Details and Deadlines: What Predicts Health Goal Completion Among Residents of Permanent Supportive Housing?

Abstract

Background: Permanent Supportive Housing (PSH) is an intervention designed to solve chronic homelessness in the United States and includes supportive services to assist people with living independently. In Tarrant County, these services are augmented by m.chat, a health coaching program that is intended to improve the overall quality of life of PSH residents. Participants meet monthly with health coaches to establish health and wellness goals which are are documented using an online health coaching program. Purpose:This study examined the association between different “SMART” (Specific, Measurable, Attainable, Realistic and Time-limited) characteristics and goal completion among m.chat participants. Methods:There were 329 participants with 1057 recorded goals over the intervention period. We excluded inactive goals, and data from the first and last three months of the participant’s involvement. Each goal was coded based on SMART traits using a binary choice (0 and 1 for absence or presence of trait, respectively). The outcome of interest was goal completion status (completed vs. active). Results: Participants were almost equally divided between females (51%) and males (49%). The mean age was 52 years. Descriptive tests revealed that 73% of goals were specific and measurable and 21.5% of goals were time-limited. The characteristics of being attainable and realistic lacked variability and were not included in further analysis. At the participant’s most recent coaching visit, 30% of the goals were completed and 70% were still active. Out of active goals, 70.5% were specific and measurable and of the completed goals, 78.9% were specific and measurable (Chi square p=0.005). Likewise, of active goals, 19.3% goals were time-limited compared to 26.5% of completed goals that were time-limited (Chi square p=0.009). Logistic regression revealed that the odds of specific and measurable goals being completed was 46% higher than those not specific and measurable (p=0.023). Similarly, the odds of timely goals being completed was 39% higher compared to non-time limited (p=0.045). Conclusions: Successful health goals were more likely to be specific, measurable, and time-limited. Limitations of this study included difficulties in standard appraisal of attainability. Future studies could further establish a temporal link between SMART traits and goal completion.