Goal-Setting Behavior for Physical Activity in Adults With Diabetes: A Pilot Project

Published:September 24, 2021DOI:https://doi.org/10.1016/j.nurpra.2021.08.015


      • Patients who met their physical activity SMART goals saw statistically significant improvements in self-reported physical activity.
      • Patients saw statistically significant reduction in HbA1C with increased self-reported physical activity.


      In this pilot project, patient-selected SMART (Specific, Measurable, Attainable, Relevant, Time-bound) goals were used a to increase self-reported physical activity and decrease hemoglobin A1C (HbA1C) in patients with type II diabetes (T2DM). We assessed pre- and postintervention physical activity levels and HbA1C at the follow-up visits spaced 3–4 months apart. In this 23-participant study, patients showed a statistically significant improvement in physical activity when SMART goals were met and a statistically significant decrease in HbA1C with increased physical activity.


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      1. Overweight and obesity. HealthyPeople 2030.
        (Accessed January 1, 2021)
        • Centers for Disease Control and Prevention
        Lack of physical activity.
        (Accessed May 1, 2020)
        • American Diabetes Association
        Statistics about diabetes: overall numbers.
        (Accessed January 1, 2020)
        • Floegel T.A.
        • Giacobbi Jr., P.R.
        • Dzierzewski J.M.
        • et al.
        Intervention markers of physical activity maintenance in older adults.
        Am J Health Behav. 2015; 39 (Accessed May 1, 2020): 487-499https://doi.org/10.5993/AJHB.39.4.5
        • Silva M.N.
        • Vieira P.N.
        • Coutinho S.R.
        • et al.
        Using self-determination theory to promote physical activity and weight control: a randomized controlled trial in women.
        J Behav Med. 2010; 33 (Accessed June 1, 2020): 110-122https://doi.org/10.1007/s10865-009-9239-y
        • Tichelaar J.
        • Uil den S.H.
        • Antonini N.F.
        • van Agtmael M.A.
        • de Vries T.P.G.M.
        • Richir M.C.
        A “SMART” way to determine treatment goals in pharmacotherapy education.
        Br J Clin Pharmacol. 2016; 82 (Accessed May 1, 2020): 280-284https://doi.org/10.1111/bcp.12919
        • Rosewilliam S.
        • Roskell C.A.
        • Pandyan A.D.
        A systematic review and synthesis of the quantitative and qualitative evidence behind patient-centered goal setting in stroke rehabilitation.
        Clin Rehabil. 2011; 25 (Accessed May 1, 2020): 501-514https://doi.org/10.1177/0269215510394467
        • Centers for Disease Control and Prevention
        Trends in meeting the 2008 physical activity guidelines, 2008–2018.
        (Accessed May 1, 2020)
        • Colberg S.R.
        • Sigal R.J.
        • Yardley J.E.
        • et al.
        Physical activity/exercise and diabetes: A position statement of the American diabetes association.
        Diabetes Care. 2016; 39 (Accessed May 1, 2020): 2065-2079https://doi.org/10.2337/dc16-1728
        • Centers for Disease Control and Prevention
        National diabetes statistics report, 2017: estimates of diabetes and its burden in the United States.
        (Accessed May 1, 2020)
        • Umpierre D.
        • Ribeiro P.A.B.
        • Schaan B.D.
        • Ribeiro J.P.
        Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis.
        Diabetologia. 2013; 56 (Accessed June 1, 2021): 242-251https://doi.org/10.1007/s00125-012-2774-z
        • Gagné M.
        • Koestner R.
        • Hope N.
        A self-determination theory approach to goals.
        in: Gagné M. The Oxford Handbook of Work Engagement, Motivation, and Self-Determination Theory. Oxford University Press, 2014
        • Walker J.R.
        • Soroush A.
        • Ainsworth B.E.
        • Belyea M.
        • Swan P.D.
        • Yngve A.
        U.S. cohort differences in body composition outcomes of a 6-month pedometer-based physical activity intervention: The ASUKI step study.
        Asian J Sports Med. 2014; 5 (Accessed May 1, 2021): e25748https://doi.org/10.5812/asjsm.25748
        • Shaw R.L.
        • Pattison H.M.
        • Holland C.
        • Cooke R.
        Be SMART: examining the experience of implementing the NHS Health Check in UK primary care.
        BMC Fam Pract. 2015; 16 (Accessed January 1, 2021): 1https://doi.org/10.1186/s12875-014-0212-7
      2. International Physical Activity Questionnaire: Short Form. Youthrex Research and Evaluation eXchange; 2002.
        (Accessed March 1, 2020)
        • Kurtze N.
        • Rangul V.
        • Hustvedt B.-E.
        Reliability and validity of the international physical activity questionnaire in the Nord-Trøndelag health study (HUNT) population of men.
        BMC Med Res Methodol. 2008; 8 (Accessed May 1, 2020): 63https://doi.org/10.1186/1471-2288-8-63


      Hanh Nguyen-Vaselaar, DNP, NP-C, is a graduate alumni at Creighton University College of Nursing, Omaha, NE, and can be contacted at [email protected] .


      Joan M. Lappe, PhD, RN, CNE is a professor at Creighton University College of Nursing, Omaha, NE.