Using SMART Goals for Intervention Planning

Intervention development, implementation, and evaluation requires a framework for effective program management, from the earliest stages to project completion. Issel (2014) defines an intervention as “those actions that are done intentionally to have a direct effect on persons with the health problem” (p. 185). A more specific definition, suggesting the need for a systematic approach is presented by McKenzie, Neiger, & Thackeray (2013) as “something that occurs between the beginning and the end of a program, or between pre- and post program measurements” (p. 206). In both cases a systematic approach guides all partners and participants through the program, with clear steps toward a desired outcome.

According to Issel (2014), there are several characteristics of a strong intervention. It must be evidence-based, with a specific targeted population. It must also be designed to result in health gains, with necessary adjustments to allow planners to customize dosage to meet the needs of the priority population. Other characteristics include program feasibility, technologically, logistically, and politically, addressing societal priorities with reasonable costs.

These characteristics align with the SMART goal, management by objectives, model, in that each step is intentional and serves a specific purpose, creating a system of program parameters and safeguards to maximize results. Although the acronym SMART has several variations, all forms suggest a fundamental set of practices that increase motivation and guide users to accomplish a set of goals (Rubin, 2002). The most common application suggests SMART is an acronym for Specific, Measurable, Attainable, Relevant, and Timebound.

The SMART Goal Model

In planning interventions, it may be beneficial to use the SMART goal approach as a framework for the broad scope of partners and participants involved. Many individuals are familiar with the model and terminology, creating a common point for initial communications.

With its nearly universal application, SMART goals can outline the intervention process, using a platform that supports the program with straight-forward stages designed to reach all members of the intervention team. increasing the likelihood of all partners understanding the performance review standards (MIT Human Resources, n.d.).

As the intervention objectives are defined, the criteria for establishing them based on SMART goal setting would include an understanding of the specific aspects of the model. All aspects must be in place to meet the criteria of SMART goal planning, since each identifies essential program elements. The following example will provide an overview of each aspect of SMART goal setting, with characteristics of sound interventions identified as they relate to the plan tactics.

Specific

The workforce in Saint Louis County, Missouri, is increasingly experiencing health related issues associated with physical inactivity and poor dietary habits. This six week intervention will promote increased physical activity and nutrition education through on-site individual educational counseling, and an educational email campaign. The target population is three worksites located in Saint Louis County. The worksites represent office environments from small, midsize, and large businesses.

Measurable

An initial survey will provide baseline information of the level of knowledge, attitudes, and behaviors, specifically measuring current physical activity and nutrition habits. Since the intervention strategies include group and individual support, increases in self-efficacy will be included in the data. Measurements will also include the number of counseling appointments, the email click-through rate, number of page views, as well as time of day when opened, and other trackable figures. The reinforcement from the email will be measured with those that participated in the one-on-one counseling. The final counseling session will offer an opportunity for counselors to interview for program efficacy.

Attainable

Studies show an increase in positive health behaviors with the use of customized health education in the workplace. A study on the effectiveness of individual counseling in the workplace showed a positive correlation in the activity levels of workers when participating in health counseling programs (Proper, Hildebrandt, Van der Beek, Twisk, & Van Mechelen, 2003).

Additionally, educating and motivating employees through a series of tailored messages has been shown to increase knowledge and health behaviors in another worksite study (Plotnikoff, McCargar, Wilson, & Loucaides, 2005). This intervention strategy meets the criteria for evidence-based planning purposes.

Relevant

The St. Louis County 2011 Community Health Needs Assessment shows an increase in health-related problems associated with physical inactivity and poor dietary habits (Saint Louis County, Missouri, 2013). It is technologically feasible and cost-effective to use health counselingand email intervention strategies to address the current health trends in the county workforce. As a societal priority, this intervention can be evaluated for application in other work settings to address the ongoing health problems in the workforce.

Timebound

The time-specific program outline offers details on the number of counseling sessionsand e-mails within the six-week program, as well as follow up evaluations at several intervals for sustainability information. The program length allows for an evaluation process based on the individual companies, with the opportunity to alter dosage as needed to reach a greater number of employees in each workplace setting.

Conclusion

The SMART goal model aligns with the stages and characteristics of sound intervention planning. It provides an outline for a systematic approach to the process, with the desired outcome of improved health through the use of intentional strategies and tactics designed to directly affect a targeted population. As more professionals and organizations use SMART goals as a model for change, a health planner’s knowledge of the model and the potential for application in some intervention settings will be beneficial.

References

Issel, L. M. (2014). Health program planning and evaluation: A practical, systematic approach for community health. Burlington, MA: Jones & Bartlett Learning.

McKenzie, J., Neiger, B., Thackeray, R. (2013). Planning, implementing, and evaluating health promotion programs. Glenview, IL: Pearson Education, Inc.

MIT Human Resources. (n.d.). Performance development. Retrieved from http://hrweb.mit.edu/performance-development/goal-setting-developmental-planning/smart-goals

Plotnikoff, R. C., McCargar, L. J., Wilson, P. M., & Loucaides, C. A. (2005). Efficacy of an Email intervention for the promotion of physical activity and nutrition behavior in the workplace context. American Journal of Health Promotion, 19(6), 422-439.

Proper, K. I., Hildebrandt, V. H., Van der Beek, A. J., Twisk, J. W., & Van Mechelen, W. (2003). Effect of individual counseling on physical activity fitness and health: a randomized controlled trial in a workplace setting. American Journal of Preventive Medicine, 24(3),218-226.

Rubin, R. S. (2002). Will the real SMART goals please stand up. The Industrial-Organizational Psychologist, 39(4), 26-27.

Saint Louis County, Missouri. (2013). 2011 Community Health Needs Assessment.[PDF]. Retrieved from http://www.stlouisco.com/HealthandWellness/ HealthEducationandInformation/2011CommunityHealthNeedsAssessment