identified from PubMed, EMBASE, and CINAHL and the databases were searched from inception to 31 May 2022. Abstracts, conference proceedings, brief reports, and commentaries were excluded. Key search terms were “interprofessional collaborative care,” “pharmacist,” “type 2 diabetes,” and “outcome.” Microsoft Excel was used for data charting and descriptive computations were conducted using the Statistical Package for Social Sciences.ResultsA total of 208 articles were identified, and after excluding 178 articles (and duplicates), 30 articles were reviewed. Most of the studies (56.7%) were conducted in the United States of America and were randomized controlled trials (50.0%) followed by cohort studies (36.7%). The most common clinical activity identified was provision of health‐ and medication‐related education (80.0%), followed by lifestyle counseling (76.7%) and development of individualized care plan and goal setting (63.3%). Other clinical activities were review of laboratory records, medication review and dose adjustments, optimization of medication adherence, minimization of drug‐related problems, identify referral to other care providers, and conduct physical assessments. HbA1c was the most reported clinical outcome (n = 26, 86.7%), with 11 studies evaluating patient‐reported outcomes (PROs) such as medication adherence, diabetes knowledge, self‐care, quality of life, diabetes distress, and treatment satisfaction.ConclusionClinical activities performed by pharmacists were heterogenous across studies and based on patients' needs. While pharmacist‐involved collaborative care models were posited as person‐centric outcome, PROs were lacking in most studies. Evaluating PROs are essential in guiding the implementation of such people‐centric care models.

Abstract P340: Development and Delivery of an Effective 16-week HealthEYou Program to Mitigate Metabolic Disease Risk Factors

Introduction: Metabolic syndrome (MetS) is a growing concern in the U.S and around the world. MetS is a cluster of disease risk factors including hypertension, hyperlipidemia, hyperglycemia, and obesity increasing the risk of cardiometabolic disease development. Purpose: The purpose of this study was to assess the efficacy of a 16-week nutrition and physical activity education program (HealthEYou) in mediating metabolic risk factors associated with MetS. Methods: This was a two phase study including phase 1) the use of a person-based approach and community needs assessment to develop a nutrition and physical activity education program, and 2) delivery of the 16-week workplace education program and assessment of its effectiveness. In phase 1, a survey and focus groups were used to assess the needs of the target population to develop the 16-week education program. Twenty-six participants (96% female; age: 50.1±9.2 yrs; BMI: 31.2±5.3 kg/m2) enrolled in the HealthEYou program. At baseline, 8- and 16-weeks participants completed assessments including blood pressure, body composition via Dual-energy X-ray absorptiometry (DXA) and waist circumference, 6-minute walk test, handgrip strength test, dietary intake via the Automated Self-Administered 24-hour (ASA-24) dietary assessment tool, and quality of life questionnaire. In addition, blood was drawn to assess metabolic disease risk markers (total cholesterol, glucose and hemoglobin A1c (HbA1c)). The education program consisted of 8-weeks in-person weekly interactive group (60 min) and individual goal setting (15 min) sessions and 8-weeks of weekly newsletters and two individual goal setting sessions. Results: Data was analyzed using repeated measures analysis of variance. The prevalence of MetS among the participants decreased significantly from 41.7% at baseline to 15.8% after completion of the program. There was a significant decrease from baseline compared to after 16-weeks in fat mass (36.8±10.5 kg and 34.4 ±10.47 kg, p=0.003) and HbA1c (5.36±0.40% and 5.12±0.37%, p=0.001). In addition, significant improvements in distance walked, handgrip strength, caloric intake and quality of life (p&lt;0.05) were also observed. However, no significant changes (p&gt;0.05) in total cholesterol, fasting blood glucose or systolic and diastolic blood pressure were observed at 16-weeks compared to baseline measures. Conclusion: In conclusion, the use of a person-based approach and community needs assessment was beneficial to the development of a 16-week nutrition and physical activity education program. Participants who completed the 16-week program had significant improvements in a number of metabolic risk factors. In addition, the physiological improvements corresponded with improvements in dietary intake and fitness levels, suggesting participants made positive lifestyle changes.

Patient-reported goal achievements after pelvic floor muscle training versus pessary in women with pelvic organ prolapse. A randomised controlled trial

The aim was to assess the achievement by self-determined goals in pelvic organ prolapse (POP) participants receiving pelvic floor muscle training (PFMT) compared to vaginal pessary. Forty participants with POP stage II to III were randomly allocated to pessary or PFMT. Participants were asked to list up 3 goals they expected from treatment. Thai version of Prolapse Quality of Life Questionnaire (P-QOL) and Pelvic Organ Prolapse Incontinence Sexual Questionnaire, IUGA-revised (PISQ-IR) were completed at 0 and 6-week period. At 6-week post-treatment, they were asked if their goals had been achieved. The totally achieved goals in the vaginal pessary group were 70% (14/20) significantly higher than PFMT group at 30% (6/20) (p = 0.01). The mean ± SD of the post-treatment P-QOL score in the vaginal pessary group was significantly lower than the PFMT group (13.90 ± 10.83 vs 22.04 ± 5.93, p = 0.01), but not different in all PISQ-IR subscales. Pessary treatment for POP yielded better total goal achievements and better quality of life than PFMT for POP treatment at a 6-week follow-up. Impact statement What is already known on this subject? Pelvic organ prolapse (POP) can severely affect the quality of life, causing physical, social, psychological, occupational, and/or sexual dysfunction. Individual patient goal setting and goal achievement scaling (GAS) offers a new method of patient-reported outcome measurement (PRO) in therapeutic success such as pessary or surgery in patient with POP. But there is no randomised controlled trial comparing pessary vs pelvic floor muscle training (PFMT) using GAS as the outcome measurement. What do the results of this study add? The results showed that women with POP stage II to III who received vaginal pessary had higher totally goal achievements and better quality of life than the women received the PFMT at 6-week follow up. What are the implications of these findings for clinical practice and/or further research? The information about the better goal achievements by using pessary can be used as the tools for counselling for patients with POP for selecting the choices for the treatment in the clinical setting.