Enhancing community allied health professionals' goal-setting practices: a mixed methods study using the Theoretical Domains Framework.

Abstract

There is evidence goal-setting promotes self-efficacy and maximises outcomes for people living with disability. Effective goal-setting in the disability sector remains challenging due to organisational structure, resource limitations and stakeholder involvement. This study aimed to explore barriers/facilitators and enhance effective goal-setting guided by the Theoretical Domains Framework (TDF) and behaviour change techniques. A mixed methods implementation study was conducted within an allied health (AH) organisation (<i>n</i> = 213 staff). Goal-setting practices were assessed by auditing goals and surveying AH professionals (AHPs) at baseline. TDF guided development of tailored intervention including multimodal training/resources. The audit and survey were repeated post-intervention (6-months) and at follow-up (12-months). Goals set post-intervention had improved across all criteria (measurable/meaningful/time-bound/specific). At follow-up, improvements continued. Goals were more measurable (18%, pre-50%, post-68%), meaningful (23%, pre-54%, post-77%), time-bound (29%, pre-37%, post-66%) and specific (32%, pre-37%, post-69%). AHPs reported their goal-setting to be more collaborative, holistic and multidisciplinary (13%, pre-69%, post-82%) however, goals were less often shared with the person and their support network (-11%, pre-69%, post-58%). Multimodal intervention improved goal setting practices in AHPs, with most gains maintained at follow-up. The TDF informed intervention could be adapted for similar organisations seeking to strengthen goal-setting practice.