title: Measuring the quality of patients' goals and action plans: development and validation of a novel tool.
abstract: BACKGROUND
  The purpose of this study is to develop and test reliability, validity, and utility of the Goal-Setting Evaluation Tool for Diabetes (GET-D). The effectiveness of diabetes self-management is predicated on goal-setting and action planning strategies. Evaluation of self-management interventions is hampered by the absence of tools to assess quality of goals and action plans. To address this gap, we developed the GET-D, a criteria-based, observer rating scale that measures the quality of patients' diabetes goals and action plans.
  
  
  METHODS
  We conducted 3-stage development of GET-D, including identification of criteria for observer ratings of goals and action plans, rater training and pilot testing; and then performed psychometric testing of the GET-D.
  
  
  RESULTS
  Trained raters could effectively rate the quality of patient-generated goals and action plans using the GET-D. Ratings performed by trained evaluators demonstrated good raw agreement (94.4%) and inter-rater reliability (Kappa = 0.66). Scores on the GET-D correlated well with measures theoretically associated with goal-setting, including patient activation (r=.252, P<.05), diabetes specific self-efficacy (r=.376, P<.001) and inverse relationship with depression (r= -.376, P<.01). Significant between group differences (P<.01) in GET-D scores between goal-setting intervention (mean = 7.33, standard deviation = 4.4) and education groups (mean = 4.93, standard deviation = 3.9) confirmed construct validity of the GET-D.
  
  
  CONCLUSIONS
  The GET-D can reliably and validly rate the quality of goals and action plans. It holds promise as a measure of intervention fidelity for clinical interventions that promote diabetes self-management behaviors to improve clinical outcomes.
  
  
  BACKGROUND
  Clinicaltrials.gov Identifier: NCT00481286.
authors.affiliation: Houston VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
authors.forename: Cayla R
authors.initials: CR
authors.lastname: Teal
authors.forename: Paul
authors.initials: P
authors.lastname: Haidet
authors.forename: Ajay S
authors.initials: AS
authors.lastname: Balasubramanyam
authors.forename: Elisa
authors.initials: E
authors.lastname: Rodriguez
authors.forename: Aanand D
authors.initials: AD
authors.lastname: Naik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy; D006040:Goals; D006801:Humans; D008875:Middle Aged; D057240:Patient Preference / Q000523:psychology*; D011594:Psychometrics; D019984:Quality Indicators, Health Care; D012648:Self Care; D011795:Surveys and Questionnaires / Q000592:standards*