Using Goal Attainment Scaling in an Intervention to Prevent Diabetes in African Americans

Background and Issues: There are 23.6 million (7.8%) children and adults in the US who have diabetes and of these, 17.9 million are diagnosed and about 5.7 million are undiagnosed. There is a period of time called pre-diabetes when people with blood glucose levels higher than normal are especially at-risk. It is estimated that 57 million people have pre-diabetes. African Americans have one of the highest prevalence of diabetes. Therefore, preventing or delaying diabetes in African Americans who are at risk for diabetes is an important public health goal. The national Diabetes Prevention Program and other research has revealed that moderate weight loss and exercise can prevent or delay type 2 diabetes among adults at high-risk for diabetes. Description: The motivational interviewing (MI) intervention to promote improvement in diet and exercise in African Americans included National Diabetes Education Program content and goal attainment scaling (GAS) as a strategy for focusing the intervention on individually determined goals, monitoring individual progress, and providing feedback to the participant. Lessons Learned: Including GAS within a MI intervention demonstrated the usefulness of formal goal setting and assessment of goal attainment in helping African Americans at risk for diabetes improve their diet and exercise behaviors. However, goals need to be clear, objective, and measureable in order for the MI intervention to have maximum effectiveness. Recommendations: The effectiveness of MI depends on the identification of target behaviors to change; GAS is a method that facilitates this process. GAS in conjunction with MI appears to enhance intervention effectiveness.