Developing tailored theoretically informed goal-setting interventions for rehabilitation services: a co-design...

Area of Science:

• Rehabilitation medicine
• Health services research
• Behavioral science

Background:

• Effective goal-setting in rehabilitation involves interdisciplinary teamwork, shared decision-making, specific goals, action planning, and feedback.
• Clinicians face barriers and enablers in implementing these goal-setting components within rehabilitation teams.
• Understanding and enhancing goal-setting requires theoretical frameworks and tailored interventions addressing context-specific challenges.

Purpose of the Study:

• To explore barriers and enablers to goal-setting implementation in diverse rehabilitation settings.
• To codesign and tailor interventions to improve goal-setting practices within rehabilitation teams.
• To enhance the application of client-centered, interdisciplinary goal-setting models.

Main Methods:

• A multisite, participatory codesign approach guided by the Knowledge to Action (KTA) framework.
• Focus groups to identify barriers and enablers, followed by staff and consumer co-design workshops.
• Analysis using the Theoretical Domains Framework (TDF) to inform intervention selection and implementation planning.

Main Results:

• Identified clinician confusion between goals and action plans, and a lack of understanding regarding comprehensive action planning and review.
• Developed site-specific interventions including staff training, client workbooks, case conference templates, and a key worker model.
• Implementation plans were tailored to each specific site, addressing identified barriers and enablers.

Conclusions:

• Rehabilitation teams face persistent challenges in adopting truly client-centered, interdisciplinary goal-setting.
• Clinicians require further education on utilizing goal-setting principles to improve client outcomes and autonomy.
• Tailored interventions and theoretical frameworks are crucial for enhancing goal-setting practices in rehabilitation.