Low levels of physical activity are strongly associated with increased mortality and numerous health issues which increase health care costs. Diabetes is one disorder that is known to require physical activity for the best control of symptoms. Use of SMART (Specific, Measurable, Attainable, Relevant, Time-bound) goals is one approach to assist patients with behavioral changes. They are of little to no cost to patients and help integrate the patient as an active participant in the health care plan. Patients set their own goals, and the health care team provides coaching. In this quality improvement project, we introduced SMART Goals as a patient-centered, self-motivating strategy to increase type II diabetics’ physical activity and thereby decrease their HbA1c (hemoglobin A1c) levels. Coaching was done via telephone for 3 to 4 months. We assessed pre- and post-intervention physical activity levels and gathered HbA1c at routine diabetic follow ups. A total of 29 participants were enrolled in the study, six were lost to follow up. Although no changes were statistically significant in this small sample, the final cohort of 23 patients generally showed an increase in walking and moderate physical activity, a decrease in self-reported sedentary behavior, and overall improvement in HbA1c. On average, greater HbA1c improvements were seen in patients who met their activity goal and change in physical activity level was positively correlated with reduced HbA1c. Findings suggest that HbA1c improvements and increased physical activity levels are possible if patients are encouraged to set actionable SMART goals. This approach can be applied to any clinical setting and could help motivate patients to increase their physical activity levels.

Disclosure

H. T. Nguyen-vaselaar: None.

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