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Diabetes Forecast

The Healthy Living Magazine

11 Steps to Setting Your Health Goals

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We all have goals. Sticking to them is the problem. Case in point: While most people make New Year's resolutions, a 2007 survey of 3,000 people found that 88 percent fail to meet them. The missing piece, experts say, is goal setting.

Setting a goal might sound like a no-brainer. But when psychologists mention goal setting, they're talking about a process, and navigating that process divides the successes from the failures.

Goal setting is motivating, says Carla Miller, PhD, associate professor of human nutrition in the College of Education and Human Ecology at Ohio State University. "It helps people focus their effort on what they want to change." Plus, setting goals can work for anyone—from workaholics with little time to kids with short attention spans. Even if your resolve tends to crumble in the face of chocolate chip cookies, there are steps you can take to make sure this time it sticks.

1. Make it matter.

There's a very good reason most people don't follow through on goals their health care providers set for them: They're not invested. Maybe your doctor told you to lose weight to prevent heart disease. But that benefit may not be specific enough for you, which means you're less likely to work hard to meet the goal.

Consider another scenario: Your grandchildren are getting older and more rambunctious, but as much as you'd like to chase them around all day, you're too exhausted. Looking at weight loss with the goal of being more active with your grandchildren may be the specific motivation you need.

2. Brainstorm all options.

So you want to get healthier. It's a good goal, but it's smart to consider smaller problems you want to fix in order to reach that worthy (yet broad) target. Those might include losing 15 pounds, quitting smoking, exercising more, lowering your A1C, and getting more sleep. "Come up with five to six issues in your life to work on," says Paul Ciechanowski, MD, MPH, associate professor of psychiatry and behavioral sciences at the University of Washington. "Start with the one that's easier to accomplish." Doing so will raise your confidence in your ability to meet harder goals.

Once you've picked the problem you plan to tackle first, brainstorm as many solutions as you can—regardless of how silly they may sound. If you plan to quit smoking, for instance, you might list quitting cold turkey, lowering the number of cigarettes you smoke each day, chewing nicotine gum, even getting hypnotized. Writing out the pros and cons of each option can help you find the best solution for your life. "If a person can generate the goal and the solution and pick the plan of action, then they're more likely to follow through with it," says Ciechanowski.

3. Set sensible targets.

It's great to have lofty ambitions, but if you set your sights too high, the stress of an unattainable goal can zap your motivation and increase your chances of failure. There's nothing wrong with failing, and there's every reason to get back up and try again, but the fact is, the more you fail, the more your confidence plummets, and the less likely you are to keep reaching for your goals.

When your A1C is 12 percent, it's unrealistic to set a goal of reaching 7 percent in three months. In the same way, an A1C of 7 percent may be just as unattainable when your number is currently 8 percent but your father just had a heart attack or you're moving to a new state. Be cautious about taking on too much, especially if you're overwhelmed or going through a stressful period.

Realistic goals, on the other hand, can boost your confidence. "When you have goals that are too generic or too big, you can get discouraged. I picked smaller goals to feel like I was accomplishing something," says Brittani Leopold, 28, who has had type 1 diabetes for three years. Knowing that her weight was harming her health, Leopold set a series of modest objectives that have helped her drop 95 pounds over the past 2 1/2 years (see "Goal Setting in Action," p. 58).

Be SMART

Here's a quick mnemonic device to help you remember the major goal-setting steps:
S Specific
M Measurable
A Attainable
R Realistic
T Timely

Vague Goal:

Avoid Hypoglycemia
There are a few reasons this goal would be difficult to meet: It may be unrealistic to expect to avoid low blood glucose completely, there's no end date for you to work toward, and it doesn't tackle how to meet that goal.

SMART Goal:

Reduce the frequency of lows from five a week to two by my next endocrinologist appointment, by stashing a source of glucose in every room and treating lows at first symptom.
Here's why this works: It is a realistic drop from five to two episodes a week, includes a time frame, and explains how you'll tackle the problem (by keeping glucose handy and using it).

4. Go into specifics.

The problem with doctor-generated goals is that they're often so broad that people have no idea where to begin. Take, for instance, the goal to "lose weight." If it were so easy, you'd already have done so. To define a specific goal that matters to you, be explicit. Maybe you want to drop 20 pounds or fit into a new swimsuit for an upcoming vacation.

5. Break it down.

There's nothing wrong with long-term goals such as losing a specific amount of weight or lowering your A1C, but to reach them you'll need to work on a smaller scale. Begin with your current abilities. If you aim to go to a weekly support group, but you have no way to get there, your first small goal may be to research all ways you might get a ride or take public transportation. The next step might be to review your research and decide how you'll commute. From there, your goals might include calling to arrange transport and then going one day a month at first.

"They need to be small baby steps and cumulative," says Linda Siminerio, RN, PhD, CDE, ​director of the University of Pittsburgh Diabetes Institute and associate professor at the University of Pittsburgh's medical and nursing schools. "Some people may be OK with three steps. Some people may be OK with only one."

Here's how it works: When you successfully meet a goal, you progress to the next step. If you don't reach a goal, Siminerio says, it's important to consider what went wrong, set a new target, and try again.

6. Give yourself a deadline.

It's hard to get motivated to meet an open-ended goal. "Having an agreed-upon time [limit] does help people move into action," says Ciechanowski. "They're more likely to follow through." In the example of the support group, you may set steps days or even weeks apart. Deadlines differ on a person-to-person basis. But just as your ambitions need to be achievable, deadlines should allow adequate time to complete the task. Pressure to meet an objective in too little time can decrease your motivation and chance of success.

7. Ask for help.

Having your health care team's support boosts your chances of success. "The hardest part is choosing which goals to set and knowing how long to take to reach them," Leopold says. After an honest conversation about your current habits, your doctor can help you set deadlines and ensure your objectives are realistic, says Siminerio. Your health care providers can also hold you accountable for meeting your goals in a given time period. So if you plan to exercise four times a week for 30 minutes or more for the next two months, your doctor can bring it up at your next visit to make sure you're following through.

Of course, if you don't have a team that sets goals with you, you can certainly take the steps on your own. "Many people would say self-setting goals is more effective than if someone gives [a goal] to you," says Miller.

8. Find cheerleaders.

Enlisting the help of friends, family, and colleagues who will cheer your progress and help you avoid slips is another ingredient for success. Some of these people may even join you in completing goals of their own, so ask around for any joiners. You might find a coworker with a similar plan who wants to take a walk at lunchtime, for example. Support groups—including diabetes support groups and weight-loss programs such as Weight Watchers—can also help you reach your goal.

If "real life" hasn't provided you with any cheerleaders, look online. You can connect with people just like you through online communities such as diabetes.org/messageboards and ChildrenWithDiabetes.org or social media platforms (think Twitter and Facebook). If you've never participated in the diabetes online community, you might be surprised how supportive and encouraging perfect strangers can be. While research on the effects of social networking is still in its infancy, early studies suggest that social networking helps goal setters stick it out.

9. Anticipate barriers.

Despite your best-laid plans, you may run into a few obstacles. You can control your own actions, but outside forces may affect your plans. Maybe your first step is to attend weekly Weight Watchers meetings, and you assume you'll borrow your friend's car for the ride. If the car's not available, your ability to reach your objective may be in jeopardy.

"Anticipate what some barriers are that might come up, and think through how you'd deal with them," says Ciechanowski. That might mean asking a friend to borrow her car every Monday or mapping out a bus or subway route as backup.

There are events in your own life you won't be able to anticipate, though. "We assume our level of emotional well-being will be the same down the line," Ciechanowski says. "But there are unforeseen circumstances." Maybe your boss will dump a ton of work on you three weeks after you've set a goal. Or there might be a death in the family. While you can't control all of these factors, you can make sure your targets are simple enough to allow you to handle kinks in the situation.

10. Reward yourself.

The fact that you've hit your target may be reward enough for you. But for some people, especially kids, the idea of a reward increases motivation. Promise a shopping trip or movie night—whatever will get you to the finish line. Self-admitted shopaholic Leopold gave herself permission once a month to buy new shoes or a new outfit to celebrate reaching a goal. Though rewards are personal, there's a general rule experts agree on: Food shouldn't be the prize.

11. Keep going.

Setting and meeting goals can be a long process, so to find success you must accept the need to put in time and effort. "It takes a long time to make those habit changes," Leopold says. "It's taken me the whole 2 1/2 years."

However long your journey is, there's a good chance it'll be filled with both successes and failures. Meeting an objective is hard, but it's important to keep trying even if you fail. The No. 1 reason people don't reach their goals? "Over time, I'd say it's a lack of persistence. They give up too soon," says Miller. "If you don't achieve it the first time, you need to come back and reflect." And then try, try again.

 
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