• Rachael N Martinez, Bridget M Smith, Bella Etingen, Thomas K Houston, Stephanie L Shimada, Daniel J Amante, Angela Patterson, Lorilei M Richardson, Gerrit Vandenberg, Sarah L Cutrona, Lisa M Quintiliani, Kathleen L Frisbee, and Timothy P Hogan.
• eHealth Partnered Evaluation Initiative, VA Bedford Healthcare System, Bedford, MA, USA.
• J Gen Intern Med. 2021 Nov 1; 36 (11): 333733453337-3345.

BackgroundThere is increasing recognition of the importance of supporting patients in their health-related goals. Patient-provider discussions and health-related mobile applications (apps) can support patients to pursue health goals; however, their impact on patient goal setting and achievement is not well understood.ObjectiveTo examine the relationships between the following: (1) patient demographics, patient-provider discussions, and health-related goal setting and achievement, and (2) patient mobile health app use and goal achievement.DesignCross-sectional survey.ParticipantsVeterans who receive Veterans Health Administration (VA) healthcare and are users of VA patient-facing technology.Main MeasuresVeteran demographics, goal-related behaviors, and goal achievement.MethodsVeterans were invited to participate in a telephone survey. VA administrative data were linked to survey data for additional health and demographic information. Logistic regression models were run to identify factors that predict health-related goal setting and achievement.Key ResultsAmong respondents (n=2552), 75% of patients indicated having set health goals in the preceding 6 months and approximately 42% reported achieving their goal. Men (vs. women) had lower odds of setting goals (OR: 0.71; CI95: 0.53-0.97), as did individuals with worse (vs. better) health (OR: 0.18; CI95: 0.04-0.88). Individuals with advanced education-some college/college degrees, and post-college degrees (vs. no college education)-demonstrated higher odds of setting goals (OR: 1.35; CI95: 1.01-1.79; OR: 1.71; CI95: 1.28-2.28, respectively). Those who reported having discussed their goals with their providers were more likely to set goals (OR: 3.60; CI95: 2.97-4.35). Patient mobile health app use was not statistically associated with goal achievement.ConclusionsEfforts to further promote patient-led goal setting should leverage the influence of patient-provider conversations. Use of patient-facing technologies, specifically mobile health apps, may facilitate goal-oriented care, but further work is needed to examine the potential benefits of apps to support patient goals, particularly if providers discuss and endorse use of those apps with patients.© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.

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