Use Of Goal Setting Research Articles

Child-led goal setting and evaluation tools for children with a disability: A scoping review.

To examine child-led goal setting and evaluation tools and approaches for children with a disability or developmental delay. Six databases were searched for studies that included population (children aged less than 18 years with disability or developmental delay); construct (child-led goal setting tool or approach); and context (developmental therapy or rehabilitation). The utility of tools and approaches across the goal setting and evaluation process was investigated using abductive content analysis. Fifty articles met the inclusion criteria. Three approaches and four tools for child-led goal setting and evaluation were identified. No studies reported the clinimetric properties of tools specifically for child self-respondents. Qualitative analysis revealed six distinct goal phases in which tools and approaches were used, which were synthesized into a new framework for child-led goal setting and evaluation titled DECIDE: Direct children to goal setting; Elicit goal topics and priorities; Construct a goal statement; Indicate baseline goal performance; Develop an action plan to address the goal; and Evaluate goal progress after the intervention. Children actively participated in goal setting and evaluation across six DECIDE goal phases. Further clinimetric information is required to support use of goal setting and evaluation tools with child self-respondents. Future research should emphasize the development of multi-phase goal setting tools and approaches for diverse populations of children.

Increasing Employee Physical Activity Using Goal Setting and a Smartphone App.

Physical inactivity is a high-priority public health issue in U.S. worksites. There is evidence that physical activity (PA) goal-setting interventions can be effective. Smartphone apps have also been used to deliver accessible and appealing PA interventions. This article describes the use of goal setting and a no-cost PA smartphone app to pilot an 8-week PA intervention, Project Move 2.0, to increase PA among a nonprofit health and social assistance workforce. The community-based partnership identified intervention strategies that addressed moderators for setting PA goals: feedback, goal commitment, situational factors, and ability. The intervention included the use of a no-cost smartphone app for tracking steps/goal setting, an orientation/health education session, weekly text messages, as well as pre- and post-measures for goal setting for PA behaviors and an intervention evaluation questionnaire. There is limited knowledge on the practical aspects of applying goal setting and the use of a no-cost smartphone app to increase employee PA through a workplace PA intervention. Applying goal setting and the use of a no-cost smartphone app shows promise for workplace health promoters to successfully address employee PA.

Student Interview-Informed Behavior Contracts for High School Students Identified as at Risk

Addressing the challenging behavior of students requires evidence-based interventions that can be implemented in school settings; however, there is a relative lack of literature investigating effective strategies for high school students in secondary settings. Behavior contracts have been used to address challenging behavior in elementary and middle settings but less so in high school settings. Furthermore, the extent to which they have involved student input at the high school level has been unclear despite research indicating that collaborative intervention development processes may be associated with several additional benefits beyond effectiveness. Despite these empirical shortcomings, behavior contracts may be well suited to address individual high school students’ challenging behavior given their flexibility, collaborative nature, and use of goal setting and clearly stated contingencies (i.e., rules) to promote behavior change. Thus, the purpose of this study was to evaluate the acceptability and effectiveness of a structured interview-informed behavior contract intervention to address the disruptive behavior of high school students. Specifically, we used a multiple baseline design across three students and found that the interview-informed behavior contracts were effective in increasing their academically engaged behavior (Tau = .62) and decreasing disruptive and passive off-task behavior. Limitations and future directions are discussed.

Certain aspects of the use of goal setting as a methodological technique for the study of administrative law

The article, based on the analysis of the norms of public and private law, offers some advantages of using goal-setting as a methodological technique for the study of administrative law. It was established that the process of formation and implementation of goals has an important role in administrative and legal regulation, and therefore should have a scientific basis in the form of “goal setting”. If the goals of all elements of the administrative law system are properly defined and formulated, then, firstly, law enforcement subjects will be able to carry out targeted management, control, law enforcementactivities and activities related to the provision of administrative services, and secondly, this will create favorable conditions for the formation and the development of legal awareness among private individuals, which will have a positive effect on the observance of the general regime оf legality in the state. It has been proven that “right in the subjective sense” goes beyondresearch through the lens of goal setting. This is due to the fact that, firstly, natural human rights are only declarations that cannot be realized in real life without “rights in the objective sense”, secondly, the rights of a citizen are the result of legal regulation of social relations in a specific country, and therefore they should be considered exclusively as a result of achieving the goals of administrative and legal regulation. It is proved that the criteria for dividing the law into public and private law are the goals of legal regulation, which can be determined through the analysis of types of legal regulation. It was found thatthe following type of legal regulation is used in administrative and legal regulation in relation to public administration entities: “Only what is provided for by law is allowed.” That is, the main goal of administrative and legal regulation in relation to subjects of public administration is to prevent arbitrariness on the part of subjects endowed with public-authority powers. In relation to private individuals, the following type of administrative and legal regulation is used: “All that is provided for and not prohibited by law is permitted.” This type of administrative-legal regulation pursues two goals at once, which are hierarchically located next to each other: 1) to maximally ensure the realization of the rights and freedoms of a person and a citizen in relationswith the state and other subjects endowed with public-authority relations; 2) not to limit the variability of the behavior of private individuals in administrative legal relations in cases where there are no clear requirements for such behavior in the form of prescriptions or prohibitions or in cases where there are gaps in administrative and legal regulation.

The performance and psychological effects of goal setting in sport: A systematic review and meta-analysis

ABSTRACT Goal setting is widely applied in sport. Whereas existing reviews have addressed the performance effects of goal setting, less is known about the concurrent psychological and psychophysiological effects. Therefore, we conducted a systematic review and meta-analysis that synthesised the effects of goal setting on task performance and various psychological and psychophysiological outcomes in sport. Searches returned 17,841 articles, with 27 meeting eligibility criteria. A meta-analysis of the performance effects and a narrative synthesis of the psychological and psychophysiological effects were undertaken. Process goals had the largest effect on performance (d = 1.36) compared to performance goals (d = 0.44) and outcome goals (d = 0.09). No significant difference in performance was found between specific (d = 0.37) and non-specific goals (d = 0.72). Process goals also had large effects on self-efficacy (d = 1.11), whereas studies guided by self-regulation theory (k = 5) produced the greatest performance enhancements (d = 1.53). It was rarely possible to draw conclusions regarding the effects of goal setting on psychological/psychophysiological outcomes due to a lack of cross study evidence. Nevertheless, these findings provide important insights to guide research and practice on the use of goal setting to enhance performance and psychological/psychophysiological outcomes in sport.

Patients' Experiences of Using a Smartphone App After Cardiac Rehabilitation: Qualitative Study.

BackgroundExercise-based cardiac rehabilitation (CR) is a crucial part of the treatment of patients with cardiac diseases, and adherence to healthy behavior is a prerequisite to improve long-term prognosis. Unfortunately, adherence to healthy behavior adapted in CR is challenging for many cardiac patients in the long term. Recently, we demonstrated that follow-up conducted via an app for 1 year significantly improved adherence to healthy behavior after CR. To increase the knowledge and understanding of mobile Health (mHealth) interventions that can promote acceptance and adherence, qualitative research investigating patients’ experiences with these interventions is warranted.ObjectiveThe aim was to investigate patient experiences with individualized long-term follow-up conducted via an app for 1 year and their thoughts about what features promoted adherence to healthy behavior after CR. The purpose was to increase the understanding of significant findings previously reported and to guide future development of similar interventions in the field of adherence.MethodsA qualitative study with individual interviews was conducted from November 2018 to May 2019. A thematic interview guide was used when conducting the semistructured in-depth interviews. The interviews were audio recorded and transcribed successively during the period in which the interviews were conducted. Texts were managed and systematized by NVivo. Interviews were analyzed by qualitative content analysis. Codes and themes were inductively developed.ResultsTen patients who had participated in a randomized controlled trial evaluating the effect of follow-up conducted via an app on adherence to healthy behavior after CR were included. The median patient age was 65 years (range 46-72 years), and both genders were represented. The analysis resulted in the following 4 themes describing the patients’ experiences: (1) The person behind the app is crucial for motivation and adherence; (2) The app as a commitment; (3) The app as a path to independence; and (4) Suggestions for improvements. Features experienced as beneficial to promote adherence were individualized feedback and the use of goal setting. The significance of the person behind the app (the supervisor) who provided individualized feedback was a consistent finding. This person seemed to promote motivation in general and to enable other known behavioral change techniques.ConclusionsThe person behind the app (the supervisor) seems to be one of the most significant success factors in promoting adherence to healthy behavior after CR. This indicates that a health care provider must actively participate in a patient’s process of adherence to healthy behavior, even when using interventions, including an app. Future development of interventions in the field of adherence should strive to create tools that enable an ongoing collaborative relationship between the patient and the health care provider. The follow-up should be based on the patient’s own goals, and individualized feedback should be provided.

“Goals Give You Hope”: An Exploration of Goal Setting in Young People Experiencing Mental Health Challenges

The mental health of New Zealand’s adolescents is, by global standards, remarkably poor. Addressing such mental health needs is not only pertinent with regards to the quality of life of our young people, but also the health of our society as a whole, with current unmet youth mental health needs becoming future adult population health deficits. While an array of evidence-based psychotherapies are available as treatment, our knowledge of the mechanism of actions underlying each of these is lacking. We propose that the practice of goal setting as a therapeutic technique may represent not only a common element across these therapies, but may also significantly contribute to their relative efficacies. Developing a fuller understanding of goal setting’s usefulness and efficacy, as perceived by youth with mental health difficulties, may serve to aid in the development and deployment of more effective interventions, providing a small stepping-stone on the path towards addressing our current youth mental health crisis. Through a series of semi-structured interviews with nine young people aged 16–24 years old in New Zealand, we strive to create a nuanced understanding of young people’s perception and use of goal setting, and its potential significance both within and beyond the realm of psychotherapy. Key themes derived from the data include (1) motivation for goal setting and achieving; (2) barriers to goal setting and achieving; (3) strategies for goal achievement; (4) the role of self-efficacy; (5) the role of support; and (6) benefits of goal setting. The findings generated from this study suggest that goal setting as a therapeutic technique, when used appropriately, can have significant positive impacts on the emotional state, productivity, and view of the future for young people experiencing mental health challenges.

Higher Education Students’ Experience of Emergency Remote Teaching during the Covid-19 Pandemic in Relation to Self-Regulation and Positivity

The main objective of the present research was to explore students’ experiences of emergency remote teaching during the Covid-19 pandemic. Specifically, we were interested in how strategies for coping with an emergency situation, learning strategies and positivity relate to this experience. A total of 337 university students participated in the study. The data were collected with an online questionnaire. The results show that students used more adaptive coping strategies (positive reappraisal, acceptance and refocus on planning) and fewer maladaptive strategies (blaming others, catastrophising). Furthermore, students reported the frequent use of two self-regulated learning strategies, i.e., environment structuring and goal setting, and the less frequent use of task strategies. Self-regulation and positivity explained a total of 40% of the variance of the students’ experience during the pandemic. Important predictors for more constructive experience were the frequent use of goal setting and environment structuring strategies, more pronounced positivity, and less frequent use of the catastrophising coping strategy. The research findings contribute to a better understanding of students’ emergency remote teaching and learning experience during the pandemic and its correlates. Moreover, the findings could enable academic staff to focus on the essential elements when supporting students to cope with the pandemic.

Common antecedent strategies within organizational behavior management: the use of goal setting, task clarification, and job aids

ABSTRACT Despite organizational behavior management placing a great deal of emphasis on interventions that alter consequences for performance, antecedent interventions play an important role in the practice of our field. Antecedent interventions utilizing variables such as goal setting, task clarification, and job aids are common. Each of these variables are examined in terms of research findings and potential behavioral functions. Being well-versed in such outcomes should inform both researchers and practitioners in their efforts to identify efficient and cost-effective solutions for workplace performance.

Physical Activity Promotion for School-Age Children With Disabilities

Physical activity (PA) promotion for children with disabilities tends to be less of a priority in physical education teacher education programs when compared with a focus on motor and sport-specific skills and strategies. As a result, physical education teachers tend to have less competence in promoting PA of students with disabilities, leaving students with disabilities to feel disconnected from the physical education class. Students with a disability subsequently are likely not to benefit from physical education in terms of PA participation. This paper aims to provide guidelines and strategies to promote PA in inclusive physical education settings. In this paper, we define PA and provide specific strategies grounded in self-determination theory and the socioecological model to promote PA during physical education class. Strategies proposed include (a) selection of disability sport and instructional models, (b) grouping practices to facilitate relatedness, skill development, and participation, (c) approaches to increase choice and encourage decision making, and (d) use of goal setting and self-evaluation.

Functional neurological symptoms: Optimising efficacy of inpatient treatment and preparation for change using the Queen Square Guided Self‐Help

AbstractObjectiveFunctional neurological symptoms (FNS) are disabling symptoms without macro‐structural cause. While inpatient treatment confers important benefits, it is resource‐intensive, and hence, it is important to optimise its efficiency.MethodsWe developed a brief, Internet‐based preparatory therapy based on psychoeducation and CBT, termed the Queen Square Guided Self‐help (QGSH), to maximise the efficacy of the inpatient FNS treatment at the National Hospital for Neurology and Neurosurgery.ResultsThe QGSH aims to ensure that prior to admission, the patient understands (a) the diagnosis of FNS, (b) the five‐areas CBT model and (c) the use of goal setting in rehabilitation. It has now run since 2017, and 191 patients have taken part in the inpatient FNS programme, with 122 of these having participated in the QGSH. It runs for up to 12 weeks and includes original videos and patient worksheets, as well as signposting to existing published resources. Information is sent weekly by email, and content is delivered in the form of 11 modules built around online video sessions.ConclusionWe believe that the set of materials used in QGSH has the potential to benefit patients with FNS and can support clinicians wishing to develop their expertise. It could help with the development of new FNS services, and we are in the process of developing it into a stand‐alone service. We hope that the experience of the Queen Square team can be used to help patients and clinicians to improve the provision of FNS services.

From couch to ultra marathon: using functional imagery training to enhance motivation

Abstract Objectives This study evaluates ultra-marathon runners’ use of goal-setting, self-talk, and imagery as strategies to help them through the challenge of long-distance running. Methods In stage one, thirty-one self-professed non-runners were recruited and received motivational interviewing (MI) in a group setting, examining their motivation to get healthy. In stage two, five months later, participants were asked if they would consider running an ultra-marathon, and fifteen (M age=39.47, SD=5.84) agreed. At this point participants were randomly split into an MI or Functional Imagery Training (FIT) group. FIT teaches participants how to master goal centred imagery by controlling attention and elaboration. Groups received similar contact hours and completed four measures that assess grit, resilience, self-efficacy, and imagery ability at baseline and after the race. Results We found no significant differences between measures for finishers and non-finishers or between groups or over time. However, the likelihood of completing the ultra-marathon was five times as likely in the FIT group, than in MI (RR=5.25). Grit and resilience scores were strongly correlated. By receiving FIT, there was a significant association (p=0.04) to complete the ultra-marathon. Conclusions FIT is a relatively cost-effective method to increase exercise adherence through multi-sensory elaboration of goal setting and overcoming barriers or challenges.

Goal Setting Improves Cognitive Performance in a Randomized Trial of Chronic Stroke Survivors.

Cognitive impairment after stroke, especially executive and attention dysfunction, is common, negatively affects daily functioning, and has limited treatment options. A single-blind, parallel-design, randomized controlled trial was used to examine the impact of goal setting on poststroke cognitive performance. Stroke survivors (n=72; mean age, 68.38 [SD=11.84] years; 69.4% men) in the chronic phase (≥3 months) after stroke from an academic stroke prevention clinic were randomly assigned to receive goal-setting instructions (n=36) or standard instructions (n=36) after completing baseline cognitive measures of executive function (primary outcome), attention/working memory, verbal learning, and verbal recall. A one-way mixed multivariate analysis of covariance (MANCOVA) found a group by instructional manipulation interaction effect for executive function (Wilks λ=0.66; F[3,66]=11.30; P≤0.001; η2p=0.34), after adjusting for age and years of education. After similar adjustment, attention/working memory (Wilks λ=0.86; F[5,63]=2.10; P=0.043; η2p=0.16) and verbal learning (F[1,60]=5.81; P=0.019; η2p=0.09) also showed improvement after instruction but not verbal recall (Wilks λ=0.95; F[1,56]=2.82; P=0.099; η2p=0.05). There were no adverse events. Goal setting improved executive function, attention/working memory, and learning in a heterogeneous sample in the chronic phase after stroke. This suggests that >3 months after stroke, vascular cognitive impairment is not a fixed deficit; there is a motivational contributor. Brief treatments targeting goal-oriented behavior and motivation may serve as a novel approach or adjunct treatment to improve cognitive outcomes after stroke. Future research should investigate the use of goal setting on functional outcomes (eg, instrumental activities of daily living and vocational function) in this population, highlighting new potential avenues for treatment for vascular cognitive impairment. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03511300.

How Does the Understanding, Experience, and Enactment of Self-Regulation Behaviour Change Techniques Vary with Age? A Thematic Analysis.

Self-regulatory behaviour change techniques (BCTs) appear less effective in promoting physical activity amongst older than younger adults. This study aimed to identify reasons for this by examining how participants of different ages understand, experience, and use these BCTs. Twelve participants (aged 39-75) in a walking intervention study were interviewed twice: immediately post-intervention and 3 months later to examine understanding and enactment of self-regulation BCTs. Thematic analysis was used, organised using the framework approach. Participants acknowledged the importance of setting realistic goals and found pedometers useful. In older adults, the use of goal setting was influenced by previous experience in work settings of this BCT. Occupational status appeared to influence the participants' responses to action planning, irrespective of age, with retired participants preferring not to restrict themselves to specific times. Self-monitoring with diaries appeared to be more useful in assisting the memory of older adults. For most BCTs, differences in understanding and enactment were apparent according to participant age. Problems with using self-regulation BCTs were apparent, which appeared more common with older adults. Occupational status, cognitive status, or a perceived lack of value of physical activity or of some BCTs are all promising explanations that warrant further investigation.

Real-World Goal Setting and Use of Outcome Measures According to the International Classification of Functioning, Disability and Health: A European Survey of Physical Therapy Practice in Multiple Sclerosis.

Goal setting is a core component of physical therapy in multiple sclerosis (MS). It is unknown whether and to what extent goals are set at different levels of the International Classification of Functioning, Disability and Health (ICF), and whether, and to which, standardized outcome measures are used in real life for evaluation at the different ICF levels. Our aim was to describe the real-world use of goal setting and outcome measures in Europe. An online cross-sectional survey, completed by 212 physical therapists (PTs) specialized in MS from 26 European countries, was conducted. Differences between European regions and relationships between goals and assessments were analyzed. PTs regularly set goals, but did not always apply the Specific, Measurable, Achievable, Realistic, Timed (SMART) criteria. Regions did not differ in the range of activities assessed, but in goals set (e.g., Western and Northern regions set significantly more goals regarding leisure and work) and outcome measures used (e.g., the Berg Balance Scale was more frequently used in Northern regions). Quality of life was not routinely assessed, despite being viewed as an important therapy goal. Discrepancies existed both in goal setting and assessment across European regions. ICF assists in understanding these discrepancies and in guiding improved health-care for the future.

Use of Evidence-Based Best Practices and Behavior Change Techniques in Breast Cancer Apps: Systematic Analysis.

BackgroundTheoretically designed mobile health (mHealth) breast cancer interventions are essential for achieving positive behavior change. In the case of breast cancer, they can improve the health outcomes of millions of women by increasing prevention and care efforts. However, little is known about the theoretical underpinnings of breast cancer apps available to the general public.ObjectiveGiven that theories may strengthen mHealth interventions, this study aimed to identify breast cancer apps designed to support behavior change, to assess the extent to which they address content along the cancer care continuum and contain behavior change techniques, and to assess the degree to which star rating is related to theory-based design.MethodsUsing a criteria-based screening process, we searched 2 major app stores for breast cancer apps designed to promote behavior change. Apps were coded for content along the cancer care continuum and analyzed for behavior change techniques. The Mann-Whitney U test was used to examine the relationship between star ratings and the use of behavior change techniques in apps with star ratings compared to those without ratings.ResultsThe search resulted in a total of 302 apps, of which 133 were identified as containing breast cancer content. Only 9.9% (30/302) of apps supported behavior change and were further analyzed. These apps were disproportionally focused on behaviors to enhance early detection, whereas only a few apps supported care management, treatment, and posttreatment behaviors. Regarding theories, 63% (19/30) of apps customized content to users, 70% (21/30) established a health-behavior link, and 80% (24/30) provided behavior change instructions. Of the 30 apps, 15 (50%) prompted intention formation whereas less than half of the apps included goal setting (9/30, 30%) and goal reviewing (7/30, 23%). Most apps did not provide information on peer behavior (7/30, 23%) or allow for social comparison (6/30, 20%). None of the apps mobilized social norms. Only half of the apps (15/30, 50%) were user rated. The results of the Mann-Whitney U test showed that apps with star ratings contained significantly more behavior change techniques (median 6.00) than apps without ratings. The analysis of behavior change techniques used in apps revealed their shortcomings in the use of goal setting and social influence features.ConclusionsOur findings indicate that commercially available breast cancer apps have not yet fully realized their potential to promote behavior change, with only a minority of apps focusing on behavior change, and even fewer including theoretical design to support behavior change along the cancer care continuum. These shortcomings are likely limiting the effectiveness of apps and their ability to improve public health. More attention needs to be paid to the involvement of professionals in app development and adherence to theories and best practices in app design to support individuals along the cancer care continuum.

Use of Goal Setting to Enhance Self-Efficacy After Sports-Related Injury: A Critically Appraised Topic.

Clinical Scenario: Patients after sports-related injury experience deficits in self-efficacy. Goal setting may be an appropriate psychoeducation technique to enhance self-efficacy after sports-related injury. Clinical Question: Does goal setting-enhanced rehabilitation improve self-efficacy compared with traditional rehabilitation alone in individuals with sports-related injury? Summary of Key Findings: Two randomized controlled trials were included. The two studies selected assessed changes in self-efficacy before and after a goal-setting intervention following sports-related injury in an athletic population. Both studies used the Sports Injury Rehabilitation Beliefs Survey to evaluate self-efficacy. Clinical Bottom Line: There is currently consistent, good-quality, patient-oriented evidence that supports the use of goal setting to improve self-efficacy in patients undergoing rehabilitation for sports-related injury compared with the standard of care group. Future research should examine optimal timing for the implementation of goal setting in order to enhance self-efficacy following sports-related injury. Strength of Recommendation: The grade of A is recommended by the Strength of Recommendation Taxonomy for consistent, good-quality, patient-oriented evidence.

Goal-setting practices that support a learning culture

What can educators do to help students care about their learning and become more invested in their own success? Chase Nordengren describes how a school district created a goal-setting culture in all classrooms at all grade levels. The district began with a complex, research-based, prescriptive program that teachers found did not work well with certain students. Young students, for example, did not understand the goal-setting forms that were part of the program. As teachers adapted the program to fit their students, Nordengren was able to discern certain commonalities in teachers’ use of goal setting that made them successful. Based on these observations, he suggests that educators start their goal-setting efforts early, set short-term goals, provide visual tools, make goal setting personal, and center student choice.

Do Elite Coaches from Disability Sport Use Psychological Techniques to Improve Their Athletes’ Sports Performance?

Goal-setting, imagery, relaxation and self-talk are psychological strategies crucial for successful psychological preparation and consequently for the improvement of the athlete’s sport performance. The coaches have an important role in the implementation of psychological skills training and may contribute to increase the use of psychological strategies by their athletes. Therefore, the purpose of this study was to examine the importance assigned to a group of psychological strategies (i.e., goal-setting, imagery, relaxation and self-talk) and its use in practice and competition setting by top elite coaches from disability sport. In-depth semi-structured interviews were conducted on ten elite Portuguese coaches. Content analysis was the qualitative methodology used for data analysis. Globally, the coaches acknowledge the importance of all four psychological strategies approached. However, the examination of the coaching routines on the application of psychological strategies suggested an undeveloped use of most of the strategies, specifically in the practice setting. Relaxation and self-talk were the most underused strategies. All the coaches reported the use of goal-setting in both the practice and competition setting. Overall, the present findings raise concerns about the effective contribution of Portuguese elite coaches for the development of successful psychological preparation among athletes with disabilities.

Acute care nurses' responses and recommendations for improvement of hand hygiene compliance: A cross-sectional factorial survey research study.

Hand hygiene is promoted as an effective practice to counter health care-acquired infections; however, compliance is less than optimal. Nurses have many patient contact opportunities and therefore are frequent participants in intervention research. The optimal combination of efficient and effective intervention components has not been conclusively identified. A factorial survey research design offers an efficient method to assess multiple factors simultaneously by combining elements into vignettes. This article describes a process, grounded in the framework of Bandura's social cognitive theory, that explored environmental and individual factors that potentially influence nurses' hand hygiene behavior in acute care settings. Survey respondents consisted of nurses employed in patient care; respondents also could address an open response item. A total of 466 participants scored a total of 3,685 vignettes. Statistically significant parameters included goal, supervisor priority, electronic monitoring, and rewards. The most frequently mentioned open response item was the need to keep hand hygiene product dispensers refilled. Participants also suggested that culture and intrinsic motivation influenced hand hygiene behavior. Researchers might consider assessing promising factors, especially use of goal setting, as an intervention rather than as components of an intervention. Further research is indicated to better understand how nurses define and view hand hygiene culture.