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An Innovative Approach to Goal Setting for Adolescents: Guided Goal Setting
G E M N O. 3 7 4
An Innovative Approach to Goal Setting for Adolescents: Guided Goal Setting Mical Kay Shilts, PhD, Department of Nutrition, University of CaliforniaDavis, Davis, Calif Marcel Horowitz, MS, Department of Nutrition, University of CaliforniaDavis, Davis, Calif Marilyn S.Townsend, PhD, RD,* Department of Nutrition, University of California-Davis, 1 Shields Ave, Davis, CA 95616-8783.Tel: (530) 754-9222; Fax: (530) 752-7588; E-mail: [email protected] ( J Nutr Educ Behav. 2004;36:155-156.) *Author for correspondence INTRODUCTION
DEVELOPMENT OF GUIDED GOAL SETTING EatFit is a theory-driven dietary and physical activity behavior change intervention for middle school adolescents. Developed by the authors, it is based on Social Cognitive Theory, with strong emphasis on goal setting. During development of the interven-
Funding was provided by the Expanded Food and Nutrition Education Program, Food Stamp Nutrition Education Program, American Distance Education Consortium, University of California, Davis School/University Partnerships, Center for Advanced Studies in Nutrition and Social Marketing, University of California, Davis.
USE OF GUIDED GOAL SETTING IN THE EATFIT INTERVENTION As part of the EatFit intervention, students set one dietary and one physical activity goal for the duration of the intervention (9 weeks).There are 6 specific major dietary goal options (calcium, fruit and vegetable, iron, fat, eating habits, and added sugar) and 4 specific physical activity goal options (flexibility, aerobic, strength, and lifestyle). To set the dietary goal, students complete a 24-hour diet record and enter foods into a computer program with personalized outputs designed specifically for the intervention (www.eatfit.net). Once a student enters his 24-hour diet record, computer algorithms determine 2 diet areas for improvement and 1 for positive recognition. The student selects his goal area, for example, “Decrease added sugar intake.”This would be his major goal.The computer program then generates 3 minor goals from which the
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student selects one, for example,“Eat a breakfast cereal with less than 10 g of sugar per serving 3 mornings a week.” The goals employ appropriate motivators that were described by adolescents in previously conducted focus groups: increased energy and improved appearance. The computer program inserts the major and minor goal selections into a contract containing the student’s name.The contract is printed and then signed by the student, a peer, and a parent or guardian (Figure 1). Students track goal achievement and are rewarded with raffle tickets and prizes (Figure 2).The EatFit intervention specifically supports goal attainment through skill-building activities, social support, barrier counseling, and cue management. We tested guided goal setting with middle school–aged adolescents, and it was shown to be effective.The guided goal setting method may be applicable to other audiences (eg, older adolescents, adults, and upper elementary school students), although further investigation is recommended. EVALUATION OF GUIDED GOAL SETTING In an evaluation of the EatFit intervention with 41 low-income ethnically diverse eighth grade students (63% male), 87% stated that they made an effort to reach their eating goal and 89% made an effort to reach their physical activity goal. Goals were generated through the guided goal setting procedure. At the completion of the intervention, participants were asked how they felt about the intervention. Selected quotations illustrate students’ enjoyment with using the guided goal setting strategy: “I attempted my goals, and I noticed a big difference. I had more energy, and now I feel great. I think more students should do this program. Thanks, I will continue to work on my goals….” “…the best part is when we set goals, because when we set goals I reach[ed] them.That made me feel good.” “I learned from the nutrition program that you have to have goals and you have to have challenges for those goals…. I am eating more fruits and vegetables, and I am exercising and not eating that many fat foods.”
GEM
Goal setting has shown promise in promoting positive behavior change in the nutrition and physical activity fields.1-3 When designing the goal-setting strategy for an intervention, a decision about goal type (who develops and chooses the goal) has to be made. Several factors, such as participant’s age, intervention setting, and readiness to change, influence the type of goal to use: (1) self-set, (2) participatory, or (3) assigned.4 This GEM is about the development and use of a fourth type, guided goal setting.This GEM (1) describes the development of the guided goal-setting strategy, (2) shows how guided goal setting was implemented in the EatFit intervention, and (3) provides a step-by-step guide for the practitioner who wishes to duplicate the guided goal-setting strategy (Table).
tion, a concern arose about the appropriateness of the current methods of goal setting with adolescents. The 3 types of goal setting listed above did not seem suitable for this audience or setting.Although goal setting has been shown to be an effective method for dietary and physical activity behavior change in adults, its effectiveness has not been shown with adolescents. Setting a goal requires abstract reasoning,5 which begins to develop during adolescence.6 Therefore, some adolescents may not yet have the cognitive ability to self-set a goal. Participatory goal setting was not an option for a school setting owing to the individualized time commitment needed from the teacher. Assigned goal setting may limit adolescent autonomy, thereby decreasing goal commitment. Instead of expecting youth to set their own goals or be assigned a goal, guided goal setting provides adolescents with a choice from a variety of practitioner-developed goals. 7 This type of goal setting eliminates the possibility of inappropriate goal selection and ensures that the goal choices contain attributes necessary for optimal goal effectiveness: specificity, proximity, difficulty, and attainability.4
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Shilts et al/GEM NO. 374 ( J Nutr Educ Behav. 2004;36:155-156.)
Table.
Practitioner Step-by-Step Guide for Implementing Guided Goal Setting
Practitioner Steps
Examples from the EatFit Intervention
1. Choose main concept(s) to be improved.
Improve dietary and physical activity behaviors.
2. Research target audience motivators for desired behaviors to incorporate into goal construction using qualitative research methods.
Increase energy or improved appearance for the adolescent audience.
3. Develop predetermined major goals based on main concepts selected.
Increase fruit and vegetable intake.
4. Develop at least 3 minor goal options for each major goal. Goals should be constructed with the following attributes: proximity, specificity, difficulty, and attainability.4
Add 1 serving of fruit to your cereal 3 mornings a week.
5. Choose or develop a self-assessment tool.
24-hour diet record, physical activity diary.
6. Choose or develop a method for scoring the assessment tool and generating appropriate goals.
EatFit eating and physical activity analysis.
7. Develop a contract to include the selected major and minor goals for participants and a peer or practitioner to sign.
See Figure 1.
8. Develop a method for participants to track goal progress.
A graphing system (Figure 2).
9. Develop a reward system for goal attainment.
Raffle tickets to be drawn for a prize.
Figure 1. Goal contract used in the EatFit intervention.
Figure 2. Goal tracking system used in the EatFit intervention.
In addition, a randomized controlled field trial investigating the effect of guided goal setting on middle school adolescents’ dietary and physical activity self-efficacy and behaviors has been conducted.A manuscript is in preparation. NOTES EatFit is available at http://anrcatalog. ucdavis.edu or by telephone at 800994-8849. REFERENCES 1. Cullen KW, Baranowski T, Smith SP. Using goal setting as a strategy for dietary behavior change. J Am Diet Assoc. 2001;101:562-566. 2. Annesi JJ. Effects of computer feedback on adherence to exercise. Percept Mot Skills. 1998;87:723-730. 3. Schnoll R, Zimmerman BJ. Selfregulation training enhances dietary self-efficacy and dietary fiber consumption. J Am Diet Assoc. 2001; 101:1006-1011. 4. Locke EA, Lantham GP. A Theory of Goal Setting and Performance. Englewood Cliffs, NJ: Prentice-Hall; 1990. 5. Bandura A. Foundations of Thought and Action:A Social Cognitive Theory. Englewood Cliffs, NJ: PrenticeHall; 1986. 6. Slavin RE. Educational Psychology: Theory and Practice. 5th ed. Boston: Allyn and Bacon; 1997. 7. Shilts M,Townsend M, Horowitz M. Pilot study of the EatFit intervention to determine sample size and protocol Nov. 2000 for a randomized controlled trial. Available at: http:// socialmarketing-nutrition.ucdavis. edu/publications.htm#review6. Accessed March 2003.
An Innovative Approach to Goal Setting for Adolescents: Guided Goal Setting Mical Kay Shilts, PhD, Department of Nutrition, University of CaliforniaDavis, Davis, Calif Marcel Horowitz, MS, Department of Nutrition, University of CaliforniaDavis, Davis, Calif Marilyn S.Townsend, PhD, RD,* Department of Nutrition, University of California-Davis, 1 Shields Ave, Davis, CA 95616-8783.Tel: (530) 754-9222; Fax: (530) 752-7588; E-mail: [email protected] ( J Nutr Educ Behav. 2004;36:155-156.) *Author for correspondence INTRODUCTION
DEVELOPMENT OF GUIDED GOAL SETTING EatFit is a theory-driven dietary and physical activity behavior change intervention for middle school adolescents. Developed by the authors, it is based on Social Cognitive Theory, with strong emphasis on goal setting. During development of the interven-
Funding was provided by the Expanded Food and Nutrition Education Program, Food Stamp Nutrition Education Program, American Distance Education Consortium, University of California, Davis School/University Partnerships, Center for Advanced Studies in Nutrition and Social Marketing, University of California, Davis.
USE OF GUIDED GOAL SETTING IN THE EATFIT INTERVENTION As part of the EatFit intervention, students set one dietary and one physical activity goal for the duration of the intervention (9 weeks).There are 6 specific major dietary goal options (calcium, fruit and vegetable, iron, fat, eating habits, and added sugar) and 4 specific physical activity goal options (flexibility, aerobic, strength, and lifestyle). To set the dietary goal, students complete a 24-hour diet record and enter foods into a computer program with personalized outputs designed specifically for the intervention (www.eatfit.net). Once a student enters his 24-hour diet record, computer algorithms determine 2 diet areas for improvement and 1 for positive recognition. The student selects his goal area, for example, “Decrease added sugar intake.”This would be his major goal.The computer program then generates 3 minor goals from which the
155
student selects one, for example,“Eat a breakfast cereal with less than 10 g of sugar per serving 3 mornings a week.” The goals employ appropriate motivators that were described by adolescents in previously conducted focus groups: increased energy and improved appearance. The computer program inserts the major and minor goal selections into a contract containing the student’s name.The contract is printed and then signed by the student, a peer, and a parent or guardian (Figure 1). Students track goal achievement and are rewarded with raffle tickets and prizes (Figure 2).The EatFit intervention specifically supports goal attainment through skill-building activities, social support, barrier counseling, and cue management. We tested guided goal setting with middle school–aged adolescents, and it was shown to be effective.The guided goal setting method may be applicable to other audiences (eg, older adolescents, adults, and upper elementary school students), although further investigation is recommended. EVALUATION OF GUIDED GOAL SETTING In an evaluation of the EatFit intervention with 41 low-income ethnically diverse eighth grade students (63% male), 87% stated that they made an effort to reach their eating goal and 89% made an effort to reach their physical activity goal. Goals were generated through the guided goal setting procedure. At the completion of the intervention, participants were asked how they felt about the intervention. Selected quotations illustrate students’ enjoyment with using the guided goal setting strategy: “I attempted my goals, and I noticed a big difference. I had more energy, and now I feel great. I think more students should do this program. Thanks, I will continue to work on my goals….” “…the best part is when we set goals, because when we set goals I reach[ed] them.That made me feel good.” “I learned from the nutrition program that you have to have goals and you have to have challenges for those goals…. I am eating more fruits and vegetables, and I am exercising and not eating that many fat foods.”
GEM
Goal setting has shown promise in promoting positive behavior change in the nutrition and physical activity fields.1-3 When designing the goal-setting strategy for an intervention, a decision about goal type (who develops and chooses the goal) has to be made. Several factors, such as participant’s age, intervention setting, and readiness to change, influence the type of goal to use: (1) self-set, (2) participatory, or (3) assigned.4 This GEM is about the development and use of a fourth type, guided goal setting.This GEM (1) describes the development of the guided goal-setting strategy, (2) shows how guided goal setting was implemented in the EatFit intervention, and (3) provides a step-by-step guide for the practitioner who wishes to duplicate the guided goal-setting strategy (Table).
tion, a concern arose about the appropriateness of the current methods of goal setting with adolescents. The 3 types of goal setting listed above did not seem suitable for this audience or setting.Although goal setting has been shown to be an effective method for dietary and physical activity behavior change in adults, its effectiveness has not been shown with adolescents. Setting a goal requires abstract reasoning,5 which begins to develop during adolescence.6 Therefore, some adolescents may not yet have the cognitive ability to self-set a goal. Participatory goal setting was not an option for a school setting owing to the individualized time commitment needed from the teacher. Assigned goal setting may limit adolescent autonomy, thereby decreasing goal commitment. Instead of expecting youth to set their own goals or be assigned a goal, guided goal setting provides adolescents with a choice from a variety of practitioner-developed goals. 7 This type of goal setting eliminates the possibility of inappropriate goal selection and ensures that the goal choices contain attributes necessary for optimal goal effectiveness: specificity, proximity, difficulty, and attainability.4
156
Shilts et al/GEM NO. 374 ( J Nutr Educ Behav. 2004;36:155-156.)
Table.
Practitioner Step-by-Step Guide for Implementing Guided Goal Setting
Practitioner Steps
Examples from the EatFit Intervention
1. Choose main concept(s) to be improved.
Improve dietary and physical activity behaviors.
2. Research target audience motivators for desired behaviors to incorporate into goal construction using qualitative research methods.
Increase energy or improved appearance for the adolescent audience.
3. Develop predetermined major goals based on main concepts selected.
Increase fruit and vegetable intake.
4. Develop at least 3 minor goal options for each major goal. Goals should be constructed with the following attributes: proximity, specificity, difficulty, and attainability.4
Add 1 serving of fruit to your cereal 3 mornings a week.
5. Choose or develop a self-assessment tool.
24-hour diet record, physical activity diary.
6. Choose or develop a method for scoring the assessment tool and generating appropriate goals.
EatFit eating and physical activity analysis.
7. Develop a contract to include the selected major and minor goals for participants and a peer or practitioner to sign.
See Figure 1.
8. Develop a method for participants to track goal progress.
A graphing system (Figure 2).
9. Develop a reward system for goal attainment.
Raffle tickets to be drawn for a prize.
Figure 1. Goal contract used in the EatFit intervention.
Figure 2. Goal tracking system used in the EatFit intervention.
In addition, a randomized controlled field trial investigating the effect of guided goal setting on middle school adolescents’ dietary and physical activity self-efficacy and behaviors has been conducted.A manuscript is in preparation. NOTES EatFit is available at http://anrcatalog. ucdavis.edu or by telephone at 800994-8849. REFERENCES 1. Cullen KW, Baranowski T, Smith SP. Using goal setting as a strategy for dietary behavior change. J Am Diet Assoc. 2001;101:562-566. 2. Annesi JJ. Effects of computer feedback on adherence to exercise. Percept Mot Skills. 1998;87:723-730. 3. Schnoll R, Zimmerman BJ. Selfregulation training enhances dietary self-efficacy and dietary fiber consumption. J Am Diet Assoc. 2001; 101:1006-1011. 4. Locke EA, Lantham GP. A Theory of Goal Setting and Performance. Englewood Cliffs, NJ: Prentice-Hall; 1990. 5. Bandura A. Foundations of Thought and Action:A Social Cognitive Theory. Englewood Cliffs, NJ: PrenticeHall; 1986. 6. Slavin RE. Educational Psychology: Theory and Practice. 5th ed. Boston: Allyn and Bacon; 1997. 7. Shilts M,Townsend M, Horowitz M. Pilot study of the EatFit intervention to determine sample size and protocol Nov. 2000 for a randomized controlled trial. Available at: http:// socialmarketing-nutrition.ucdavis. edu/publications.htm#review6. Accessed March 2003.