Evaluation of goal setting and behavior change training for transition care case managers using Kirkpatrick's Model

The transition care program (TCP) is a multidisciplinary, restorative care and rehabilitation program designed to support older adults in regaining functional independence. The integration of goal-setting and behavior change techniques in transition care can help support the uptake of health-related behaviors among older adults to optimize functional and cognitive health outcomes, although standardized education in TCP is not available.

We developed a goal-setting training module for case managers and therapists to address this need and evaluated its efficacy in improving learning outcomes, including knowledge and skills, of transition care staff.

The study used an uncontrolled, paired samples, pre- and post-test design. The 2-h workshop was delivered by two researchers for case managers and therapists across three TCP sites to build on their existing behavior change and goal-setting knowledge and skills. The training was based on theoretical (e.g. presentation) and practical (e.g. hands-on case series) frameworks delivered using interactive instructional strategies. Data from pre-training and post-training surveys were collected to evaluate the efficacy of the training using Kirkpatrick's evaluation model at levels 1 (reaction) and 2 (learning outcomes).

Out of 69 case managers who completed the pre-survey, two-thirds had less than three years of transition care experience. Case managers and therapists rated satisfaction with training content, materials, and delivery above the 75th percentile. In paired analyses (n = 53), pre- to post-training means [mean difference(CI)] improved for SMART goals (1.15 [0.61, 1.79]), action & coping planning (3.00 [2.16, 3.83]), motivational interviewing (1.31 [1.30, 3.50]), behavior change techniques (2.16 [1.30, 3.00]), attitude (0.73 [0.11, 1.34]), and confidence (1.60 [0.80, 2.39]); Bonferroni-adjusted tests indicated significant improvements for all domains except attitude.

Case managers' reported post-training improvement in overall knowledge, skills and confidence scores, which might suggest the effectiveness of the training in improving goal setting and behavior change techniques in transition care.